摘要：Objectives. We describe long-term trends in the characteristics of foreign-trained new entrants to the registered nurse (RN) workforce in the United States. Methods. Using the 1990 and 2000 US Census 5% Public Use Microdata Sample files, we compared trends in characteristics of US- and foreign-trained new entrants to the RN labor force (n=40827) and identified trends in the country of origin of the foreign-trained new entrants. Results. Foreign-trained RNs grew as a percentage of new entrants to the RN workforce, from 8.8% in 1990 to 15.2% in 2000. Compared with US-trained RNs, foreign-trained RNs were 3 times as likely to work in nursing homes and were more likely to have earned a bachelor’s degree. In 2000, 21% of foreign-trained RNs originated from low-income countries, a doubling of the rate since 1990. Conclusions. Foreign-trained RNs now account for a substantial and growing proportion of the US RN workforce. Our findings suggest foreign-trained RNs entering the United States are not of lower quality than US-trained RNs. However, growth in the proportion of RNs from low-income countries may have negative consequences in those countries. Foreign-trained nurses have been a small but steady part of the nursing workforce in the United States for more than 50 years. Shortages in the US registered nurse (RN) work-force, which have occurred cyclically over this period, typically provide the impetus for employers to seek foreign workers. 1 – 3 With the current nursing shortage and reported RN vacancy rates of 10% to 15% in hospitals and nursing homes, there is currently a heightened interest in foreign-trained RNs. 3 – 5 Estimates of the number of RNs based on the Current Population Survey 6 show that the number of foreign-born RNs employed in the United States (11.5% of RNs employed in the United States in 2000) grew 4 times faster than the number of US-born RNs during the 1990s and accounted for one third of the growth in the nursing workforce between 2001 and 2003. 5 These trends have raised concerns that the aggressive recruitment of nurses from overseas will not be met with equally vigorous assurance of the quality and skills of the immigrating nurses 7 , 8 and that recruiting nurses from vulnerable low-income countries may have negative health consequences for the populations of those countries. 9 – 16 We used the US decennial censuses to compare the sociodemographic and employment characteristics of US- and foreign-trained new entrants to the RN workforce. We also present trends from 1990 to 2000 in the characteristics of the country of origin of foreign-trained entrants. Finally, we describe the short- and long-term implications of nurse migration for the nursing workforce needs in the United States and in developing countries.
