Petition to the Congress by US International RNs

Advanced Practice Columnist / Guide · Feb 12, 2009

Please endorse the petition at http://usirns.com/info/shortage or at http://usirns.com/
Greetings to all US International Registered Nurses in these horrible times!
Our battle with the US immigration continues but I think time has come when we can not remain passive and get united behind our effort to raise awareness of our unique immigration problem. A couple of us here in New York are trying to raise awareness of acute nursing shortage in America and champion the cause of petitioning to the Congress on behalf of US International Registered Nurses--educated, trained and licensed in the US--who in spite of the dire nursing shortage have no provisions to work in this country at present.
We do understand we are acting a bit selfish when we are just advocating for the US International Registered Nurses and not for the entire registered nurses coming to this country from abroad, but our intention was never to discredit the international nurses qualifications or credibility and prove ourselves different otherwise. It was that we just got overwhelmed with so many other immigration, CGFNS certification, issues when we tried to advocate for the entire international nursing community that we at the end therefore decided to just focus on foreign nurses that were educated, trained and licensed in the US.
Many South Asians, Filipinos, Caribbean, Africans, Europeans and Latin Americans RNs who were educated, trained and licensed here are in the same boat, so let us make that clear that no one is getting any preference over others. This is our collective effort to raise the issue and we are hoping that with the new Administration and with its promises to bring big changes in health care, we hope someone up there might listen to our unique immigration situation. I know they have their hands full with even bigger challenges, but people like us in skilled nursing profession, with passage of every day, it is one day less in our ability to provide health care, one day less in slowly losing our hard learned skills and medical/nursing knowledge. Its been months and we are still waiting. Please do visit the website and please don't forget to sign the petition.
I think last year Rep. Sensenbrenner from Wisconsin and Rep. Wexler from Florida introduced the Emergency Nursing Supply Relief Act (H.R. 5924) but I think it did not make it through at the end. We are therefore urging US international registered nurses to help us endorse and spread the word around about the site and petition, and once we have enough petitions, we will start contacting various Senators/Congressmen and NGOs working towards helping immigrants like us. At least in this path, we would have done something and not waited in vain.
We will all appreciate your help in whatever ways possible and all helpful advise, criticisms, diatribes against us will also be appreciated.
Thanks
Phudorji Sherpa, RN, BSN

Mr. Sherpa,

I looked at the wesbite with you and Mr. Lama's pictures on it. Both of you graduated from a US-based BSN program. Did you finish your respective programs while on a student visa? As a nurse who received his undergraduate degree from a foreign university and a graduate degree from a US-based public university, I know the difference between the price of earning a degree in both settings. Am I right in assuming that both of you were able to finance your education in the US as conditional requirements for earning a student visa? I think it's ridiculous that you were able to do that given the high cost of a college degree these days especially when you are talking about a degree at NYU! How can you prove to me that you deserve a job here in the US when there are US citizens who were scraping whatever they can to afford a community college education to become Registered Nurses so that they can earn a modest living in this horrible economy where prices of goods are so high that a nurse's salary isn't even going to cut it anymore? These are people living in their own homeland and have no option to find jobs in a foreign country the way you are asking the US government to do. Don't you think they deserve the nursing jobs available from a pool that is becoming smaller and smaller as the ecomony worsens?

As a former foreign nurse who is now a US citizen, I am concerned with your comments. They are enough to anger any nationalistic American who cares about the future of this country and its people. I am sorry but I just had to respond.

Ginger's Mom, MSN, RN · Feb 12, 2009

I agree on the bad timing thing, but generally I do think that being educated in the country should give you an immigration advantage over foreign-educated nurses since it means you've been trained for our system. If we are not willing to do this we should not be accepting them as students in the first place, since it puts them between a rock and a hard place to train them for our system and refuse to let them work in it. On that note too, if we don't want them to work, we are essentially taking spots from US residents we do want to work, so the system seems illogical and at best a way to scam international students into paying us high tuition.
To this:
"I can't speak for MDs, but as a nurse and a consumer I wish the same consumer protections that tradesmen enjoy. I have never seen a foreign plumber or electrician practice in the USA without completing the whole program in the USA. Why should nursing have a lower standard then plumbers or electricians ? I personally don't think the screening for IEN is high. In Canada they are starting to do an assessment of IENs which is fair."
I posted this so I feel I am qualified to respond. This answer is not in response to the petition.
Reread the OP, I believe they are referring to those who HAVE been trained in the US, just happen to not be US citizens. I agree that the assessments are a good idea for truly IENs, but make no sense for those who have received their nursing schooling here.
In Canada, international students graduating from University are eligible for a 3-year work permit, which gives them enough time to get full-time, Canadian work experience and qualify for permanent residency if they so desire. I think this is a very good system, as it prevents brain drain and acknowledges the investment that person has made in the country already.

