Health Policy In Hiring Foreign Nurses Sample Essay

Understanding Nurse Migration

Nowadays, more and more healthcare institutions tend to hire foreign nurses. The rapid growth in the popularity of this profession is one of the reasons for the global nurse migration (Li, Nie, & Li, 2014). In this case, Jessica Smith, a nurse from Florida Hospital Orlando was interviewed to reveal some insights into the existent policy of hiring international specialists. This clinic site recruits foreign nurses, and they have to comply with the characteristics that are mentioned in the description of the position. Apart from that, nurses have to have a relevant certification from the accredited educational institution and sufficient work experience if necessary.

“Today, my workplace hires nurses from different countries. The majority comes from Canada and Asian countries”, Smith claimed (personal communication, January 12, 2017). It could be assumed that the hospitals recruit specialists from these regions since they have well-balanced theoretical knowledge and practice and a high potential for growth and development. As for the verification of the credentials, the potential RNs will need to contact the Credentials Evaluation Service to certify and approve their foreign qualifications. “Also, international nurses may need to pass TOEFL test and apply for visas”, Smith says (personal communication, January 12, 2017).

The transition of foreign nurses is accomplished with the help of various programs. In the first place, nurses can monitor and apply to open positions online via different job agencies. Alternatively, there are specialized websites such as Florida Hospital International Recruitment. It can help foreign healthcare professionals become team members at hospitals such as Florida Hospital East Orlando, Florida Hospital Celebration Health, and other locations (Florida Hospital, 2017). These organizations ease the application process and provide equal opportunities to qualified professionals from different countries.

Alternatively, it remains apparent that nurses need to participate in different programs to adapt successfully to a new cultural environment. These programs offer various case studies, training, and cultural activities. Smith (personal communication, January 12, 2017) claims that these programs are targeted not only at young specialists but also at the experienced medical staff and managers to improve their working conditions and create a friendly atmosphere at the worksite. Lastly, one cannot underestimate that migration of nurses has a positive impact on the patient-to-staff ratio. In this case, this ratio tends to be 1:2 and 1:1 in some departments of the medical institution. Consequently, fulfilling open positions with foreign specialists helps avoid shortages.

Research of the Country

The interview revealed that the majority of the foreign nurses were from Canada and the Philippines that are developed and industrialized countries respectively. The government of Canada provides a universal healthcare system, and it implies that medical assistance is available for free for the different layers of the population. It is majorly financed by the federal and national governments (Marchildon, 2013). Nonetheless, healthcare costs continue to increase while questioning the effectiveness of the proposed model (Marchildon, 2013). Speaking of the major health problems, surprisingly, Canada has high mortality rates among mothers and children (Marchildon, 2013). Apart from common diseases and illnesses such as cancer and HIV, it is one of the important issues to resolve since it has a negative impact on the wellbeing of the population.

Nonetheless, the authorities of the country tend to underline the significance of medical education. In this case, to become qualified specialists, the nurses have to complete a bachelor’s degree and pass national certification to become registered professionals (Marchildon, 2013). As for the shortage of nurses and physicians, it tends to be high in Canada. For instance, the number of practicing nurses per 1000 citizens has decreased from 11 in 1990 to 9 in 2009 (Marchildon, 2013). It could be said that a combination of the factors mentioned above could be discovered as one of the reasons for the migration of the nurses to the United States of America, as working in a foreign country helps fulfill their professional goals and have a competitive salary.

Position Paper

Today, globalization not only affects international trade but also the migration of the workers (Li et al., 2014). For example, now, registered nurses and practitioners have an extended variety of options in the United States of America. There are many programs that help them achieve their professional goals and adapt to different cultural environments. Nonetheless, in my opinion, it is necessary to improve transition and recruitment policies by providing consulting services and interesting orientation programs to the potential foreign applicants, introduce quotas to avoid shortage in personnel, and keep the relevant patient-to-nurse ratio, and clarify the verification procedures of the foreign certificates.

