INS memo eyes nursing shortage

  1. INS Guidance on Registered Nurses and H-1B Temporary Visas
    On November 27, the Immigration and Naturalization Service (INS) issued the following document, "Guidance on Adjudication of H-1B Petitions Filed on Behalf of Nurses". This document provides guidance to the state and regional INS offices on the circumstances that a registered nurse might be able to enter the United States on a temporary H-1B visa.

    The document can be found at:

    And from Dallas area....

    Stephanie Patrick Staff Writer

    GREATER METROPLEX-Classified ads touting lucrative sign-on bonuses and flexible schedules have become the norm, and job fairs giving away everything from cars to luxury vacations are becoming commonplace.

    Still, the Dallas-Fort Worth area's vacancy rate for registered nurses hovers around 12%. So dire is the shortage that many hospitals have turned to foreign recruitment, but the processing time to bring a nurse into the United States often takes nine to 18 months.

    That could soon change.

    A recent U.S. Immigration and Naturalization Service memo to its field offices is instructing officers to approve some nurses for H-1B visas. The H1-B visas-used to allow technology professionals, doctors and others with "distinguished merit and ability" into the United States-could reduce the processing times for nurses to as little as two weeks.

    "It took us close to a year to recruit four nurses from India-two for RHD Memorial Medical Center and two at Trinity Medical Center," said Craig Sims, president and CEO of Trinity. Both are Tenet Healthcare Corp. facilities.

    Since 1995, there has not been a special immigration provision for most nurses. The only viable method for nurses was the traditional immigrant visa process, which takes much longer.

    "The INS has got the message about the nursing shortage, which is happening nationally," said Carl Shusterman, a well-known immigration attorney in Los Angeles who has helped place several nurses in Texas. "Before it was easier for a fashion model to enter the country than a nurse. With this change, I hope that will no longer be the case."

    The INS memo, dated Nov. 27, indicates health facilities may petition for H1-B status on behalf of registered nurses, including those wanting to work in emergency rooms, operating rooms, critical care, oncology and pediatrics. The H1-B also may apply to some upper level administrative positions. General registered nurses would not qualify.

    Health care officials must show that a four-year university degree or equal experience is required to perform the job.

    INS officials could not be reached for comment and it's unknown how many nurses might come to the United States as a result of the change. Between Oct. 1, 2001, and June 30, the latest figures available, 60,500 foreigners were given approval to begin employment under H1-B status, according to INS statistics.

    The limit is 195,000 for fiscal 2002.

    Ironically, the exclusion of nurses in the H1-B provision is the result of the Immigration Nursing Relief Act of 1989, which established a separate visa status for nurses during the last worker shortage. The Relief Act's five-year program expired in September 1995 at which time the traditional immigration visa process kicked in for the vast majority of nurses.

    "We'll probably begin to see the first nurses come over on H1-B visas in about six months," said Shusterman, who recommended that health facilities petition for H1-B visas for nurses before stricter screening regulations go into effect sometime in the first half of 2003. The regulations are likely to extend the visa processing time for nurses by a few months.

    He also suggested that those seeking to bring foreign nurses into the United States use premium processing, where the INS guarantees a 15-day turnaround in processing for an additional filing fee.

    Texas lawmakers predict the state will need 138,000 nurses and nurses aides within the next seven to 10 years.

    Sims has no plans to recruit more foreign nurses, but Mark Morales, vice president of planning and placement for Texas Health Resources, is hopeful the changes will help bring about 150 foreign nurses into the Arlington-based hospital system. THR has been trying to recruit nurses from the Philippines for several months.

    THR's vacancy rate for registered nurses is about 10.5%, and THR has announced plans to spend more than $1.5 billion in the next 10 years to renovate its hospitals and add more beds.

    A nonprofit system, THR runs 13 acute-care hospitals in the state, including Harris Methodist Fort Worth, Presbyterian Hospital of Dallas and Harris Methodist HEB Hospital.

    "We thought we would have four to eight nurses here in January, but now it looks like it's more likely to be March," Morales said.

    Michael Denis, executive director of Allied Health Education Center of North Texas, which promotes allied health professions, also is optimistic.

    "We easily need 2,000 additional registered nurses in the Dallas-Fort Worth area today," he said. "If we could get say 200 in the next five months or so, it doesn't solve the problem, but it does make a positive contribution."

    Contact DBJ writer Stephanie Patrick at or (214) 706-7121.
  2. Visit NRSKarenRN profile page

    About NRSKarenRN, BSN, RN Moderator

    Joined: Oct '00; Posts: 27,543; Likes: 13,751
    Utilization Review, prior Intake Mgr Home Care; from PA , US
    Specialty: 40 year(s) of experience in Home Care, Vents, Telemetry, Home infusion


  3. by   oramar
    That first paragraph about lucrative bonuses and car give aways made me cringe. We keep telling people what is really wrong and they keep ignoring it.
  4. by   funnygirl_rn
    I have two cousins in Arizona who are also nurses...they send me classified ads with similar offers...recently a hospital was offering free house cleaning for a year or lawn care/maintenance! Sheeeesh!!
  5. by   sjoe

    Any more doubts about how hospitals are going to deal with the so-called "nursing shortage?"

    Anyone still naive enough to think these facilities are finally going to change their ways, to make the working environment more supportive and safe for nurses in order to gain more employees?

    If so, I've got a bridge in NYC to sell you....
    Last edit by sjoe on Jan 2, '03
  6. by   oramar
    sjoe, remember that "who will empty my bedpan" article by Jan Jennings that has us all so up in arms. Basically that was what that article was about. We all chose to focus on other things in the article he said that offended us but the core statement was about importing labor. If I remember correctly you may have noted the fact. Big healthcare business is pushing accross the board for import of cheap labor.
  7. by   maureeno
    about three weeks ago I noticed an H-IB placement office open near my bus stop.
  8. by   mjamesRN
    Here's a good one thanks to the INS:

    Dateline: January 13, 2003

    Mr. Abel Castello-Diaz

    Despite a growing national critical nursing shortage, the INS is deporting USA trained Registered Nurses.

    ABINGTON, PA -. Abel Castello-Diaz, (INS# A029-109-758) a 39 year old Critical Care RN who was trained in this country during his 26 years living here is being deported at the end of a 15 year effort to become a citizen, because of a clerical error.

    The Vice President of Patient Services, Linda Schofield, RN, MBA, and Denise Lavery, RN, CCRN, Director of Critical Care Services, along with hundreds of RN's who are his colleagues at Abington Memorial Hospital, Abington, PA have worked to keep Mr. Castello serving the medical needs of their patients at their medical facility. They cite both his abilities and the need for such qualified personnel due to the significant shortage of Registered Nurses in the USA, especially in specialties such as Critical Care. So far, their efforts have not made any difference to the INS.

    Ms. Schofield states, "Mr. Castello is a valuable member of our Critical Care Department at Abington Memorial Hospital and we've been frustrated by our inability to retain him as part of our healthcare community."

    Friends of Mr. Castello and the families of patients whose lives he has helped to save are seeking a reversal of the deportation order based on the fact that he never received notification of his date of Appeal and had his case decided without his Appeal. Apparently, there is not enough staff in the Philadelphia INS office to take the steps needed to properly notify individuals and their attorneys, so important mail is sent through non-certified - non-acknowledged mail resulting in an environment that has few checks on possible abuse.

    Senators Arlen Specter and Rick Santorum have been contacted by a great many people trying to prevent this miscarriage of justice and loss to the community. So far both offices are offering no assistance.