Internationally educated nurse hiring: geographic distribution, community, and hospital characteristics

As the largest importer of internationally educated nurses (IENs), the United States is considered to be the epicenter of global nurse migration. The purposes of this study were to examine the geographic distribution of IEN hiring and determine associations between community and hospital characteristics and IEN hiring. More community characteristics than hospital characteristics were strongly associated with IEN hiring which suggest perceived community needs and receptivity to lENs could be an important consideration in hospital administrators' decisions to hire IENs. These findings suggest that as the U.S. population ages and becomes increasingly diverse, the demand for IENs is likely to grow. Nurse leaders and faculty may face challenges with regard to the ethical recruitment of IENs from low-income countries, incorporation of IENs into U.S. health care organizations, and continued development of a diverse U.S.-educated nursing workforce. This study expands understanding of the demand side of IEN employment in U.S. hospitals by providing the first in-depth examination of the community and hospital factors related to hospitals' IEN hiring.     

Are Chinese nurses a viable source to relieve the U.S. nurse shortage?

The viability of recruiting Chinese nurses to ease the current U.S. nurse shortage is examined by assessing nursing's socioeconomic status and the educational preparation of nurses in China. Recruiting Chinese nurses is a win-win scenario for individual Chinese nurses, the Chinese nursing profession, and the two countries involved.     

The 'Parent Shift' program: incentives for nurses, rewards for nursing teams

To create new opportunities for nurses to reenter the workforce, a RN p.r.n. program must meet the needs of nurses who wish to make dual commitments to home and work. The Parent Shift program provides an innovative model of attracting and retaining nurses in a hospital workforce. Many nurses who joined the program were away from the field of nursing for many years and were drawn to the program because of the promise of flexible shifts and minimal requirements for participation. In this study, flexible shifts not only encouraged program entry, they were also a powerful motivator for continued program participation over time. Parent Shift nurse presence was perceived by nurse managers to decrease stressors and improve time efficiency of full-shift staff.     

Why are shortages of hospital RNs concentrated in specialty care units?

This article is the first in a series examining the interplay between the aging of the nurse workforce and other factors driving the growing nursing shortage that are already affecting some specialty areas. Nearly 60% of the current RN workforce is over 40 years of age; and the percentage of RNs under age 30 has fallen by nearly 40% since 1980. The total number of FTE RNs is projected to shrink after 2010, likely resulting in shortages of RNs "when the large baby-boom generation of RNs starts to retire." Because ICUs have historically attracted younger RNs, the rapid decline in the number of RNs in the workforce under age 30 plays a large role in explaining the development of shortages in the ICU. The growing difficulties staffing operating rooms and other peri-operative services is seen as related to the aging work force as more diploma prepared nurses have been attracted to this specialty because they had educational exposure to this area.     

Public perceptions of nursing careers: the influence of the media and nursing shortages

The high public regard for nurses has not necessarily translated into an adequate supply of individuals who are willing to be nurses. The expected future demand for nurse labor challenges us to look more closely at the public's perceptions of nursing and nursing careers, and consider how they are shaped by personal experience, media messages, and socio-demographic factors. As part of ongoing efforts to examine factors shaping the future of the nursing workforce, a national survey of Americans was conducted to probe attitudes toward the nursing profession and their experiences with nurses. The data in this national survey of the public about nursing demonstrate that the nursing profession is highly respected and that the vast majority of the general public would recommend nursing careers to qualified students. If the profession is so well thought of and so highly recommended, why are there persistent concerns that not enough people are becoming RNs to avoid or at least slow down the development of future shortages? A prolonged and persistent effort is needed to educate people about nursing careers, to stimulate the expanded production of nursing faculty, and to bring creative approaches to financing nursing education and workforce improvements to convert the large number of seriously interested candidates into the nursing profession.     

The nursing informatics workforce: who are they and what do they do?

Nursing informatics has evolved into an integral part of health care delivery and a differentiating factor in the selection, implementation, and evaluation of health IT that supports safe, high-quality, patient-centric care. New nursing informatics workforce data reveal changing dynamics in clinical experience, job responsibilities, applications, barriers to success, information, and compensation and benefits. In addition to the more traditional informatics nurse role, a new position has begun to emerge in the health care C-suite with the introduction of the chief nursing informatics officer (CNIO). The CNIO is the senior informatics nurse guiding the implementation and optimization of HIT systems for an organization. With their fused clinical and informatics background, informatics nurses and CNIOs are uniquely positioned to help with "meaningful use" initiatives which are so important to changing the face of health care in the United States.     