As it was mentioned earlier, a transition of nurses is one of the essential stages of the recruitment process. Consequently, these aspects have to be improved by introducing well-developed online portals. These websites should present relevant information about the recruitment process and the required documentation and provide assistance. Applying this strategy will offer more opportunities for foreign RNs since they will have a chance to learn more about the required documents and the country where they want to work. At the same time, it is necessary to reconsider and review policies concerning verifications of the certificates. The government has to design different standards that will be used to assess the eligibility of the candidates from foreign countries. In this case, improving this process will help ensure that the applicants have certified degrees and minimize the frequency of misunderstandings and medical errors.

In turn, it remains apparent that the constant migration of the workers may create an imbalance in the global healthcare system (Li et al., 2014). In this case, the governments of countries have to introduce a universal policy that will help control the number of foreign professionals hired by the medical institutions. In this case, establishing quotas will help avoid shortages and provide the appropriate number of working positions to the domestic professionals. Furthermore, when improving the recruitment process, one cannot underestimate the significance of cultural adaptations. According to the proposed policy, medical institutions and agencies must provide orientation programs if they hire international specialists. This strategy is believed to improve communication between the employees by increasing their awareness of the country and its customs and offering additional training (Xie, 2013).

In the end, based on the factors mentioned above, it could be said that the current recruitment process has gaps that have to be filled. Consequently, verification and adaptation programs have to be improved. Apart from the hospital’s patient-to-staff ratio, it is necessary to consider the shortages when hiring professionals from other countries since it can create an imbalance in the global healthcare system.


Florida Hospital: Hospital locations. (2017). Web.

Li, H., Nie, W., & Li, J. (2014). The benefits and caveats of international nurse migration. International Journal of Nursing Sciences, 1(3), 314-317.

Marchildon, G. (2013). Canada: Heath system review. Health Systems in Transitions, 15(1), 1-211.

Xie, Y. (2013). Cross-cultural communication barriers between staff in overseas-funded enterprises and management strategies for overcoming them. Journal of Languages and Culture, 4(4), 44-48.

The Federal Insurance Contributions Act: Economic Burden


Governments usually require taxes to meet expenses such as healthcare, security, and other public requirements. To raise the revenue, the government imposes taxes on goods and services as well as on the wages and salaries that employers pay and employees earn. In essence, payroll tax, such as the Federal Insurance Contributions Act (FICA), is a form of tax imposed on the wages that employees receive from a given firm. The tax appears as a deduction from an employee’s gross salary or wages. To minimize the effects of the tax on the employees, the government can at times impose laws that compel the employers to pay half of the tax. As a result, the employers pay half of the tax, and the employees experience minimal deductions from their payrolls, which represent half of the total payroll tax. Presently, the payroll tax in the United States is 7.65% for the workers and employers. It is within this context that the study explains the bearers of the economic burden of the payrolls and analyzes the effect of the economic burden shift that can result from a shift in unemployment.


The bearers of the economic burden resulting from payroll tax are both the firms and the workers. Notably, payroll tax aims to raise government revenues by deducting the amount of money that employees receive from firms. The implication of the deduction is increased wages and salaries by respective firms to minimize the effect of deductions on the employee’s net pay (Rubin, 2007). Consequently, the employees earn little pay as opposed to the actual gross salary or wage. When employees receive little pay and employers pay high salaries and wages due to payroll taxes, the implication is reluctance from employers to hire new employees and reduce the unemployment rate. As such, several students or individuals, who would opt for part-time or temporary jobs, demonstrate low demand. Since the workers and firms are subject to payroll taxes, reduced employment leads to minimal taxes, and thus, companies and workers end up sharing the economic burden of the payroll tax.

The tax incidence approach explains the distribution of tax among individuals, who dictate the economy. Therefore, since firms and workers are subject to payroll taxes, they dictate the economy. According to Hyman (2013), when an employee net pay drops because of the payroll tax, the demand for labor decreases. On the other hand, since payroll tax compels firms to increase wages or salaries that they pay to their workers, they become reluctant to hire additional workers. This reluctance is evident in goods and services, which are subject to taxes and price controls. Taxes, which tend to increase the price of a product, initiates reduced demand from buyers, whereas taxes or regulations that compel sellers to reduce the price of products create high demand from potential buyers. In the context of workers and firms, workers can represent goods whereas firms represent buyers, and the wages or salaries can represent the price. In the aspect of the economic principles, a price increase leads to decreased demand for the product and minimal sales, whereas a reduction in price occasions an increase in demand.

