Washington, Feb. 3 (BNA): With US hospitals facing a severe nurse shortage amid a severe pandemic, many are looking abroad for health care workers.
It can be timely.
There are an unusually high number of green cards available this year for foreign professionals, including nurses, who want to move to the United States — twice as many as just a few years ago.
That’s because US consulates closed during the coronavirus pandemic have not issued visas to relatives of US citizens, and by law those unused boxes are now being passed on to eligible workers, the Associated Press reports.
Amy L. Erlbacher Anderson, an immigration attorney in Omaha, Nebraska, said she’s seen more demand for foreign nurses in two years than in the rest of her 18-year career. This year, she said, they will likely be approved to attend, as long as US consular offices can process all applications.
“We have twice the number of visas we’ve had for decades,” she said. “This kind of temporarily created a very open situation.”
American hospitals have a nurse shortage that has only worsened as pandemic fatigue has led many to retire or leave their jobs. Meanwhile, coronavirus cases continue to rise and fall, putting enormous pressure on the health care system. In California alone, there is a gap of 40,000 nurses, or 14% of the workforce, according to a recent report from the University of California, San Francisco.
Hospitals are closing the gap by hiring mobile nurses, but this can be costly. Hospital administrators say there aren’t enough nurses graduating from American schools each year to meet demand.
Some hospitals have long brought in nurses from the Philippines, Jamaica and other English-speaking countries, and more are now following suit. Both old employees and newcomers are trying to cash in on the windfall green card gains before the fiscal year ends in September.
The United States typically offers at least 140,000 green cards each year to people who move to the country permanently for certain professional jobs, including nursing. Most are issued to people already living in the United States on temporary visas, although some go to overseas workers. This year, 280,000 of those green cards are available, and recruiters hope for some extras from nurses seeking work in hospitals overwhelmed by epidemics in the United States.
The Biden administration, which has taken steps to reverse Trump-era policies restricting legal immigration, has taken some steps to try to help foreign health care workers so they can help with the pandemic. US Citizenship and Immigration Services said it will speed up work permit renewals for health care workers, which could help keep some foreign nationals already in the United States in their jobs. An agency official said the State Department asked consulates last year to prioritize applications for workers at facilities responding to the pandemic.
Faith Akinmade, a 22-year-old nurse from Nigeria, is among those hoping for a quick fix. After completing his undergraduate studies in the United States, Akinmade worked as a nurse in the intensive care unit at the University of Louisville Hospital in Kentucky. But her work permit is set to expire in March. She said she needed to renew, or approve her green card, to stay on the job.
“At this point and time, I feel like a believer that at the end of March something will come up to keep working,” Akinmade said. She said the issue affects many of her international colleagues as well as local colleagues, who may be pressured to take work shifts for their colleagues if their immigration paperwork is not done.
Dr. Roxy Wells, chief of Cape Fear Valley Hawk Hospital in Reford, North Carolina, said she began trying to bring in foreign nurses before the pandemic, but it wasn’t until last year that those recruits began conducting consular interviews in greater numbers. So far, about 150 have been approved for work, but Wells said they are still waiting for another 75.
“It’s clearly becoming more important during the pandemic,” she said. “The 150, if we didn’t have it, we’d be in a precarious situation.”
The sudden rise in the omicron variant in the United States has made the strained employment situation more pronounced in hospitals, where health care workers, like many others, have contracted the highly contagious virus and have been sidelined from work at a time when more patients are coming here.
Sinead Carberry, head of nurse recruitment solutions at AMN Healthcare, said demand for international nurses has risen between 300% and 400% since the pandemic began. She said that the number of nurses who could be brought to the United States even with additional green cards would not be enough to meet the demand, and many recruiters are now seeking to hire nurses abroad due to the availability of immigrant visas.
“This is a good opportunity,” she said. “Because everything is flowing so well, there is a lot of competition for that talent.”
The National Nurses’ Union, a union representing 175,000 registered nurses, said more scrutiny should be done on international recruitment to ensure foreign nurses are not brought in and subjected to unsafe working conditions. The union alleges hospitals have fired American nurses by keeping staffing levels too low — and this was long before there were concerns about worker safety and protection during the COVID-19 pandemic.
Michelle Mahon, the union’s assistant director of nursing practice, said many foreign nurses sign multi-year contracts with employers, which can make it difficult for them to talk about work or patient safety concerns. She said hospitals that have seen nurses quit during the pandemic are turning to an overseas workforce to replace them.
“This kind of dynamic is particularly attractive right now for employers who haven’t made any necessary changes to ensure patient and nurse safety during the COVID-19 pandemic,” Mahon said. “Instead of tackling the actual problem, they want to go and focus on this other really fake solution.”
However, hospital administrators maintain that there are not enough trained nurses in the United States to move around. Patti Jeffrey, president of the American Association for International Health Care Employment, said the United States should expand nursing education programs to train more nurses locally, as well as allow more nurses to come from abroad. But she acknowledged that bringing in far more nurses would require legislation.
“The calls are ringing every day non-stop: We need 100, we need 200, we need all these nurses,” Jeffrey said.
Jorge Almeida Neri, a 26-year-old nurse from Portugal, arrived in the United States in December, although he started the operation before the pandemic spread. He said the required international nursing exam was delayed due to the virus and it took four months for a consular interview, although other international nurses he interviewed waited longer. He gave an interview about his current job at a hospital in Virginia, which he got through a recruitment agency, about a year ago.
“After getting everything certified, the immigration process started, and I said, ‘Oh, that’s going to be fast. “I was wrong,” he said.
Almeida Neri said that many Portuguese nurses seek to work abroad because wages are low, although many of them go elsewhere in Europe, which does not take as long as the United States.
Despite the demand, there is no guarantee that hospitals will in fact receive more visas. Greg Siskind, an immigration attorney, said US consular offices are not required to issue visas simply because they are available, hampered by restrictions on remote work and video interviews. He said most employment-related green cards tend to go to professionals already in the United States, not abroad, although more could be done to speed them up as well.
Of the possibility that the US government will issue all available visas, he said, “Under their current policies, if they don’t make any changes, it will be difficult, but there are a lot of things they can do.”