From this morning:
Diagnosis: Critical
It's been reported in these columns and elsewhere that the dysfunctional U.S. immigration system contributes to labor shortages in agriculture. Less well-known is that low green card quotas have also left the U.S. with an undersupply of nurses that threatens patient care.
"The aging U.S. population and low domestic production of nurses in the U.S. has created a nursing shortage that carries deadly consequences," says a new study by Stuart Anderson of the National Foundation for American Policy. "[A] shortage of nurses at U.S. hospitals is leading to increased death and illness for Americans."
Estimates of the looming shortage vary. The Bureau of Labor Statistics and Department of Health and Human Services project that more than a million new and replacement nurses will be needed over the next decade. Health analysts David Auerbach, Peter Buerhaus and Douglas Staiger cite a lower but still substantial 340,000, though even that "is three times larger than the size of the current shortage when it was at its peak in 2001." All agree that the coming retirement of 77 million baby boomers means something will have to give.
Wage increases in recent years have attracted more people to nursing. In California, annual average salaries for full-time registered nurses grew to $69,000 in 2006 from $52,000 in 2000, a 32% gain. According to the Bureau of Labor Statistics, the nationwide mean salary for registered nurses today is nearly $60,000. Better pay alone, however, won't solve the problem, or at least not anytime soon.
Despite more interest in the profession, faculty shortages and inadequate facilities have prevented nursing programs from expanding enrollment. More than 70% of schools responding to a 2006 American Association of College Nursing survey listed faculty shortages as a reason for not accepting all qualified applicants. In 2005 nursing schools rejected 147,000 qualified applicants, citing lack of classroom space and clinical placement sites for students.
When growers can't find field hands, food rots and businesses lose money. But when hospitals can't find nurses, patient care suffers. "The effectiveness of nurse surveillance is influenced by the number of registered nurses available to assess patients on an ongoing basis," concluded a 2002 Journal of the American Medical Association study. The study -- which looked at general, orthopedic and vascular surgery patients at hospitals -- found a 31% increase in patient mortality when a nurse's workload rose to eight from four patients.
"Given that even optimistic projections of raising wages and increasing domestic nurse production assumes a continued shortage of a decade or more," writes Mr. Anderson, "policymakers concerned about the impact of the nursing shortage on patient deaths and illnesses must consider relaxing current immigration quotas."
The long-term solution here is to increase nursing faculty and teaching facilities. But in the short run, Congress could help enormously by easing the limit on foreign nurses allowed entry to the U.S. That's what lawmakers did in 2005 when they allocated 50,000 extra green cards with a priority for foreign nurses. They were used up in 18 months. About 4% of U.S. registered nurses are foreign-trained, which means many hospitals couldn't function without them.
More such green cards are needed now, before hospital understaffing contributes to more preventable illness and death.
Diagnosis: Critical
It's been reported in these columns and elsewhere that the dysfunctional U.S. immigration system contributes to labor shortages in agriculture. Less well-known is that low green card quotas have also left the U.S. with an undersupply of nurses that threatens patient care.
"The aging U.S. population and low domestic production of nurses in the U.S. has created a nursing shortage that carries deadly consequences," says a new study by Stuart Anderson of the National Foundation for American Policy. "[A] shortage of nurses at U.S. hospitals is leading to increased death and illness for Americans."
Estimates of the looming shortage vary. The Bureau of Labor Statistics and Department of Health and Human Services project that more than a million new and replacement nurses will be needed over the next decade. Health analysts David Auerbach, Peter Buerhaus and Douglas Staiger cite a lower but still substantial 340,000, though even that "is three times larger than the size of the current shortage when it was at its peak in 2001." All agree that the coming retirement of 77 million baby boomers means something will have to give.
Wage increases in recent years have attracted more people to nursing. In California, annual average salaries for full-time registered nurses grew to $69,000 in 2006 from $52,000 in 2000, a 32% gain. According to the Bureau of Labor Statistics, the nationwide mean salary for registered nurses today is nearly $60,000. Better pay alone, however, won't solve the problem, or at least not anytime soon.
Despite more interest in the profession, faculty shortages and inadequate facilities have prevented nursing programs from expanding enrollment. More than 70% of schools responding to a 2006 American Association of College Nursing survey listed faculty shortages as a reason for not accepting all qualified applicants. In 2005 nursing schools rejected 147,000 qualified applicants, citing lack of classroom space and clinical placement sites for students.
When growers can't find field hands, food rots and businesses lose money. But when hospitals can't find nurses, patient care suffers. "The effectiveness of nurse surveillance is influenced by the number of registered nurses available to assess patients on an ongoing basis," concluded a 2002 Journal of the American Medical Association study. The study -- which looked at general, orthopedic and vascular surgery patients at hospitals -- found a 31% increase in patient mortality when a nurse's workload rose to eight from four patients.
"Given that even optimistic projections of raising wages and increasing domestic nurse production assumes a continued shortage of a decade or more," writes Mr. Anderson, "policymakers concerned about the impact of the nursing shortage on patient deaths and illnesses must consider relaxing current immigration quotas."
