Survey: Should nurses from other countries be recruited to aid in the nursing shortag

[Brian]

This month's survey Question:

Should nurses from other countries be recruited to aid in the nursing shortage?

Please take a minute to take answer our survey and please feel free to reply to this topic to post any comments that you may have on the topic.

[totallytheresa]

You know what? Instead of being critical of us US nurses before you even come here, why don't you take a look at what this whole topic is about!!!We're not talking about a few nurses coming here to work, etc... we're talking about the active recruiting of foreign nurses. Enough already!

It appears to me that this is a flashpoint for many US nurses, with numerous points to the argument.

As a UK nurse coming over to the USA shortly I feel that my thoughts may be added to the discussion.

It seems that the main concern is the retention of staff - rather than the employment of new nurses. Well, unfortunately this is a buyers market... labor has (and always will be) bought at the cheapest cost. For those nurses that have left the profession in search of higher pay and better conditions - I fear that they have learned an important lesson - They are regarded as expendable!!! Sad as that seems I feel that bringing these people back to nursing is an almost impossible task. For those that feel that this would be the right thing to do I ask one question: If the 'ex-nurses' are to return will they need to be reformatted to the job as it may have changed in the time that they have been absent. And how much of a change in salary etc would they need to see?

This is not a situation that is experienced by the USA alone, most of the developed countries are hiring staff from some of the more 'undeveloped' countries. Generally you can count on the fact that they are trained to the appropriate level, are proficient in their job and have a drive to succeed in a foreign land. I agree that communication should play a necessary part in the introduction of these nurses. As Suzanne4 has stated, there are English tests that have to be passed in order to obtain a working position in the USA. Personally, I have never found a foreign nurse that has been completely unfathomable in the accent department.. however I have worked with some UK nurses whose regional accent has been so strong that I can never understand what they are saying!

So, it comes down to this:

Would you rather take away the foreign nurses (and their skills, support etc) with the intention of recruiting your 'ex-nurses'. If so are the remaining active nurses prepared to cover the period of transition... because, call me a pessimist, but i doubt that you will have the luxury of retraining staff and keeping the foreign nurses in the interim. I for one, would be happy with a nurse who knows what they are doing, can provide good patient care and help me out with the workload. I don't really care if they have a better salary (it gives me the incentive to negotiate a better deal for myself) and I don't care what their mother-tongue is as long as they can accurately describe the clinical side of their work and can write properly.

One last comment to those who talk about the importance of being understood and understanding what is being said.... take a look at your own spelling, some of the posts on this forum from native english speakers are probably more difficult to interpret than your foreign colleagues!:rotfl:

[mother/babyRN, RN]

I too think the UK nurse who was put off by the survey results should include herself ONLY if she has a problem with communications skills or job performance because that is what we are talking about. No need to get so upset as was evidenced in your post...Your perception of the results is, in my opinion and those of many of us here, inaccurate...It isn't about the foreign nurses not being wanted..It IS about treating the nurses we already have appropriately and professionally financially and all the rest RATHER than failing or refusing to do that and THEN purposely recruiting nurses in some cases with less skils willing to work for less money and in some cases difficult communication. THAT is the insulting and infuriating part. As for you ( the poster I spoke of)..Welcome...Think about losing the attitude...Or, if you are being treated incorrectly or wrongly, speak up...I do..

[Gromit]

I wasn't really replying to any of your posts, but I was replying to "we don't need foreign nurses" "I'm always going to take an American over a non-American" and that type of thing. I just found it enlightening because nobody is ever likely to say this to my face, but instead they ask me as to why I'm living in their country and where did I get my education. For some naive reason I thought this might be because they were genuinely interested, but the statistics on the poll and replies to the thread prove otherwise.

I'm not really that offended either, and I undestand the language barrier can be very dangerous.

I've also now read up a little on the contracts some unscrupulous companies lock foreign nurses into. It isn't fair to take advantage of them.

For the record, the UK also has to recruit from overseas. It isn't as easy to get into the US as you think, I waited 11 months to get a greencard as a spouse. My husband waited only 6 weeks for his to go to the UK. Also for the record, when I worked for the Department of Employment in the UK, application forms for unemployment benefit were written in 32 different languages including Urdu, Chinese, Hindi etc. So the US is not the only country that has immigrants that don't learn the language, nor is the USA as easy to get into as you think it is. Spain does not equate to the rest of the world when it comes to employment for foreigners.

And yes, I realize I'm one of those foreigners that needs to sling my hook. :)

Well, I'm glad I didn't really offend you -I can come off a bit sharp -especially when I'm passionate about something. I know what its like to have people not want to say things to your face, but say it behind your back or other ways (I really don't like that. And rest assured, if I have something to say, I've no problem saying to your (or anyones) face -bosses as well (once told the DON what I thought, gave my honest opinion -surprisingly enough, while she wasn't happy, she at least seemed to respect me for it -even to the point of asking my opinions (and reasons) on other matters -granted, I could have just as easily lost my job (and expected to, for that matter)).

