Understanding Nurse Migration

Purpose:

The current nursing shortage in the United States, which began in 1998, still lingers with no end in sight. The causes of the nursing shortage in the Caribbean are different from those of the U.S. The movement of Caribbean nurses historically has been within the region or outside the region to the United Kingdom (UK), Canada, and the U.S. Significant migration by Caribbean nurses is generally seen in Florida, which is considered the gateway to the Caribbean basin. This migration has served as the catalyst for a rapidly growing global business that attracts a number of entrepreneurial ventures and players. The results have been challenging with the most negative being exploitation of nurse migrants.

The purpose of this inquiry was to identify the challenges the Florida Board of Nursing face in credentialing Internationally Educated Nurses (IEN) from three source countries: Haiti, Jamaica, and Trinidad & Tobago; and design an evaluation model or matrix to facilitate the authentication of IENs credentials who migrate to Florida. The theoretical framework used was that of Donabedian, which includes 3 components structure, process and outcome.

Methods:

This was an IRB approved triangulated evaluation study. This descriptive, evaluation inquiry used a mixed method design. It included quantitative data gathered through a researcher designed survey tool which was used to collect data about the Boards of Nursing credentialing process;  two researcher designed questionnaires  used to gather data about the  Credentialing Agencies credential evaluation process and a source country questionnaire used to gather data about the source country credentialing and licensing process. Finally, a record review of the FL BON  credential approval process and  the NCLEX pass rate of RNs and LPNs by source country were conducted.   The qualitative data  were gathered through individual interviews with Credentialing Agency representatives and source country representatives and a focus group  was conducted with FL BON nursing education consultants.

Results:

Findings from the study provided valuable information and insight about the credentialing process of IENs overall and in Florida in particular. The information obtained may be utilized to process IEN applications and to give approval to take the NCLEX examination. The data from the inquiry were used to create a credential evaluation model that can be used to facilitate the process of authenticating and credentialing IEN applicants who seek licensure in Florida.

Conclusion:

Implementation of the model has significant regulatory implication that will ensure the delivery of safe nursing care & protection of the public. In addition, addressing the credentialing process of foreign graduates, which is complex and multifaceted is to create a specialized IEN staff within the FL BON. This staff would need to have focused training in fraud detection. They would maintain open lines of communication with CES and with the appropriate government Ministry from the source.