Emergency Nurse Relief Act 2009- Update

rainbow11 · Jun 2, 2009

the sad part is that many qualified americans have to go to foreign medical schools to qualify to practice in the usa. do we want american nursing to follow in medicine's foot steps and have american nurses who have to be educated overseas?
i noticed that when someone makes a point different from yours you seem to exaggerate to one extreme!! just think what portion of nursing students are foreign-students? this must a verrrry small number (very small percentage of foreign students choose to major in fields like nursing, physical therapy, whereas majority of international students study business, computer science etc.) for example, there were 22 students in my class, 3 american students dropped out, because they didn't feel nursing was for them (it proves that nursing is not for anyone to go into no matter whether you are american or foreign-born!) and i was the only foreign-student in my class. when you think that a tiny portion of nursing grads are foreign-born i do not think that's going to have a huge impact whatsoever, not even mentioning pushing american students to study nursing abroad. that's sooo unrealistic!
http://www.govtrack.us/congress/billtext.xpd?bill=h111-2536
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look at this stats. there will be over one million open nursing positions by 2020 (i don't know the current number). if there is a demand & you can't fill these positions with american nurses, than what's wrong with bringing only 20,000 qualified foreign-born rns? if nurses, hospitals etc. really care about the quality of patient care they should allow foreign nurses to work, until us is able to train enough of its own nurses, which is going to take some time.
alexk49, i didn't write about my case to make you or others to feel sorry for me!! that was not my intention at all!! i wanted some people who are opposing this nursing act to understand that there are different interests in regard of this bill!! so, please try not to look at this bill from only one angle! also, i wanted to point out that there are many flaws in american immigration system.
http://shusterman.com/siu.html
the american dream may not only be over for thousands of talented scientists and engineers born in other countries, but since we no longer seem to have room for the world's best and brightest, for our country as well.
craig barrett, the chairman of intel, puts it in stark terms. "we are watching the decline and fall of the united states as an economic power."
this may not be an exaggeration. andrew grove, the co- founder of intel is an immigrant. ditto for sergey brin (google), jerry yang (yahoo), vinod khosla and andreas von bechtolsheim (sun microsystems). i could go on... another troubling aspect of the disappearance of eb-3 visas is prolonged family separation...>>
- this is just one example about visa "disappearance" in eb3 skilled workers category.
as i said before, and i'm repeating again, the fact that there is no nursing visa has nothing to do with my school. nobody knew that schedule a category visas were no longer going to be available. so, i'm not here to play a blame game, and blame my school for that. even today no-one, not even immigration attorneys, or hospitals, knows if this bill will pass or not! it's really up to the lawmakers (the congress)!!! i hope there are healthy minds in d.c. to realize the demand, quality of patient care and the big picture!
also, i'm not here to ask anyone to hire me etc.! it's not like i can't find a job, there are nursing jobs everywhere! every hospital in my area has open positions! as i said before i have multiple employers willing to hire, and immigration attorneys willing to do paperworks, the only problem is there is no visa numbers available, so they can't help. after i explained you still do not seem to have any slightest idea about immigration processes. i'm not trying to insult you, but i don't think you get it. i've been playing by the rules. as i mentioned in my previous writing the process involves more steps, many tests, more papers if you are a non-us-educated rn! if you are a us-trained nurse i think the steps fewer, but stil going through the same process...
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rainbow11 · Jun 2, 2009

... Your school should have counseled you that retrogression was in place( since 2006) and you could not go to grad schools without experience...

Oh, I forgot to say that when I was in my BSN program I was NOT planning on going to a grad. school at all! Even now I do not really want to do master's in nursing. Seems like most NP, CNS programs require nursing experience (I learned that's another disadvantage of nursing major even though there are programs for non-nursing majors to get BSN, and go directly into MSN without experience?!), but I only applied to a few schools. If I try hard I might find schools that do not care much about experience. Also, if I change my concentration & choose something like Nurse Educator etc. I know I can get easily accepted into a grad. school. MSN is still an option if there is no bill, and I want to stay in the US. Again, there will be no financial aid, no tuition assistance/reimbursement from an employer for foreign students. At this point I'm a bit hesitant of spending more money, and seeing no benefit afterall...

Hushdawg · Jun 2, 2009

Moon, I know you're frustrated. Believe me, I'm frustrated for all non-citizen nurses who want to practice in the USA.

Something has to give, the shortage is real and retrogression is masking its growth since the hospitals can't afford to hire for the gaps in staff and retirees are not taking retirement because of fear of financial insecurity.

Once the current recession rolls back then the floodgates will open and this shortage which is being hidden now will become a gaping wound.

I'd rather something happen NOW as a preventative measure than something get pushed through at the last minute like some sloppy battlefield triage.

