Stop Foreign Nurses

EmBeMap · Jul 10, 2008

I understand your complaint about foreign nurses lowering the wages. My previous career was in IT (7 years) where outsourcing and cheap labor in INDIA is a huge problem. But slowly companies have begun to realize that you get what you pay for and bring the IT jobs back because The poor english skills and disparity in education and adaptabilty factor in american trained IT people wins out in the end. Do you really want the jobs at the places that are so cheap as to do what you are claiming "greasing the wheels". I mean I don't begrudge juan the dishwasher job at CICIs pizza because I went to school and have outgrown that job. They can only take jobs we don't atively compete for. If you do it better and faster you will win out , eventually. Look at the Shell Oil IT outsourcing debacle online.

Home Health Columnist / Guide · Jul 10, 2008

06/17/08: ana testifies on registered nurse immigration

the american nurses association (ana) testified on capitol hill thursday, june 12 on the issue of registered nurse immigration. ana senior policy fellow cheryl peterson, msn, rn spoke before the judiciary subcommittee on immigration, citizenship, refugees, border security, and international law on the issue of foreign educated nurses.

read ana media advisory and testimony...

ana testifies on capitol hill on registered nurse immigration (6/13/08) media advisory [pdf]

..."over reliance on foreign educated nurses by the health care industry serves only to postpone efforts to address the needs of nursing students and the u.s. nursing workforce. ana maintains that it is inappropriate to look overseas for nursing workforce relief when the real problem is the fact that congress does not provide sufficient funding for domestic schools of nursing, the u.s. health care industry has failed to maintain a work environment that retains experienced u.s. nurses, and the u.s. government does not engage in active health workforce planning to build a sustainable nursing and health professions workforce for the future." cheryl peterson, msn, rn, ana senior policy fellow.

statement for the committee on the judiciary - subcommittee on immigration, citizenship, refugees, border security, and international law on registered nurse immigration [pdf]

...nurse retention
consistently high turnover rates and dissatisfaction with the current work environment also continue to complicate efforts to address the nursing shortage. experienced nurses are reporting high levels of burn out, turnover among new nurses is very high, and large numbers of nurses are leaving the profession outright. a study reported in last month’s journal of nursing administration shows that 43 percent of experienced nurses score abnormally high on indicators of job burnout. in a study released last year, the price waterhouse cooper’s health research institute reported that 27 percent of new nursing graduates leave their first jobs within a year. these studies are consistent with many others taken over the last two decades.

in an effort to ascertain the extent and cause of nurse discontent, ana recently conducted an on-line survey of nurses across the nation. more than 10,000 nurses took the opportunity to express their opinions about their working conditions. results from the survey, revealed on may 21, show that more than 50 percent of nurses are considering leaving their current job, and that nearly a quarter of all nurses are considering leaving the profession altogether. sixty percent reported that they knew nurses on their unit who had left due to concerns about working conditions. it should concern all of us that the majority of nurses involved in this survey believe that the poor working conditions in their facility are harming patient care. more than 50 percent of the respondents stated that they believe that the quality of nursing care on their unit had declined over the last year, and that more than 48 percent would not feel confident having someone close to them receive care in the facility where they work.
years of discontent with the work environment have led us to a situation in which an alarming number of our experienced rns have chosen to leave the profession. the 2004 national sample survey of registered nurses conducted by the department of health and human services shows that a large number of nurses (488,000 nurses - nearly 17 percent of the nurse workforce) who have active licenses are no longer working in nursing. numerically speaking, if these nurses were to re-enter the workforce today, the current shortage would be solved....
immigration
the ana opposes the use of immigration as a means to address the growing nursing shortage. as you are well aware, immigration is the standard “answer” proposed by employers who have difficulty attracting domestic nurses to work in their facilities. it is disheartening to be here contemplating largescale nurse immigration yet again, when we have been down this road many times before without success.
in addition to the impact of nurse immigration on the domestic workforce, there are serious ethical questions about recruiting nurses from other countries when there is a world-wide shortage of nurses.
according to the leonard davis institute of health economics, the source countries for foreigne ducated nurses shifted toward low-income countries and those with a low supply of nurses during the period of 1990 to 2000. this same report notes that almost 20% of the world’s nursing population is in the united states, including half of all english speaking professional nurses....

