Reliance on such a large proportion of expatriate nurses contributes to several issues, specifically, how they are recruited.Sometimes nurses are very disappointed because of workload allocation.These nurses are usually recruited through agencies based in countries, such as India and Philippines, with few systems or controls in place to ensure standards are followed.These nurses bring an additional workload for other experienced nurses, as the latter are required to teach and monitor the novice nurses, while still undertaking their usual duties.Furthermore, the requirement for nurses is great to the point that average quality is endured, adding to the disappointment of the nurse leaders and the more talented nurses.A high workload is likely to reduce nursing care quality and increase risks to patient care outcomes, which can negatively impact patients' satisfaction.This then contributes to a higher workload for these nurses.