REPORT: July/August 2006

Healthcare employers look for RNs overseas

U.S. Senate supports unlimited nurse immigration

by Nancy Webber

For decades, nurses have come to New York from other countries.

Foreign-born registered nurses indeed are the backbone of the nursing staff at many hospitals in the New York City metropolitan area, where 36% of nurses were educated overseas. Many of these RNs have become leaders in their communities, workplaces, and professional associations.

Actions by government and healthcare employers indicate, however, that the coming year may bring an unprecedented influx of foreign-born nurses to New York State. What might be the impact on health care and on the nursing profession?

Immigration bill may open floodgates

The shortfall of registered nurses in New York State is already causing hospital administrators to cast longing eyes overseas. Recruiting agencies hired by hospitals are actively pursuing RNs in India, China, and the Philippines.

Until now, the potential flood of immigrant nurses has been restricted by the number of visas issued by the U.S., with an estimated 14,000 RNs arriving each year. But that could soon change. A provision in the controversial immigration bill passed by the U.S. Senate in May would allow an unlimited number of registered nurses to come to this country.

Because of the differences between the immigration bills passed by the Senate and the House of Representatives, a joint committee will hammer out a compromise. As Report went to press, it was unlikely that this would happen before November.

Draining RNs from needy nations

Some nurses think wholesale immigration is a bad policy and the American Nurses Association has gone on record opposing this proposal.

“Although we have welcomed many foreign nurses as NYSNA members, solving a shortage of nurses by bringing in RNs from overseas is short-sighted and irresponsible,” said NYSNA Deputy Executive Director Tina Gerardi. “The government should be investing in U.S. nursing education programs rather than ‘outsourcing.’ Qualified nurses are being drained from areas of the world where they are desperately needed.”

Coming: thousands of Korean nurses?

Perhaps anticipating a change in the immigration law, in April a recruitment agency announced that it had an agreement with St. John’s Riverside Hospital in Yonkers to send 10,000 nurses to the U.S. from South Korea over the next five years. According to a news release issued by the HRS Global agency, the nurses would come to the U.S. as “interns” and be trained at the hospital’s Cochran School of Nursing.

Shortly after this announcement, NYSNA was told by a rival nurse recruitment agency that nurses were being lured to America under false pretenses. “Among other things, they are being told that they will be members of the ‘state nurses union’ and be paid $25 an hour during their internship,” said Ryan Davis of Bonacare LLC.

A spokesman at St. John’s Riverside said that the announcement of an agreement was premature. “HRS came to us with this proposal and the details are still being worked out,” said Vice President of External Affairs Stephen Lucas. Lucas said the HRS agency would handle the visas, arrange housing, and locate employment for the RNs, although St. John’s might help with placement.

“There is no interim or intermediary position for the practice of nursing,” said Barbara Zittel, executive secretary of the New York State Board for Nursing (NYSBN), adding that “interns” could not practice as RNs. As NYSNA is a labor union for registered nurses, the South Korean “interns” could neither be represented by NYSNA nor covered by the terms of a NYSNA labor contract.

HANYS partners with foreign recruiter

Also this spring, the Healthcare Association of New York (HANYS) announced a partnership with Team Healthcare Staffing (THS), an agency that specializes in recruiting foreign nurses. According the HANYS newsletter, “Team Healthcare is positioned to help healthcare facilities face the ongoing nursing shortage.”

HANYS members manage 550 private-sector hospitals, nursing homes, and home care agencies in the state. “We have carefully researched this firm and believe them to be reputable,” said HANYS spokesman Bill Van Slyke. He said that the endorsement of THS would encourage hospitals to use a trustworthy agency.

THS, which recently changed its name from Innovative Healthcare Group, Inc., has training centers in the United Kingdom, India, Dubai, and the Philippines. THS official Michele Ditommaso said the company supports foreign nurses throughout the immigration process and has placed approximately 350 nurses in the U.S. since 2001.

Hospitals can decide whether the RNs recruited by THS will become hospital employees immediately or work for the agency for one year. Each nurse must commit to work at the placement hospital for at least two years.

Nurses need to be protected

The government, the healthcare industry, and recruiting agencies evidently are eager to use what they call the “global supply” of RNs. The nursing profession is perhaps the only entity that sees these nurses as individuals.

“We have already gotten reports that recruiting agencies are not living up to their promises,” said Lorraine Seidel director of the NYSNA Economic and General Welfare Program. “According to postings on the Internet, nurses were not informed about where they would be assigned to work, salary rates were below prevailing wages, and provided housing was substandard.”

NYSNA will advocate for foreign nurses whenever these injustices come to light. Sometimes, however, little can be done once contracts are signed.

“Before they come to the U.S., nurses must be careful about signing open-ended contracts and paying exorbitant placement fees,” said Seidel. “We also recommend that they consult an immigration attorney to ensure that contracts they sign protect their rights.”

See Presidents’ Column on page 2 and related story.