Based on a review of initial evidence, this article suggests that transition of internationally educated nurses (IENs) is a regulatory issue. Given the absence of global nurse regulation, the questionable credibility in many areas where national regulation does operate, and more important, the commercialization of nurse training in some countries to meet international demand, the quality and competence of IENs are likely to be varied in both quantitative and qualitative terms. This variability in quality and competence affect their ability and readiness to practice with direct implications for patient safety and quality of care. After description of a transition program as a proposed regulatory mechanism modeled after the National Council of State Boards of Nursing’s Transition Initiatives, this article calls for comparative outcomes research on IENs and U.S. educated nurses to definitively determine if transition of IENs is a regulatory issue.
AcademyHealth. (2008, May). Voluntary code of ethical conduct for the recruitment of foreign-educated nurses to the United States. Retrieved from http://www.fairinternationalrecruitment.org/TheCode.pdf
2.
Adeniran, R., Rich, V., Gonzalez, E., Peterson, C., Jost, S., & Gabriel, M. ( 2008). Transitioning internationally educated nurses for success: A model program. OJIN: The Online Journal of Issues in Nursing , 13(2). Manuscript 3. Retrieved from www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/vol132008/No2May08/TIENS.aspx
3.
Aiken, L.H. ( 2007). U.S. nurse labor market dynamics are key to global nurse insufficiency. Health Services Research, 42, 1299-1320.
4.
Aiken, L.H., Buchan, J., Sochalski, J., Nichols, B., & Powell, M. ( 2004). Trends in international nurse migration. Health Affairs. 23(3), 69-77.
5.
Aiken, L.H., & Cheung, R. ( 2008, October). Nurse workforce challenges in the United States: Implications for policy. Retrieved from http://www.oecd.org/dataoecd/34/9/41431864.pdf
6.
Baj, P.A. ( 1995). Integrating the Russian émigré nurse into U.S. nursing. Journal of Nursing Administration, 25(3), 43-47.
7.
Brush, B.L., Sochalski, J., & Berger, A.M. ( 2004). Imported care: Recruiting foreign nurses to U.S. health care facilities. Health Affairs, 23(3), 78-87.
8.
Buerhaus, P.I., Auerback, D.I., & Staiger, D.O. ( 2009, June 12). The recent surge in nursing employment: Causes and implications. Health Affairs [web exclusive], w657-w668.
9.
Choy, C.C. ( 2004). Empire of care: Nursing and migration in Filipino American history. Durham, NC: Duke University Press.
10.
Chung, H.J. ( 1986). A study of Korean nurse immigrants’ adaptation experience to the nursing profession in the Los Angeles area (California) (Unpublished doctoral dissertation). University of Michigan , Ann Arbor.
11.
Commission on Graduates of Foreign Nursing Schools. ( 1996). Assessment of North American nursing. Philadelphia, PA: Author.
12.
Davis, C.R., & Nichols, B.L. ( 2002). Foreign-educated nurses and the changing U.S. nursing workforce. Nursing Administration Quarterly, 26(2), 43-51.
13.
Edwards, P.A., & Davis, C.R. ( 2006). Internationally educated nurses’ perceptions of their clinical competence. Journal of Continuing Education in Nursing, 37, 265-269.
14.
French, P., Anderson, J., Burnard, P., Holmes, C., Mashaba, G., Wong, T., & Bing-Hua, Z. ( 1996). International comparison of baccalaureate nursing degrees: collaboration in qualitative analysis. Journal of Advanced Nursing, 23, 594-602.
15.
Harmon, R.B. ( 2008). Teaching psychiatric mental health nursing in the People’s Republic of China. Archives of Psychiatric Nursing, 22(6), 328-333.
16.
Hancock, P.K. ( 2008). Nurse migration: The effects on nursing education. International Nursing Review, 55, 258-264.
17.
Health Resources and Services Administration. ( 2010, March). The registered nurse population: Initial findings from the 2008 National Sample Survey of Registered Nurses. Retrieved from http://bhpr.hrsa.gov/healthworkforce/rnsurvey/initialfindings2008.pdf
18.
