Immigrant nurses embody more ‘human capital’ than US-born peers — study

Immigrant nurses were far more likely to speak multiple languages, have additional certificates, years of experience, and had licenses to practice in more states than American-born nurses, says study.

COLUMBIA, Missouri — A new study by a nurse scientist now at University of Missouri found that immigrant nurses often represent far more human capital than their American-born counterparts.

Studies often focus on years of experience and traditional educational backgrounds as the skills and competencies or “human capital” of long-term care registered nurses in the United States.

However, additional criteria, such as ability to speak multiple languages, additional certificates or trainings and licenses to practice in multiple states add considerably to the human capital often represented by immigrant nurses.

Roy Thompson, a postdoctoral fellow in the MU Sinclair School of Nursing and immigrant with a doctoral degree in nursing at Duke University, found that immigrant nurses were far more likely to speak multiple languages, have additional certificates, years of experience, and had licenses to practice in more states than American-born nurses.

Thompson and his team studied demographic data of more than 1,800 nurses working in nursing homes or long-term care rehabilitation centers in the U.S.

“By incorporating the additional criteria, we get a much better model for comparison, and I wanted to show that immigrant nurses often have a wealth of transferrable skills, are more mobile and adaptable given their experiences practicing in different long-term care settings,” Thompson is quoted in Mirage News.

While most immigrant nurses from the Philippines, Sub-Saharan Africa, and the English Caribbean may embody significant amounts of human capital, they are often hired for underpaid, entry-level positions and forced to work their way up after arriving in the U.S., Thompson said.

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Previous research also shows that immigrant nurses experience discrimination, racism, exploitation, inequitable pay, and unfavorable treatment at work.

“For example, there was some evidence that immigrant nurses were more likely to be assigned to COVID-19 units in long-term care during the pandemic. In fact, about 30% of nurses who died from COVID-19 were from the Philippines.

“While most nursing research focuses on hospitals, clinical research, patient populations and patient health outcomes, nursing homes and long-term care facilities tend to be an understudied, yet overregulated sector. I wanted to look deeper into the nursing home workforce itself.”

The long-term goal of Thompson’s research is to eventually improve immigration policies that currently typically restrict nurse migration to the US.

“Immigrant nurses are highly qualified, highly skilled and come to the U.S. with knowledge that the nursing workforce needs to improve health outcomes,” Thompson said.

“For example, previous studies have shown that in nursing homes with higher proportions of immigrant nurses tend to improve health outcomes such as decreased rates of pain, use of physical restraints and falls.”

While Thompson became the first Black male to ever earn a doctoral degree in nursing from Duke University, he hopes to see more highly skilled immigrant nurses working in nursing homes going forward.

“As the median age of Americans continues to rise, we are starting to see more diverse patient populations receiving care in nursing homes,” Thomson said. “So ideally, we would want a more diverse workforce to better reflect the patients they are serving.”

“Examining Human Capital Among Foreign and United States Educated Nurses in Long-Term Care” was published in the Journal of Nursing Regulation. The study was conducted while Thompson was a doctoral student at Duke University.