Nursing shortage should be top priority in health care and immigration reform

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Nursing shortage should be top priority in health care and immigration reform
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AS policymakers, special interest groups, health care professionals and others discuss the need for health care reform in the US and debate how this reform should take place, one of the most important issues to health care is being left out of the debate: the national nursing shortage. So far, the debate over health care has hinged around whether there should be a "public option," creating room for divisive ideological debate at the expense of any real progress toward improvements to the current broken system. The nursing shortage continues to exacerbate the health care crisis, such that no true healthcare reform can occur without immigration law reform.

The health care industry has and continues to face a crisis in filling current open positions with trained, skilled nurses. As the baby boomers enter their golden years, an increasing strain is put on the health care system to provide care for this large, aging population. Further compounding the problem is the fact that the current nursing population is aging as well.

For example, the average age of nurses in California is 47. The California Institute for Nursing and Health Care estimates that the state will need 108,000 new nurses by 2020 to fill the vacancies left by retiring nurses and to fill the new positions opened up to meet the increased demands for health care. Nationally, the US Bureau of Labor Statistics estimates that 1 million new and replacement nurses will be needed by 2016 to meet staffing needs.

Individual states have ramped up their efforts to tackle their individual nursing shortages by offering more grants and scholarships to nursing students and trying to increase enrollments at nursing schools. While these efforts may help meet some of the future nursing needs, they do little to nothing to meet current staffing demands — including the 135,000 open positions across the country for registered nurses. What makes this shortage all the more difficult to understand is the fact that there are hundreds of qualified, available nurses from other countries who are willing to immigrate to the United States but, because of the immigration system, cannot get a visa to enter the country.

There are two different categories of visas foreign nurses can apply for to enter the US to work: nonimmigrant visas and immigrant visas. Nonimmigrant visas are temporary visas that allow them to enter the US for a limited amount of time. There are three types of nonimmigrant visas nurses may be eligible for: H1-B visas, TN visas and H-1C visas.

Nonimmigrant visas present a couple of difficulties. First, they are valid for a limited amount of time, whereas the nursing crisis is an ongoing problem. Second, there are very few available nonimmigrant visas for which nurses can apply. For example, H1-B visas are only available to those who have a bachelor’s degree or higher and many nurses do not have the required educational degree. TN visas, on the other hand, are only available to qualified nurses from Canada and Mexico. Lastly, H1-C visas, which were created specifically to address the nursing shortage, are limited to only 500 per year and currently only 14 hospitals have the required certification to qualify for the visas!

The second option, immigrant visas, allows foreign nurses to receive permanent residence in the US, otherwise known as a "green card." Nurses typically are eligible for EB-3 visas, or a "third priority employment based visa." In order to apply for an immigrant visa, the foreign nurse must be sponsored by a US employer, like a hospital. The employer then must enter a lengthy application process before the foreign nurse can become eligible to apply for a visa. The process includes filing an I-140 petition and labor certification with the US Citizenship and Immigration Services (USCIS) office.

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