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Chris Musillo on Nurse and Allied Health Immigration

Is There a Nurse in the House?

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The New York Times published a fantastic editorial over the weekend, which had one fatal flaw. The editorial, Is There A Nurse in the House?, was written by Theresa Brown. Ms. Brown is an oncology nurse and is a contributor to The Times's "Well" blog. She is also the author of "Critical Care: A New Nurse Faces Death, Life and Everything In Between."

In the article, Ms. Brown makes the case that nurse-patient ratios, such as those in California can substantially improve patient care. Ms. Brown cites work such as a recent study led by Linda Aiken, a professor at the University of Pennsylvania School of Nursing, which
found that New Jersey hospitals would have 14 percent fewer surgical deaths if they matched California's ratio, while Pennsylvania would have 11 percent fewer. The evidence is compelling: nurses save lives.

Ms. Brown explains why nurse-staffing ratios have not caught on as much as one might think.

The real issue, of course, is cost. There's no denying that hiring more nurses is more expensive in the short term. But having too few nurses leads to burnout, not only because it's too much work, but because good nurses quit from the stress of knowing they can't keep their patients safe. Mandated ratios could ultimately save money, because they would reduce both staff turnover and the number of patients who become critically ill due to insufficient care.

So what is the article's fatal flaw? It should be obvious if you regularly read the MU Healthcare Immigration Law Blog. While the nursing shortage temporarily has abated, economists predict that the
US' nursing shortage is expected to grow dramatically in the next decade. Ms. Brown should have explained where the nurses are going to come from. They are not coming from US nursing schools, that's for certain.


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  1. Rala's Avatar
    This article is good, but how will the congressmen know. Even in case they know they might not be concerned for the lives of Americans.
  2. Jim's Avatar
    Another impt. piece that was left is that CA maybe the poster child of nurse-patient ratios BUT the State is still reporting shortages and is still projected to grow further.

    In fact, I think the mandatory nurse-patient ratios is actually putting additional pressure on finding the nurses. The reported jump in nursing grads in CA (whether true or not) is obviously not enough. There's a nursing school shortage as well.

    And CA's nurse-patient ratio has been in place since 2005/2006 and yet CA currently still has a 20,000 shortage and projected to grow to 50,000-80,000 within 5 years.
  3. Chris Musillo's Avatar
    Excellent point about the CA nursing ratios, Jim.
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