EmBeMap · Jul 10, 2008

I know I will get flamed for this but every job has good things and bad things. Some days it will suck...That's why its called WORK. Nurses have it hard yes (but its a HARD job) no amount of ratios or changes will ever make it easy. Better preparation for the pt loads and what real life nursing looks like will cut down on the turn-over. And no offense but I haven't ever heard on the news amount massive amounts of nurses losing there licenses due to theses awful conditions. Just a lot about people who quit nursing for fear of losing their license or mal-practice. Well guess what you buy insurance and you continue to practice as safely a you can until they pry that license from your cold dead hands if you really want to be a nurse, you don't quit when its to hard.

Home Health Columnist / Guide · Jul 10, 2008

nurseweek: foreign investments...

..but critics of foreign nurse recruitment point to a darker side to the practice of hiring international nurses for positions in american hospitals. they suggest that recruiting foreign nurses is a short-term solution to the shortage and argue that hospitals shouldn't be doling out thousands of dollars to recruit each foreign nurse, but instead should direct that money to strategies that will attract americans to those jobs. opponents also question the morality of taking nurses from countries struggling with shortages of their own.

global stopgap for us nurse deficit | csmonitor.com

...it is not easy to practice as a nurse in the us, and many foreign-educated nurses also go to countries like england and canada. here they must pass english proficiency exams and other competency tests - goals that ms. peterson says the ana supports to ensure standards. some hospital groups and others want to loosen those barriers. "where the rub comes with us, with regard to immigration, is that we have no national workforce planning for healthcare professionals," she says. "we totally let the market dictate."

azna ~2002: foreign-educated nurses: ensuring success for patients and nurses ...

empire of care: nursing and migration in filipino american history - google books result

NursKris82 · Jul 10, 2008

Foreign Nurses are wonderful people and they are great contributors yes, but they are needed in their own countries or origin for their is a worldwide shortage of nurses.

Wow!! Who are you to tell someone where they can live and practice as a nurse!! America is indeed the land of opportunity. If they are here legally and working as nurses legally then there is no issue. Also, you mentioned the nursing shortage helps keep us in demand, but what about the stress of being short- staffed. What about the patients? This whole discussion is flat out racist. Nothing more, nothing less. If you feel your job is being threatened, increase your capabilities and become a better nurse- don't blame another nurse for your own short comings!! :angryfire

RN1989 · Jul 10, 2008

This country needs to get on the same page that there is NOT a shortage of licensed nurses in the US. There is a shortage of licensed nurses willing to work in unsafe conditions, intolerable conditions, for terrible wages.

The influx of foreign nurses into this country hinders nursing's collective ability to force employers to provide adequate staffing, appropriate orientation/job training, and decent wages for the work being done.

The foreign nurses coming from such underdeveloped countries like the Philipines and Africa are desperate to get the to the U.S. They are willing to take a job anywhere for any amount of money. With the threat of losing their visa and being deported hanging over their heads, they will tolerate any amount of inappropriate behavior from employers including continuing to work in facillities that are unsafe for both patients and staff.

These nurses will work large amts of OT to get the extra money, regardless of whether they have enough rest to be able to function properly. This OT work is also how employers justify not hiring enough staff because they have enough nurses willing to work lots of OT.

Many foreign nurses are too afraid to speak up when things are bad. These nurses often come from countries where women are subservient to men and they have been taught to smile and keep quiet. This coupled with their fear of losing their job and/or being deported makes these nurses easy prey for employers wanting to put money ahead of patient safety.

As seen on other threads, when foreign nurse have tried to stand up and say "no more" they have been prosecuted by our justice system. I have never seen this same type of thing happen to US nurses.

Many of these nurses are not coming here to become citizens and productive members of our society. They are only interested in large sums of money and perpetuate the problem by seeking out employers who are notorious for unsafe conditions but pay large wages or sign on bonuses. These nurses are only interested in making money and sending it home with their ultimate goal being to go back home when they have amassed enough to live on in their country. This lack of dedication to being a productive member of of the US nursing society keeps this nurses from being interested in changing nursing for the better. They continue to allow employers to get away with low standards because they are willing to work for bad employers, many times in places where US nurses are unwilling to work, such as the southern US border towns and other "icky" places to live.

As far as some people not believing in "diploma mills", they do exist. The tests that foreign nurses take can be passed by someone who has not been trained to the standards of US healthcare. I have found that the new computer NCLEX is passing US nurses that are unsafe to practice which tells me that someone that is good at taking exams can pass the tests needed to practice in the US.

I have worked with and managed foreign nurses and have found that there is a disparity in training for nurses coming from poor countries. Some nurses have gone to excellent schools and do well here but others are so scary that they have killed people with their lack of knowledge. You never know which one you will get when you start negotiating with one of these import agencies.