Hearnden, M.V. ( 2007). Nursing across cultures: The communicative needs of internationally educated nurses working with older adults. Unpublished doctoral dissertation , University of Toronto.
19.
International Council of Nurses. (1997). An approval system for schools of nursing-Guidelines. Geneva, Switzerland: Author.
20.
International Council of Nurses. (2009). People’s Republic of China. Retrieved from http://www.anmc.org.au/wpsear/china.php
21.
The Joint Commission. (2009). National patient safety goals. Retrieved from http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals
22.
Kenward, K., & Zhong, E. ( 2006). Transition to practice: Newly licensed registered nurses (RN) and licensed practice/vocational nurses (LPN/LVN) activities. Chicago, IL: National Council of State Boards of Nursing .
23.
Kingma, M. ( 2006). Nurses on the move: Migration and the global health care economy. Ithaca, NY: Cornell University Press.
24.
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (1999). To err is human: Building a safer health system . Washington, DC: National Academies Press.
25.
Kramer, M. ( 1974). Reality shock: Why nurses leave nursing. St. Louis, MO: CV Mosby.
26.
Li, S. ( 2007). The impact of transition experience on practice of newly licensed registered nurses. Retrieved from https://www.ncsbn.org/1246.htm
27.
Lopez, N. ( 1990). The acculturation of selected Filipino nurses to nursing practice in the United States (Unpublished doctoral dissertation). University of Pennsylvania, Philadelphia.
28.
McCloskey, J.C., & Aquino, N.S. ( 1988). Job effectiveness of foreign nurse graduates. Western Journal of Nursing Research, 10(4), 477-491.
29.
Mick, S.S., & Comfort, M.E. ( 1997). The quality of care of international medical graduates: How does it compare to that of U.S. medical graduates?Medical Care Research and Review, 54, 379-413.
30.
Miraflor, C.G. ( 1976). The Philippine nurses: Implications for orientation and in-service education for foreign nurses in the United States (Unpublished doctoral dissertation). Loyola University of Chicago, Chicago, IL.
31.
National Council of State Boards of Nursing. ( 2008, April). Regulatory model for transition to practice report . Retrieved from https://www.ncsbn.org/Final_08_reg_model.pdf
32.
National Council of State Boards of Nursing. ( 2009, November 13). Description of NCSBN’s transition to practice model. Retrieved from https://www.ncsbn.org/TransitiontoPractice_modeldescription_111309.pdf
33.
National Council of State Boards of Nursing. (n.d.-b). Transitional initiatives. Retrieved from https://www.ncsbn.org/363.htm
34.
National Council of State Boards of Nursing. (n.d.-a). Resource manual for international nurses. Retrieved from https://www.ncsbn.org/08_Manual_for_International_nurses.pdf
35.
O’Neill, T.R., Tannenbaum, R.J., & Tiffen, J. ( 2005). Recommending a minimum English proficiency standard for entry-level nursing. Journal of Nursing Measurement, 13, 129-146.
36.
Overland, M.A. ( 2004, November 19). Philippine government shuts down 23 nursing programs. Chronicle of Higher Education, A43.
37.
Pittman, P., Folson, A., Bass, E., & Leonhardy, K. ( 2007). U.S.-based international nurse recruitment: Structure and practices of a burgeoning industry. Washington, DC : AcademyHealth.
38.
Salt, J., Cummings, G.G., & Profetto-McGrath, J. (2008). Increasing retention of new graduate nurses: A systematic review of interventions by healthcare organizations. Journal of Nursing Administration, 38, 287-296.
39.
Sarsfield, N. ( 1973). An Acculturative Study of the Filipino Nurse into New Jersey Hospitals. Unpublished Doctoral Dissertation. New York University.
40.
Savage, J. ( 1995). Global trends in nursing education: A World Health Organization perspective. In D. M. Modly, J. J. Fitzpatrick, P. Poletti , & R. Zanotti (Eds.), Advancing nursing education worldwide (pp. 3-13). New York, NY: Springer.
