The success of the United States health care system depends largely on the availability of registered nurses to work in the sector. Nonetheless, the United States has been experiencing acute shortages in the number of nurses since the late 20th century. Additionally, the number of American students willing to work in the nursing sector has decreased over the years further contributing to the shortage. There has been a recurrent need for a permanent solution that will ensure a constant supply of nurses to meet the high demand. Since the 1970s, the United States has opted for the recruitment of nurses from other countries to meet its health care needs. However, there have been various arguments against and for immigrant nurses. Scandals involving immigrant nurses have led to hot debates discussing whether the impact of immigrant nurses is positive or negative. This paper presents the arguments that have been raised concerning the issue of immigrant nurses. The importance of this debate is to understand the different positions that exist concerning the recruitment of foreign nurses to the United States.
One of the most discussed examples of immigrant nurses scandals is that of the 27 Filipino nurses who were hired in 2005 from the Philippines to work in SentosaCare nursing homes (Berger 1). It is important to note that nurses from the Philippines account for the highest percentage of immigrant nurses in the United States. Their employer was the Sentosa Enterprise, which is a recruiting agency, affiliated to the New York nursing homes. After working for sometime, the nurses complained of exploitation and breach of contract thus resigning in 2006. The nurses were then indicted by the Suffolk County attorneys for abandoning and endangering patients’ lives. The nurses walked out of the Avalon gardens nursing home after resigning from their jobs due to harsh working conditions. However, their employer argues that they did not provide adequate notice before resignation and thus their action was illegal. This case has been a cause for debate among people of different backgrounds with each person taking different sides.
First, an argument has been presented to support the SentosaCare and the Suffolk County attorneys in their bid to punish the nurses for their actions. The argument is that the action that the nurses took was too dangerous as the patients who were left in the nursing homes were in critical conditions. Some of the patients left were on ventilators and they required monitoring due to the risk of suffocation (Berger 2). Although the actions did not result in any harm to the patients, there is a common agreement among people that a repeat of such action could lead to worse repercussions. In support of this opinion, the parents of the children in this nursing home said they were upset about the actions of the nurses. The officials of the SentosaCare Enterprise say that it is important to have regulations that ensure the safety of all American citizens. The fact that the nurses were immigrants was also an issue of discussion. The nurses are said to have walked out so easily because they did not have any responsibility to the American people. People opposed to the idea of recruiting nurses from other countries argue that such nurses are capable of neglecting patients because they are foreigners (Berger 2).
Another argument that exists in this debate is the credibility of immigrant nurses. The acute shortage in nurses in the United States has been resolved by recruiting more foreign nurses. However, there are increasing concerns as to whether the correct procedure is followed in the recruitment process to ensure that all nurses have the skills and competency to work in the United States. Questions have been raised as to whether the current systems of registration are strict enough to meet the qualification needs of the American health care system (Nichols, et al. 21). The quality of care given by foreign nurses is constantly under scrutiny to examine whether they meet the required academic and technical standards. Other researchers who say that the United States has a well-established recruitment program that ensures all procedures are followed have countered this argument. Foreign nurses undergo an established screening program before joining the American workforce (Buchan and Sochalski 32). Educational qualifications are verified during this process with all documents being checked thoroughly. Additionally, foreign nurses must have qualifications similar to those of nurses in the United States. This is why nurses from countries like India, Philippines and Canada are more likely to be recruited into the American system (Choy 208). Foreign nurse licenses are also thoroughly checked to ensure they are valid. It is also worth noting that most immigrant nurses have a higher level of education as opposed to domestic nurses. However, although much regulation is put in place to cut back on illegal immigration of nurses, there still exists arguments that question the credibility of foreign nurses. The recommendation from such arguments is to cut down on recruitment of foreign nurses and focus on domestic nurses.
Consequently, another argument has risen concerning the impact of immigrant nurses on the nursing industries. There are questions as to whether the increase in the number of immigrant nurses is a threat to American registered nurses. The question on whether the employment of immigrant nurses into the United States system reduces the wages of American nurses has emerged. However, research shows that the rate of unemployment for American registered nurses has been very low as compared to other professions. In 2002, the unemployment rate for registered nurses was at 1.0 percent and has been reducing since then (Nichols et al. 21). As a result of the shortage that has been experienced over the years, almost all domestic trained nurses are absorbed into the system. Additionally, the number of foreign nurses who are currently being recruited cannot fill the gap left. It is also important to note that the wages for nurses have been on an upward trend for many years. The high demand and low supply of nurses has led to a sharp increase in their monthly wages. In this perspective, it is notable that immigrant nurses have little or no impact on the amount of money the nurses are paid. On the contrary, immigrant nurses have a positive impact on the sector as they help alleviate the problem of understaffing that exists in most hospitals and nursing homes.