Well, as for the difficulties in getting into the US, many seem to NOT have as much difficulty, or have to take as long -guess you need a company to want to recruit you ? -I can also imagine that it has gotten a little more difficult after the 9/11 bit (probably no more secure, just more hassle -its about all our govmnt really knows how to do (hassle)).

I've never had any honest trouble with foreigners (except for the language thing, and I totally despise the illegals -do it the HONEST way. My great grandparents did, and many do today. I really don't care what your situation is, you can do it in an honest way, or its dishonorable, period) .

Well, just got off-shift, and traffic was interesting on the way home. so I'm outta here. Y'all have a good day :)

[UK2USA]

You know what? Instead of being critical of us US nurses before you even come here, why don't you take a look at what this whole topic is about!!!We're not talking about a few nurses coming here to work, etc... we're talking about the active recruiting of foreign nurses. Enough already!

Apologies if my post has been taken as critical of US nurses, it appeared that many US nurses had responded to this discussion, that is why the direction was towards the US posters.

My point was that in ALL developed countries the status of nurses has been devalued leading to an exodus from the profession by native nurses. The immediate response is to fill the shortage by foreign labour. However this does not relieve the larger problem - that of retention (this was the point I identified in my original post). The re-introduction of ex-nurses back to the bedside is hindered by the fact that the profession continues to be somewhat behind others in terms of development and reward etc. My point was that we should all (not just the USA) be appreciative of the skills that are being offered to us by these nurses. I don't know what it would take to get nurses to come back to work... but I don't think that we would have the luxury of short term contracts for foreign nurses whilst we retrain nurses who have left the service.

The titile of the discussion was 'should foreign nurses be recruited to overcome the nursing shortage' and that was what I replied to. However, if it has become 'should the resources be in place to redevelop the nurses rewards in an attempt to train and hire native nurses over foreign nurses' then I feel that this is a different question.

In an attempt to clarify what my initial intention had been, let me offer an example outside of nursing:

If there is a lack of Volkswagon mechanics, but a surplus of Ford mechanics should they be recruited to cover the shortage in VW garages? My answer would be the same - yes. What happens further down the track is a different question.

Just to be absolutely clear about one thing, I don't apologise for holding my own views. I do apologise if I phrase them with any ambiguity (which in this case I guess I must have). Re-reading my original post I don't think that I said anything that was overly critical. Certainly not compared to some of the very passionate views expressed earlier on in the thread.

The main point of my argument was that: in the majority the nurses that have left will never return, things will never be as good as on the outside world. The impetus to put student nurses through their training is simply not there, healthcare at our level does not generate the income (certainly in the UK) to risk the sort of investment that is needed. Therefore the answer is to get labour elsewhere (Phillipines, India, Spain, Sweden, etc etc etc).

My comments about the spelling still stands! (Although this has been written in such haste in order to explain myself that there are probably plenty of mistakes here).

Once again, I regret if I was originally misunderstood.

[Rep]

On this thread, one has only to answer "yes' or "no."

If one answered " yes" then fine. If one answered "no" then that is their choice. But never, ever, blame the foreign nurses for coming to America and working in the hospitals because US nurses can only blame themselves.

The nurses on this thread should explain why they are against recruitment of foreign nurses to ease the shortage. Most of them said that with recruitment of foreign nurses, it brings down wages, it does not improve the working conditions in the hospitals, also language problems would occur between patients and the health team. These reasons cited are not valid enough because it blames the foreign nurses but do not address the problem.

The problem that every American nurses should address is how to change corporate America. Corporate America those in particular handling the big hospitals, etc.

Get your act together. Unite and serve an example by not running away from your job by changing careers because of poor staffing.

Write to your congressmen and senators and show the the American nurses has a voice. But as long these are not happening, then don't blame the foreigners for coming here to work in your hospitals. After all they too want to have their share of the American dream that your forefathers had aspired before.

As for the language problem, starting 1997, the US government has required every foreign nurses to take the TOEFL ( Test on English as a foreign language) and TSE ( Test on Spoken English).

These English exams are requirements for the visa screen certiticate aside from the CGFNS/NCLEX. The visa screen certificate is a federal requirement before an immigrant visa is issued. No foreign nurse can immigrate to the USA without it.

Even working visas for nurses, H1C or H1b, require the visa screen certificate.

In fact, the US government has made it harder for foreign nurses to come and work in your country.

By the way, the type of English that is given on these exams is college English, the kind of English we hear from CNN or Foxnews. Not the type of English that is spoken in the streets of New York or in San Francisco.

