Immigrant nurses serve crucial functions in healthcare systems all over the world. They provide culturally-sensitive care and fill crucial staffing shortages in healthcare systems across developing countries. According to a 2018 study, there are significant numbers of immigrant nurses in the U.K., New Zealand, Australia, Switzerland, Canada, and the United States.
U.S. hospitals are unable to fill a surplus of open positions due to high immigration costs and delays. The need for nurses is so acute that healthcare staff who test positive for COVID-19 but are asymptomatic return to work after a few days as there isn’t sufficient staff to allow them to quarantine for 14 days fully.
The pandemic exacerbated existing problems. The healthcare industry has predicted a staffing shortfall for years. Various studies estimate that the U.S. will need hundreds of thousands more doctors and millions of more nurses by 2030. The pandemic exposed the existing staffing shortages as hospitals were overwhelmed with patients. According to the Texas Nurses Association, Texas needs 30,000 nurses right now and will need 60,000 nurses by 2032.
The problem is particularly significant in rural areas. Staffing agencies are reporting unprecedented requests from hospitals for immigrant nurses. One company reported open requests from 28 states.
Filling the Staffing Gap: Immigrant Nurses
Hospitals are filling these staffing shortages by turning to immigrant nurses. However, the costs to get visas for foreign nurses skyrocketed under the Trump Administration, which imposed several immigration restrictions and fostered a cultural atmosphere that was hostile to immigration. Using immigrant nurses is not new to U.S. policy. According to a study by the Immigrant Learning Center and the Institute for Immigration Research at George Mason University, foreign-born nurses compose about 15% of U.S. registered nurses.
Many hospitals were hiring foreign-born nurses long before the pandemic. However, due to time lags and costs, there is a shortage of immigrants to serve as nurses in U.S hospitals. Senators Durbin (D-IL), Perdue (R-GA [former]), Young (R-IN), and Coons (D-DE) introduced a bill last year that would have allocated unused existing visa slots for nurses and doctors and expedite the process. However, Sen. Lindsey Graham neglected to hold a hearing on the proposed bill.
Issues Immigrant Nurses Face
Immigrant nurses are educated and certified abroad but are often unable to practice medicine in the United States because they lack local certification. Getting certified as a nurse in the U.S. often requires them to attend school and pass certifications. Internationally-trained nurses who are otherwise competent are locked out of the healthcare system because they must take years of additional schooling and tests. These restrictions are imposed because it is believed that internationally-trained nurses are not as competent as their US-trained counterparts.
These positions are anathema to decades of U.S. policy which encouraged and supported Filipino nurses. The U.S. has relied on immigrants from the Philippines to fill healthcare gaps since the 1960s. Moreover, many of these policies were relaxed during the pandemic, and hospital systems did not experience a sharp rise in preventable harms due to incompetence.