Usually I have nothing in common with the ANA but I was happy to see that they have finally seen the light and gone against the big buck facilities with their statements on foreign nurses.

As long as there are foreign nurses standing in line to work in unsafe conditions and keep their mouth shut about it and not try to change things, we will not be able to make the sweeping changes needed in this country.

cherrysky · Jul 10, 2008

Protecting our profession? Our profession is practiced in other countires as well. If it is "nothing personal", why make your username "Stop foreign nurses" and why are you blaming the foreign nurses for "taking over" LTC? It certainly sounds personal. If you want to blame someone or some group, why not blame the administration, not the foreign nurses.

The OP just sounds racist.

GilaRRT · Jul 10, 2008

I love it. Everything is so black and white. What if I have a foreign nurse that is more qualified than her/his domestic counterpart? Since it's all about the profession and providing the best nursing care possible, give it to the foreign nurse. Nothing personal, it's all about the profession.

Come on people, this is a complicated subject. We simply cannot say "stop foreign nurses." I understand the problems but it not as simple as stopping foreign nurses from working in this country.

Nurse Salt · Jul 10, 2008

The issue I see with foreign people coming over to our country (at least with the hispanic population) is that some of them are bilingual and that is a big plus for them seeing as many who come here do not learn the language and our higher ups somehow think that we need to accomodate the non-english speakers. I see job ads now that require a person to be bilingual and it seems to me that they will have the upper hand being able to speak two languages. It may seem short sighted but a great deal of people I know will not learn spanish simply b/c this country is an english speaking one and anyone who comes here needs to learn english. Peace

English is NOT our national language, it just happens to be the one spoken by the majority of the population. And to refuse education for as flimsy a reason as "they don't want to learn" is ridiculous, close minded and ignorant!

My concern with foreign educated nurses, is it seems many of them were never taught about cultural diversity... I know that is something heavily emphasized in US nursing schools as we are a country of immigrants. We are taught about different common cultural practices surrounding health, sickness, and death/dying. But I have often seen foreign educated nurses treating patients with a lack of compassion, not because they are cold but simply because specific emotions are considered a weakness or unnecessary in their country. I value foreign educated nurses as they are a great resource, but I also value compassion, caring and understanding of different beliefs. As health care providers we must often set aside our own beliefs to make our patients more comfortable...

cherrysky · Jul 10, 2008

Someone here said something like "foreign nurses are willing to work in horrible conditions which means the conditions will never change for us". GIVE ME A BREAK. Those "desperate" nurses from the Philippines and Africa are used to walking MILES just to get some fresh water. They are merely more adept to working hard than Americans. Let's face it, as a society we are extremely lazy so when we see some foreigner that's willing to work his or her butt off and not complain in order to achieve the "American dream" all of a sudden everyone gets defense because THEY start to look bad. Don't get me wrong, I know many Americans are overworked, especially nurses, but for the most part we are an extremely lazy society so don't go blaming hardworking foreign nurses as the ones that are not allowing conditions to get better in America. "STOP FOREIGN NURSES"? Let's stop our ignorance and laziness instead.

Home Health Columnist / Guide · Jul 10, 2008

ethics of recruiting foreign nurses, the | health progress | find ...

...the nursing shortages in poorer developing countries stem from three major challenges.
hiv/aids epidemic the hiv/aids epidemic in sub-saharan africa has increased the need for nurses in those countries-especially because the illness has taken many nurses' lives.
external and internal migration the emigration of nurses to other countries is one cause of shortages in developing nations. so, too, however, is "internal migration"-the movement of nurses "from rural to urban areas, from public sector employment to private sector employment, and from nursing employment to non-nursing employment (or no employment)."7
nursing workforce issues developing countries have failed to attract candidates to the nursing profession in part because they have not adequately addressed such issues as low nurses' pay, long working hours and poor working conditions, insufficient educational opportunities and training, and the inappropriate use of skills.8
these three factors considerably affect the number of nurses available to provide care in developing countries, thereby aggravating a nursing shortage that was already substantially greater than those in the united states and other developed countries. the average nurse-to-population ratio in this and other developed countries is almost eight times greater than the ratio in developing countries. for example, uganda has six nurses for every 100,000 people, whereas the united states has 773 nurses for every 100,000 people.9 of course, the low nurse-to-patient ratio found in developing countries is driven even lower when nurses emigrate to developed countries....

