 A unique foreign recruiting program helped this Long Island hospital go from a 13% vacancy rate to zero.
Chief nursing officers around the country are singing the blues over the current nursing shortage, expected to continue for many years. Yvette Mooney, senior vice president of patient care services at South Nassau Communities Hospital and COO of startup SN Nursing Solutions, is singing a different tune.
 Yvette Mooney, COO
That year, when one of the hospital’s bariatric surgeons, an India native, began talking about running his own unit, Mooney looked at him incredulously. “I said, ‘There’s a nursing shortage going on.’ And he said, essentially, ‘Stop complaining, and go to India.’”
Indeed, nurses from India met all of Mooney’s requirements. They were experienced and spoke English, and there were so many in the overpopulated country that hiring them away did not pose an ethics problem.
One ad, many resumes
Mooney decided to give the idea a try and ran a help-wanted ad in The Times of India, asking qualified nurses to apply. She was amazed at the response, which came in the form of bundles of thick applications that included immigration information. The flow was so great that Mooney hired a nurse PhD to research the education and certification equivalents and come up with a list of qualified applicants.
Mooney had determined that to make a trip to India to interview candidates worthwhile for the hospital, she would need about 50 candidates. “We just ran that one ad and ended up with 99 superlative candidates to interview,” she said. After deciding on three cities that the nurses could travel to for interviews, Mooney and her associate booked flights and hotels. They were delighted when the hospital’s chief of pathology, Dr. Khapra, also an India native, suggested accompanying them on the trip as a guide.
Planning to hire 30 nurses for SNCH, Mooney said virtually every one of the 99 candidates she interviewed was on target. “We were so impressed with their demeanor, education, and language skills. At the time, I thought that with all of the competition for nurses on Long Island, wouldn’t it be great if I could bring in nurses for other hospitals so we could stop vying with each other for a single qualified nurse.”
Finding a law firm with experience in nursing immigration to New York State and overcoming the challenges posed by post-9/11 sentiment proved difficult, said Mooney. But she and her colleagues persevered, and at the end of 2004, nurses from that first interview in February 2001 began arriving. “It’s unbelievable that they would wait that long, but they did come,” she said.
Preparing to emigrate
Mooney’s next step was to partner with a company to help with the immigration side of the program, which she found in a Princeton, NJ-based company specializing in international IT staffing. “They didn’t know the nursing pieces, but we knew we could teach them that.”
The partnership proved a success, with what is now Bion Healthcare taking Indian nurses through all the steps involved in preparing to emigrate, including funding the cost of the required exams. “Once the nurses are certified, the immigration process is much faster,” said Mooney. “If they’re not certified, it adds about a year to your time line.”
Mooney credits Bion (called Team Health in India) with stepping up to the plate in a major way. Some agents charge the nurses fees for helping them emigrate, and some try to keep their papers or passports, she said. “We checked with the nurses when we visited India to make sure all of Team Health’s practices were proper, and they were. They were also incredibly receptive about my suggestions to incorporate new pieces from The Joint Commission and others into their program.”
When Mooney’s colleagues in other Long Island hospitals learned of the program and her trips to India, some asked if she could bring back some nurses for them. “And I was happy to do this,” said Mooney. “There are so many nurses who want to emigrate, and spending time competing for nurses is a waste of time. It takes focus away from patients. I was happy to bring over as many nurses as I possibly could and spread them around.”
On day one
In 2003, the hospital entered into a joint venture with Bion to place Indian nurses in area hospitals. As Mooney went on sales calls with Bion executives, she realized that although hospitals had a difficult time coming up with the placement fee (around $13,000 at the time), they ended up spending much more for agency and traveling nurses. “Hospitals spend millions of dollars per year on agency nurses who have no loyalty to the organization and don’t contribute at the same level that a permanent staff nurse does,” she said.
After a few months, Mooney realized that Bion’s intended role, to handle the administrative side of the placements, wasn’t large enough to justify the partnership. “We have to be so intimately involved in getting nurses trained and ensuring that they’re successful.” It made sense for the hospital to launch its own for-profit company, and NS Nursing Solutions will debut this month.
Mooney and her team have already brought about 250 Indian nurses into New York, and an additional 350 have been personally approved by Mooney for jobs here. It’s a win for everyone, she said. Hospitals hire through Nursing Solutions, paying each nurse’s fee over 12 months instead of a lump sum. At the end of that period, they can hire the nurse with no additional fee required.
The nurses are trained by Mooney and the staff at SNCH for 12 weeks. There are specialized training programs for ED and OR nurses based on national standards of those associations. The nurses have begun to acclimate and are ready to function in their new jobs—and that includes ED nurses. “You just can’t get a qualified ED nurse to walk in the door,” said Mooney, noting that classroom training is combined with in-hospital hours with preceptors.
Mooney is understandably excited about the new venture. “Hospitals are paying the same money and getting a better quality nurse,” she said. Indeed, in many cases, they are paying less. “If I had to hire an ED nurse to come in tomorrow, I’d pay anywhere between $75 and $112 per hour, depending on the shift or holiday they work. Our nurses are charged at $63 per hour without the specialty three-month training programs. And that nurse is ready to go from day one and is there for a year.”
The benefits for SNCH continue to add up. Mooney said the year the first nurses arrived, her overtime costs went down 41%, and she eliminated agency nurses altogether. But perhaps the best news going forward is that SNCH and other hospitals can plan for the future.
Mooney recalled that as Nursing Solutions was being developed, SNCH was building a new hospital that would require 86 additional FTEs. “My boss told me he wasn’t worried about the money for the 170,000-square-foot building, but he was worried we wouldn’t be able to staff it,” she said. “We opened last year, and on day one, we had every nurse in place.”
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