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Health Care Matters is edited by Karen A. Hart, RN, BSN, and Sandy Haeberle, RN

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Being a Good Consumer: Selecting an International Recruitment Agency

By Kate Christmas, RN
Vice President, Health Care Division

The international recruitment of health care professionals continues to be an appealing option for hospitals and health systems. Workers from outside the United States can be wonderful and loyal employees. The process of selecting and hiring them, however, must be tenaciously managed. Major changes are afoot for both organizations and professionals—from new licensing requirements to the upsurge of unethical go-between agencies—so it is vital to proceed with care. Read More >

 

Being a Good Consumer (continued)

Due to the ongoing shortages in health care, a host of new companies has emerged seeking to exploit the pressing staffing needs of U.S. hospitals and health systems. These fly-by-night vendors are everywhere, advertising their wares on websites, in print publications, and via other media.

The stakes in using untested agencies to recruit international health care professionals can be high if the ones you choose turn out to operate without scruples. Shameless commerce in a free market is not a crime, but unethical practices may harm others and are morally wrong. As purchaser of these services, an organization must bear responsibility for the parties who contract on their behalf.

Cutting the red tape

International recruiting efforts may seem pretty straightforward to those who have never dealt with the Commission on Graduates of Foreign Nursing Schools (CGFNS), state licensing boards and the U.S. Citizenship and Immigration Services (USCIS, formerly know as INS).

In practice, however, recruiting from overseas is an immensely taxing production, which will tremendously impact the financial and staffing implications for your organization and units. There are also the financial and personal ramifications for the international professional and his or her dependents. And valuable time is lost to all when procedure is not followed to the letter.

Those recruiting internationally should be aware that the licensing process now includes a visa screen. Most candidates must pass a licensing exam to qualify to work in the state of their prospective employer. The licensing process varies from state to state, so a knowledgeable agent will be necessary to help navigate the red tape and assist health care professionals in preparing packets for submission.

If you are recruiting on your own, or using an agency that does not manage the legal process, engage the services of a specialized immigration attorney to help with USCIS. In the post-9/11 world, it is important to make sure that paperwork is complete, submissions are accurate and filing is done properly. Any deviation can cause delays, or even rejection of the application.

A good international agent or company will take time to assess your needs, preparing you in all key areas prior to interviews with prospective candidates. The process of interviewing and selection should be guided by an insider who has detailed information on the best schools, programs and practices in the country or countries from which you are recruiting. Without this insider’s knowledge, your hires will flounder, your manager will be frustrated and time will be lost.

A cautionary tale

Consider the story of a 15-year Trauma OR veteran from Ireland who applied to work in the States through an agency. That company had previously functioned merely as a local staffing agency, yet it plunged into foreign recruitment. The nurse requested work at a large southern health system, and the agency assured her they could secure such a position.

She paid for, and successfully completed, the visa screen and RN licensing examination, and provided nearly $7,000 for the processing of green cards for herself and her spouse. The RN traveled to the state, hoping to speak with someone at the prospective hospital. The agency cautioned her not to do so as it was “too early”; she would risk losing the job if she “wasted their time.” Still, the company representative assured her she would be living and working in the States within four months. So, she gave notice to her current employer, put her home in Ireland on the market, bought a house here and began packing to move from her homeland.

Three weeks after escrow closed on her American home, another company representative called to say they had been unable to find her a position and that USCIS had rejected her Green Card application. It turns out the agency had filed for it without ever having a crucial component—a petitioning employer.

The RN and her family were devastated, out thousands of dollars and almost two years of their lives. The RN wisely contacted a reputable US immigration attorney who agreed to assist her with re-applying to USCIS if an employer could be found. The attorney suggested she contact the Bernard Hodes Group Health Care Division. Happily, we were able to aid this talented and experienced RN in securing a position at one of our client facilities.

What to look for

As an employer, if you decide to engage an agent to assist with international recruitment, do what you would do for any potential hire—check references. Request at least four from the agency, two of which should be from other health systems that have recently used their services. The other two should be from health care professionals who have been placed by the agency within the past year. Ask the agency for metrics on the number of professionals placed in the past year; the pass rate for licensing examinations, and the average time it takes them to get candidates onsite with valid work visas.

Ask the employers about the process, timelines, any glitches and the quality of candidates presented or hired. Find out exactly what the agent did as some only present candidates, while others are full service. Full-service agencies will screen and interview, secure licensure, file USCIS paperwork, and provide relocation services.

Ask the professionals how they were treated, how they decided to use the agency and whether they would recommend it to friends. Find out if they were offered any preparation for their licensing exam, assistance with paperwork and detailed information on their destinations of interest.

It is not uncommon to hear of disreputable agencies that charge candidates thousands of dollars to help them with placement, and then have the employer pay for the same services. Many of these agents have operated in countries where nurses are eager to immigrate to countries with significantly higher earning potential and a better standard of living.

Beware if the agency or agent cannot come up with such references, and assume that it means that your company will be their guinea pig as they sort out their processes by trial and error. Find an agency that is familiar with the business and has current professionals in the pipeline and/or working in the US. Ask your fellow recruiters or human resources professionals who they have used, and how the employees have worked out.

If it is a true start-up company, ask about the previous experience of the company principals. Being the first client and getting a price break from a new company may end up costing you time and money. With so much at stake, make wise choices and remember that the lives of the professionals you hope to recruit are also in the equation.

Bernard Hodes Group Health Care Division can assist you in planning for international recruitment, and provide a big-picture view of the process to help you make the very best decision for your organization. Contact your local Hodes representative or the Health Care Division at healthcare@hodes.com.