A decade of natural gas development: The makings of a resource curse?

Many studies find that areas more dependent on natural resources grow more slowly – a relationship known as the resource curse. For counties in the south-central U.S., I find little evidence of an emerging curse from greater natural gas production in the 2000s. Each gas-related mining job created more than one nonmining job, indicating that counties did not become more dependent on mining as measured by employment. Increases in population largely mitigated a rise in earnings per job and crowding out. Furthermore, changes in the adult population by education level reveal that greater production did not lead to a less educated population.     

How work environment impacts retention

Work environment is a major aspect of the day-to-day grind that drives the retention (or turnover) of RNs. When opportunities abound, it is easy to jump ship, and when turnover begins, it is usually the best and brightest who are first to depart. Recent research reported a whopping 27.1% average voluntary turnover rate among new graduate nurses during their first year of employment. Aging of the nurse workforce may be the largest factor impacting health care work environments, as employers struggle to diminish the physical effect of lifting thousands of pounds and walking several miles during each shift. Every influence on the work environment (management, peer behavior, patient acuity, equipment availability, the physical plant) should be assessed for impact on the workforce. While we cannot hope to create paradise in each work setting, we can promote an environment that is healing both to patient and to caregiver.     

Transition programs for internationally educated nurses: what can the United States learn from the United Kingdom, Australia, and Canada?

It is critical to conduct competency assessments of internationally educated nurses (IENs) to ensure public safety, as well as uphold accountability to nursing as a regulated profession. Transition programs are needed because of the required proficiency of the working language, as well as differences in nursing education, national health care systems, nursing practice and culture, etc. Transition programs in the United States are grossly under-developed because of lack of recognition of their importance, lack of funding and standardization, and decentralized regulation in nursing. United States can learn from the United Kingdom, Australia, and Canada regarding how to best transition IENs. Its current hit-and-miss approach is inadequate and inconsistent with the emerging global trend to systematically deal with the transitional challenges of IENs at the national level.     

Onboarding: delivering on the promise

The nursing workforce continues to age and exit the workplace. U.S. Bureau of Labor Statistics studies indicate as many as 40% will retire or are considering retirement. Fewer qualified graduates are in place to replace aging baby boomers, leading to a knowledge and skills gap as well as a numbers gap. Globalization of the nursing workforce has increased competition for all employers to find, hire, and retain good employees.     

The Political Economy of Domestic Labor Mobility: Specific Factors,Landowners, and Education

Political actors today seek to influence labor mobility via education just as they have for centuries. Landowners in countries with large industrial sectors attempt to suppress education levels to maintain their labor supply, as educated workers are able to move into industrial work more easily than uneducated workers. However, the relationship between large landowners and education is more complex than has been previously theorized. Using a specific‐factors model, I show that large landowners in countries with little economic development actually have an incentive to increase education levels. They realize the returns of an educated workforce without fearing their mobility because competing industrial opportunities for the workers do not exist. In either case, the ability of landowners to achieve their political goals is a function of their ability to overcome the collective action problem and effectively influence the state's provision of education. Powerful landowners successfully deny education in industrialized countries and provide it in agricultural countries. An analysis of panel data covering 77 countries from 1975 to 2000 confirms the conditional nature of the relationship.     

Is the importance of religion in daily life related to social trust? Cross-country and cross-state comparisons

We look at the effect of importance of religion in daily life on social trust, defined as the share of a population that thinks that people in general can be trusted. We make use of new data from the Gallup World Poll for 109 countries and 43 U.S. states. Our empirical results indicate a robust, negative relationship between this measure of religiosity and trust, both internationally and within the U.S. The size of this association increases with the degree of religious diversity.     