Why are you applying here knowing you will not be able to work as a nurse? I have not met many foreign students who didn't understand going to school with temporary. Both my kids did a semester aboard and it was very clearly stated numerous places that their stay was temporary.

As a person who has lived their life advocating for doing the right thing. Why should a person who is waiting in line for years for some one who has had the resources to be educated in the USA? What sort of message would that send ?

Wait your turn, we are going to take this US educate nurse over you because they are financially better off? In my opinion immigration is wonderful and should be granted to all equally.

Nurse!Nurse!Hello? · Feb 12, 2009

Foreigners come to the US all the time with student visas because we have one of the best educational systems in the world. They study nursing, engineering, physics--and most of them do so with the intent to take their knowledge back to their home countries and improve the quality of life there. I believe that's the purpose of the student visa.

For people to attempt to use their student visa as a means to avoid going through the proper channels of immigration is just plain selfish! You applied for a student visa in order to study in the US. If you want to immigrate permanently, you always have the option of applying for a green card. You can rationalize it any way you want to support your position, but a student visa and a green card are two separate entities, and should be considered as such.

Advanced Practice Columnist / Guide · Feb 13, 2009

Growing up in a third world country like the Philippines, I remember that only the children of affluent families are able to attend college in the US or UK because of the cost of tuition and living expenses in a foreign country while on a temporary student visa. It's a "prestige" thing as I recall and many such Filipinos do go back to the Philippines after earning their degrees and become shoo-ins for high level positions in government, public service, business, and healthcare. The current Philippine president is US-educated and allegedly attended a class with former President Clinton at Georgetown. Speaking of healthcare, some of these Filipinos were educated in the US and UK as physicians, no nurses and other healthcare professionals as I can recall. This is what surprised me about Mr. Sherpa and Mr. Lama's case as they studied nursing here with the apparent intent to receive US licensure and work here. It must have been really expensive for both these obviosuly talented men to finish their degrees while living in the US and graduating with honors. However, I still find it hard to accept that their US education gives them the unique priviledge to cut the line and be ahead for nursing jobs among a multitude of foreign applicants from various countries of training in an economic climate where even citizens of the US coming straight out of nursing school are finding jobs harder to secure. I do hope Mr. Sherpa can comment some more as I am really interested in how this came along.

psherpa · Mar 18, 2009

Dear All,

Thanks for all your comments. I personally cannot speak for everyone within USIRNs. Like generations of immigrants who came to this country, I am sure if you look in your family history you will find somewhere that a member of your family moved here to pursue some dreams of their own--or the American Dreams as we call these days, please if you consider us from the perspective of your first generation of your family members who moved here, maybe we can find some common points from where we can get this discussion on immigration debate move forward.

If we were in some other other professional lines where we were competing with American citizens, we would not be so stupid and dumb to press on with this petition, but the important thing to consider is we USIRNs are not taking away American citizens jobs. We all know and understand what Americans are going in these difficult desperate times with the state of the current American and global economies, and that there is a hiring freeze going on through most health institutions, and these are things we never saw coming. And also, we would not have vouched for this petition had it not been all the information that we acquired regarding Ameican nursing shortage were actually highlighted by the American government websites (eg HRSA), the established media outlets such as PBS, ABC, NBC and prominent newspapers such as New York Times and others (as you can all see on the website). And this nursing shortage situation was continuously reinforced in our nursing classes across all nursing schools. As early as ten days ago (March 8, 2009), this article was covered by Reuters.

