In today’s competitive healthcare environment, hospitals across the United States are under intense pressure to reduce labor costs, stabilize staffing, and maintain high-quality patient care. One health system that has made remarkable progress on this front is Mercy, based in Chesterfield, Missouri.
Mercy has successfully cut its spending on agency nurse staffing by 50% through a strategic mix of flexible scheduling, internal workforce development, and cutting-edge AI tools. For healthcare organizations exploring long-term staffing solutions including hiring international nurses Mercy’s model offers valuable lessons.
At VisaMadeEZ, an immigration law firm focused exclusively on helping healthcare organizations hire international nurses, we closely follow these workforce trends. Understanding how systems like Mercy are reducing dependency on agency nurses can help facilities develop more sustainable strategies that combine domestic and international recruitment.
Flexible Scheduling: “Mercy Works on Demand” and the Gig-Style Nursing Model
A cornerstone of Mercy’s staffing transformation is its “Mercy Works on Demand” app. This internal platform allows nurses to self-schedule shifts across multiple facilities in a gig-style model.
Instead of relying heavily on external agency nurses, Mercy gives its own nurses more control over when and where they work. This on-demand nursing model:
- Allows nurses to pick up extra shifts across the system
- Increases flexibility and autonomy for staff
- Helps fill hard-to-cover shifts without turning to travel nurses
- Enhances engagement and satisfaction among existing staff
According to Mercy leadership, this approach has resulted in an 86% fill rate for open shifts and contributed to a 12% reduction in overall care delivery costs. That is a significant achievement in an industry where staffing gaps often translate directly into higher expenses and burnout.
For hospitals and health systems that are recruiting international nurses, this type of flexible scheduling infrastructure is especially valuable. When international RNs arrive, they are more likely to thrive in environments that support work-life balance, predictable scheduling, and transparent staffing practices.
Building an Internal Pipeline: “Win From Within” and Workforce Development
While technology and scheduling flexibility have played a major role, Mercy has also invested heavily in developing its own workforce.
The system expanded its “Win From Within” program to 20 hospitals, offering:
- Tuition coverage for individuals pursuing nursing degrees
- Part-time roles within the system while they train
- Clear pathways into nursing positions after graduation
More than 340 caregivers are enrolled for the spring 2026 semester, adding to the 671 who have already participated over the past year. This internal pipeline helps Mercy grow its own supply of nurses over time, reducing reliance on external staffing agencies and travel nurses.
From an immigration and international hiring perspective, this is a critical point:
Healthcare organizations that invest in both internal training and international nurse recruitment tend to be more stable and resilient. Domestic pipelines alone often cannot keep up with demand, especially in specialized units or rural locations. International nurses, particularly those on EB-3 green card pathways or other long-term visa options, can complement these internal pipelines and provide a reliable, permanent solution to chronic staffing shortages.
Technology & AI: Dragon Copilot and Smarter Documentation
Mercy has also taken a forward-looking approach to nurse workload by tackling one of the most time-consuming parts of clinical practice: documentation.
In collaboration with Microsoft and Epic, Mercy co-developed Dragon Copilot, an AI-powered ambient documentation tool. Rolled out in February 2025, this solution listens to clinical encounters and assists with generating accurate, structured documentation.
The results so far have been impressive:
- Documentation accuracy improved from 30% to 90% across pilot units in Missouri and Arkansas
- Nurses and providers spend less time charting and more time on direct patient care
- Administrative burden is reduced, which helps mitigate burnout
For both domestic and international nurses, documentation can often be a significant source of stress, especially in highly regulated healthcare environments like the U.S.
When hospitals implement tools like Dragon Copilot and other AI-driven solutions to streamline documentation, they create a more supportive environment for all nurses including internationally educated nurses who may be adjusting to new charting standards, EHR systems, and regulatory requirements.
Reducing Burnout and Improving Retention
According to Stephanie Clements, Mercy’s senior vice president and chief nurse executive, the combination of:
- Flexible staffing via “Mercy Works on Demand”
- Internal education pipelines like “Win From Within”
- AI-enabled tools such as Dragon Copilot
has helped the system reduce burnout, retain experienced nurses, and build a more sustainable nursing workforce.
This is directly aligned with what we see across the healthcare organizations we advise at VisaMadeEZ:
- Facilities that prioritize nurse well-being and flexibility retain staff longer.
- Organizations that align technology, education, and staffing models are better positioned to integrate international nurses successfully.
- A thoughtful workforce strategy reduces short-term crisis hiring and reliance on high-cost travel nurses.
What This Means for Healthcare Organizations Hiring International Nurses
Mercy’s success does not mean the need for international nurses is disappearing far from it. In many regions, demand still dramatically outpaces the supply of U.S.-trained nurses.
However, it does highlight an important shift:
Sustainable staffing models now combine:
1. Internal training and upskilling
2. Flexible scheduling and internal float pools
3. Smart use of technology and AI
4. Strategic international nurse recruitment
Hospitals that rely solely on travel nurses or short-term agency contracts may find it increasingly difficult to control costs and maintain continuity of care. By contrast, healthcare systems that build a balanced strategy including hiring international nurses on permanent or long-term bases can stabilize their workforce and reduce volatility.
At VisaMadeEZ, we help healthcare organizations integrate international nurse recruitment into a broader staffing vision. Our services include:
- Immigration strategy and visa planning for international nurses (including EB-3, H-1B where applicable, and other categories)
- Compliance guidance for healthcare employers sponsoring foreign-trained nurses
- Coordination with HR, recruitment teams, and credentialing bodies
- Long-term workforce immigration planning tailored to each facility’s needs
How VisaMadeEZ Supports Your Nursing Workforce Strategy
If your organization is looking to:
- Reduce reliance on agency and travel nurses
- Build a stable core team of full-time RNs
- Integrate international nurses into a sustainable staffing plan
- Ensure full immigration and regulatory compliance
VisaMadeEZ can help you design and execute an immigration strategy that supports those goals.
By combining:
- Proven immigration law expertise in healthcare
- A deep understanding of nurse staffing challenges
- Knowledge of trends like Mercy’s flexible scheduling and AI adoption
we help hospitals and health systems create long-term, cost-effective solutions to the nursing shortage.
Ready to Explore International Nurse Hiring?
Mercy’s story shows what’s possible when a health system embraces innovation, technology, education, and smarter staffing models. For many organizations, the missing piece is a structured, compliant, and scalable international nurse recruitment program.
If your facility is ready to:
- Supplement your internal pipelines with highly qualified international nurses
- Develop a long-term immigration strategy for your nursing workforce
- Move away from reactive staffing and agency dependency
VisaMadeEZ is here to guide you through every step of the process.
Contact VisaMadeEZ today to discuss how a strategic international nurse hiring program can support your organization’s goals and help you build a stable, sustainable, and globally diverse nursing workforce.