The importance of employment status in determining exit rates from nursing

To mitigate nurse shortages, health care decision makers tend to employ retention strategies that assume nurses employed in full-time, part-time, or casual positions and working in different sectors have similar preferences for work. However, this assumption has not been validated in the literature. The relationship between a nurse's propensity to exit the nurse profession in Ontario and employment status was explored by building an extended Cox Proportional Hazards Regression Model using a counting process technique. The differential exit patterns between part-time and casual nurses suggest that the common practice of treating part-time and casual nurses as equivalent is misleading. Health care decision makers should consider nurse retention strategies specifically targeting casual nurses because this segment of the profession is at the greatest risk of leaving. Nurse executives and nurse managers should investigate the different work preferences of part-time and casual nurses to devise tailored rather than "one-size fits all" nurse retention strategies to retain casual nurses.     

WAGES AND EMPLOYMENT IN THE U.S. APPAREL INDUSTRY

This article uses individual-level data from the U.S. Census, Public Use Microdata Sample (PUMS), to examine wages and employment in the U.S. apparel industry. Total employment in this sector has been falling since 1970, and its overall average wage is the lowest of 25 industry aggregates. But disaggregation by gender, education, and nativity reveals that groups of highly educated male native workers earn higher average wages in apparel than in other industries. Moreover, after adjusting for observed individual differences in human capital (in addition to the three characteristics used to form worker subsets), highly educated male natives earn positive wage premiums in this sector. In contrast, most categories of immigrants and female natives earn relatively low average wages and experience negative wage premiums in apparel. This variation in the adjusted industry wage premiums across worker groups may be related to apparel's relative exposure to imports and immigrant workers.     

The older nurse in the workplace: does age matter?

Between 2010 and 2020, over 40% of the RN workforce will be over 50 years of age, and many RNs are expected to retire and withdraw from the workforce. Given that older nurses are the fastest growing cohort of the workforce, the important findings presented in this article deserve careful consideration by policymakers, health care leaders, and managers.     

Profiles of nurses professionally involved in public policy

A widely acclaimed goal of the nursing profession is to increase the number of nurses involved in shaping U.S. health policy. This study describes 33 nurses holding positions in regulatory agencies, state legislatures, and congressional offices.     

Do regional economies converge?

Current interest in the new economic growth theory, linked with the development of new, innovative methods of measurement, has resurrected interest in spatial economic convergence. The primary objective of this paper is to examine the extent that regional economies seem to be converging or diverging. It explores the expanding theoretical literature in the field and examines the growing body of empirical evidence that has emerged in recent years not only in the U.S. but also internationally. The paper is retrospective but also embraces new findings relating to the United Kingdom and the U.S., putting particular emphasis on long- and short-term indicators of economic convergence.     

What does a military nursing shortage mean to us?

The current nursing shortage makes U.S. military medical readiness questionable. Legislative initiatives for attracting nurses to the military and reserves are being employed. In spite of these efforts, plans are underway to draft nurses during a military emergency.     

DID INTERNATIONAL ECONOMIC FORCES CAUSE THE GREAT DEPRESSION?

This paper reviews and assesses international explanations for the depth and duration of the Great Depression. Many of the conclusions are negative. The U.S. Smoot-Hawley Tariff Act of 1930 came too late to account for the 1929 downturn and fails to explain the severity of the contraction in the U.S. The competitive devaluations of the 1930s redistributed the Depression's effects across countries but did not worsen it overall. The deflationary consequences of the liquidation of foreign exchange reserves were minor. Domestic central bank policies and their failure to be coordinated internationally must bear the major responsibility for the Depression.     

Regulatory reform and labour earnings in Portuguese banking

This study examines changes in union contracts and wage structure during and after the introduction of regulatory reforms (deregulation and privatisation) in the Portuguese banking sector. The main finding is that, despite a relative wage erosion detected in the contract data, banking workers were able to enjoy an increasing wage premium in the period 1985–2000, probably reflecting the increasing profitability of the industry and the rise in labour productivity. The evidence also shows that some specific groups benefited relatively more than others: the least skilled and educated workforce and male workers gained more from the regulatory reforms. However, this unequal sharing of the wage premium did not raise wage inequality across ownership groups in the industry. I thank Mark Stewart, Odd Rune Straume, Ian Walker and two anonymous referees for very helpful comments. I am indebted to the Ministério do Trabalho e da Solidariedade for allowing the availability of data from Quadros de Pessoal. Financial support was provided by the Ministério da Ciência e Tecnologia under the grant BD/SFRH/2000/1291.