Immigration is key to easing the nursing shortage

COVID-19 cases have been increasing in some of the U.S., with recent surges in parts of Illinois and a 145% increase in cases across California in just one month. With this news comes the startling reminder there are not enough nurses to care for patients. The “Great Resignation” is hitting the health care sector especially hard, with 30% of nurses among those quitting.

A recent McKinsey report warned the shortage of U.S. nurses could be dire by 2025. But it’s already dire: Nationwide, there will be 194,500 open positions for registered nurses each year, and the demand for nurses is expected to rise to 3.3 million overall in the next seven years.

Because of the shortage, nurses are experiencing burnout from emotional and physical distress. They are spread too thin, and the stress of too many patients means they cannot provide the level of care they strive for and that patients deserve.

Some nurses, aware that shortages and burnout increase the risk of making life-altering mistakes at work and being villainized as a result, left their careers following the RaDonda Vaught trial.

Vaught was convicted in March of two felonies for a fatal, but accidental, drug error. Protesters in the nursing profession rallied around Vaught in support, and some held signs that read “I am RaDonda.” Ultimately, the case was cited as setting a dangerous precedent that would make the nursing shortage even worse.

Innovations such as the use of more digital tools and hospital robots are helping nurses by easing their work burden. But technology cannot meet the current need for real, human nurses who can provide staff support and help limit room for error among their colleagues.

However, states are taking action to help people enter the nursing profession and relocate for better conditions and pay. Within these state-based initiatives, immigrants can fill the gap. This has happened before in U.S. history: During the 1980’s and 1990’s, when hospitals were understaffed due to the AIDS epidemic, immigrant nurses played a key role in alleviating the shortage.

Over 350,000 immigrant health care workers were born in the Philippines, and roughly 143,000 of them are qualified to be registered nurses. Chile, where the number of trained nurses increased by more than 59% between 2014 and 2019, is home to at least 53,000 potential immigrants who hold the required credentials to be nurses.

Reform the visa system

Nursing is a “Schedule A” occupation, meaning there is a documented shortage and immigrant nurses would not take jobs away from U.S. nurses. Immigrant nurses would provide a steady stream of qualified nurses to fill job vacancies. Hospitals could do this by supplementing moving costs and visa fees, as well as advertising that wages in the U.S. are high compared to most countries. Housing assistance and a relocation advisor would also be beneficial.

As well, the U.S. visa system needs to be reformed for immigrant nurses, starting with making the process for H1B Visa Approval more timely and effective. Immigrant visas for close relatives, such as a spouse, child or parent, of current U.S. citizens are unlimited.

However, the Immigration and Nationality Act limits the number of family-sponsored preference visas, which encompasses more distant relatives, that the State Department can issue each year for non-citizens seeking a green card. Only 226,000 family-sponsored preference visas and 140,000 employer- sponsored visas are allowed each year.

Due to pandemic-related closures, the processing of family-sponsored preference visas slowed dramatically, leaving many unused in fiscal year 2021. These unused visa slots have been moved to employment-based visas, including those for nurses. This means there is a tremendous opportunity for hospitals to fill open nursing positions.

State representatives and government officials should be encouraged to increase the number of available visas and support policies that bring more immigrant nurses into the U.S. Three bills have been introduced in the House of Representatives to support immigration for health care workers.

The Immigrants in Nursing and Allied Health Act would create a grant program to cover licensing, certification, training and education costs. The International Medical Graduate Assistance Act would allow immigrants to work under supervision with their home country’s licensure while getting a U.S. license and also create residency opportunities. And the Professional’s Access to Health Workforce Integration Act would provide current immigrants with foreign licensure or training with assistance in working toward U.S. licensure.

Now is the time of a great nursing shortage. It is also the time to vote “yes” on bills that will bring more immigrant nurses into the U.S health care system.

Julie Collins is program director of the Department of Cardiopulmonary Sciences at the College of Health Sciences, Rush University.

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