As for contracts, the minimum wage given on foreign nurses are based on your labor laws on current legal wage. So. this means foreign nurses are not bringing down wages because they are paid the same as that of American nurses.

Also, somebody mentioned the problem of spending money on the recruitment of foreign nurses instead on the education of Americans who want to take up nursing. Well, form a business point of view, will I invest in someone who has yet to take up nursing and with the high attrition rate in schools and the NCLEX? I don't think so. I would invest in somebody who has finished nursing school, who has a license and is willing to spend the rest of his/her life in nursing. That is business to me. Don't get me wrong on here but most of you would agree.

So, UNITE AND GET YOUR ACT TOGETHER! In the meantime, foreign nurses are arriving in your country everyday. :)

[Rep]

On this thread, one has only to answer "yes' or "no."

If one answered " yes" then fine. If one answered "no" then that is their choice. But never, ever, blame the foreign nurses for coming to America and working in the hospitals because US nurses can only blame themselves.

The nurses on this thread should explain why they are against recruitment of foreign nurses to ease the shortage. Most of them said that with recruitment of foreign nurses, it brings down wages, it does not improve the working conditions in the hospitals, also language problems would occur between patients and the health team. These reasons cited are not valid enough because it blames the foreign nurses but do not address the problem.

The problem that every American nurses should address is how to change corporate America. Corporate America those in particular handling the big hospitals, etc.

Get your act together. Unite and serve an example by not running away from your job by changing careers because of poor staffing.

Write to your congressmen and senators and show the the American nurses has a voice. But as long these are not happening, then don't blame the foreigners for coming here to work in your hospitals. After all they too want to have their share of the American dream that your forefathers had aspired before.

As for the language problem, starting 1997, the US government has required every foreign nurses to take the TOEFL ( Test on English as a foreign language) and TSE ( Test on Spoken English).

These English exams are requirements for the visa screen certiticate aside from the CGFNS/NCLEX. The visa screen certificate is a federal requirement before an immigrant visa is issued. No foreign nurse can immigrate to the USA without it.

Even working visas for nurses, H1C or H1b, require the visa screen certificate.

In fact, the US government has made it harder for foreign nurses to come and work in your country.

By the way, the type of English that is given on these exams is college English, the kind of English we hear from CNN or Foxnews. Not the type of English that is spoken in the streets of New York or in San Francisco.

As for contracts, the minimum wage given on foreign nurses are based on your labor laws on current legal wage. So. this means foreign nurses are not bringing down wages because they are paid the same as that of American nurses.

Also, somebody mentioned the problem of spending money on the recruitment of foreign nurses instead on the education of Americans who want to take up nursing. Well, form a business point of view, will I invest in someone who has yet to take up nursing and with the high attrition rate in schools and the NCLEX? I don't think so. I would invest in somebody who has finished nursing school, who has a license and is willing to spend the rest of his/her life in nursing. That is business to me. Don't get me wrong on here but most of you would agree.

So, UNITE AND GET YOUR ACT TOGETHER! In the meantime, foreign nurses are arriving in your country everyday. :)

[rstewart]

On this thread, one has only to answer "yes' or "no."

If one answered " yes" then fine. If one answered "no" then that is their choice. But never, ever, blame the foreign nurses for coming to America and working in the hospitals because US nurses can only blame themselves.

The nurses on this thread should explain why they are against recruitment of foreign nurses to ease the shortage. Most of them said that with recruitment of foreign nurses, it brings down wages, it does not improve the working conditions in the hospitals, also language problems would occur between patients and the health team. These reasons cited are not valid enough because it blames the foreign nurses but do not address the problem.

Ahhhhhh.....But was the original question, "Who is to blame for foreign nurses coming to America?" I didn't think so.

In my view, many posters have been quite clear as to their reasons for opposing the recruitment of foreign nurses. You have simply chosen to reject those reasons. You believe that successfully completing the TOEFL and TSE exams guarantees adequate communication skills; From recent personal experience I would strongly argue that is not the case. You choose to believe that increasing the pool of willing workers at the lower end of the pay range does not have the effect of depressing wages; I could offer countless examples, both theoretical and in the marketplace that it does.

I'll go one politically incorrect step further: In my opinion, the languages, appearances, religions and cultures of some foreign nurses are so radically different from those of their patients here, even a semblence of wholistic care is just not a realistic expectation. It is unfortunate when this occurs in the medical field, but for nursing it is a tragic loss. Indeed, if we accept that the nursing profession is primarily "about" safely and efficiently performing tasks, then I predict we are doomed to extinction.

Does anyone truly believe that we are doing all we can to retain nurses at the bedside? Does anyone truly believe that we are doing all we can to educate nurses here in the US? Well, until we can answer "yes" to both questions I do not favor recruitment from other countries.