Advanced Practice Columnist / Guide · Jun 2, 2009

I thought of posting a link to this research published in 2002 and co-authored by Linda Aiken, a nursing professor who also published quite a bit of material on foreign nurse recruitment in the early 2000's. I do agree that the current economic climate in the US just does not afford an overwhelming support to foreign nurse recrutiment and that in times of "true shortage", foreign nurse recruitment can be a "band-aid" approach instead of a lasting solution to the reality of why nursing goes through cyclical "shortages". But I'll have to agree with Dr. Aiken's study - nurses will be nurses wherever they may be from. Our ideal of better working conditions will essentially be similar regardless of our country of origin.

fulltext.pdf

Ginger's Mom, MSN, RN · Jun 3, 2009

Moon, I know you're frustrated. Believe me, I'm frustrated for all non-citizen nurses who want to practice in the USA.
Something has to give, the shortage is real and retrogression is masking its growth since the hospitals can't afford to hire for the gaps in staff and retirees are not taking retirement because of fear of financial insecurity.
Once the current recession rolls back then the floodgates will open and this shortage which is being hidden now will become a gaping wound.
I'd rather something happen NOW as a preventative measure than something get pushed through at the last minute like some sloppy battlefield triage.

I agree with you, that is why congress has a bill to increase fundings to US Colleges for Nursing Education. More US citizens and legal residents can attend school and be it the wing when there are funded positions. These American Nurses will be able to fill the gaping wound.

I gather since you are an EX-Pat and currently do not pay taxes, you maybe unaware how bad the situation is now.

Hospital Census is down, elective surgery is down, number of US Citizens insured is down, tax revenues is down, nurses are being laid off and collecting unemployment. So where would these nurses work ?

If you know of hospitals that are hiring you would be doing service to post. I check the link you gave before, the positions I saw were per diem and for highly experience nurses.

VICEDRN, BSN, RN · Jun 3, 2009

First of all what does it matter if I am from the moon? Are you seeking to nullyfy my argument purely based on that you think I am a Brit? Also, having a British mommy neither makes you an authority on Britain nor its foreign policy. In fact, I guarantee you have no idea how many countries Britain has formal open immigration policies with. From your accusation, of them having a jingoistic immigration policy, you essentially think there are none. Wrong-o my little friend.
Any crackpot with internet access can post an article that would come up in a Google search. Try searching for one's that claim Elvis still lives or that alien abductions happen. Your sources are skewed. The information that this government gets is information based of census data and that which is supplied by our own profession (hence my suggestion that you look for your own BONs white paper on this subject). Now if you reject out of hand the reasoning for bringing nurses from abroad because don't trust our profession (BONs and similar) and you don't trust the government, fine. But your scope of data collection for your argument (uncited google sources and "friends of mine") hardly move me to even consider your opinion has merit.
You still did not address how American nurses better serve culturally. Serve who better, culturally? And how (specifically)?
Thank God for foreign nurses because they prevent us from having to hire some of the dross out there out of sheer desperation.

Its mummy, not mommy! :yeah:

As for the indictment of my sources, I am certainly not trying to turn this into rn2tobe's little research project. My point is that it does not take a genius to find articles from reputable journals/sites that demonstrate that there is a shortage of job openings in this field. My personal experience with this topic is backed up by just about every other possible way of verifying what I see: listings for job openings, accounts from local hospital recruiters, accounts from other nursing students, the news media, folks on this site, etc.

How about you do the research? Why don't you find for us some incredibly reputable bullet proof source that says, "This is all tosh. There are TONS of jobs for new nurses right now.)?

I went to college and can read pretty well so it didn't take me too long to use a little critical thinking and come to the conclusion that other countries' immigration policies (especially Europe) are quite a bit more stringent then ours are. My conclusions are certainly backed up by what I have seen in Europeans I know. As for open immigration policies, they certainly allow other Europeans to come and go according to their needs, you have that right. Generally speaking for the rest of us, not so much. (Although I give you credit for a clever phrasing since it clearly paints a picture quite different from the reality of immigration there.)

White papers talk about a proposed shortage in the future. The fact remains that there is no shortage. Dance around it all you want. There is no shortage of registered nurses in this country. Also, it is my opinion (oh yes, I have one) that the white papers might turn out to be wrong.

1. The idea that doctors offices will hire nurses in the future sounds like academic fluff. There is a trend away from hiring RNs and towards hiring techs. Who is to say that there will or won't be openings in the future?

2. LTCs and home health will have in the future more openings for Registered Nurses. Again, who is to say that they won't hire techs? Who says that these openings will actually exist? What if the landscape of health care changes and we no longer see large numbers of folks using these services?

3. Hospitals will have more openings for staff nurses. Do they now? What if they don't? What if the current decline in patient census (censi?) continues for the duration?

4. There are licensed nurses in this country who do not work. What would stop them from returning to the bedside? Anecdotally, it appears some of them have.

