It’s 2025, and healthcare systems across the U.S. are still facing a serious nursing shortage. Internationally educated nurses (IENs) are stepping up to fill the gap, but many programs aren’t setting them up for success. These programs need to provide the kind of all-in support nurses need, both professionally and personally.
Insight Global Health (IGH) experts Jose Arnold Tariga, Mel Tedesco, and Damaris Delp recently joined Becker’s Healthcare Podcast to discuss this need. Let’s look at some of the ways IGH works to support its nursing workforce and how your international nursing program can pivot to better care for its nurses.
Supporting Nurses Through Transitions
Of the current workforce of 4.7 million nurses, 16% are IENs. However, many IENs struggle in their new environment. Jose Arnold Tariga, Director of Clinical Education and Development at IGH, creates clinical and personal development curricula based on his own experiences as an IEN. He explains, “As much as these nurses come with a lot of experience, they need tailored support because there are a lot of nuances in terms of where they previously worked and when they come to the United States.”
These nuances range from unfamiliar electronic health record systems to cultural expectations around communication and advocacy. Without proper preparation, IENs often struggle to adapt, and this can negatively impact both patient care and employee retention.
The challenges IENs face go beyond clinical skills and are deeply rooted in the personal journey of relocation. “Moving to a new country is just a big feat. It takes a lot of bravery,” says Damaris Delp, Senior Manager of U.S. Operations and Nurse Experience at IGH. She emphasizes that supporting nurses through the personal aspects of relocation—such as securing housing, enrolling children in school, and navigating credit systems—is essential to their professional success.
This sentiment is echoed by Mel Tedesco, Executive Director at IGH International: “Getting [placed internationally] is one step, but then how do you acclimate and really make that your home? That’s where our team really steps in.”
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Nursing Program Best Practices
IGH has built a proactive, people-first support system that helps IENs hit the ground running. Here are four foundational practices IGH uses to set our international nursing programs up for success.
Pre-Arrival Preparation
Nurses receive training before arriving in the U.S., including exposure to U.S.-grade simulation labs at IGH’s Great Academy in the Philippines. “We simulate an actual shift […] so that when they come [to Manila], they feel like, ‘Oh, I’ve done this already, and this is not something that’s new to me, and therefore I can really make sure that I provide high-quality care for the patient.’” says Tariga.
Structured, Simulation-Enhanced Orientation
Beyond online modules, nurses engage in hands-on simulations that mirror real-life scenarios. Nurses practice full shifts, patient handoffs, electronic medical record (EMR) documentation, and equipment use before arriving. This allows them to feel confident in their abilities and work structure from day one.
Dual-Support Model
Training both the incoming nurses and the teams receiving them is key to integrative success. This ensures cultural humility and effective communication on both sides. “I think [our] main differentiator […] is that we have a proactive approach. And by proactive, I mean that we do the training even before the nurses arrive,” Tariga says. “We need to make sure that we train our team [onsite] so that they can help provide that environment wherein the nurses can really thrive.” This proactive approach not only shortens onboarding time but reduces burnout for existing staff on every side.
Ongoing Holistic Support
Immigration and clinical readiness shouldn’t be the sole focus during your nurses’ transition. Programs should remember to recognize the emotional toll of relocation and lean in hardest during the “culture shock” period. This period is typically between two and four months post-arrival.
Delp maintains that the type of support IENs experience during this sensitive time is key to alleviating personal struggles and setting IENs up for long-term success. Tariga adds, “It’s not just about focusing on making sure that you are clinically competent [as an IEN]. You have to be also prepared and make sure that you know what the culture is in the community that you’re going to be living in, because you’re going to be living or moving your life there.”
The more programs can do to prepare their nurses for this transition, the better.
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Pathways to Success for International Nursing Programs
Most healthcare organizations begin transition programs only after the nurses arrive. This reactive approach can leave nurses overwhelmed and underprepared. “My training [as an IEN] started only when I was stateside,” recalls Tariga. “I was so stressed because I didn’t know what to prepare and what to expect.”
Sometimes, IENs can be viewed as temporary fixes rather than long-term investments. “We should make sure that we build the bridge for these IENs because hiring internationally educated nurses is not really just about plugging holes in our staffing,” Tariga says. “It’s really about investing in people who can bring diversity, experience, their expertise, and even resilience to our workforce.” He maintains that strengthening your entire care culture leads to better outcomes for your patients.
To create successful programs, healthcare organizations should consider the following strategies:
- Start training before arrival: Equip nurses with clinical and cultural knowledge in their home countries.
- Invest in simulation-based orientation: Provide realistic, hands-on training that mirrors U.S. hospital workflows.
- Support the whole person: Address housing, transportation, family needs, and emotional well-being.
- Train receiving teams: Foster cultural humility and communication skills among U.S.-based staff.
- Respond to emotional transitions: Recognize and support nurses through culture shock and adjustment phases.
- Build long-term relationships: Focus on retention by understanding each nurse’s personal goals and matching them with the right client.
Build Your International Nursing Programs with Insight Global
At Insight Global, we’re passionate about building stronger teams that last. As Tedesco puts it, “We hope to be a long-term partner to health systems and be able to help them stabilize and build a sustainable workforce.”
We’re here to help you do more than just hire. We’re your partner in onboarding, development, and long-term success through our professional services. Whether you’re starting fresh or leveling up an existing international nursing program, we’re ready to be your partner every step of the way. From pre-arrival prep to cultural integration and retention strategies, we’ve got your back in building a nursing workforce that thrives.
by Celine Pham 