Now You Know | Staffing Agency vs. Direct Hire for US Nurses

September 08, 2020  |  Unistaff

Direct Hire vs Agency Hire article header

Hey nurse heroes, welcome to our page! We know how challenging it is to land your dream job abroad. There’s so much you need to know!

Don’t worry, we’re here to support you with informative articles crafted to keep you right on track. We connect you with verified partners and link you to reliable sources. You’ll have everything you need to make the right decisions and feel confident to take action. Stick with us and make sure you read until the end of this installment of: Now You Know!


“Do I secure my employment through a direct hire facility or through a staffing agency?”


You might have been asking yourself this question as you think about getting a job in the United States. We have helped thousands of nurses navigate this complex journey. In this article, we put together some helpful points to help you gain a better understanding, and effectively weigh the pros and cons of both possible avenues for your career.

Securing employment abroad can do wonders for both your career and your personal growth. Working in a different country may be your goal, but the routes to get there are wildly different. It will definitely take time and effort. The process is complex, lengthy and there are various expenses to deal with along the way. 

For the majority, they obtain their ticket to working abroad by going through staffing agencies. They publish overseas jobs, facilitate the whole recruitment process, all the way through the final steps to get a candidate officially hired by a multinational company.

In comparison, other eligible candidates may choose to get hired directly by an overseas company, in compliance with POEA’s rules and regulations.

If you are thinking about accepting a nursing or healthcare professional position in the United States, it is important to understand that not all job offers are created equal. Since the US is currently facing a huge nursing shortage, it can mean that there is a surplus of healthcare job roles. Basically, there are more jobs than there are qualified professionals to fill them with.

There are many different potential employers out there offering varying employment packages. It is crucial that you carefully examine every detail of the offer you receive. It is your responsibility to ensure that the full package meets your needs. We can not stress this enough. 

You may have heard it before, but it’s so important that it bears repeating -- explore your options! Take time to review your employment options before committing to one employer. Keep in mind that what works for someone else may not necessarily work for you and vice versa. 

So, which route would work best for you? Understanding where you’re coming from is key to know where you want to be and how you will get there.


When you apply for a nursing job in the United States you generally have two options – 

(1) Direct Hire: a job offer and contract from a direct healthcare facility or, 

(2) Staffing Agency: a job offer from a nurse placement agency that contracts your services to a healthcare facility


What is direct hire for nurses? 

US Direct Hire Nurses

A direct hire means recruitment is made directly by a company, or through an employment agency, to fill a long-term need. 

Direct hires are recruited by Professional Employer Organizations (PEO) or by staffing agencies. Once the job is accepted, the candidates become permanent employees of the hospital or healthcare facility. And they will typically receive the same pay and benefits as regular staff members of the company or facility.

Employment contracts signed into by the hired candidate will be under the hospital’s or healthcare facility’s name, and not the staffing agency’s. 

For direct hire, the hospital or healthcare facility will act as the green card sponsor. 

Since the application process is quite complex and lengthy, it may be worth noting that many nurses seek assistance with their US, application process particularly around these subjects:

  1. The CGFNS

  2. The NCLEX Application

  3. Testing and Licensing Costs

  4. License Processing

  5. The IELTS

  6. The VisaScreen

  7. EB-3 Priority Dates

We at Universal Staffing (UNISTAFF) offer direct hire opportunities. We can assure you that we actively partner only with verified and reputable US counterparts who work just as hard as we do to make sure that our nurse candidates get through all the processes listed above!


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What is a staffing agency for nurses? 

US Staffing Agency Hire

Universal Staffing (UNISTAFF) also works with verified staffing agency partners. The process of getting hired by a staffing agency works in a slightly different way. 

A staffing agency hire means that the successful candidate secures a job at one of our US partner agency’s many healthcare organizations. They know which specific healthcare facility they have been matched with before they depart for the US. And they will have been contracted by the healthcare organization for the position in which they were interviewed and hired. 

