In BMJ Open, Hayley Germack and colleagues, including Linda Aiken, examine the association between patient satisfaction with nursing care in National Health Service (NHS) hospitals in England and the proportion of non-UK educated nurses providing care. The authors used data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. They found a significant association between the percentage of non-UK educated nurses providing bedside care and patient satisfaction; hospitals with higher percentages of non-UK educated nurses had lower patient satisfaction. Each 10-point increase in the percentage of non-UK educated nurses decreased the odds of patients reporting good or excellent care by 12%, and decreased the odds of patients agreeing that they always had confidence and trust in nurse by 13%. Their findings suggest importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care.