What We Do

Local hospital looks overseas to help meet increasing demand for nurses

Challenges and Opportunities – International Health Care Resources & Alliances

Business First- July 29th 2005 Louisville, KY

Local hospital looks overseas to help meet increasing demand for nurses
Ed Green
Business First Staff Writer

Lolit Delos Santos has been a nurse for more than 25 years, helping doctors, caring for patients and trying to manage long hours that required her to find balance between her work and family.

But since 2003, things have gotten better, she said, boasting that almost two years ago, she received a substantial raise and began working more manageable hours.

It would be nice if those changes were a reward from her employer to recognize her talents and hard work. But for Santos, getting the higher salary and better working conditions required a move -- halfway around the world.

"I was working in the Philippines, and there was a consultation agency (that) was kind of recruiting nurses for the U.S.," said Delos Santos, who now works at Louisville's Norton Southwest Hospital.

Delos Santos said that at the time she was being recruited by Norton, the only things she knew about Louisville were that it was the home of boxing legend Muhammad Ali and fast-food giant KFC Corp.

Her husband, who had been a Baptist minister in the Philippines, later told her that Louisville also is the home of "a large Southern Baptist seminary."

"I don't know anything about the hospital here" before being recruited, she said. However, after showing an interest in Louisville, Delos Santos was shown videos of the area and the hospital to help her learn more.

She adds that she now "adores" Louisville and considers it her home. She lives here with her husband and 16-year-old son.

"I was getting frustrated from what was being done in the Philippines," said Delos Santos, who was active in that country's nursing association before seeking work in the United States. "Nurses are overworked and underpaid."

In the Philippines, nurses are paid as little a $1 per hour, according to a report by The Washington Post.

Registered nurses in this country are paid an average of about $26 per hour, according to data from the U.S. Bureau of Labor Statistics.

Nurse is among dozens recruited by Norton

Delos Santos is among more than 40 nurses who have been recruited from overseas by Norton Healthcare Inc., according to Judy Kees, vice president of human resources for the Louisville-based health care organization that owns Southwest hospital and four other area hospitals.

She said the company began recruiting nurses for its hospitals about five years ago from countries such as the Philippines and India to help address a shortage of registered nurses. Overall, Norton employs about 3,200 nurses at its hospitals and other health care facilities.

Initially, officials from Norton recruited nurses from overseas internally, but in 2003, the company contracted with IDG Management Services Inc., an international staffing company based in Louisville.

That company, owned and operated by India native Chris Noronha, operates offices in the Philippines and India as well as Dubai and New Zealand. The company also is expanding its international operations to include Qatar, Noronha said.

IDG has about 15 employees who help identify candidates from overseas and help them meet requirements to work as nurses in the United States. Those include: passing a board exam; having a good grasp of the English language, including terms used in the health care industry; and completing the process of earning a visa to work here. "It's a question of finding the ideal person," he added. "It's not hard to find people who want to come here. But can they integrate into the culture and communicate well with patients?"

The entire process takes about two years, Noronha said, and each nurse signs a two-year contract before receiving a U.S. visa and coming to Louisville.

Kees and Noronha said IDG has about 150 more nurses "in the pipeline" who will join Norton's hospitals during the next year or so.

Countries have technology, language similarities

All of the nurses being recruited by Norton and IDG are natives of either the Philippines or India because of similarities between U.S. hospitals and hospitals in those two countries.

Equipment in the hospitals in those countries is in all cases imported from the U.S. or Europe," and training of health care workers is similar, Noronha said.

So far, all but one nurse recruited to Norton by IDG has passed the board exam on the first attempt, said Kees, adding that the success rate is "phenomenal."

The Philippines, India and the United States also have cultural similarities because they each have large populations of Christians, and most workers speak English.

Many nurses plan to stay

Kees said she and other Norton officials have been pleased with IDG's recruiting efforts. She added that all of the employees recruited by the company have remained Norton workers.

And many of the nurses, including Delos Santos, plan to continue working for the company after their employment agreements expire, Kees said.

"They can stay with me as long as they want to stay," she said.

Nursing in critical demand

IDG focuses specifically on recruiting registered nurses, but it is considering expanding its services to include other health care professions that have a shortage of workers in the United States.

Noronha, who started his business in the late 1990s to help recruit computer programmers from India for U.S. companies, said he began focusing on health care when he saw data showing the "critical shortage" this country faces as its population gets older and there is more demand for registered nurses.

IDG no longer recruits programmers, and Norton currently is its only local client.

He also is in negotiations to recruit nurses for hospitals in St. Louis, Cincinnati and Chicago, Noronha said.

Officials with Baptist Healthcare Inc. and Jewish Hospital HealthCare Services Inc., two other Louisville hospital operators, said they have not needed to address their shortage of nurses by recruiting overseas.

Linda McGinity Jackson, vice president of public relations for JHHS, said the organization has provided scholarships and other opportunities to try to increase the number of nursing graduates who come to work for the company.

According to information from the American Nurses Association -- a Maryland-based professional organization that represents about 2.7 million registered nurses -- the shortage of nurses is a national problem.

According to a fact sheet provided by the organization, the United States is expected to have a shortage of about 1.1 million nurses by 2020. (See chart on this page.) The ANA recognizes nurses' right to immigrate to other countries but advocates first increasing wages and improving working conditions in the nursing field to increase the numbers of nurses working in this country, according to information provided by the organization.

Currently, about 2.3 million nurses work in the United States, according to the U.S. Bureau of Labor Statistics.

Recruiting to continue inside and outside of the United States

Kees will continue to review her staffing needs and contract with IDG if she needs additional nurses and can't recruit enough in the United States, she said.

Norton also is focusing on its scholarship program to help the company recruit American nurses to work at its hospitals.

Those efforts have helped Norton lower its vacancy rate for nurses to less than 3 percent, but officials plan "to keep an eye on the future," Kees added.

"We must keep recruiting (and) keep growing our programs both inside the United States and by continuing our international efforts," she said.

Contact the writer via e-mail at