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Abstract: This paper empirically examines the source of the returns to bilingual registered nurses (RNs) in the United States. Bilingual RNs are found to earn higher wages than monolingual nurses. A direct measure of fluency in a language other than English is used to examine the source of the bilingual wage premium. Two avenues for the premium are examined, (1) a response to demand for bilingual workers and (2) a response to accounting for a portion of innate ability and skills that would otherwise have been unobserved by the employer. Regressing interactions of various language regions and fluency indicators provides limited evidence for the premium arising from an increase in demand for bilinguals. The majority of the premium is due to accounting for levels of skill and ability that would otherwise be unknown. [Copyright &y& Elsevier]