NURSE BILL INTRODUCED IN HOUSE

H.R. 2536 has been introduced in the House by Congressman Robert Wexler. This is the first step in what will be a very tough process. The bill's text has not yet been released, but it is going to be highly similar to H.R. 5924, introduced last year. The bill would allocate 20,000 additional green cards per year for three years for nurses and physical therapists. Spouses and children will get green cards and will not be included in the 20,000 figure. Employer petitioners will pay a $1500 fee in addition to regular green card fees. The fee will support nurse training programs around the US.

Comments

[Jim]

Guess, the troll is back !!

First of all before you make comments, make sure you know what you are talking about.

These are not H1B working visas. These are for permanent visas. Much different from H1Bs.

Secondly, actually try reading the replies here so that you don't repeat the same wrong notions over and over again.

Don't take the American people as fools. Everyone knows there is a nursing shortage nationally. Even your fellow nurses know it too and profess to it.

I suggest you quit this game you are trying. Aren't you tired of trolling different websites already?

Write your Representative if you must. That's your right. You do not need to troll different sites and using multiple usernames and keep yapping the same thing. Give it a rest cause it will never end. Life is short.

Write your Representative, already!! After that there is nothing else you can do, really. So, I suggest stop trolling.

The rest will write their Representatives as well. They have rights too you know and their opinions counts as well.

[hillary]

Many US citizens bought the story of nursing shortage and invested scarce family resources only to find that there is in fact a surplus of nurses. There are hiring freezes and elimination of new grad training and demands of two years of experience just to be nurse's aid (CNA). These H1B visas are supposed to be wen there aren't enough skilled Americans to fill the positions.Many of my fellow grads took more than a year and re-location to find work. I don't stand a chance at my age. Better a 25 yo esl than an American over 40. i wish I could get my tuition and lost wages back.

[Jim]

"Last year when hr5924 was around I urged some American friends for help and some of them contacted their representatives' office to give them the signal that their constituents are interested in such a bill. This year I will ask my friends to do the same. So please DO NOT JUDGE anyone of what they have done to help,simply because you do not know. Thanks. "

- Then stop your aura of negativity. It is all over on another site as well. You can just have simply said you are doing something as well instead of appearing pessimistic. Thanks for the help. You can't blame people to pre-judge or misconstrue you when you make your post overtly pessimistic.

What you appear in cyberspace is base on what you post. That's the nuisance of blogs and forums.

Good luck.

[guest]

To Jim:
Last year when hr5924 was around I urged some American friends for help and some of them contacted their representatives' office to give them the signal that their constituents are interested in such a bill. This year I will ask my friends to do the same. So please DO NOT JUDGE anyone of what they have done to help,simply because you do not know. Thanks.

[Jim]

"Dear participants. This discussion is very emotional, but unfortunately Congress is not in session until June 1st. Then another delaying tactics, summer brake, etc etc. How long can the nurses wait? How come are nurses trated this way by not even having their own visa cathegory permanently? No signs of quick passage of this bill yet, a bill that is way overdue and awaited by immigrant community. Nursing shortage and issuance of green cards to nurses - it just look like last year's history repeating itself, giving poeple hopes and illusions... "

- You don't have to wait for it. You can do something else.
No one ever said it's a sureball. Nothing is. I would not waste my time monitoring, reading and making comments on pro-immigration blogs if you made up your mind already that nothing is going to happen.

What have you done to at least help in your own little way besides projecting hopelessness all over the net?

A lot of people behind the scenes have done a lot of work and lots of non-foreign nurses are trying to fight for it, including the members here because whatever profession we may be we are ALL patients at the end.

Sometimes, it's best if one don't say a thing if one can't contribute in even some small way on your own.

[guest]

Dear participants. This discussion is very emotional, but unfortunately Congress is not in session until June 1st. Then another delaying tactics, summer brake, etc etc. How long can the nurses wait? How come are nurses trated this way by not even having their own visa cathegory permanently? No signs of quick passage of this bill yet, a bill that is way overdue and awaited by immigrant community. Nursing shortage and issuance of green cards to nurses - it just look like last year's history repeating itself, giving poeple hopes and illusions...

[Jim]

"I work in the Philippines to help nurses get licensure in the USA (among other things) so I think if you'd like to get some background information it would be a good idea for us to communicate.

Believe it or not I'm on your side.. which is why I'm trying to get you to realize that you're losing an argument by getting off point. The argument about levels of education are irrelevant.

All nurses have to pass NCLEX to become licensed; foreign nurses have credentials evaluated to make sure that they graduated from good programs before they are allowed to sit for NCLEX. The point about foreign education is moot."

- Thanks for your service HD. I think everyone just got caught up emotionally because someone is trolling the site (and using diff. usernames) and spewing xenophobic comments and just plain non-sense that he or she can't prove.