41.
Smith, J., & Crawford, L. ( 2002). 2001 Employers Survey. Chicago, IL : National Council of State Boards of Nursing.
42.
Smith, J., & Crawford, L. ( 2004). 2003 Employers Survey. Chicago, IL : National Council of State Boards of Nursing.
43.
Story, D.K., Smola, B.K., & Liu, K.H. ( 1990). Comparison of results of Chinese and American forecasting of nursing curriculum needs. Journal of Nursing Education , 29, 400-405.
44.
Sun, J., Xu, Y., Xu, Z., & Zhang, J. ( 2001). Baccalaureate nursing education curriculum in the People’s Republic of China: Status, issues, and reforms. Nursing & Health Sciences, 3, 225-235.
45.
Takeno, Y. ( 2010). Facilitating the transition of Asian nurses to work in Australia. Journal of Nursing Management, 18, 215-224.
46.
The Joint Commission. (2002). Health care at the crossroads: Strategies for addressing the evolving nursing crisis (White Paper). Retrieved December 3, 2009, from http://www.jointcommission.org/Nurses/nurse_staffing.htm
47.
Tregunno, D.Peters, S., Campbell, H., & Gordon, S. ( 2009). International nurse migration: U-turn for safe workplace transition. Nursing Inquiry, 16(3), 182-190.
48.
World Health Organization. (2009). Global standards for the initial education of professional nurses and midwives . Geneva, Switzerland: Author.
49.
Xu, Y. ( 2006). From diplomacy to national development: Evolution of Chinese policy on the international mobility of nurses. Harvard Health Policy Review, 7, 121-132.
50.
Xu, Y. ( 2007). Strangers in strange lands: A meta-synthesis of lived experiences of immigrant Asian nurses working in Western countries. Advances in Nursing Science, 30, 246-265.
51.
Xu, Y. ( 2010). Transition of international nurses: An evidence-based program for dissemination, adoption, and implementation. Manuscript submitted for publication.
52.
Xu, Y., Bolstad, A., Shen, J., Colosimo, R., Covelli, M., Torpey, M., & Jorgenson, M. (in press). Speak for Success: A pilot study on communication competence of post-hire international nurses. Journal of Nursing Regulation .
53.
Xu, Y., Davis, D.C., Clements, C., & Xu, Z. ( 2002). Assessment of AACN baccalaureate nursing education curriculum model in the People’s Republic of China: A transcultural exploratory study. Journal of Professional Nursing, 18, 147-156.
54.
Xu, Y., Gutierrez, T., & Kim, S.H. ( 2008). Adaptation and transformation through (un)learning: Lived experiences of immigrant Chinese nurses in U.S. healthcare environment. Advances in Nursing Science, 31, E33-E47.
55.
Xu, Y., & Kwak, C. ( 2005). Characteristics of internationally educated nurses in the United States. Nursing Economics, 23, 233-238.
56.
Xu, Y., Xu, Z., & Zhang, J. ( 2000). Nursing education system in the People’s Republic of China: Evolution, structure, and reform. International Nursing Review, 47, 201-217.
57.
Xu, Y., Xu, Z., & Zhang, J. ( 2002). Nursing education curriculum in Mainland China and the United States: A comparative perspective. Journal of Nursing Education, 41, 310-316.
58.
Xu, Y., Zaikina-Montgomery, H., & Shen, J.J. ( 2010). Characteristics of internationally educated nurses in the United States: An update from 2004 National Sample Survey of Registered Nurses. Nursing Economics, 28, 19-25, 43.
59.
Yahes, E., & Dunn, A.K. ( 1996). Enculturaltion of foreign nurse graduates: An integrated model. Journal of Continuing Education in Nursing, 27, 120-123.
60.
Yi, M. ( 1993). Adjustment of Korean nurses to United States hospital settings (Unpublished doctoral dissertation). State University of New York at Buffalo.
