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Articles from The Business Forum Journal

By George Banks

The Law Offices of James G. Beirne

The healthcare industry faces many problems, and one of the most serious to attract attention recently is the worsening shortage of qualified nurses (RN’s). While this issue has been with us for many years it has recently become more prominent due to several factors. First, many experienced nurses are retiring or leaving the profession, and there are not sufficient new graduates to make up these losses. Second, California has become the first state to propose new regulations to limit the number of hospital patients assigned to each nurse. The new rules, when implemented over the next 18 months, will prohibit hospitals from assigning a nurse to more than five patients recovering from surgery or serious illnesses. This is half the number typically assigned in many facilities, and half what the industry has proposed. The new proposals will also limit nurses in emergency rooms to one trauma patient, pediatric nurses to four child patients, and obstetrics nurses to two mothers in labor.

While nurses unions and consumer advocates have welcomed these proposals, hospital industry officials have said that it will be extremely difficult to achieve these figures in a state which has one of the worst problems in the national nursing shortage.  California ranks 49 among states in its share of registered nurses with 544 per 100,000 residents. A spokesman for the California Healthcare Association has said that several thousand new nurses will need to be employed to meet these requirements, and they are just not available in the current situation. Many hospitals are already incurring excessive costs by being forced to hire expensive temporary staff and offering signing on bonuses and other incentives to attract and recruit permanent nursing staff.

What are the solutions to this problem, which is a major concern to both patients and hospital officials? The state and the profession will need to offer more incentives in order to increase enrollment in the nursing schools. Medical facilities should try to improve conditions, salaries and benefits to better retain existing staff. Another possible solution is to consider recruiting qualified nurses from overseas. Due to the national shortage, the Immigration and Naturalization Service will grant a permanent resident visa to nurses who have graduated from a recognized foreign nursing school, and have passed a basic skills test. There are many nurses in this category who would like to work in the United States, and there are some organizations actively engaged in recruiting and screening nurses overseas, and assisting hospitals with the sponsoring and immigration process. The cost is modest, and is usually no more than a regular agency fee, or a signing-on bonus. The only obligation the hospital undertakes is to pay the incoming nurses wages comparable to existing staff. Past experience suggests that retention rates for these nurses are excellent, and most are so happy to be working in the United States that they will often sign a two or three year contract.     

The Business Forum has done a survey to find out why more hospitals do not consider overseas nurse recruiting a solution to their problem.  It appears that their reluctance comes from a lack of understanding of the process, and fear that it will be costly, complicated and may not even work at all. We have found that this method can work very satisfactorily, providing certain rules are observed.

  1. Work only with a reputable organization, which has been in business for many years.

  2. Understand that once sponsorship papers have been filed with the INS it takes 9 to 12 months to complete the process.

  3. Carefully select candidates with the skills and experience required.

  4. Provide some financial assistance for the costs of visa applications and tests which the candidate must take to qualify for the program. The costs are usually reimbursed  by means of a payroll deduction.

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