U.S. healthcare system pinched by nursing shortage

By Will Dunham Will Dunham Sun Mar 8, 8:10 am ET

WASHINGTON (Reuters) - The U.S. healthcare system is pinched by a persistent nursing shortage that threatens the quality of patient care even as tens of thousands of people are turned away from nursing schools, according to experts.

The shortage has drawn the attention of President Barack Obama. During a White House meeting on Thursday to promote his promised healthcare system overhaul, Obama expressed alarm over the notion that the United States might have to import trained foreign nurses because so many U.S. nursing jobs are unfilled.

Democratic U.S. Representative Lois Capps, a former school nurse, said meaningful healthcare overhaul cannot occur without fixing the nursing shortage. "Nurses deliver healthcare," Capps said in a telephone interview. An estimated 116,000 registered nurse positions are unfilled at U.S. hospitals and nearly 100,000 jobs go vacant in nursing homes, experts said.

The shortage is expected to worsen in coming years as the 78 million people in the post-World War Two baby boom generation begin to hit retirement age. An aging population requires more care for chronic illnesses and at nursing homes.

"The nursing shortage is not driven by a lack of interest in nursing careers. The bottleneck is at the schools of nursing because there's not a large enough pool of faculty," Robert Rosseter of the American Association of Colleges of Nursing said in a telephone interview.

Nursing colleges have been unable to expand enrollment levels to meet the rising demand, and some U.S. lawmakers blame years of weak federal financial help for the schools.

Almost 50,000 qualified applicants to professional nursing programs were turned away in 2008, including nearly 6,000 people seeking to earn master's and doctoral degrees, the American Association of Colleges of Nursing said.

PAY DIFFERENCES

One reason for the faculty squeeze is that a nurse with a graduate degree needed to teach can earn more as a practicing nurse, about $82,000, than teaching, about $68,000.

Obama called nurses "the front lines of the healthcare system," adding: "They don't get paid very well. Their working conditions aren't as good as they should be."

The economic stimulus bill Obama signed last month included $500 million to address shortages of health workers. About $100 million of this could go to tackling the nursing shortage. There are about 2.5 million working U.S. registered nurses.

Separately, Senator Dick Durbin and Representative Nita Lowey, both Democrats, have introduced a measure to increase federal grants to help nursing colleges.

Peter Buerhaus, a nursing work force expert at Vanderbilt University in Tennessee, said the nursing shortage is a "quality and safety" issue. Hospital staffs may be stretched thin due to unfilled nursing jobs, raising the risk of medical errors, safety lapses and delays in care, he said.

A study by Buerhaus showed that 6,700 patient deaths and 4 million days of hospital care could be averted annually by increasing the number of nurses. "Nurses are the glue holding the system together," Buerhaus said.

Addressing the nursing shortage is important in the context of healthcare reform, Buerhaus added. Future shortages could drive up nurse wages, adding costs to the system, he said.

And if the health changes championed by Obama raise the number of Americans with access to medical care, more nurses will be needed to help accommodate them, Buerhaus said.

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And American Nursing Shortage was covered in the program NOW in PBS a month or two ago.

We all understand the timing of our petition is at the worst possible time in the US economic history. When tens of millions of illegal immigrants can come out to the streets across many big cities in the US seeking their rights, and when President Obama himself promised Immigration Reforms in his primaries and esp. in Hispanic Channels, I think we international RNs should be allowed to press forward our concerns and something which is endorsed by fellow American citizens, the media houses, and some of the well-known American senators themselves.

As regards to some personal questions regarding my qualifications, I am a qualified RN from NY State. And please, I am definitely not from that tiny percentage of previliged families from the third world countries who can afford to send their kids to the most expensive universities anywhere in the world. I went to NYU with my own savings, borrowings from my relatives and with loans from banks. As regards to contributing back to my home country Nepal, flying to Nepal is quicker than walking for days in my mountain terrains back home. So, flying time matters more than the geographical distance in today's global world. If Dr. Paul Farmer, President Carter, Clinton and rich personalities like Bill and Melinda Gates, and someone as poor as Greg Mortenson (please read "Three Cups of Tea") can contribute globally from America to such an extent, and my own personal hero late Sir Edmund Hillary from New Zealand can do so much in my own country, so can I with my qualifications and experience (if given the opportunity). AND for that matter, I shall not ask you to go and serve in the US inner-cities and in reservations and ask you to volunteer for community services, even though President Obama certainly encourages every American to do it! To me it is a personal decision that one has to make.