5. Retirement. God bless the baby boomers! I swear those folks plan to work themselves into the grave. Who says they are going to retire? Did they say this? No. The studies looked at their age not their individual plans and now there are general concerns about retirement savings and the recent downturn. Why would they retire? (Funny how a study about nursing openings doesn't ask nurses what their plans are!!)

I have a healthy respect for people who do research and the data that is collected but I see a lot of research being done by folks that haven't nursed since dinosaurs roamed the Earth. I suppose that I tend to take it with a grain of salt.

Regardless, my opinion has merit because I am a voter, a taxpayer and a citizen. I am a cautious person as well. Why would we even consider importing nurses for openings that don't exist?

I am sorry you don't like some of our newbie nursing grads but that is not a reason to hand out visas like candy.

lindarn · Jun 3, 2009

There are many new grads (and older experiemced nurses like myself), who cannot find work. That is not stopping Swedish Medical Center in Seattle from sending recruiters to the Phillipines to recruit nurses. This, in a town, that has two major BSN programs, several ADN programs, and here in Spokane (300 miles away), where there is no shortage because we have three schools of nursing in this small community (two BSN, one ADN/LPN). And right over the border to Idaho, there are several ADN programs, and one BSN program.

Tell me again why we have to import foreign nurses. I too feel that they are over reacting to a non existant problem.

What they are REALLY AFRAID OF is a real crunch for nurses, and God forbid, they have nurses who can name their price for a job. They do not fear a nursing shortage, and the effect that it will have on patient care, they are afraid of how it will increase the cost of nursing salaries.

I just got off the phone with a Maxim representative who offered me a job in an out of town area caring for a man with a trach, G tube, and who is on the ventilator. Guess what he offered me for pay? $17.00 and hour. That is right, you heard it here. I got the song and dance routing about how patients who have DSHS paying for their medical care. He said that is all that DSHS will pay. I told him then DSHS better be ready to go to this man's house and suction him and do his trach and nursing care for $17.00 and hour.

And they want to import foreign nurses? In your dreams. We will be working for minimum wage. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Hushdawg · Jun 3, 2009

I agree with you, that is why congress has a bill to increase fundings to US Colleges for Nursing Education. More US citizens and legal residents can attend school and be it the wing when there are funded positions. These American Nurses will be able to fill the gaping wound.

Wait... first you want to say that there is no shortage and now you admit there is a shortage and you need to increase funds for nursing education... you can't have it both ways.

Yes, I'm for increasing funds to nursing education; the problem is TIMING. There is no physical way to produce enough qualified RNs fast enough in the USA that is why there has to be a two-part solution, bring in foreign nurses to fill the immediate needs and then increase nursing education to fill the long-term need.

I gather since you are an EX-Pat and currently do not pay taxes, you maybe unaware how bad the situation is now.

Did you know that as a US citizen living in another country that I still have to file income tax returns? I do.

Also, just because I'm living in the Philippines does not mean I'm completely out of touch. I've had long phone calls with family and friends in the USA who are loosing jobs and struggling with pay cuts and losses in commission earnings. I'm aware of how things are NOW. I'm focusing on what is happening in the next 24-36 months.

If you know of hospitals that are hiring you would be doing service to post. I check the link you gave before, the positions I saw were per diem and for highly experience nurses.

I only know of agencies that are hiring, the hospital administrators that I've met are not willing to disclose the hospital names to anyone except for the agencies that they have contracts with. This is a very competitive and in many ways secretive business in the Philippines because there is a great fear of hijacking clients and prospects.

They will say that they work for "a major hospital in NY state" and that's about the best I can get out of them.

Additionally, based on AllNurses.com TOS I'm not sure I am allowed to post the recruitment agency information here.

Hushdawg · Jun 3, 2009

I am sorry you don't like some of our newbie nursing grads but that is not a reason to hand out visas like candy.

If you have any clue how much work and effort a foreign nurse has to go through to even get to the point of applying for a visa you would never say something that callous and irresponsible.

Even if the bill is approved to give 20,000 new visa allocations it is hardly ever going to amount to handing them out like candy.

Advanced Practice Columnist / Guide · Jun 3, 2009

I think everyone has made really good points in this thread. What concerns me with a visa that ties up one's employment to only one specific sponsor is that the foreign nurse can be at risk for unfair labor practices that many nurses in this thread have mentioned. We can all cite the fact that the employer will guarantee that the foreign nurse will be paid the same salary as the market rate in the area but that's only the tip of the iceberg. The employer can easily subject the hired foreign nurse to high patient to nurse ratios, long work hours by mandating overtime, unmanageable patient acuity, and the list can go on. This is reality and employers can get away with this as there is no law protecting the nurse in some localities and even practice settings such as nursing homes.