The long-term solution here is to increase nursing faculty and teaching facilities. But in the short run, Congress could help enormously by easing the limit on foreign nurses allowed entry to the U.S. That's what lawmakers did in 2005 when they allocated 50,000 extra green cards with a priority for foreign nurses. They were used up in 18 months. About 4% of U.S. registered nurses are foreign-trained, which means many hospitals couldn't function without them.
More such green cards are needed now, before hospital understaffing contributes to more preventable illness and death.
Nurse shortage?! Check out dailycents.com, the direct link to the article is http://blogs.dailycents.com/?p=803
Posted by: Zoe | January 11, 2008 at 06:58 PM
With no PP for I-140, there still could be a fairly long wait, even if EX or similar is brought back for Sched. A.
Posted by: Limbo | September 13, 2007 at 10:16 PM
"Hi GREG, Do you think some nursing amendment (like the previous Schedule-A) can get approved in this month of September. What happened to the Schumer amendment that was withdrawn to be submitted later. What's your take on that nursing amendment ? Thanks. AC"
THere is something cooking. Should have more to report very soon...
Posted by: Greg Siskind | September 13, 2007 at 02:56 PM
Hi GREG,
Do you think some nursing amendment (like the previous Schedule-A) can get approved in this month of September. What happened to the Schumer amendment that was withdrawn to be submitted later. What's your take on that nursing amendment ? Thanks.
AC
Posted by: AC | September 13, 2007 at 01:34 PM
Immigration voice rally on the 18th day of Sept will be the ultimate response to the irresponsible inaction of congress regarding this serious matter.I'm sure they will be shaken up by bold message of this coming rally.If our dear friends in congress do some miracles to fix it then this might bring a golden sun shining upon us all future immigrants. Let us all support the rally!!!
Posted by: grouchy | September 12, 2007 at 08:55 PM
EB3 India cannot "rob" anyone. The spillover is only allowed if the visa bulletin is "current". This July was an anomaly. The saving grace here is that 30,000 Green cards would otherwise have been wasted. Since everything is never going to be current again (barring serious)reform, the spillover will not happen. Look back at last year to see how badly EB3 India will do with 2,800 numbers available. If EB3 ROW were to become current it would benefit everyone in EB2 (India and China) as well, since they would get spillover.
Posted by: legal-forever-waiting-forever | September 12, 2007 at 06:37 PM
USC,
I think we can assume that there are currently at least 60,000 India EB3 (probably a lot more). At 2,800/year, even with that conservative estimate, that would be over a 20 year wait!! And if they rob other categories (like ROW) to help them out, that will make the waits for everybody atrocious. When you start doing the math, things get pretty scary.
Posted by: Limbo | September 12, 2007 at 05:03 PM
"Only a 5 year wait."
Facts:
(a) June bulletin (the one prior to the July mess) EB3 ROW 01JUN05 China 01JUN03 India 01JUN03 Mexico 01JUN03 Phillipines 01JUN05
(b) October bulletin EB3 ROW 01AUG02 China 01SEP01 India 22APR01 Mexico 22APR01 Phillipines 01AUG02
(c) INS reports that in 2003 there were 36,000 H1bers from India.
(d) Nurses use EB3
(e) EB3 worldwide quota is 40,040 out of which 10,000 go to other (unskilled) workers. Per country limit is 2802.
Analysis:
(a) People with earlier dates than the June bulletin (with the exception of a few people hiding in the woodwork) would have filed in June. Since, all the dates in the June bulletin are later than the October bulletin it logical to assume that the 300,000 (lets take out 50,000 for EB2) are still waiting in line for a visa number. That is 250,000 or so for EB3.
So, do the math. I stick to my belief that EB3 is toast in so far as new applicants are concerned!
So, you do the math.
Posted by: USC | September 12, 2007 at 02:14 PM
Why do you say that EB3 is not viable? EB3 is at August 1, 2002. Only a 5 year wait.
Posted by: DC | September 12, 2007 at 01:34 PM
One thing is clear from the October visa bulletin, that EB3 is not going to be viable (remember the 300,000 applications that INS received, most will be EB3) for ROW, China or India (so much for your ROW v India food fights, now all you guys are in the same boat) for a long, long time to come. Therefore, no more nurses. Now that the immigration system is totally broken, perhaps, Congress will be forced to act. I am not holding my breath, though!!
Posted by: USC | September 12, 2007 at 12:22 PM
Hi Greg,
Do you think some nursing amendment (like the previous Schedule-A) can get approved in this month of September. What happened to the Schumer amendment that was withdrawn to be submitted later. What's your take on that nursing amendment ? Thanks.
AC
Posted by: AC | September 12, 2007 at 10:27 AM
Hopefully this congress people still read the news papers since there has been no shortage of reporting on this issue.
Posted by: Another voice | September 12, 2007 at 09:23 AM
it's so funny though since all of the people sitting in congress are maybe starting to experience some kind of age-related problems right now. Majority of them are now in the last chapter of their lives.I think there's an immediate need to act on this future serious problem of the american people like them.If they do nothing on this matter,i can imagine now what will happen to them in the future.
Posted by: grouchy | September 12, 2007 at 07:17 AM