I will help my country one day and that is my dream, and nothing that someone can force me to. Coming from one of the poorest contries in the world, I can definitely take so many positive aspects of US medical and nursing practices back to Nepal and improve the health care situation there. But you will have to let me stand on my own feet first. Please do forgive me but I shall refrain from answering personal questions from this point onwards, but anything to do with USIRNs and my international friends, I shall be more than happy to answer. Our petition was not supposed to be offensive in any regards, but if it has, our sincere apologies. A famous Tibetan Rinpoche (revered monk) says "In Silence we find our answers" and I shall certainly encourage you to spend some good amount of time in our website and you will realize why we decided to make this petition. If it still does not make any sese, once again, our sincere apologies. Lastly, I thank Suzanne from the bottom of my heart for her generous services to Allnurses.

Thanks and our hearts are with Americans in these difficult times.

Ginger's Mom, MSN, RN · Mar 18, 2009

I have issues with people cutting in ahead of the line. I read how many nurses here are waiting to come to the USA to practice and have been hit hard by retrogression. If the doors are going to open, these nurses are the ones who should be allowed to migrate.

Read the boards here, many nurses are loosing their jobs. There is no nursing shortage. And as a Clinical Instructor there are many students in the pipeline, and hopefully more when Clinical Instructors can afford to leave their day job and teach fulltime.

Go back to your home country and elevate nursing practice, that would truly be a wonderful thing to do.

To Summarize, nursing who have been patiently waiting should get entry first. Second there is no need for qualified IEN to stay. Of course this is only my opinion, and since I am registered voter I will contact my legislators.

Kosmonavt · Mar 18, 2009

I agree that the U.S. citizens should have an advantage in getting jobs, and anyone who is familiar with the U.S. employment-based immigration system will confirm that per established procedures for nurses, employers have to prove that no American applied for the position for some period of time (for non-unionized hospitals that's about 44 days) immediately before the immigrant petition was filed, AND a petition will not be approved if any layoffs took place during the last 6 month or so. But I do believe that International students educated in the US should have some advantage over those waiting in other countries.

Let's look how things work in countries like Canada or Australia. International students educated in those countries DO have some reasonable advantage over those educated abroad due to the facts they

Have better adaptability;
Spent their money for education there (providing extra revenues for universities), not abroad;
Have better knowledge of English;
Are more competitive and proactive comparing to those passively waiting abroad.

Almost a half of the immigrant visas in Australia are granted to those already in the country on student and work visas. Canadian and Australian immigration is mostly employment based, and they change their immigration quotas annually based on the market demands. Until recently, one could emigrate to Australia as a carpenter, just because there were not enough Australians willing to take those jobs! Now, as market gets saturated, they removed that profession from the list. Now, compare that to the US. Out of almost 2 million immigrants coming here annually, only less than 140,000 (or 7 percent) are coming here through employment. The quotas have not been revisited for over a decade! Since there is no avenue for the legal immigration for many much needed professions, both employers and workers have to violate the law. Please don't forget, that by the time most of the international new grads were accepted into the BSN programs the job market was much better and Schedule "A" EB3 visas were available as well. Who could predict that things will turn upside-down in a relatively short period of time?

Daly City RN · Mar 20, 2009

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The U.S. lawmalers are currently saddled with gargantuan economic problems that would take many years to solve. Many nurses who are U.S. Citizens cannot find nursing jobs. During these hard economic times I don't think that the U.S. lawmakers will prioritize the plights of the International RNs who are not even U.S. citizens. Unemployed U.S. citizens should be their priority, and rightfully so.

Also, put yourself in the shoes of those RNs living abroad who have been waiting for many years to get a U.S. visa. You wouldn't be happy if someone tried to cut in line, would you?

You were right when you said you are selfish. Therefore, be professional and do the right thing. Kindly go to the end of the line and wait for your turn.

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Kosmonavt · Mar 20, 2009

There is no line cutting (the hint word is "priority date").