Yvette Mooney, a registered nurse, is senior vice president for patient care services at South Nassau Communities Hospital.
Overhauling the U.S. health care system is a momentous task. But there is one important and sensible reform that is easy to accomplish and will reduce costs while improving care.
Restrictions that bar foreign-educated registered nurses from practicing in the United States must be relaxed. Hundreds of these highly qualified, dedicated professionals already play a vital role in Long Island's hospitals. But since 2006, the number has slowed to a trickle because of a shortage of available work visas.
Although the economic downturn has resulted in retired nurses returning to work and reducing the gap, the shortage will widen steadily as the nursing workforce ages and the economy heals.
Even if efforts to train more nurses are successful, the shortage will be dramatic: By 2014, an estimated 500,000 additional U.S. nurses will retire, while the nation's population continues to grow and age.
In each of the last three sessions of Congress, several foreign nurse-visa bills have been introduced, sent to committee, languished and died. Inaction has largely been due to conflicts between those advocating a comprehensive immigration bill to address the problem of millions of undocumented aliens, and those who support policies that address specific categories, such as health care workers.
But there are other stumbling blocks. Because of cuts made, some nurses' groups oppose the import of more foreign nurses, saying it would hurt their profession by discouraging the health care industry from improving compensation and working conditions.
The most recent Nursing Relief Act, which was introduced in February, would require employers sponsoring nonimmigrant visas to attest that they will offer the foreign nurses the same wages paid to similarly situated employees or the prevailing wage for the position. It also stipulates that the working conditions and pay of U.S. nurses not be adversely affected by the hiring of foreign workers.
The nursing shortage has many implications, including the increasing cost of care and decreasing quality of care. Many hospitals pay millions of dollars annually for temporary agency nurses to fill out their ranks. Overtime costs to fill gaps in coverage are similarly expensive.
Under the current system, hospitals are laying out tens of thousands of dollars to sponsor foreign nurses, even as they wait to enter the country.
While U.S. nursing schools do an excellent job of preparing graduates for the workplace, foreign-trained nurses are generally well educated, come with great experience and are fluent in English. In addition to a nursing degree, to earn permission to work here, foreign nurses must pass two rigorous tests to assess their nursing and English skills.
Recently, a comprehensive code of ethics for recruiting foreign-educated nurses was adopted by several dozen prominent health care groups, including the American Nurses Association and the American Hospital Association. The code, adopted by South Nassau Communities Hospital, sets standards for working conditions, equal pay, nondiscrimination, worker rights and a host of other labor practices.
The tradition of foreign health care professionals training and practicing in the United States goes back a long way. Ironically, the current nursing shortage has been largely responsible for some of the adverse issues, such as workload and overtime, that concern U.S. nurses the most. Foreign-educated nurses should be part of the solution.