Fundamentally, the shift in the economic burden when the rate of unemployment changes from 9% to 5% is minimal since the government imposes taxes on individual payrolls. Boeri and Ours (2008) assert that when the unemployment rate reduces, revenues that the government earns increase. Increased revenues transpire because of the increased number of individuals working in various firms. These individuals pay their taxes, and in turn, boost revenues that a particular government receives. Conversely, the economic burden does not demonstrate a pronounced change. The minimal change in economic burden is because salaries and wages paid by a firm increase, while the number of workers who remit taxes rises. It is imperative to understand that regardless of the increased rates of employment, which can shift unemployment rates from 9% to 5%, wages or salaries paid by firms and earned by employees would not display a major change in the distribution of the economic burden.

Evidently, taxation of payroll taxes on firms, workers or its division between firms and workers cannot create a substantial impact on the economic burden. In relation to the economic principles, when the price of a commodity increases due to taxation, its demand goes down. Therefore, by imposing payroll tax exclusively on firms, the government subjects them to a lot of pressure, which can result in reduced wages and salaries. Moreover, the firms become reluctant to hire new employees as the tax affects their willingness to hire. Goerke (2002) explains that high taxes imposed on firms lead to high rates of unemployment and low wages or salaries especially for those employees, who work in the technical departments. Reduced wages and salaries occasion as the firms attempt to pay the additional taxes imposed on them. When salaries reduce, demand for labor decreases because several employees may not like to work and receive low wages or salaries. As such, the labor market experiences scarcity in the quantity of labor required by firms.

On the other hand, when the government shifts the tax exclusively on the workers, wages and salaries reduce. The reduction of wages or salaries occurs due to the reduced taxes deducted from workers’ gross earnings. As a result, a number of workers would opt out of the labor market and look for alternative ways of raising income. When workers exit the labor market, a scarcity of labor develops, and firms fail to get sufficient workforce required in their respective departments. Consequently, a division of payroll tax between firms and employees means that the amount of tax paid by the firms and the workers is half. The employee’s net pay is subject to deductions, which represent half of the total amount required by the government (Mankiw, 2015). Furthermore, firms pay half of the payroll tax, a factor that makes them and the workers share the burden. Apparently, the challenges presented by taxation methods are similar, and as such, it is evident that exclusive taxation or division of taxes between firms and workers does not have a pronounced differential impact on the economic burden.


Payroll tax helps the government raise revenues that are essential for its growth and development. The taxes are deductions that the government deducts from the gross pay of employees working in a given firm. In most cases, the government dictates firms and workers share the total amount of payroll tax. As a result, firms and workers pay half of the total payroll tax required by the state. In relation to the principles of economics, the changes occasioned by different methods of taxation are minimal on the economic burden. The minimal changes in taxation, whether on firms, workers, or division between firms and workers, leads to a shift in demand and supply of labor and employment rate.


Boeri, T., & Ours, J. (2008). The Economics of Imperfect Labor Markets. Princeton: Princeton University Press.

Goerke, L. (2002). Taxes and Unemployment: Collective Bargaining and Efficiency Wage Models. Boston, MA: Springer.

Hyman, D. (2013). Public Finance: A Contemporary Application of Theory to Policy. New York: Cengage Learning.

Mankiw, N. (2015). Principles of Microeconomics, 7th Edition. New York: Harvard University.

Rubin, M. (2007). Beyond Paycheck to Paycheck: A Conversation about Income, Wealth, and the Steps in Between. Portsmouth: Wachtel & Martin.

Language Acquisition And Brain Development In Children


The connection between brain development and the acquisition of language is the subject of numerous debates throughout the history of scientific thought. Particularly, since the beginning of the 20th century, the discussion about this connection became more profound and diverse because significant discoveries have been made in this period. Therefore, scientists and scholars became more capable of investigating how language shapes the development of the brain. However, to this day the discussion is far from being complete since numerous aspects of neural mechanisms, which are responsible for learning languages, are not studied enough. Thus, the purpose of this paper is to give an overview of the recent academic literature on the topic in order to understand how contemporary scholars perceive the issues related to language acquisition and brain development.

