Electronic Health Reporter

By Patti Artley, DNP, RN, NEA-BC, President, WorldWide HealthStaff Solutions, and 
Chief Clinical Officer, Medical Solutions.

In my 35 years in nursing, I have seen how quickly a staffing gap can affect a patient’s care. Surgery may be scheduled, the care team may be ready, and the family may have rearranged work, travel and caregiving responsibilities. But everything can still come down to one question: Are enough experienced nurses available to care for the patient?

When perioperative staffing (which supports patients before, during and after surgery) falls short, the impact goes far beyond the operating room schedule. Patients may face delays, prolonged pain or worsening symptoms; families are left to adjust their plans again; and care teams carry the added pressure of trying to do more with fewer people.

That is why perioperative staffing is not just a recruitment issue. It is an access-to-care issue and a patient care issue.

The need for experienced perioperative nurses remains significant. The Association of periOperative Registered Nurses reported that vacant perioperative positions declined from 18% in 2022 to 8% in 2024. That progress is encouraging, but 53% of respondents in 2024 still said surgeries had been delayed or canceled because of short staffing. Staffing challenges continued to disrupt surgical care for more than half of respondents.

At the same time, perioperative nursing is not simply a matter of adding more people. These roles require specialized experience across pre-op, the operating room, circulating and scrubbing, post-anesthesia care, recovery, endoscopy and other procedural settings.

AORN’s 2026 position statement on safe perioperative staffing reinforces that point. Staffing decisions should reflect patient needs, procedural complexity, technology, professional competency and the overall skill mix of the team. Healthcare organizations need nurses whose experience fits the clinical environments in which they will practice.

Finding those nurses is becoming more difficult across the broader labor market. The U.S. Bureau of Labor Statistics projects about 189,100 registered nurse openings each year from 2024 through 2034. The Health Resources and Services Administration also projects an 8% national RN shortage in 2028 and a shortage of about 108,960 full-time-equivalent registered nurses in 2038.

Healthcare organizations cannot wait for the labor market to correct itself. They need a range of workforce strategies, including retaining experienced nurses, strengthening specialty education, improving work environments, and creating more pathways for experienced nurses to join their teams.

International direct hire recruitment is one of those pathways. It can help hospitals and surgical care providers connect with experienced nurses who have already worked in highly specialized clinical settings.

WorldWide HealthStaff Solutions currently has a pipeline of more than 2,700 internationally trained registered nurses who have passed the NCLEX-RN examination and are prepared to pursue perioperative and procedural roles in the United States.

More than 1,000 have operating room and OR subspecialty experience. More than 200 have worked in women’s services, obstetric operating rooms and labor and delivery. More than 300 have experience in pre-op, post-op or post-anesthesia care.

On average, these nurses bring seven years of total nursing experience and 6.5 years in their specialty units. They are not new to nursing. They have worked in areas such as cardiovascular surgery, orthopedic surgery, general surgery, endoscopy, interventional radiology, and post-anesthesia care units.

That level of experience can help organizations strengthen surgical teams, reduce vacancy pressure and support more consistent patient care. But successful international recruitment requires more than filling an open position.

International nurses must complete licensing, credentialing and immigration requirements before they begin employment. Healthcare organizations also have an important role to play once nurses arrive. Strong clinical orientation, peer support, cultural integration and opportunities for continued development all contribute to long-term success.

Recruitment should not be treated as a transaction that ends when a nurse starts the job. It should be viewed as a long-term workforce partnership.

International recruitment is not a replacement for domestic nursing education, stronger retention efforts or healthier work environments. It will not solve the perioperative workforce shortage on its own. But when it is thoughtful and connected to a broader workforce strategy, international direct hire recruitment can help organizations bring experienced clinicians into areas where they are urgently needed.

After many years in nursing, I still believe that workforce planning is patient care planning. Every surgical schedule represents a patient who is counting on a qualified team to be ready.

Our responsibility as healthcare leaders is to build those teams with intention, support them well and create the stability patients and clinicians need. International nurse recruitment, when done thoughtfully and responsibly, can help make that possible.