Document Type
Peer-Reviewed Article
Publication Date
2026
Abstract
Background
Internationally educated nurses play a vital role in addressing global nursing workforce shortages and supporting healthcare systems across many high-income countries. As international nurse migration continues to increase worldwide, effective transition, onboarding, and acculturation practices have become important determinants of workforce integration and retention. In the United States, internationally educated nurses comprise a growing segment of the nursing workforce; however, variability in onboarding practices may affect successful integration and retention.
Aim
To examine recruitment agency–mediated onboarding and acculturation practices and their association with contract completion among internationally educated nurses in the United States.
Design
Cross-sectional descriptive correlational study.
Methods
A 30-item survey was administered using snowball sampling (N = 76). Descriptive statistics and Pearson correlations were used to examine relationships between onboarding practices, professional characteristics, and contract completion.
Results
Thirty-six percent of respondents reported no pre-arrival onboarding. Key gaps included legal orientation, communication training, and mentorship. No statistically significant associations were found between contract completion and years of experience (r = −.13, p = .24) or contract length (r = .02, p = .86). Modest, non-significant associations were observed between contract completion and ongoing agency engagement (r = .18, p= .11).
Conclusions
Recruitment agency practices vary substantially and may influence internationally educated nurses’ transition experiences. Standardized onboarding and sustained support mechanisms warrant further investigation as potential strategies to enhance workforce integration and retention.
Impact
Findings highlight recruitment agencies as underexamined actors in workforce integration and suggest opportunities for standardizing policy and practice.
DOI
10.1016/j.ijnsa.2026.100622
Recommended Citation
Tolarba, J. E., Orbeso, J., & Rivera, R. R. (2026). Recruitment agency-mediated onboarding, acculturation, and contract completion among internationally educated nurses in the United States: A questionnaire survey. International Journal of Nursing Studies Advances, 100622. Doi: 0.1016/j.ijnsa.2026.100622
Publication
International Journal of Nursing Studies Advances
Volume
11
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
