Overcoming Challenges of Recruiting Foreign Trained Nurses

According to the U.S. Bureau of Labour Statistics,the job market for domestic and foreign-trained nurses will grow by 7 percent before 2029. Currently, there is a shortage of 450,000 registered nurses in the US and the country will need more than 20,300 nurses every year till 2026 to meet the shortage. (Source). Reasons for such shortage concerns began well before the pandemic but certainly the last three years have not helped with core issues of burnout, an increase in the aging population, and nurses reaching their own retirement.  

Many hospitals and healthcare facilities alike are expanding their recruitment efforts to international talent. However, there can be specific challenges that prevent them from filling key roles as fast as they would like. Addressing some of those key challenges with ways to overcome them will help in building a strong foreign-trained nursing recruitment strategy.  

Visa and immigration

Obtaining work visas and navigating the complex immigration system can be time-consuming and challenging for international nurses. The process often requires sponsorship from the employer and adherence to specific requirements. These requirements for employers can include proving there is a shortage of qualified nurses in the local job market and supporting the license procurement to practice nursing in the specific state.  

However, healthcare facilities can sponsor temporary employment-based or EB-3 visas by showing that the sponsored position is in a specialty occupation. Additionally, healthcare facilities can sponsor foreign-trained nurses for permanent residence in the US through a Schedule-A petition process. By doing this, you can shorten the hiring process and have nurses start work immediately. Nonetheless, you should do this only for nurses you want to hire on a permanent basis. [Do know that SkillGigs have immigration support on hand for our employer partners. Contact us to learn more.] 

Language and cultural barriers

Foreign-trained nurses may face language barriers if English is not their first language. Communication skills are crucial in healthcare, and proficiency in English is essential for providing quality patient care. Cultural differences can also pose challenges in adapting to the US healthcare system and patient expectations. 

Healthcare facilities must specify the language requirements in their advertisements for foreign nurse jobs in the US. Additionally, if you come across candidates who are very skilled but lack knowledge of English you can have them undergo language and communication training. Also, note that it is very common to require a language proficiency exam prior to interviewing a candidate. 

Licensing and certification

Foreign-trained nurses must meet specific licensing and certification requirements to practice in the US including but not limited to the NCLEX. These requirements can vary from state to state, and nurses may need to pass additional exams or complete educational programs to meet the standards set by the state nursing boards. 

Once you have shortlisted your candidates, you must check the type of permits they would need to work. By applying for them immediately, you can reduce the burden on your existing staff and speed up the hiring process.  

Recruitment competition

There is intense global competition for qualified registered nurses, and many countries are actively recruiting and retaining their nursing workforce. This competition makes it more challenging for US hospitals to attract foreign nurses, especially when countries offer more favorable working conditions, benefits, and career opportunities. 

US hospitals must actively participate in international nursing job fairs, conferences, and recruitment events to reach a wider pool of qualified foreign nurses. Also, they must connect with nurses on a personal level to find out if they need anything to help them start the job. Another alternative is using a talent marketplace such as SkillGigs to alleviate this burden. Talent marketplaces are curated fresh talent daily allowing you to focus on the connecting and sponsoring. 

Cultural adjustment and retention

Moving to a new country and adjusting to a different culture can be overwhelming for foreign-trained nurses. The cultural adjustment process may affect their job satisfaction and retention rates. Additionally, the cost of living in the US may be higher than in their home countries. This can impact their decision to pursue employment opportunities in the US. 

International nurses may prefer hospitals that provide support systems, mentorship programs, and cultural integration initiatives that can help alleviate these challenges and promote retention. 


Hospitals and healthcare facilities must cultivate a positive reputation among all nursing, including those that are foreign-trained. By highlighting your commitment to providing quality patient care, professional development, and a supportive work environment, you can attract the best foreign nurses. Naturally, if you want to post jobs for foreign nurses in the US, we recommend trying SkillGigs — for free.  

SkillGigs is a talent marketplace that cultivates active nurses and their information in an efficient manner including pay expectations, preferred location, and personal details. Also, the marketplace manages the credentialing of their key documentation, skillsets, and certification. Healthcare facilities can easily browse many profiles of domestic and foreign nurses. Also, they can leverage the AI-based advanced matching system of SkillGigs to get the best recommendations for job postings.  

If you would like to learn more — no worries, schedule a demo today to learn more. And get to using SkillGigs by posting your open jobs for free. 

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