Another point of view that has been expressed in the debate on immigrant nurses is the issue of ‘brain drain’. The United States is accused of causing a ‘brain drain’ in poor countries (Buchan and Sochalski 36). The argument here is that the countries from which the United States recruits nurses, have a greater need for them as opposed to the US. Moreover, the countries that provide an additional number of nurses to the United States have worse health care personnel shortages as compared to the United States. In support of this point of view, are scholars who say that the United States government should focus on enhancing the domestic nursing education sector first, before looking for foreign solutions to the problem (Choy 133). They say that the recruitment of foreign nurses is not a permanent solution, and could lead to problems if there are political problems between the United States and other countries. Additionally, most workers’ unions support this opinion as they maintain that domestic labor is more reliable and helpful to the economy. In opposition to this view are those who argue that by hiring foreign nurses, the United States is helping the poor countries as these people have a constant and more reliable source of income. Additionally, the money they send to their home countries is used for community development programs. Moreover, immigrant nurses help to promote the concept of multi-culturalism in the workplace. After the first few months of working in the United States, foreign nurses acclimatize and are able to serve competently a culturally diverse patient base.
Another important point of view is that of the foreign nurses themselves. Most foreign nurses form associations that protect their rights. For example, in most states, nurses from the Philippines have an association that help immigrant nurses to access information and cater for their different needs. Additionally, the Philippines’ Nurses Association of America is the national union of all nurses from the Philippines and working in America. Foreign nurses often complain of being exploited by the agencies that help them immigrate. In the Sentosa case mentioned above, the nurses complained of being overworked and underpaid. Moreover, they worked as nurses and were paid as clerks, which was contrary to the contract they had made before (Berger 2). However, they could not sue their employer out of fear of intimidation. Exploitation is one of the major challenges that face immigrant nurses (Cherry and Jacob 271). Additionally, the nurses accused the American government of favoring the employers due to their political influence. The nurses’ argument is that all immigrants should be protected by the United States especially in the work place. Immigrant nurses face challenges ranging from mental stress, language barriers, and following the American way of life. In their point of view, all they need to work efficiently is the fulfillment of the contracts, which they sign before starting employment. Immigrant nurses insist on the improvement of working conditions and an easier registration process as some of the issues that they would like addressed.
In conclusion, many arguments have been raised on the issue of immigrant nurses. From the research conducted in relation to this subject, the arguments discussed above have emerged. Each group has its own information to support their argument and discredit other arguments. The credibility of immigrant nurses and the process used to establish their qualifications are some of the questions that have been raised. Consequently, other scholars have come up with explanations that justify the processes used in recruitment. Arguments have also been brought forward to discourage recruitment of foreign nurses due to the effect it has on poor countries. The topic of immigrant nurses is important as it will help give recommendations that can solve the problems that exist today. Moreover, it is also important to understand the challenges that foreign nurses face in order to come up with implementable solutions. In conclusion, the issue remains a topic of debate as the shortage of nurses and the search for a long-term solution continues.
Berger, Joseph. “Filipino Nurses, Healers in trouble.” The New York Times 27 Jan. 2008. Web. 26 Oct. 2010. <http://www.nytimes.com/2008/01/27/nyregion/nyregionspecial2/27Rnurses.html?pagewanted=1&_r=1&sq=january%202008,%20nurses&st=cse&scp=1>
Buchan, James and Julie, Sochalski. “The Migration of Nurses: Trends and Policies.” Bulletin of the World Health Organization, 82.8 (2004): 31-40. Print.
Cherry, Barbara, and Susan, Jacob. Contemporary Nursing: Issues, Trends, & Management. St. Louis, Missouri: Elsevier/Mosby, 2005. Print.
Choy, Catherine. Empire of Care: Nursing and Migration in Filipino American History. Durham: Duke University Press, 2003. Print.
Nichols, Barbara, Charles, Gessert, and Catherine, Davis. Foreign trained nurses in US healthcare delivery. American journal of Public health, 97.12 (2007): 20-21. Print.