Causes and Impact of Importing Foreign Nurses

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Causes and Impact of Importing Foreign Nurses
Can you imagine this scene? When your child suddenly has a high fever in the middle of night, you hurry to the hospital. You find out that you have to wait in a crowded emergency room with your crying child because there are not enough nurses and doctors to take care of many patients right away. After a long wait, a nurse finally comes to check your sick baby, but you notice the nurse speaks English with heavy accent. You start to get irritated trying to understand her because you are tired and worried about your baby. You start to wonder if you can trust this nurse. Why this foreign nurse working at this hospital in the United States? Is she qualified? This situation is not unusual anymore in the United States. Foreign nurses who work in America are increasing every year because of the serious nursing shortage in America. The current shortage is the product of several trends including population growth especially of the aging, high attrition rate in the nursing workforce, and an insufficient number of nursing schools. Typical solutions to address past nursing shortages have included increasing wages and recruiting nurses from other countries. As the United States has focused on importation of foreign nurse to solve its nursing shortage problem, this trend brought about three important consequences: nursing shortages in the donor countries, concerns about foreign nurses’ technical and cultural competence, and impact on existing work condition problems for American nurses. The nursing shortage is not a fresh issue since the United States has experienced this problem since the Second World War. The problem has not yet been solved and has intensified every year. However, today’s nursing shortage is fundamentally different from past shortages, which largely resulted from short term, cyclical changes in the supply and demand for nurses. But the current shortage is unique because it is getting worse even as the demand for nursing is rising. “This shortage is centered on more than just wages and compensation. It is a lot more complicated,” says Len Nichols, vice president of the Center for Studying Health System Change in Washington, D.C. He also states that “the current shortage is partly an outgrowth of changes in the role of women in society during the 1970s” (qtd. in Hansen 758). Many women who would have entered nursing in the past are now entering managerial and professional occupations that used to be traditionally male. In addition, according to Brian Hansen, the nursing profession has been harmed by the managed-care revolution that swept the country in the early 1990s (758). Managed-care companies sought to keep healthcare costs down by limiting their customers’ access to expensive hospital procedures. Whenever possible, they treated patients in less expensive, non-hospital settings, such as doctors’ offices and clinics. These for-profit managed-care companies pressured hospitals to lay off thousands of registered nurses in the 1990s. The cost cutting efforts made working conditions intolerable for the hospital nurses who were not laid off. Under managed care, nurses are frequently denied the opportunity to deliver the quality of care they expect to deliver. The nurses have been leaving their profession for years because of a decline in RN earnings relative to other career options, low job satisfaction and poor working conditions. According to Barbara Brush, Julie Sochalski, and Anne Berger, “the U.S. Department of Health and Human Services (HHS) estimated that the United States was weathering a shortfall of 111,000 full-time-equivalent (FTE) RNs in 2000 and projected that this figure will grow to 275,000 by 2010” (78). As a result of the nursing shortage, U.S. health care facilities worked out some strategies to attract nurses to fill current nursing vacancies and to prevent future shortfalls, and they have preferred importing foreign nurses to...
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