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Greg Siskind on Immigration Law and Policy

DEADLY CONSEQUENCES: THE HIDDEN IMPACT OF AMERICA'S NURSING SHORTAGE

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A frightening report from Stuart Anderson of the National Foundation for American Policy. First, the report reviews data on patient mortality rates and points out strong evidence to suggest that the fewer nurses per patient in a hospital, the more likely the patient will die. And it's not a slight correlation. Increasing a nurses patient load from four to eight, according to an American Medical Association study, is accompanied by a 31% increase in mortality. How much more blunt does the message need to be? The current blockade of foreign nurses is literally killing people.



Those opposing nursing immigration argue we should instead be training more American nurses, but Anderson's report puts to bed this as a a realistic solution. According to the statement released with the report:

The study recommends policymakers focus on the two most practical solutions to alleviate the impact of the nursing shortage on U.S. patients. 1) Increasing nursing faculty and school infrastructure and 2) Raising immigration quotas to facilitate the entry of foreign nurses.



So far, U.S. nursing schools have shown they do not have enough capacity to accommodate
significant increases in their graduation rates. "In 2005, schools of nursing were forced to reject 147,000 qualified applicants because of shortages of faculty, classroom space, and clinical placement sites for students." Given that even optimistic projections assume a continued nurse shortage lasting a decade or more, policymakers concerned about the shortage's impact on U.S. hospital patients must consider relaxing current immigration quotas.



"Immigration alone cannot solve the nursing shortage but it can alleviate many of its most
damaging impacts on patients," said NFAP Executive Director Stuart Anderson, the author of the study. Anderson served as Executive Associate Commissioner for Policy and Counselor to the Commissioner of the INS (August 2001 to January 2003) and as Staff Director of the Senate Immigration Subcommittee.

Congress will likely be taking up a nurse immigration measure in the coming weeks. If this report doesn't convince them of the need to act, then they just don't care about what's in the best interest of the citizenry.

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  1. Limbo's Avatar
    "The current blockade of foreign nurses is literally killing people"

    Blockade is the perfect word for it. Any overseas nurse wanting to start the painful process of immigrating (the only way they can get into the country to work legally) is looking at many, many years of waiting (perhaps up to 5 years if not more for some countries). This must be a recruiting nightmare for health care providers (and could, according to this report, become a nightmare for patients also in the long run).

    Can the senators get their act together to fix this hopelessly broken immigration system? Sadly, I for one am not to optimistic that we will see anything soon. I hope I am wrong.
  2. Lorraine's Avatar
    Its just not the overseas ones. Canadian Nurses are being hurt also. I had been using a TN Visa for working here in the US but after doing that for 10 years wanted a more permanent solution. I am now in limbo after applying for a Green Card.

    Lorraine
  3. Anonymous's Avatar
    So this begs the question. Instead of importing foreign nurses, why not import foreign faculty - who will help train the 147,000 students who couldn't get into a program because of a faculty shortage? That sounds like a win-win.

    Divide the 147,000 by 20 (a nice class size) and there you have a rational allotment of visas for faculty.
  4. Greg Siskind's Avatar
    Your suggestion is not bad, Anonymous, regarding regarding recruiting faculty, but given there is no H-1B cap for college faculty members, presumably these folks are not easy to recruit from abroad or the market would already be moving in that direction.
  5. Anonymous's Avatar
    "presumably these folks are not easy to recruit from abroad or the market would already be moving in that direction. "

    Sweeten the offer with a greencard. Spend more federal $$$ on higher education.
  6. Greg Siskind's Avatar
    That's not the problem either. Getting a green card is fairly easy for a faculty member. There's a special process. This is simply a supply issue.
  7. Anonymous's Avatar
    "There's a special process. This is simply a supply issue."

    Maybe I should have been a professor ;-)

    So the answer to most supply problems is more money. How much money do nursing faculty earn? How does that compare with other faculty?

    College is expensive enough - costs are skyrocketing. Where is all that money going, if not to faculty? Something's not right here when we have skyrocketing tuition, and not enough faculty.
  8. Greg Siskind's Avatar
    And why are you trying so hard to come up with an alternative to nursing immigration? It's like you're contorting yourself to find another way. Immigration ain't so bad when you have people wanting to come and a need for their services.
  9. Limbo's Avatar
    "So this begs the question. Instead of importing foreign nurses, why not import foreign faculty"

    The pay is crappy considering you need a masters degree, and there are not enough spots available for clinical training in hospitals anyway. Nurses with an MS can work as nurse practitioners and make mega $'s. My job stealing immigrant wife is an RN who works as a preceptor to help new (American) nurses transition into the workforce.
  10. 's Avatar
    In a perverse kind of way the nursing shortage is a good thing. The resultant lowering of the life expectancy, will be a boon to reducing the future social security and medicare bill.

    This is a double bonus as the rich and well-off can maintain their life expectancy either by paying for extra staff or getting on a plane to Asia. The pinch will be felt by people who cannot afford special measures - and this will also be the class that takes more out of social security than it pays in.
  11. Anonymous's Avatar
    "And why are you trying so hard to come up with an alternative to nursing immigration? It's like you're contorting yourself to find another way."

    I'm not. My thought was that immigrant faculty would be a better idea. You said that they won't come (supply side issue). Basic economics dictates that if you want to increase the supply throw more money at it - the supply will come.

    I'm not saying don't hire immigrants. The root problem here - if I understand the article correctly - is that there aren't enough faculty so 147,000 qualified students are being turned down.

    The solution to the problem is an increase in faculty. It doesn't matter what nationality they are, we need more faculty. Increasing immigrant nurses won't solve the faculty shortage. Increasing immigrant faculty, will.

