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Another Bill Aims to Increase International Nurse Supply

Analysis  |  By Jennifer Thew RN  
   October 10, 2017

The Emergency Nursing Supply Relief Act proposes to designate 8,000 visas for healthcare workers in shortage professions.

To help ease staffing issues, hospitals and health systems are seeking international nurses to fill vacant positions, but current visa regulations can make it difficult to ensure supply keeps pace with demand.

"My company has 1,000 open orders, and I would say that other companies within the AAIHR [American Association of International Healthcare Recruitment] are clearly in the hundreds, if not higher, of open job orders for international nurses," says Shari Dingle Costantini, MBA, RN, AAIHR.

She is chair of regulatory affairs and CEO of Avant Healthcare Professionals, a staffing agency that specializes in recruiting internationally-educated RNs.

But even though they are in demand, it can take years to bring an international nurse to the U.S. For example, there's typically a three year wait for Filipino nurses to enter the country, says Costantini.

Additionally, since the Trump administration has taken office, the process for bringing international nurses to the U.S. has slowed.

"We have been recruiting international nurses and healthcare professionals for more than 14 years. The delays we are seeing with government agencies since the change in administration are dramatic. They are truly creating a hardship for many healthcare clients in critical need of nurses," she says.

The Emergency Nursing Supply Relief Act, a house bill introduced in July by U.S. Rep. Jim Sensenbrennar, (R-WI), aims to address this problem.

Visa Criteria for International Healthcare Workers

The bill designates up to 8,000 visas in the employment-based immigration third preference category (EB-3) for nurses, physical therapists, and other healthcare professionals in critical needs categories.

The beneficiaries of these visas must meet specific requirements, Costantini says:

  • The profession must be on the Department of Labor's schedule A—a list of professions designated as shortage areas. Registered nurses and physical therapists are consistently on this list.
  • Nurses must pass an English fluency exam.
  • The applicants' education must be evaluated and deemed equal to a U.S. education.
  • Applicants must apply for and pass the NCLEX.
  • Foreign-issued nursing licenses must be reviewed to make sure they are authentic and unencumbered.

"Hopefully, it will allow for more nurses to come in. That's the goal," says Costantini. "Because of the requirements on nurses it's a little longer process to get them in, but knowing that you have those visas available, you'll begin to see that pipeline fill and deliver nurses."

Not All Legislation is Equal

Costantini points out that other bills addressing immigrant workers have been put forward, but not all of them would bode well for the supply of international nurses.

Take the Fairness for High-Skilled Immigrants Act introduced by former Rep. Jason Chaffetz, (R-UT).

"If that bill was passed in its current form, you would not have any international nurses coming in for about three to five years," she says.

Still the bill has gained traction in the house and has 230 cosponsors from both parties.

Costantini understands healthcare executives have many issues vying for their attention, but she encourages them to educate legislators about effects various bills can have on healthcare worker supply.

"They don't always put together immigration and the shortage," she says.

"We know right now healthcare workers are shortage professions and highly in demand. In a lot of rural communities, patients aren't going to have access to care if they don't have healthcare workers."

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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