Brain Development and Exposure to Language

It could be hardly doubted that childhood, as well as adolescence, are the most important periods in terms of the overall development of the human organism, concerning both physical and psychological development. This statement, to a great extent, relates to the process of language learning since the majority of scholars agree that at the early stages of life, people are more capable of acquiring new information, and thus form new neural patterns. However, the particular aspects of this learning process are not always studied by researchers from the perspective of neuroscience and the article by Romeo et al. (2018) is a significant example of such research.

Based on the sample of 36 children from different socioeconomic status groups aged 4 to 6 years, the authors employed the method of magnetic resonance tomography (MRI) in order to investigate how the participants will react to the listening task. This study is highly important since it is the first research that empirically proves the existence of “the neural activation patterns underlying the relation between children’s early language exposure and verbal skills” (Romeo et al., 2018, p. 8). The researchers emphasize the importance of active communication between children and adults because, according to the results of the study, such communication plays a highly significant role in the process of brain development (Romeo et al., 2018). Children who had more conversational experience with their parents showed greater activation in left inferior frontal regions (Romeo et al., 2018). Thus, it is apparent that there is scientific evidence of the connection between the development of neural mechanisms and exposure to language and communication.

The Concept of Bilingualism and Its Impact on the Brain Development

In addition to the facts identified in the previous section, it is highly important to investigate the concept of bilingualism and the age of language acquisition in their connection with brain development. The article by Berken, Gracco, and Klein (2017) explores these ideas, focusing on the question of the particular ages in which language acquisition is more efficient. The authors employ the method of task-based and resting-state functional magnetic resonance imaging (fMRI) to study “differences in brain structure and function between simultaneous and sequential bilingual” (Berken et al., 2017, p. 220). Berken et al. (2017) argue that brain development is largely determined by “a series of nested optimal periods of variable onset, offset, and duration that are influenced by both pre-programmed molecular signals and sensory experience” (p. 225). It is also noted that brain stimulation induced by the bilingual environment that occurs on the microscopic level during the prenatal period, can significantly affect the child’s language learning ability (Berken et al., 2017).

However, the most important conclusion that could be retrieved from the study by Berken et al. (2017) is that simultaneous acquisition of two languages in the early stages of life stimulates the brain development to an immense extent. A different conclusion is developed by Klein, Mok, Chen, and Watkins (2014). Klein et al. (2014) state that simultaneous bilingualism has no significant impact on the brain development; however, acquisition of the second language when the proficiency in the native language is reached could be very stimulating for the brain (Klein et al., 2014).

Socioeconomic Factors that Shape the Brain Development

Another aspect of the topic under discussion that is worth mentioning is the influence of socioeconomic factors on brain development. The article by Hair, Hanson, Wolfe, and Pollak (2015) investigates this question, with particular attention to the impact of the social environment of children’s academic performance and language proficiency. It is concluded by the authors that exposure to poverty has a significant impact on the development of the temporal lobe of the brain, which is responsible for language acquisition and use. It is also appropriate to mention the study by Romeo et al. (2018), in which the authors, along with the investigation of the neural mechanisms related to language acquisition, explore how socioeconomic status influences the language capacities of children.


In conclusion, it should be stated that the question of the connection between brain development and language acquisition is evidently presented in the recent academic literature. This paper exemplifies several topics that are currently being elaborated by scholars. Overall, it is possible to observe that significant progress is made in the identified area of concern.


Berken, J. A., Gracco, V. L., & Klein, D. (2017). Early bilingualism, language attainment, and brain development. Neuropsychologia, 98, 220-227, Web.

Hair, N. L., Hanson, J. L., Wolfe, B. L., & Pollak, S. D. (2015). Association of child poverty, brain development, and academic achievement. JAMA Pediatrics, 169(9), 822-829, Web.

Klein, D., Mok, K., Chen, J. K., & Watkins, K. E. (2014). Age of language learning shapes brain structure: A cortical thickness study of bilingual and monolingual individuals. Brain and Language, 131, 20-24, Web.

Romeo, R. R., Leonard, J. A., Robinson, S. T., West, M. R., Mackey, A. P., Rowe, M. L., & Gabrieli, J. D. (2018). Beyond the 30-million-word gap: Children’s conversational exposure is associated with language-related brain function. Psychological Science, 29(5), 700-710, Web.

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