Group Says No to Unethical Nurse Recruitment

NHS Professor Kathryn Leonhardy, who is among an O’Neill Institute team looking at the ethics of international nurse recruitment, contributed to an AcademyHealth publication on the same topic.

A task force—including faculty members from NHS and the O’Neill Institute for National and Global Health Law—recently released its Code of Conduct for the Recruitment of Foreign-Educated Nurses to the United States.

The code, which was officially unveiled on Thursday, Sept. 4, at the National Press Club, aims to ensure that the growing practice of recruiting foreign-educated nurse to the United States is done in a responsible and transparent manner.

“There are concerns that the rapid increase in international recruiting creates opportunities for unethical behavior on both sides,” says Patricia Pittman, Ph.D., executive vice president of AcademyHealth, who convened the task force and led a recent study of the structure and practices of the U.S.-based international recruitment industry.

This task force brought together stakeholders with differing, and sometimes conflicting, perspectives who nonetheless worked together to find a consensus solution that protects the rights of foreign educated nurses and, in doing so, promotes quality patient care,” Pittman said.

AcademyHealth, in a report funded by the John D. and Catherine T. MacArthur Foundation, identified almost 300 U.S.-based international nurse recruitment firms, a tenfold increase in the number of companies since the late 1990s.

During the same time period, the annual percentage of newly licensed, foreign-educated registered nurses in the United States rose from five percent to 16 percent, based on data from the National Council of State Boards of Nursing.

The AcademyHealth study found some foreign-educated nurses who described situations in which they were subjected to unfair labor conditions, questionable contract practices, and threats related to their immigration status.

Conversely, employers and recruiters point to cases where nurses have breached their contracts after receiving assistance with immigration and resettlement.

The voluntary code aims to increase transparency and accountability in international recruitment and ensure adequate orientation programs for foreign educated nurses.

It also provides guidance on ways to ensure recruitment is not harmful to the nurses’ home countries.Health care organizations and recruiters that subscribe are committing to adhere to a series of practical standards and to emulate best practices.

“The code is a model for oversight and monitoring of recruitment practices,” said Kathryn Leonhardy, Ph.D., RN, assistant professor of international health at NHS and a task force participant.

“The ideal goal is to create a system where you have recruiters and hospitals subscribing to this code and the abuses stop,” Leonhardy said. “A second goal is to create a monitoring system of the recruitment process. The code will shed light on the industry and the workforce.”