Sinai Hospital and Foreign Nurse Recruitment: Getting Beyond "Stealing" Nurses
May 2003 Ideas in Action e-Newsletter, the Maryland Hospital Association

In talking to Vice President for Patient Care Services Diane Johnson about Sinai Hospital’s foreign nurse recruitment effort, you get the distinct impression that she is a resilient person.  That’s because after a conversation about her Philippine recruitment experience — a conversation that describes "aggravation, pain, and heartache" and an "emotional roller coaster" — she ends on an upbeat note: "For us, it was time well spent."

Johnson explains that she suggested her hospital try recruiting foreign nurses because she got tired of the competitive "how-can-I-make-my-opportunity-more-attractive" strategy that hospitals were using to steal nurses from the next facility — a strategy Johnson candidly admits she has used herself.  With executive management support, she identified a small recruitment agency and assembled a team of three directors and a Human Resources nurse recruiter to go to the Philippines in December 2000.  The team consulted both clinical and administrative experts to craft a list of screening questions for interviews — for example, "If you had a patient that presented with xyz symptoms, how would you handle it?"

An abundant supply — and a lengthy process

The recruiting team found the Philippine nurses well prepared and the number wanting to come to the U.S. abundant — driven partly by a Philippine over-supply of nurses.  The team contracted with just over 160 nurses, with a three-year term of commitment contingent on obtaining a visa and license, and subject to hospital employee rules and regulations.

While the original plan was to have the nurses obtain their license before coming to the U.S., that did not always work out in practice; Sinai now allows those that need to, to take the test here.  Nurses must pass the Test of Spoken English before obtaining a visa and their Maryland license: a tough hurdle, with a 50 percent failure rate.

The first Philippine nurses started arriving in small groups early in 2002; so far 56 are working at Sinai, and, with a switch to a larger recruiting agency, the hospital is committed to speeding up the process and bringing the remaining 50 here (the lengthy wait has had an attrition rate).

Johnson and her staff used the time before the nurses' arrival to lay groundwork: among other steps, they conducted the equivalent of an in-service program for front-line staff to educate them on Philippine culture.  Johnson made a particular point of educating herself on training for nurses in the Philippines — all bachelor's prepared, their education is similar to that in the U.S. — and then meeting with small groups of physicians to describe competency level and hear concerns.  At the same time, Sinai kept in touch with their Philippine recruits, supplying background information on the U.S. and Baltimore as well as clinical and cultural information about the hospital.

Sinai’s Director of Patient Care Services for Medical-Surgical Services, Linda LaHart, and Director of Patient Care Services for Cardiac Services, Valerie Allen, took on key roles in helping the nurses adjust once they had arrived.  LaHart watches over their cultural and clinical needs and Allen helps them settle into (and move on from) the apartments the hospital provides for their first three months.

Meeting objectives — including physician approval

With only a few bumps, the Philippine nurses are melding smoothly into the staff.  "They are pleasant and competent," notes Johnson.  "The one over-arching issue is they need more coaching in technology than U.S.-trained nurses; Philippine hospital technology is typically several generations back."

There are early signs that Sinai’s foreign recruitment effort is meeting its objectives: vacancy, turnover, and agency use rates are all declining.  And there are signs of physician satisfaction, says Johnson, citing a recent encounter with a surgeon, who told her: "Diane, that’s one of the best things Sinai has ever done."  Of course, being a resilient and realistic person, Johnson knows that physicians will move on to other issues.

Copyright 2003 © The Maryland Hospital Association. This article is republished with permission from Sinai Hospital of Baltimore and the Maryland Hospital Association, and is not an endorsement of Blue Heron HealthPro by either organization.

 

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