Printable Version

Email Story

Want a Reprint?

More Print Edition Stories

Recruitment process of foreign nurses gets a boost from INS

The high-tech collapse and a new English language test should soon help hospitals recruit foreign nurses, bringing them into the country in a matter of weeks, rather than a couple of years.

The Bureau of Labor Statistics says there are 400,000 vacant nursing positions in the United States today, and the number will only grow as the population ages. Foreign nurses are considered one way to bridge the gap.

The Immigration and Naturalization Service gave the recruiting industry a boost at the end of the year by issuing for the first time clear guidelines for using a H1-B visa for a nurse. The H1-B has a quota limit and was originally created to import high-tech workers, but some nurses were also able to apply if they had a specialized skill. One stipulation of the visa is that the immigrant have at least a four-year degree in their field. Since nurses in the United States can practice without a degree, the INS has interpreted the rules to say that a nurse isn't necessarily a technical, skilled position.

"It's not been used much by nurses because the INS takes the position that states will allow a nurse to get a license without a B.S. degree, so they don't meet the criteria of a specialty," says Greg Siskind, an attorney who concentrates on immigration law. "Most countries where we recruit nurses require a B.S. degree."

It can cost a hospital $10,000 to find and bring in a foreign nurse, so the lack of clear guidelines was always a damper on the idea. A former visa type, the H1-A, expired in the mid-1990s and was not renewed under pressure from nursing unions. Since then, the only way to bring in a foreign nurse has been through the green card route. That entails preliminary approval from the INS, followed by a consular investigation and a visa screening.

	Hospitals, Human Resources
	Sign up to receive free daily business updates by email every weekday afternoon.
	Use Search Watch to watch for related topics, companies.
	Receive free Industry News via email. Choose from 46 different industries.

Most foreign nurses come from the Philippines.

"A lot of these nurses are already overseas," Siskind says. "The United States is the first choice for most, so a recruiter will park a nurse in England, Canada or Norway while going through this process."

The green card process can take up to two years, making it difficult to plan manpower needs at a hospital. Since the demand for technology workers has plummeted there are plenty of visas available, but that may change as the economy recovers.

Siskind is encouraged by a new visa proposal that would mirror the H1-A and be designed specifically for nurses. The bill is sponsored in the House of Representatives by Sheila Jackson Lee, (D-Texas), and in the Senate by Sen. Sam Brownback, (R-Kansas). If passed in this session of Congress, the new visa would allow a nurse to come into the country in as little as four weeks.

Along with a nursing degree and practical experience, foreign nurses must pass an English proficiency exam. That's made the Philippines -- where American English is everyone's second language -- the single largest source.

But India, a former British colony, may be the next big supply store.

The INS delegates assessment to the Commission on Graduates of Foreign Nursing Schools. Foreign recruiting was slowed in November when the Michigan English Language Assessment Battery ceased to be offered. A key part of the test was a cassette tape of the nurse speaking, but many potential employers said the tapes were made in noisy, public areas and it was impossible to assess language skills. A new test begins this month: the International English Language Testing System.

Nurses unions defeated the H1-A visa by arguing that there was no nursing shortage, which has become untenable today.

"Now they focus on wages and hours, so the shortage works to their advantage," Siskind says. "They now claim that foreign recruiting exploits other countries and exacerbates nursing shortages overseas, but the countries where these nurses come from have enormous surpluses of nurses, especially India and the Philippines."

In those countries, becoming a nurse is marketed as a path to success in a Western country and a way to send money home to support the family. More than 5 million Filipinos work overseas, for example, and send home more than $6 billion a year, 60% of it from the United States and Canada. Remittances are the country's single largest source of foreign trade.

"India is a classic example of a country that now sees its brightest people as an export industry," Siskind says. "High-tech is a good example. They leave, send money back, and eventually do business with India."

CONTACT staff writer Scott Shepard at 259-1724 or sshepard@bizjournals.com