Term Paper on "Pros and Cons of Foreign Educated Nurses Working in America"

Term Paper 7 pages (1846 words) Sources: 1+

[EXCERPT] . . . .

foreign nurses- PROS AND CONS

Nursing shortage is now a well-known problem in the country and one that deeply concerns health care institutions nationwide. As these hospitals are doing everything in their power to retain and attract nurses, it is felt that in the next two decades, this problem is likely to persist and may even turn more serious. To fill the gap between job opportunities appearing every year and number of suitable applicants for them, United States is actively importing nurses from foreign countries.

Some important statistics might help get a better idea of how serious this nursing shortage really is and why U.S. has resorted to attracting foreign qualified nurses. One study projects that as United States population continues to grow at 18%, the number of patients aged sixty-five and above are likely to triple that rate.. It is now a grave concern since number of elderly patients will continue to increase while the number of Registered Nurses needed to provide them with quality healthcare is persistently on the decline. The U.S. Department of Health and Human Services (HHS) estimated that by 2000, United States had a severe shortage of 111,000 full time registered nurses and maintained that this number was likely to go up to 275,000 by 2010. And in the next ten years, by 2020, this shortfall of 111,000 might move up to a staggering 800,000.

This serious crisis calls for desperate measures and one such action is recruitment of foreign nurses which is not something new but the scale of which it is being and the manner in which recruitment now takes place is significantly different than what it used to be a decade ago. Many of these nurses are coming from countries that already have a serious nursing shortage and are not suitably positioned to allow such massive expert of nursing staff. While the world is concerned about the possible consequences of this kind of trade, United States has only increased its recruitment activities, even though it is not the worlds only or even biggest importer of nursing staff yet.

The trend of recruiting nurses from other countries is almost five decades old and United States has been attracting foreign nursing staff regularly for past many decades. However the rate of recruitment has increased significantly and now 5% of the total U.S. nursing workforce consists of foreign qualified nurses and unfortunately or otherwise, this number is consistently increasing.

The Philippines has been actively sending its nurses to the U.S. And by mid-1980s, almost 85% of all foreign nurses came from this part of the world. This number declined when other countries also began participating in nurse export program. The number of foreign nurses employed in U.S. hospitals grew steadily after 1998 and by 2003 it had reached 14% of the total U.S. nursing workforce.

By 2001, along with the Philippines, the countries that were sending their nurses to the U.S. included Canada, the United Kingdom, India, Korea, and Nigeria and some other smaller countries. These nurses were absorbed in various setting when the came to the U.S. And over the years, the employment of foreign nurses in U.S. hospitals has declined from 79.9% to 71.5% as out of hospital patient care is becoming popular. Foreign nurses are now seen more in public/community health and ambulatory related jobs and their percentage in these settings are growing just that that of U.S.-qualified nurses. Foreign trained nurses are also opting more for jobs in nursing homes where their participation has increased from 7.4% to 9.3%.

As more and more foreign trained nurses enter the U.S. nurse workforce, concerns about their impact on healthcare local and abroad are rising. Most nurses leave their home countries for better job opportunities with more lucrative fringe benefits in the U.S. They are attracted by such perks as free lodging and boarding, better practice options and greater growth opportunities. According to 2004 statistics by the U.S. Department of Labor, glaring differences in pay scale is a great motivating factor for foreign nurses to leave their homes. Compared to an average $48,090 that RNs earned in the U.S., foreign nurses from Philippines would earn close to $2,000 in their home countries.

Developing countries are now questioning the ethics of recruiting nurses from their healthcare sector since decline in the number of suitably qualified nurses has caused a serious nursing shortage in the exporting countries. The economic benefits that it had once provided are now being outweighed by serious healthcare-related concerns. Wall Street Journal found that recruitment of Filipino nurses by the U.S. has had a seriously negative impact on Philippines healthcare institutions and economic advantages are no longer making up for loss of well-qualified nursing staff.

Apart from Philippines, other developing countries from sub-Saharan Africa, Southeast Asia, and the Caribbean are also facing nursing staff dearth due to massive recruitment of nurses by the U.S. For example South Africa is facing problems with its own healthcare system because of shortage of nurses as the U.S., UK and Australia has recruited a large number of its well trained nurses. United Kingdom had recruited 5,259 nurses from South Africa between 1998 and 2002 while it recruited around 1,166 from Nigeria, less than 500 from Ghana and a little more than 1000 from Zimbabwe.

The delicate and not so well developed healthcare system in Africa is also threatened by massive recruitment of well trained nurses. With fewer resources, AIDS epidemic looming large and diseases always spreading at an alarming rate, Africa is the w3orst hit continent by United States' recruitment activities. What is even more disturbing is the serious lop-sided nurse to patient ratio that already exists in many African nations. For example sixteen countries of Africa have 100 nurses for per population of 100,000; 10 countries have around 50 nurses for the same size of population, 9 countries have 20; while three have less than 10 per 100,000 people. Compared to such low nurse to patient ratio, the U.S. And UK despite serious nursing shortage have 782 and 847 nurses for a population of 100,000, respectively.

While the departure of these nurses from their home countries causes grave healthcare concerns, their arrival in the U.S. is not all the smooth as well. They are definitely welcomed with open arms but their qualifications are usually doubted and their suitability for the job is suspected. Communication barrier due to language related problems is also a concern. Most people question U.S.'s decision to hire foreign nurses and feel they may not be able to provide high quality care. Stevens maintains that when recruiting nurses from foreign countries, their ability to communicate with patients and perform certain job-specific tasks must be closely measured.

To ensure high quality care, the government of United States established the Commission on Graduates of Foreign Nursing Schools (CGFNS) in 1977 which is responsible for to screening nurses and ensuring that they are technically and culturally competent. This commission also looks out for suitably qualified nurses and identifies those that have a lower chance of clearing the U.S. nurse licensure exam (NCLEX-RN) before migrating to the U.S. All foreign nurses are required to clear this exam prior to their entry into the U.S. And this assesses nursing competence along with English language proficiency. Upon clearing this exam, a CGFNS certificate is issued which grants them access to U.S. nurse workforce through nonimmigrant visas.

Foreign nurses are also required to prove that they had completed didactic and clinical education as "first-level nurses" which according to the International Council of Nurses (ICN) is a standard used to determine technical competence. Clearing the NCLEX-RN is the most important and final step of recruiting process. There are no reliable studies conducted so far to determine if there are any differences in quality of care provided by foreign trained nurses when compared with local nurses. The certification process is considered a suitable measure of assessing nursing competence but more research is needed to measure actual quality of care provided by foreign qualified nurses. We know the quality of care cannot be solely assessed by nursing competence since it is also influenced by such factors as inadequate orientation and training provided by U.S. hospitals. Assimilation issues may also have an impact on quality. For this reason there is a need for more evaluation measures which would ensure that foreign qualified nurses are provided high-quality-care according to the guidelines of AHA. These measures are important in order to improve patient care and to make sure that the nurses we are importing are just as competent and quality-conscious as our local nurses.

References

National Center for Health Workforce Analysis, Bureau of Health Professions, Health Resources and Services Administration, "Projected Supply, Demand, and Shortage of Registered Nurses: 2000-2020," 2002, bhpr.hrsa.gov/healthworkforce (17 September 2005);

J. Buchan, T. Parkin, and J. Sochalski, International Nurse Mobility: Trends and Policy Implications (Geneva: World Health Organization, 2003);

Division of Nursing, BHPr, National Sample Survey of Registered Nurses, 1980-2000.

U.S. General Accounting Office, Information on Foreign Nurses Working in the… READ MORE

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