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Chris Musillo on Nurse and Allied Health Immigration

Fewest Intl NCLEX Test Takers on Record

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The latest NCLEX data paints a dire picture for healthcare officials who may be looking toward international workers to help alleviate the nursing shortage. The first quarter of 2010 saw the fewest number of international NCLEX test takers and test passers since 2006. The 3,120 international NCLEX test passers are just 55% of peak 2007 numbers.

While the US nursing shortage certainly has eased in recent months, economists and government officials all agree that this is a temporary condition. The U.S. nursing shortage is projected to grow to between
260,000 and 500,000 registered nurses by next decade. If even the smallest estimates are correct, a shortage of this magnitude would be twice as large as any nursing shortage experienced in this country since the mid-1960s.

Only 3,120 international test takers took and passed the NCLEX in the first quarter of 2010. That's the smallest number of international test takers since at least 2006, which is the earliest data on the NCSBN website.

In 2006, about 20,907 internationally educated RNs passed the NCLEX exam for an average of 5,227 per quarter. In 2007, the volume jumped; 22,827 internationally educated nurses passed the NCLEX exam, or 5,707 per quarter. With the onset of retrogression, 2008 saw a decline; 18,905 internationally educated RNs passed the exam, or 4,726 per quarter. In 2009, the international NCLEX pass number shrunk to 13,799 per year (3,450 per quarter).

It is obvious that reasonable visa opportunities for international nurses must happen or else the US is going to find that it has a massive nursing shortage and international nurses are no longer there to fill the gap.

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  1. Cheryl France's Avatar
    What a story! I wonder who is telling the truth?

    Three times this week, three separate news channels reported that there is a glut of nurses in the United States, and those who are graduating nursing school are finding it very difficult to find full-time work, whether it be RNs, LPNs, or nurse practitioners.

    What I'd REALLY like to know is whether hospitals are hiring American nurses first? Or is there massive hiring of foreign workers/nurses taking these jobs while American nurses are being told a lie.

    Any response would be greatly appreciated.


    Cheryl France
  2. guest's Avatar
    There is no massive hiring of foreign nurses, in fact, it is very difficult for a foreign nurse to get any kind of visa for years now, because of the existing visa backlog, no exclusive nurse visa pool and long wait periods.
  3. Chris Musillo's Avatar

    I think everyone is telling the truth. The difference is that there is no significant nursing shortage today, but there will likely be one in the next few years.

    The conventional wisdom is that very few foreign nurses are being hired right now. It is near impossible to do so. Indeed, there seems to be a supply overload right now. And recent graduates are finding it tough to find jobs.

    That having been said, most economists project that this is a temporary condition caused by the current economy. For instance, nurses who would normally retire, are not retiring since they need the money. (The average nurse is now nearly 50 years old, which is a very old average occupational age, especially for an occupation that is so physically and mentally taxing). Also, the large "baby-boomer" generation is expected to demand greater nursing services in the next few years.

    Still, the nursing "surplus" is likley a temporary condition. Most economists (see links in my article) believe that there will be many retirements in the near future and greater demand for nursing services, and so there is expected to be a massive nursing shortage in the next few years.

    Traditionally, foreign educated nurses have made up about 5-10% of all nurse positions, but that number has dropped in the last few years, which doesn't bode well if you're an American who will need a nurse in the next few years.

  4. Simple Guy's Avatar
    Hi Chris,
    Any updates about HR 2536. Articles are floating in the internet about Dream Act and AgJobs bills being considered as a piecemeal legislative move since the chances of CIR this year look slim to none. Is the nursing bill being considered the same way?

  5. Adi's Avatar
    "nurses who would normally retire, are not retiring since they need the money."

    I have also seen some retired nurses come back to profession, since their better half is laid off and want to support the family. Its common sense that as soon as economy improves these nurses will go back to retirement. Also do not forget that people quitting profession is very high in nursing. In my class we started with 80 students, nearly 60 graduated, 30 went to graduate schools, 15 are stay at home moms now. So out of 80 only 15 are currently working. This is within 2.5yrs of graduation. It remains to be seen how many of those 15 will still work in coming years. When I talk to them, the only reason they are working is because they want money right now. Their husbands are looking for better jobs. As soon as they get something, some of the 15 left will either go to graduate school or stay at home. On top of it, 15 of the working are not always full time.

    This is a very dire situation for US. As more and more nurses retire, there will be few left in profession. I remember the days back in 2006-07 when nursing shortage was severe, nurses were handling loads of 20 patients in a single unit. These situations were prone to lot of errors and totally unacceptable. Not to mention that from 2014 (thanks to HCR)when 40million uninsured will start using healthcare on regular basis, the situation will only get worse.

    Also experienced nurses from developing countries are moving to Australia, Canada, Arab world. Once they are making good money in those countries and well settled in their lives, it will be hard for US to attract them back here. Opportunities in their own countries are getting better. I would honestly want Congress to pass nursing relief act ASAP and stay ahead of the problem. I hope it will not be too little too late when the actual need arises.
  6. Adi's Avatar
    Also to add that attrition rates in coming years will be high due to shortage and it will eventually drive up salaries and cost of delievering healthcare at a time when healthcare costs are ready to bankrupt the country.
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