posted at medscapenurses:

from nursing economics

foreign-educated nurses: an overview of migration and credentialing issues

posted 04/30/2007

conclusion:
foreign recruitment is not a permanent solution for the escalating international shortage of nurses. increased recruitment of foreign-educated nurses to the united states has wide ranging effects on nurses, the health care system, and populations worldwide in both donor and receiving countries. foreign-educated nurses must adjust to numerous cultural, social, and organizational experiences. it is pertinent to evaluate educational patterns, cultural differences, and economic and public policies as they relate to the use of this workforce. stringent policy and practice guidelines for foreign-educated nurse recruitment and migration must be monitored.
foreign-educated nurses who enter the country meet u.s. educational standards. they deserve the same workplace protection as u.s. nurses. not only do these nurses fill vacancies, they also bring a wealth of talent and cultural diversity to health care facilities as clinicians, educators, and re searchers. they add diversity to the u.s. workforce and can assist staff in understanding cultural differences, as well as assisting non-english speaking patients and families in communicating with the health care team...

2004: imported care: recruiting foreign nurses to u.s. health care ...

the agencies. in recent years recruitment agencies have been placing foreign nurses in larger numbers in states that attracted both large and small numbers of nurses in the past. in 1992 california and new york were home to nearly half of all foreign nurses in the united states. by 2000 their shares of foreign nurses had declined to 38 percent, while the combined shares of the next most frequent locations—florida, illinois, michigan, new jersey, and texas—rose to equal them. more than half of the remaining states saw increases in their shares of foreign nurses.34
venkat neni’s global healthcare recruiters provides a good example of the marketing allure of foreign nurses in states that previously did not typically recruit or employ international nurses. a physician in india before immigrating to the united states, neni founded his wisconsin-based agency in 2002. in less than a year he successfully supplied 145 nurses from india to milwaukee’s columbia st. mary’s and oshkosh’s mercy medical center. in november 2002 he and executives from covenant healthcare system in milwaukee traveled to india and hired another 100 nurses. in an interview with the milwaukee journal sentinel, neni shared his goal to recruit an additional 500 nurses to wisconsin by 2004, estimating profits to exceed $5 million.35 neni’s earnings pale in comparison with those of more established firms.36

on average, hospitals pay recruiting agencies $5,000–$10,000 per nurse.37 in return, nurses contract to work from two to three years in the hiring institution. in the covenant healthcare system example, global healthcare agreed to fully refund the recruiting fee to the hospital if a nurse recruit failed to continue working past three months. the hospital was partially repaid if nurses fell short of their three-year commitment.

the hiring facilities. although hospitals agree that the initial cost of recruiting foreign nurses is higher than that of hiring domestic nurses, many feel that they save money in the long run because of reduced turnover and the agency’s assurance of full or partial remuneration if recruited nurses fail their contractual obligations. recruiting abroad may also be less costly than raising salaries, increasing benefits, and providing other economic incentives needed to retain domestic nurses. under the terms and conditions of hiring foreign nurses from recruiting agencies, therefore, hospitals enter into a relatively risk-free arrangement that provides further incentive for procuring staff abroad. strategies for such recruitment at one facility are described in a 2003 aha report on workplace innovations.38
the advantages of recruiting foreign nurses have had particular appeal for long-term care facilities. since 1989 nursing homes have secured foreign nurses through an "attestation" process stipulated in the immigration nursing relief act (inra).39 in recent years recruitment agencies have capitalized on the crisis in long-term care staffing, partnering with nursing home operators to provide nurses from several countries.40 long-term care institutions will likely continue to look abroad to fill nearly 14,000 staff rn and 25,100 licensed practical nurse (lpn) vacancies.41 ...

workforce strategy issues. finally, u.s. workforce planning efforts require the development of systems that monitor the inflow of foreign nurses, their countries of origin, the settings where they work, and their impact on the nurse shortage. increasing demand for foreign nurses in the face of greater domestic production is a signal that domestic efforts are insufficient to keep up with demand. a broader-based workforce strategy that balances foreign nurse recruitment, domestic production, and concerted retention efforts is needed to ensure that the nursing care needs of the public will be met.

WickedRedRN, BSN, RN · Jul 10, 2008

The comment that Kindred is the worst offender? As a Kindred employee in both a LTC and an LTAC, I have to say I have only worked with ONE foreign nurse, and she is awesome. Not to mention, she is no longer "foreign" to me, she is in the process of naturalization, so she will be just as American as you and I.