[rstewart]

On this thread, one has only to answer "yes' or "no."

If one answered " yes" then fine. If one answered "no" then that is their choice. But never, ever, blame the foreign nurses for coming to America and working in the hospitals because US nurses can only blame themselves.

The nurses on this thread should explain why they are against recruitment of foreign nurses to ease the shortage. Most of them said that with recruitment of foreign nurses, it brings down wages, it does not improve the working conditions in the hospitals, also language problems would occur between patients and the health team. These reasons cited are not valid enough because it blames the foreign nurses but do not address the problem.

Ahhhhhh.....But was the original question, "Who is to blame for foreign nurses coming to America?" I didn't think so.

In my view, many posters have been quite clear as to their reasons for opposing the recruitment of foreign nurses. You have simply chosen to reject those reasons. You believe that successfully completing the TOEFL and TSE exams guarantees adequate communication skills; From recent personal experience I would strongly argue that is not the case. You choose to believe that increasing the pool of willing workers at the lower end of the pay range does not have the effect of depressing wages; I could offer countless examples, both theoretical and in the marketplace that it does.

I'll go one politically incorrect step further: In my opinion, the languages, appearances, religions and cultures of some foreign nurses are so radically different from those of their patients here, even a semblence of wholistic care is just not a realistic expectation. It is unfortunate when this occurs in the medical field, but for nursing it is a tragic loss. Indeed, if we accept that the nursing profession is primarily "about" safely and efficiently performing tasks, then I predict we are doomed to extinction.

Does anyone truly believe that we are doing all we can to retain nurses at the bedside? Does anyone truly believe that we are doing all we can to educate nurses here in the US? Well, until we can answer "yes" to both questions I do not favor recruitment from other countries.

[fergus51]

Rep, I don't think anyone is blaming foreign nurses from coming here. But like it or not, foreign recruitment allows hospitals to ignore the problems they have foisted onto their staff. Nurses can be as organized and vocal as they like, but they will never be able to affect real change as long as they can be replaced by a cheaper, more submissive alternative. Fortunately I work in unionized environments and that does not happen.

As an aside, how can you say that language barriers are not a valid concern? It doesn't matter if it is the foreign nurse's fault or not, but if she can't communicate with staff and patients (and that means the English that is spoken on the streets as well as that you hear on CNN), she is not safe to practice. Patient safety is a valid concern imho.

[fergus51]

Rep, I don't think anyone is blaming foreign nurses from coming here. But like it or not, foreign recruitment allows hospitals to ignore the problems they have foisted onto their staff. Nurses can be as organized and vocal as they like, but they will never be able to affect real change as long as they can be replaced by a cheaper, more submissive alternative. Fortunately I work in unionized environments and that does not happen.

As an aside, how can you say that language barriers are not a valid concern? It doesn't matter if it is the foreign nurse's fault or not, but if she can't communicate with staff and patients (and that means the English that is spoken on the streets as well as that you hear on CNN), she is not safe to practice. Patient safety is a valid concern imho.

[Gromit]

rep:

toefl ( test on english as a foreign language) and tse ( test on spoken english).

these have absolutely nothing to do with medical communication, or "medical english" if you will.

i spent six years in seville, spain. upon leaving the country for the last time, i was very fluent (and spoke formal castillian more correctly than most of the natives -as happens when its a true second language) but if i were to suddenly have been thrust into the medical community, and had to translate for a nurse/doctor/etc. to a patient, regarding their medical condition and treatment, i'd not have been up to the challenge. the "toefl" and "tse" fall into the same category. ok, they can understand cnn. big deal. they will be able to go for a night out on the town. but thats hardly preparing or even showing one is prepared, for the communication requirements in the english-speaking medical world of hospitalized patients, staff and ancillary care-givers.

the question was answered in compliance with the rules or parameters set forth in the original post. don't go changing the parameters without fair warning.

[Gromit]

rep:

toefl ( test on english as a foreign language) and tse ( test on spoken english).

these have absolutely nothing to do with medical communication, or "medical english" if you will.

i spent six years in seville, spain. upon leaving the country for the last time, i was very fluent (and spoke formal castillian more correctly than most of the natives -as happens when its a true second language) but if i were to suddenly have been thrust into the medical community, and had to translate for a nurse/doctor/etc. to a patient, regarding their medical condition and treatment, i'd not have been up to the challenge. the "toefl" and "tse" fall into the same category. ok, they can understand cnn. big deal. they will be able to go for a night out on the town. but thats hardly preparing or even showing one is prepared, for the communication requirements in the english-speaking medical world of hospitalized patients, staff and ancillary care-givers.

the question was answered in compliance with the rules or parameters set forth in the original post. don't go changing the parameters without fair warning.