    I'm not against immigration. I think we should be smart about it. What are some problems our society faces? What are the ROOT cause of those problems? Is there any way immigration can solve the ROOT cause of the problem?

    If I understand your solution correctly, it doesn't solve the root cause of the problem. It remedies a symptom of the problem (nursing shortage). Why is there a nursing shortage? How can immigration help?

    Actually, a shortage of faculty is a symptom of yet another root cause - not enough pay/incentives to become faculty. What is the cause of that?

    And to the guy who posted about a shortage being good because people will die off, that's just morbid.
  12. Legal and waiting's Avatar
    "Basic economics dictates that if you want to increase the supply throw more money at it - the supply will come."

    This works for widgets, but does not work for people (aka labor). That's Economics 102 that you did not take.

    The easiest way to aleviate nursing shortage is to encourage older people to retire in Mexico.
  13. Anonymous's Avatar
    "The easiest way to aleviate nursing shortage is to encourage older people to retire in Mexico."

    I hope your kidding. So send our parents to Mexico to die? That's your retirement plan?

    "This works for widgets, but does not work for people (aka labor). That's Economics 102 that you did not take."

    Well, since you claim to be strong in economics - show me an economist supporting your claim distinguishing the two (and the text to back it up). I have read Wealth of Nations cover to cover. I don't recall Adam Smith supporting your statement.
  14. Greg Siskind's Avatar
    Anonymous - My entire world view is shaped by Adam Smith and I nearly spit out my coffee this morning when you cited economic theory as something you care about. If you believed an iota in Smith's theories, you would consider Lou Dobbs to be the antichrist.
  15. Anonymous's Avatar
    "My entire world view is shaped by Adam Smith and I nearly spit out my coffee this morning when you cited economic theory as something you care about. "

    Economic theory is fascinating. Not only have I read his book, I watched the DVD ;-)

    If I ever have a long break, I'll delve into Ricardo.

    Dobbs has long been a supporter of Smith and open markets. After all, his background is in the markets. Until he started railing on our current trade policy, he was celebrated by economists.

    I think Dobbs arrived at the conclusion that in the days of Adam Smith, global trade consisted of shipping cattle over the English channel in exchange for nails from Ireland. He couldn't have possibly considered what would happen if you could ship a product anywhere in the world practically overnight, and if business processes and communications could occur anywhere you have an Internet connection.

    Because of the Internet, the airplane, the automobile, trains, large ships, immigration, etc - the situation is different. Does it mean we turn out the lights and build a big wall? No, absolutely not. But we must consider the impact on society.

    Our goals for our society here in the United States may be different than the goals Chinese society has for example - plus our economies are at different stages. We value a 40 hour work week, clean air, etc. China has it's own values. Maybe not wrong - thats subjective, but different.

    Should our manufacturers face greater trade pressures because their competitors in China are free to pollute, disregard workplace protections, etc?

    Is it OK that currencies are manipulated, artificially reducing the costs of business and putting pressures on domestic companies?

    The bottom line is that I consider Smith to be a compelling contribution to modern day economics. Unlike like some people, I don't believe he is a "God". His knowledge was based on circumstances in a different time and place. You must respect the fact that he was ahead of his time, but I think he is behind our time.
  16. Legal and waiting's Avatar
    "I hope your kidding. So send our parents to Mexico to die? That's your retirement plan? "

    First, no I am not kidding. Second, they will die in the US without proper nursing care earlier. Third, Mexico is the country of choice for many Americans to retire in style, of course, that does not include those who have to work till death, which you seem to imply about your parents.
  17. Limbo's Avatar
    I think the arguments here might be getting a bit too theoretical. There are some practical issues to consider.

    Many of those 147,000 have been waiting for several years and furthermore, many of them are foreign students in the first place. If we had more faculty (at great cost mind you), perhaps a reasonable increase to be expected would be in the neighborhood of 25 to 50 thousand new American students each year (rough guess). Of that, maybe half will make it through to passing their licensing exams and becoming practicing nurses. Many will find the job too stressful and quit, or will take jobs working for drug companies or what have you, so the attrition will be tremendous (1 in 7 quit every year).

    And remember also, in your scenario, many would come over as instructors, but unless the pay is increased DRAMATICALLY, few will continue to do it once they get their green cards, so the attrition here will also be extremely high.

    That is why foreign nurses who already are licensed, and already have proven (through years of experience) that they can handle the job, will always be needed to supplement the number of native nurses.
  18. USC's Avatar
    "I'm not saying don't hire immigrants. The root problem here - if I understand the article correctly - is that there aren't enough faculty so 147,000 qualified students are being turned down."

    I think the root problem is that Americans have no interest in getting into the nursing profession. If they were dedicated to the idea of becoming a nurse they would go overseas as a foreign student and train to become a nurse in India/Phillipines etc. Isn't that why foreign students come to the US because training is not available in their home
    countries?
  19. Anonymous's Avatar
    "Third, Mexico is the country of choice for many Americans to retire in style, of course, that does not include those who have to work till death, which you seem to imply about your parents."

    I hope I can see the look on your parents face when you explain how when they get to old for you to help them, their off to Mexico.

    If you were my kid I'd scratch your name off of the will. I have an anoying bird I'd leave you with.
  20. 's Avatar
    The US ranks 38 in the world in terms of life expectancy. Surprising places like Cuba and Chile have better life expectancy.

    Obviously something is way wrong with the healthcare system in this country given how much is spent on it. Retiring abroad in one of the other 38 countries is just a smart choice in order to live longer.
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