FOREIGN NURSES have been denied American visas for more than a year even as the healthcare industry struggles to deal with a shortage, according to healthcare recruiters and hospital executives.
The effects of the nursing shortage could be softened by bringing in international nurses to help stabilize the industry long enough to “grow our own,” a top hospital executive has said. However, labor analysts say the U.S. government is treating the visa distribution as an immigration and border security issue.
“One of the issues is that there are not enough nurses coming out of the U.S. today,” said Jim Goodloe, senior vice president of the Tennessee Hospital Association. “We have a lot of nursing vacancies that aren’t being addressed, and we’re not being allowed to bring nurses in internationally. We need help to give us time to fix the real problem of producing enough nurses ourselves.”
The THA reported a 5.4 percent vacancy rate for nursing positions in 2006, meaning there were about 1,500 nurse positions unfilled in hospitals. Other vacancies exist in the state’s nursing homes, skilled nursing facilities and outpatient care sites.
Nationwide, some 8.5 percent of all nursing positions are vacant, and the nation will need an estimated 1.2 million nurses by 2014, according to the U.S. Department of Labor.
The Joint Commission on Accreditation of Healthcare Organizations estimates that low staffing levels are a contributing factor in one out of every four hospital deaths. In response, California has established minimum staff-to-patient ratios in hospitals.
While foreign nurses could provide some relief, the current approach for granting temporary guest worker visas, known as H-1Bs, makes it difficult to get those nurses here. A limited number of new visas are available each year, and that number is divided among several specialty occupations. According to The U.S. Department of Citizenship and Immigration Services, which processes H-1B visas, more than 100,000 applications arrived last April seeking the 65,000 openings.
Debate over increasing the number of visas is clouded by the emotionally charged issue of regulating immigration, said Karen Fleming, vice president of immigration and processing for HCCA International, a healthcare recruiting company.
The Coalition to Improve Healthcare Staffing, led by the Hammond Law Group and with 40 to 50 other members, is joining the American Association of International Healthcare Recruiters to lobby Congress to address the healthcare worker shortage. One proposed bill seeks to exempt nurses and physical therapists (Schedule A occupations in critical shortage as determined by the Labor Department) from visa caps for a specified period of time and provides that employers will pay $1,500 into a fund for each primary visa used. The contributions would be used to educate nurses domestically.
“There just aren’t enough foreign nurses to solve our problem. The nursing shortage itself is a complex problem, and the solution is complex, too,” Fleming said. “If we can bring in these international nurses, it is just one spoke in the solution, but it will provide us with time to produce our own.”
Many factors are causing the nurse shortage. The annual turnover rate in the U.S. is approaching 80,000 nurses, and one bottleneck to resolving the situation is the lack of educational resources. In 2005, nursing schools rejected 147,000 qualified applicants due to shortages of faculty, classroom space and clinical placement sites for students, according to reports.
Hospitals are particularly hard-hit because the nursing workforce has more options for employment – such as retail-based clinics, typically staffed by nurse practitioners, said Ted L. Merhoff, HCCA’s vice president.
Because of inadequate green card quotas, a skilled foreign professional could wait five years or more to immigrate legally to the United States, according to a report released last October by the National Foundation for American Policy.
While proposed reforms of America’s healthcare system is a hot topic, reform won’t be successful without an increase in the nation’s supply of physicians and nurses, according to a recent report by AMN Healthcare, a temporary staffing agency based in San Diego.
“There are lots of solutions; we know what it will take,” said Goodloe of the Tennessee Hospital Association. “But getting it done and getting it done in a timely fashion is the hard part.”