recruitment of foreign nurses to the United States

The New England J of Medicine on 10/27/05 carried an article about global patterns of recruitment of nurses. There is a global shortage of nurses. In the United States, the shortage is estimated at 126,000.
In an earlier posting, I reported that of the roughly 3,000,000 nurses in the country, about 11% are foreign workers. The authors say that the United States cannot expect to resolve a nursing shortage by foreign worker recruitment, in part because of global shortages of nurses. A letter responding to the article asserts that low compensation and few education slots are responsible for the nursing shortage.
The article reports that in 2005 a new law to expedite nursing recruitment from overseas was passed: the Emergency Supplemental Appropriations for Defense, the Global War on Terror, and Tsunami Relief. The law provides for 50,000 new foreign nurses. The law discards a prior policy of requiring that each recruitment be backed up with a prevailing wage certification.

this problem is the fact that as baby boomers are growing older and their medical needs are increasing, enrollment in nursing schools is declining. Increasing demands on nurses, partially a result of the shortage of nurses, have led to early career burnout, with as many as 20 percent of nurses retiring early. The Department of Health and Human Services projects that by 2020, the shortage of registered nurses in relation to demand will reach 29 percent, with more than 1 million nursing positions left open.

About recruiting of foreign nurses in the United Kingdom….

For years, the National Health Service (NHS) of the United Kingdom relied heavily on the direct recruitment of nurses from African countries such as Botswana, Ghana, Malawi, Nigeria, Kenya, South Africa, Zambia, and Zimbabwe — all former British colonies. These very countries have been among those hit hardest by the HIV pandemic; some have a prevalence of HIV infection of 30 to 40 percent, with a majority of the young, working population debilitated by disease, and are reporting huge nursing shortages themselves….More than half the nursing positions in Kenya and Ghana remain unfilled. As a result, many health clinics in Kenya have closed and many others are severely understaffed. The nursing shortage in the developing world is being felt more intensely even as increased foreign aid becomes available to provide drugs for millions of people with AIDS.

Although the British government promised in 2001 to stop the direct recruitment of nurses from countries with nursing shortages, large private-sector institutions continue to lure nurses from many African countries; 7000 African nurses have registered to work in the United Kingdom since 2001. Meanwhile, the NHS continues to recruit nurses from India, the Philippines, and Spain: countries that supposedly have a national surplus of nurses but that have regional or specialty-specific shortages. Private-sector hospitals in these countries tend to retain their nurses longer than public-sector hospitals do.

Ironically, for every two nurses recruited from overseas to work in the United Kingdom, one nurse certified in the United Kingdom emigrates. Many of these nurses end up in the United States, along with nurses from other developed countries such as Canada, Ireland, and Australia, all of which have their own nursing shortages. In effect, the nursing crisis is global, with developed countries stealing nurses from one another and developing countries subsidizing richer countries with nurses they cannot afford to lose. Entire public health systems are at risk of collapse because of the growing shortage of nurses in the developing world.

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