The poor foreign nurse is then left with no other option but to oblige to the employer's whims for fear of having the visa taken away and the nurse being deported back or having to hide and stay in the US illegally. What I figure would happen are three things: the foreign nurse will eventually leave the employer once the visa is expired and not renewed, or the foreign nurse will find a better employer who will sponsor, or the foreign nurse gets an immigrant visa and leaves the employer to work anywhere else. It then becomes a vicious cycle - the next batch of foreign nurse recruits come and endure horrible working conditions and nothing gets resolved as to why these sponsoring employers could not keep any nursing staff for a long period of time.

lawrence01 · Jun 3, 2009

I think everyone has made really good points in this thread. What concerns me with a visa that ties up one's employment to only one specific sponsor is that the foreign nurse can be at risk for unfair labor practices that many nurses in this thread have mentioned. We can all cite the fact that the employer will guarantee that the foreign nurse will be paid the same salary as the market rate in the area but that's only the tip of the iceberg. The employer can easily subject the hired foreign nurse to high patient to nurse ratios, long work hours by mandating overtime, unmanageable patient acuity, and the list can go on. This is reality and employers can get away with this as there is no law protecting the nurse in some localities and even practice settings such as nursing homes.
The poor foreign nurse is then left with no other option but to oblige to the employer's whims for fear of having the visa taken away and the nurse being deported back or having to hide and stay in the US illegally. What I figure would happen are three things: the foreign nurse will eventually leave the employer once the visa is expired and not renewed, or the foreign nurse will find a better employer who will sponsor, or the foreign nurse gets an immigrant visa and leaves the employer to work anywhere else. It then becomes a vicious cycle - the next batch of foreign nurse recruits come and endure horrible working conditions and nothing gets resolved as to why these sponsoring employers could not keep any nursing staff for a long period of time.

NP Gilly. These are not temporary work visas being talked about. Once they set foot in US they are given permanent residency aka green cards so all the scenarios you mentioned does not apply.

You came to the US yourself from another country, so you should know the difference between a work visa and being a permanent resident. Or you forgot how you came to the US yourself as you claim.

Lovely_RN, MSN · Jun 3, 2009

This is exactly what happens at the facility that I work for. The conditions aren't good for the foreign nurses and because there are so many of them the power of the U.S nurses is reduced because we lack numbers. Most importantly patient care suffers under these conditions. An example is that administration took away our wound care nurse and added two trach patients to the floor. So now anyone who doesn't work 7-3pm shift mon-fri must do Txs, the grueling 41 person med pass, as well as do trach care and suctioning along with all the other responsibilities that come with the job. Who was there to speak up for the residents or the nurses? No one because the foreign nurses are not in a posiiton to negotiate about anything lest they be fired and have to return to their country. They're to scared to tell the truth and say that they work load is impossible. The handful of U.S nurses who dare speak up are called lazy and compared to the nurses that don't complain. We eventually get to the point where we can't take it anymore and leave to be replaced by another foreign agency nurse. The DNS claims that she can't find enough U.S LPN/RNs to fill the positions but when anyone sends a friend to apply they don't get called back. I live in NYC and I'm afraid that we will eventually have ratios as bad as some of the nurses in the south and mid-west because of the influx. I have read about 50 and 60:1 ratios in a lot of states where unions are not welcome. We have unions in NYC but it seems as if the employers are finding a way to work around them by claiming that they can't find enough U.S nurses to work and hiring foreign agency nurses. I don't think I'm being xenophobic and I don't hate foreigners it's just that I'm scared of the future. I just can't provide decent care for that many people and neither can the foreign nurses. They aren't superhuman or any better/worse than U.S nurses it's just that they have a lot more to lose and are willing to pretend to be superhuman so that they can stay in this country.

I think everyone has made really good points in this thread. What concerns me with a visa that ties up one's employment to only one specific sponsor is that the foreign nurse can be at risk for unfair labor practices that many nurses in this thread have mentioned. We can all cite the fact that the employer will guarantee that the foreign nurse will be paid the same salary as the market rate in the area but that's only the tip of the iceberg. The employer can easily subject the hired foreign nurse to high patient to nurse ratios, long work hours by mandating overtime, unmanageable patient acuity, and the list can go on. This is reality and employers can get away with this as there is no law protecting the nurse in some localities and even practice settings such as nursing homes.
The poor foreign nurse is then left with no other option but to oblige to the employer's whims for fear of having the visa taken away and the nurse being deported back or having to hide and stay in the US illegally. What I figure would happen are three things: the foreign nurse will eventually leave the employer once the visa is expired and not renewed, or the foreign nurse will find a better employer who will sponsor, or the foreign nurse gets an immigrant visa and leaves the employer to work anywhere else. It then becomes a vicious cycle - the next batch of foreign nurse recruits come and endure horrible working conditions and nothing gets resolved as to why these sponsoring employers could not keep any nursing staff for a long period of time.