Is the Grass Still Greener? Examining Trends in Canada to US Nurse Migration (Mar 2011)

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Title: Is the Grass Still Greener? Examining Trends in Canada to US Nurse Migration
Principal ApplicantTitle(s)Institutional AffiliationFunding AmountAnticipated Completion Date
Dr. Linda McGillis Hall Professor and Associate Dean Research and External Relations, Lawrence S. Bloomberg Faculty of Nursing at University of Toronto $25,000 March 2011
Co-Applicant(s)Titles(s)Institutional Affiliation(s)
Dr. Cheryl B. Jones Associate Professor School of Nursing at University of North Carolina, Chapel Hill
Dr. George H. Pink Humana Distinguished Professor Dept. of Health Policy and Management, Gillings School of Global Public Health at University of North Carolina, Chapel Hill
Dr. Peggy Leatt Professor and Associate Dean Gillings School of Global Health at University of North Carolina, Chapel Hill
Dr. Michael Gates Assistant Professor San Diego State University
Dr. Jessica Peterson Associate Professor Lawrence S. Bloomberg Faculty of Nursing at University of Toronto

 linda-mcgillis2Biography of Principal Investigator: Linda McGillis Hall, RN, PhD, FAAN, FCAHS, is a Professor at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.

She is a recognized leader in nursing health services and systems research and is the first Canadian nurse to be inducted as an American Academy of Nursing International Fellow (2007), is the inaugural recipient of the Canadian Nurses Association Order of Merit for Nursing Research in Canada (2008), and was inducted as a fellow of the Canadian Academy of Health Sciences in the fall of 2010. Her research has also earned her a Ministry of Health and Long-Term Care [MOHLTC] Nursing Senior Career Research Award (2009-2012), a Canadian Institutes of Health Research [CIHR] New Investigator Award (2002-2007), and a Premier’s Research Excellence Award from the Government of Ontario (2003-2008). 

She has developed a research program focusing on health human resources, the nursing work environment and how this influences nurse migration and nurses’ health, and patient safety outcomes of nursing practice.


A great deal of policy attention globally has been directed towards the shortage of nurses. Initial work in this area has focused predominantly on issues related to the supply and demand for health human resources (HHR). While efforts are underway in Ontario to examine nursing HHR planning from a more needs-based perspective, little attention has been directed to the area of nurse migration. The objectives of this research relate to the issue of nurse retention in Ontario and Canada, the factors related to nurse migration and the policy directions necessary to make effective change.

Recent workforce projections identify that there are currently 251,675 nurses employed in Canada. A report released by the Canadian Nurses Association predicts a nursing shortage that will reach 78,000 by 2011 and increase to 113,000 by 2016. At the same time, it has been projected that the US will face a shortage of over a million nurses by the year 2020. These numbers are staggering and affirm the urgency with which the US is recruiting foreign-educated nurses to cope with the nursing shortage. A study of international mobility trends, reported that recent graduates employed in the US were most likely to come from Canada. Preliminary work conducted by McGillis Hall and this team of researchers identified that substantial increases in Canadian nurse migration to the US occurred between 1990 and 1999. Specifically, full-time work opportunities and the potential for ongoing education were key motivators for Canadian nurse mobility to the US, and of particular importance to baccalaureate-prepared nurses. Despite national attention to HHR, quality fo worklife and the work environment for nurses in Canada, data from the US National Sample Survey of Registered Nurses conducted in 2004 indicated that there were now 100,791 foreign-educated nurses working in the US, and 20% (i.e., 20,359) of these are from Canada. Of critical importance to Canadian policy makers, is evidence that the percentage of Canadian nurses in the US had risen from 16% in 2000 to 20.2% in 2004. This suggests that Canadian nurses were continuing to migrate to the US. The results of the 2008 NSSRN are about to be released in the US providing the opportunity for this research team to conduct further investigation to determine if this disturbing trend continues. This current study proposes to use the most recent NSSRN data conducted in 2008 to describe Canadian-educated nurses in the US; identify differences between Canadian-educated nurses in the US and US educated nurses; compare, at an aggregate level Canadian-educated nurses in the US to RNs in Canada; and conduct a comparative analysis of differences over time (to earlier work conducted by this research team on the 1996, 2000 and 2004 NSSRN) of Canadian-educated nurses in the US and US educated nurses.

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