Importing Foreign Nurses is Not a Long-Term Solution to Staffing Shortages

To ease the burden of the coronavirus pandemic on hospitals, both New Jersey and New York approved the fast-tracking of medical school graduations to get more hands to the front lines. Connecticut Gov. Ned Lamont and the Veterans Health Administration have issued pleas to retired medical professionals to return to service. But some believe there is an additional need and are calling for expedited processing of visas for foreign nurses.

In an April 3 letter to Secretary of State Mike Pompeo, Secretary of Labor Eugene Scalia, and Acting Secretary of Homeland Security Chad Wolf, Georgia Senators Kelly Loeffler and David Perdue, both Republicans, urged the Trump administration to prioritize the processing of EB-3 visas for foreign nurses.

“Our nation’s hospitals will be overwhelmed if they are not able to hire more nursing staff. We urge you to help our hospitals address this crisis by expediting your processing of visas for immigrant nurses,” they wrote. Senator Bill Cassidy (R-La.), who is a doctor, co-signed the letter.

The State Department did encourage foreign medical professionals, particularly those working on COVID-19 treatment, to contact the “nearest embassy or consulate for procedures to request a visa appointment.” Ian Brownlee, the assistant Secretary of State for Consular Affairs, clarified a day later that the March 26 guidance only applied to those “already accepted into existing U.S. programs.”

While foreign-educated nurses may be necessary in the short-term, foreign recruiting groups and like-minded columnists are trying to exploit the current crisis to make a case for importing foreign nationals to fix a decades-old problem – a shortage of nurses.

The first problem with this argument can be found in a new World Health Organization (WHO) report that finds a global shortfall of 5.9 million nurses. The greatest gaps are found in poorer countries, such as India and the Philippines, which happens to be the source of most immigrant nurses in the U.S. and Europe.

To reverse the shortfall, WHO suggests “countries that are over reliant on migrant nurses should aim towards greater self-sufficiency by investing more in domestic production of nurses.” Second, ours is not a problem of a lack of interest in nursing, but a dearth of nursing school teachers. As CNN reported, despite a rising number of retirements, nursing schools rejected more than 56,000 qualified applicants from undergraduate programs in 2017.

According to a survey issued by the American Association of Colleges of Nursing, U.S. nursing schools turned away 75,029 qualified applicants from baccalaureate and graduate nursing programs in 2018 with most schools pointing to faculty shortages as a reason for not accepting all qualified applicants into baccalaureate programs. Again, another problem for which importing more nurses won’t fix.

Lastly, a 2014 paper from the Boston Federal Reserve Bank concluded that while importing foreign-born nurses may be a short-term solution, it comes with long-term negative consequences. The researchers found that wage rigidity may “limit the scope for observable wage declines.” However, “foreign nurses reduce employers’ incentives to improve working conditions,” which affect overall job satisfaction among native nurses.

That matters because several studies and surveys determined job satisfaction and the quality of the work environment were more important than wage levels to nurses when they were weighing retirement, which is a major reason for the current shortage.

“Our findings that there are large displacement effects on the native nurse population suggest that relying heavily on foreign nurses to fill the gap in the U.S. healthcare workforce is a potentially counterproductive policy in the longer run,” the Fed analysis concluded.

The COVID-19 pandemic has exposed many holes in our health care system, but importing more foreign nurses is nothing more than a Band Aid solution,