Wait for Foreign-Born Nurses is Getting Longer

The United States faces a critical lack of nurses in every corner of the nation. The U.S. Labor Department reports that the nation has an immediate shortage of 126,000 nurses. By some estimates, that shortage will grow to 500,000 nurses in seven years. Yet, it has never been more difficult than now for foreign-born nurses to get green cards.

"Right now it's looking like a little more than six years. That has got to be a record," says Carl Shusterman, an immigration lawyer in Los Angeles. "In the 30-something years I've practice immigration law it's never been that long."

Shusterman cites a March 9 visa bulletin from the U.S. State Department that lists waiting times for various categories of immigrants. As of April 1, 2009, the bulletin states, green card processing times for nurses and other immigrants in the EB-3 visa category will increase from four years to more than six years.

This is particularly tough news for the healthcare sector because—unlike just about every other sector of skilled labor—there is no temporary visa category for nurses. Hospitals and other healthcare entities have to apply directly for the green card on the nurses' behalf, and the six-year wait begins, even for nurses who've been educated at U.S. nursing schools.

Aileen Lange, manager of recruitment at White Memorial Medical Center, an Adventist hospital in East Los Angeles, says the 350-bed hospital needs help, but has stopped petitioning for foreign-born nurses because the wait is too long. "It's very painful for us," Lange says. "We really try to find as many nurses locally from our various schools, and schools associated with this hospital and through our religious affiliation. We go to regular job fairs. We go everywhere. It's become such a competitive environment that nurses will change hospitals for a little bit more money. We find the foreign nurses are a little more loyal."

White Memorial has about 700 RNs on staff or serving in other capacities and has about 20 vacancies to fill right now. To comply with California's strict staffing ratios, and with nowhere else to turn, White Memorial has hired temporary nurses.

"It's not that they're bad nurses, but they don't have the same commitment. They also make a tremendous amount more money and that causes a lot of dissention among the staff," Lange says. In addition, temporary nurses are a temporary fix. "It's like putting your finger in a dam. If fixes it for a moment but doesn't solve the problem," she says.

The nurse shortage is a problem recognized throughout healthcare. Nearly nine out of ten (88%) respondents to the HealthLeaders Media Industry Survey 2009 say that the nurse shortage would have a negative impact on their organization in the next three years.

So why is it so hard to bring in foreign-born nurses?

Shusterman blames the nurses unions, specifically the Service Employees International Union.

"The nurse unions really don't want any foreign nurses here," he says. "When it comes to non-nurses, they do back flips and say the immigration laws are too harsh. They want to organize illegal workers, and I'm all for that. But here we are trying to do it the legal way and they are against it. I don't know why nurses are different from everybody else they want to organize."

Calls to SEIU's Washington office seeking comment on the issue were not returned.

President Obama, a strong supporter of organized labor, at a healthcare summit this month in the White House, said recruiting foreign-born nurses "makes absolutely no sense."

Instead, Obama said the nation should be focusing on creating more nurse training programs to fill the void. "That's something that we've got to fix. That should be a bipartisan no-brainer, to make sure that we've got the best possible nursing staffs in the country," Obama told the gathering.

Shusterman, who regards himself as pro-union, who voted for Obama, donated money and worked for his presidential campaign, says the president and the unions are simply wrong. "The idea that they are going to get all these people in nursing schools and graduated to fill these vacancies to solve this problem in our lifetimes is fantasy land," he says. "We need every possible source. The president is just being informed by the nurse unions who don't want nurses to come here, which is a shame."

Far from posing a threat to organized labor, Shusterman says, foreign-born nurses would join unions and increase their membership, which would also address the unions' constant carping over staffing ratios.

"We've got about 90,000 people dying needlessly in hospitals every year and part of that is because there aren't enough nurses," he says. "I thought patients' needs were supposed to come before nurses' salaries. The only people getting hurt by the current system are American patients."