These candidates who accept the job have their services contracted by the staffing agency to the hospital where they will work -- hence they may also be called, “contract hires.” 

The contract typically lasts two to three years. After which, the candidate will have the freedom to either apply for a permanent position within the same healthcare facility they’ve worked with, or choose to move to a new state. If they choose to, they can also make an effort to find another employer with referrals from their current facility.

In this case, the staffing agency they work with will be listed as their green card sponsor, not the healthcare facility. 


Who pays for placement fees?

Although some staffing agencies impose placement fees, Universal Staffing (UNISTAFF) has not, does not and will not ever require any placement fees or salary deductions to successfully hired nurses. We also do not charge any application fees to anyone who submits their resumes or CVs to us. We work hard to help talented nurses who have applied to us match with our clients at no cost to candidates. Over decades of operation in the industry, Universal Staffing (UNISTAFF) receives agency fees from their US counterparts, never from candidates. Universal Staffing (UNISTAFF) is extremely happy to have helped thousands of nurses to fulfill their dreams of working in the USA. 


Now you know! Here are the differences between direct hire and staffing agency

Direct Hire VS Staffing Agency

Still confused? That’s totally alright, no worries! We got you covered. To make things easier, we captured the differences between these two processes in this chart. 

Sharing is caring! Take a screenshot and share this information with your friends to help them understand, too.

Now you know!




How can Universal Staffing (UNISTAFF) help you?

USCDP program photos


Universal Staffing (UNISTAFF) has decades of experience working with numerous reputable employers globally and deploying thousands of nurses to the US and several other countries. We understand how complicated the application process is. It is time-consuming because of the amount of work and effort required to complete the demanding procedure.


When healthcare companies lack the network, expertise, resources, or have just struggled to fill their role vacancies on their own, they will often work with a recruitment agency that specializes in a particular skill set or locale to identify qualified individuals.


Universal Staffing (UNISTAFF) has the experience and expertise when it comes to working with employers and nurses alike to help professionals come to the US to work. We have been working with most reliable US employers, both through direct hire and staffing agencies. We have helped thousands of Filipino nurses get successfully placed, and they’re now living the American dream with their families.


Get to know our direct hire US employers!

PPS apply now CTA


Get to know our staffing agency partners, too!

Universal Staffing (UNISTAFF) works with well-regarded US staffing agencies. Professional Placement Services (PPS) is just one of our US employers who offer EB-3 Visas to qualified nurses who have gone through interviews and have successfully completed all that is required of them. 

Universal Staffing (UNISTAFF) and PPS have been working together since its inception, and together, we have helped thousands secure their dream jobs.

While most US employers require you to obtain working experience in a tertiary hospital in order to qualify. With PPS, if you are currently employed in a secondary hospital with the job role required, you still have a high chance of being interviewed and qualifying for it. They may also consider you for other roles that match your profile and experience. 

You already know by now that obtaining employment in the US with a reputable employer is not easy. To help you out with the complex procedures involved, we created the United States Candidate Development Program (USCDP)! Join this program to gain access to the latest information, job openings and expert advice to help you navigate the process of becoming a U.S. Registered Nurse and achieving your dreams of working abroad.  Best of all, you can become a member for free! Register now!

If you have any questions, contact us anytime. We’ll see you at one of our future orientations!




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Unistaff Content Team

This article was put together by Unistaff's team of researchers, creative writers and content creators. We pride ourselves by publishing the most updated pieces of content in our blog section to enable you to make well informed decisions.

Universal Staffing Services, Incorporated

Universal Staffing Services Inc. (POEA License No. 35-LB-022019-R) has been a trusted International Permanent Staffing Firm for more than two decades, maintaining its prestige and reputation as one of the best in the country. Our source of pride comes from placing over 30,000 top-class professionals in the Gulf Region, Africa, South Asia, South-East Asia, United States, and Europe in Academic, Engineering, Skilled, Administrative, Hospitality, IT and Healthcare settings.

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