The paper draws its inspiration from the issue of nursing shortages that has been a major point of concern for the entire US health care system during the last 20-30 years. Schumacher explores one the implications of the policy of the importation of nurses from other countries: differences between foreign and native nurses in the US labor market. The study constitutes largely a research on the economic side of the issue, but it has significant value for the understanding of the phenomenon in general.
The research aims to examine the difference between the labor experience of foreign-born and native nurses. In particular, the study’s objective is to identify the earning disadvantages faced by the first group. In addition, the researcher pursues the goal of determining whether the presence of foreign-trained and foreign-educated nurses on the health care market has an adverse effect on the wages of native registered nurses (RN). At the same time, the research is not limited to examining the wage situation, but also intends to identify the proportion of foreign RN on the market and their countries of origin.
Type of research
The research is economic, as it focuses on exploring the labor market dynamics in connection with hiring nurses from abroad. From the technical point of view, it is a quantitative study. Schumacher looks at the statistics outlining the numbers the participation of foreign-educated nurses in the National Council Licensure Examination (NCLEX-RN) to establish their presence on the US labor market. The author proceeds with measuring the impact of foreign RN on the market dynamics in the United States.
The researcher uses the statistical data of the NCLEX examination to establish the proportion of nurses on the markets. To examine the impact on the labor, the study refers to the data of the Current Population Survey (CPS) for the earning files (for the time period from September 1995 till June 2008). These files include the information on the citizenship status, the country of birth and the year of entry. The CPS data samples include nurses ages 18 and over employed with positive earnings and hours.
The second part of the sample comes from the data of the National Survey of Registered Nurses (NSRN) from years 1988, 1992, 1996, 2000, and 2004. The NSRN contains major demographic data that can indicate both the origin of RN and their entry into the labor market in the United States.
Several hypotheses can be identified in the paper. First, foreign nurses experience lower wages, especially in the early career years. Second, the appearance of foreign NR on the US labor market leads only to a very small decrease in the earnings of native nurses.
The methodology involves the comparison of the immigrants’ earnings to native salaries in general. Consequently, Schumacher determines the level of foreign nurses’ earnings by using a Mincerian wage equation. The researcher also develops an equation for measuring the impact of foreign RN on the wages of native nurses. This equation is more complex as it includes a non-nursing comparison group.
The results of this study can be divided into two major groups. Firstly, the research determined the wage particularities of foreign nurses. It revealed that only very recent immigrant nurses experience a significant wage differential. There are no considerable differences between foreign nurses with several years of experiences on the US labor market and native-born RN. In other words, foreign nurses might start their careers at lower wage levels due to the absence of certain qualifications (including the proficiency in English), but they quickly gain the same level of remuneration as they integrate into the market.
Secondly, the reached the findings that there is little evidence of the negative effect of the presence of foreign nurses on the earnings of native RN. Any measurable decrease happens only at the initial stage of the entry of the large foreign-born workforce and translates into an increase very quickly.
- Schumacher, E. J. (2011). Foreign‐born nurses in the US labor market. Health economics, 20(3), 362-378.