US hospitals strain to seek foreign nurses amid visa drop



With US hospitals facing a severe shortage of nurses amid the raging pandemic, many are looking for healthcare workers abroad.

And it may come at the right time.

There was an unusually high number of green cards available to foreign professionals this year, including nurses, who want to move to the United States – twice as many as just a few years ago. That’s because US consulates closed during the coronavirus pandemic have not issued visas to relatives of US citizens, and by law these unused spaces are now being turned over to qualified workers. .

Amy L. Erlbacher-Anderson, an immigration attorney in Omaha, Nebraska, says she sees more demand for foreign nurses in two years than in the remaining 18 years of her career. And this year, she said, there’s a good chance they’ll be approved to come, as long as US consular offices can process all applications.

“We have twice as many visas as we have had for decades,” she said. “It’s the kind of temporary that creates a very open situation.”

US hospitals are grappling with a shortage of nurses exacerbated by pandemic burnout that has forced many to retire or leave their jobs. Meanwhile, coronavirus cases continue to rise and fall, putting enormous pressure on the healthcare system. In California alone, there are an estimated 40,000 nurses, or 14% of the workforce, according to a recent report from the University of California, San Francisco.

Hospitals are filling the void by hiring nurses to travel, but that can be expensive. And hospital managers say there aren’t enough nurses graduating from US schools each year to meet demand.

Several hospitals have long brought in nurses from the Philippines, Jamaica and other English-speaking countries, and many more are now following suit. And both established employers and newcomers are scrambling to take advantage of the opportunity to get a green card before the financial year ends in September.

The United States typically offers at least 140,000 green cards a year to people who move to the country permanently for certain professional work, including nursing. Most are issued to people already living in the United States on temporary visas, although some work abroad. This year, 280,000 of these green cards are already available, and employers are hoping some additional benefits can be gained as nurses look to work in pandemic-weary hospitals in the United States.

The Biden administration, which has taken moves to reverse Trump-era policies that have restricted legal immigration, has taken several steps to try to help foreign health care workers so they can assist them. pandemic support. The US Citizenship and Immigration Services said it would speed up the renewal of work permits for health care workers, which could help keep some foreign nationals already in the US working. Last year, the State Department told consulates to prioritize job applications for workers at facilities responding to the pandemic, an agency official said.

Faith Akinmade, a 22-year-old nurse from Nigeria, is among those hoping for a quick solution. After completing college in the US, Akinmade worked as an ICU nurse for the University Hospital of Louisville in Kentucky. But her work permit is due to expire in March. She said she needed to get an extension, or get her green card approved, to continue working.

“At this point, I just feel confident that by the end of March something will emerge to keep working,” Akinmade said. She said the issue affects many of her international colleagues as well as those in the country, who could be forced to change shifts for colleagues if their immigration proceedings are not cleared.

Roxie Wells, president of Cape Fear Valley Hoke Hospital in Raeford, North Carolina, said she had started trying to attract foreign nurses before the pandemic, but it wasn’t until last year that the new recruits started. The first was consular interviews with a larger number. About 150 have been approved for work so far, but Wells said it is still waiting for another 75.

“Clearly it has become more necessary during a pandemic,” she said. “The 150, if we didn’t have them, we’d be in a precarious situation.”

The increase in the omicron variation in the United States has made the stressful staffing situation even more apparent in hospitals as healthcare workers, like many others, have become very ill with the virus. contagious and had to take time off work at a time when there were more patients. enter.

Sinead Carbery, president of Nurse HR Solutions at AMN Healthcare, said the demand for international nurses has increased from 300% to 400% since the pandemic began. The number of nurses that can be brought into the US even with an additional green card will not be enough to meet demand, and many employers are now looking to hire nurses abroad because of immigrant visas, she said. .

“This is an opportunity,” she said. “Because things are going so well, there’s a lot of competition for that talent.”

National Nurses United, a union representing 175,000 registered nurses, says more scrutiny is needed on international recruitment to ensure foreign nurses are not brought in and subject to working conditions. unsafe work. The union alleges that hospitals drove away US nurses by keeping staffing levels too low – and this was before concerns about worker safety and protection during the COVID-19 pandemic emerged. 19.

Michelle Mahon, the union’s assistant director of nursing practice, said many foreign nurses sign long-term contracts with employers, which can make it difficult for them to speak out about safety concerns. worker or patient. She said hospitals that have seen nurses leave their jobs during the pandemic are turning to foreign workforces to replace them.

“This type of dynamic is especially appealing right now for employers who have not made any of the changes needed to ensure patient and nursing safety during this COVID-19 pandemic.” Mahon said. “Instead of solving the real problem, they want to move on to this other pseudo-real solution.”

However, hospital managers argue that there simply aren’t enough nurses trained in the United States to get around. Patty Jeffrey, president of the American Association of International Healthcare Employers, said the United States should expand its nursing education programs to train more nurses in the country, as well as to bring in more nurses from abroad. outside to. But she acknowledged that bringing in a much larger number of nurses would require legislation.

“Every day there are calls: We need 100, we need 200, we need all these nurses,” Jeffrey said.

Jorge Almeida Neri, a 26-year-old nurse from Portugal, arrived in the United States in December, although he began the process before the pandemic. He said a mandatory international nursing exam was delayed due to the virus and it took four months to get a consular interview, although other international nurses he met waited longer. . He interviewed for his current job at a Virginia hospital, which he got through a staffing agency, about a year ago.

“Once everything was certified, the immigration process started, and I was like, ‘Oh, this will be quick.’ I was wrong,” he said.

Almeida Neri said many Portuguese nurses look for work abroad because of the low wages, although many go elsewhere in Europe, which doesn’t take as long as the United States.

Despite the demand, there is no guarantee hospitals will in fact issue more visas. Greg Siskind, an immigration attorney, said US consular offices are not required to issue visas just because they are available and are hampered by limitations on remote work and video interviews. He said most employment-based green cards tend to go to professionals already in the United States, not abroad, although more can be done to speed this up.

“Under their current policies, if they don’t make any changes it will be very difficult,” he said of the possibility that the US government would issue all the visas available, “but there are so many many things they can do.”

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