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.