PassportUSA Chief Nursing Officer Earl Dalton, MHA, MSL, RN, NEA-BC, has over 20 years of acute hospital experience and is an award-winning director in various healthcare settings. He is an international speaker on the topic of transforming care at the bedside, and is a creator of many innovative and successful magnet implementations.

We recently sat down with Earl to discuss nursing in the U.S. and what international nurses moving to America should know before they arrive.


PassportUSA: What should new nurses know about the U.S. healthcare system before beginning work in America?

Earl Dalton: Thinking big picture, healthcare is a trillion-dollar industry in the United States. Recent changes in the industry, including the Affordable Care Act, have altered the ratio between quality care, patient experience, and reimbursements to the hospital. As the “Baby Boomer” generation continues to age, staffing demands in healthcare facilities continues to outpace the supply of nurses and other medical professionals.

PassportUSA: What regulatory agencies affect the bedside RNs in the U.S.?

Dalton: There are two key regulatory agencies to be aware of: The Joint Commission and the Magnet program. The Joint Commission is an active governmental body that inspects hospitals and other healthcare organizations to ensure they are meeting the requirements set. Magnet status is achieved by hospitals who commit to the American Nurses Credentialing Services’ Magnet model, and requires a massive level of commitment from both hospital leadership and the division of nursing within the facility.

PassportUSA: What core competencies should a nurse have before working in a U.S. healthcare facility?

Dalton: In terms of U.S. patient care, the nurse is often the most influential voice on a large and robust multi-disciplinary team. This means that the RN must have high technical, communication, customer-experience skills.

PassportUSA: How are internationally-trained nurses perceived in U.S. hospitals?

Dalton: In a survey with over 10 years of sampling and 650 responses from CNOs and other hospital administrators, over 95% of respondents said that international nurses that have worked in their facilities have show an average or above-average quality of clinical skills and competency. In that same survey, over 97% of respondents said that international nurses that have worked in their facilities appropriately communicated with patients, families, and other patient-care members at an average or above-average level. 99% of respondents reported that the level of cooperation and teamwork of international nurses, in their experience, has been average or above-average. Simply put, international nurses have been well-received by U.S. hospital administrators and staff, and are well respected within the American healthcare industry.


Earl serves as an advocate to all PassportUSA RNs, including those who are currently working in the U.S. and those preparing for their first assignment. To learn more about our CNO and his team, reach out to PassportUSA today.

If you’re interested in working as a nurse in the U.S., contact PassportUSA now by clicking the button below and filling out the registration form.

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