Hope to see you more here and be a regular commentator as well. : )

[HD]

"Photographer? $75,000? It's always fun to argue with anti-immigrants because the facts are never on their side."

Greg, I'm not anti-immigrant.. you obviously did not read my comment completely.

Yes, three of my graduating class were earning $75,000 within the first two years of graduation with an AA in Photography and no other degrees.

I don't care what your scale is, these are people I know personally.

My only purpose in pointing it out is that you are allowing people to distract you from the real issue about the needed nurse immigration and are pandering to criticisms about levels of education which is pointless.

I work in the Philippines to help nurses get licensure in the USA (among other things) so I think if you'd like to get some background information it would be a good idea for us to communicate.

Believe it or not I'm on your side.. which is why I'm trying to get you to realize that you're losing an argument by getting off point. The argument about levels of education are irrelevant.

All nurses have to pass NCLEX to become licensed; foreign nurses have credentials evaluated to make sure that they graduated from good programs before they are allowed to sit for NCLEX. The point about foreign education is moot.

[Greg Siskind]

Hi John - I think a lot of the best ideas in bills like this will be incorporated in to a comprehensive bill. The bills won't move on their own until it becomes clear that comprehensive legislation is going to fail or not move. After that, it might have a chance passing on its own.

[B. Matthew]

Foreign nurses are highly qualified and have many years of work experience. In India, you can go for nursing only after completing 12 years of schooling and require 3 years of study to get a diploma and 4 years for a degree.

Their credentials are evaluated in US and they have to pass English test with high band score. (for expample: IELTS- Overall bandscore 6.5 with Speaking module 7). They also require to pass NCLEX to get their license.

So, foreign nurses are highly qualified and experienced and legally obtained all necessary certifications to work in US.

NCSBN started 5 NCLEX test centres in India ( and CGFNS started another 5) and do invite nurses to America. It is better to ask these American agencies to stop their activities in India (or elsewhere outside USA) rather than blaming foreign nurses.

Foreign nurses do not steal money from US. They work and earn and spend their money. No matter whether they spend it in USA or send it to their home country.

[John]

Greg,

What is your thought in the new bill introduced in senate on 05/20 called Reuniting Families Act?

S.1085 Reuniting Families Act
http://thomas.loc.gov/cgi-bin/query/z?c111:S.1085:

H.R. 2536 Emergency Nursing Supply Relief Act
http://thomas.loc.gov/cgi-bin/query/D?c111:61:./temp/~c111XwBtBW::

[George Chell]

Medina:

Make a statement here that you will oppose all tax roll backs referendum in the states until nursing education is funded adequately..and then I am with you. In fact, promise to actively oppose through grassroots levels any funding cuts that would hamper education of American nurses. Otherwise your assertions have no teeth.

[George Chell]

"Why bring foreigners here to be trained in American schools on visa when the un-employment rate is so high?"

How high? 10%? Last I looked it was bound for 2%, the worst case scenario. So dont insult the intelligence of the people.

[George Chell]

"Now the other issue. Why bring foreigners here to be trained in American schools on visa when the un-employment rate is so high? Why not train the people who live here first before we go recruiting?"

Because the foreigners will pay out of their pockets while the Americans will ask for financial aid from their states while cutting taxes at the same time. Vote for a tax increase for nursing education and then talk. Furthermore, some scholarships based in places such as Korea are for foreign nationals only. You pay you get the goodies, you want tax cuts, you dont get the goodies. That is fair!

[George Chell]

Registered Nurse -
Level 1 Wage: $28.54 hour - $59,363 year
Level 2 Wage: $33.24 hour - $69,139 year
Level 3 Wage: $37.94 hour - $78,915 year
Level 4 Wage: $42.64 hour - $88,691 year

Colgan Air

Level 1: $16,000 year
Level 2: $28,000 year
Level 3: $40,000 year
Level 4: $60,000 year

And airline pilots have no foreign competition. Hence blaming foreign nurses for lower wages is a bunch of baloney. If someone wants to pay low wages, they will, whether there are any foreign nurses or pilots or not!

[Legal and no longer waiting]

"Also many of these foreign nurses don't have a high school education equal to the US, their high school ends at Sophomore year of US High School"

Praising US high school degree? You gotta be kidding me!

I am one of those foreigners with 10 years of schooling before college. When was an exchange student at a reputable US university, I took several courses by exam, and they all were grades 6 through 8 in my school. I needed them to get a Bachelor's degree in the US because my univeresity in the home country did not offer any middle school nonsense, and I could only transfer college-level classes.

[Dan]

"JIM: And what exactly does this has anything to do with the nursing bill and this thread or blog entry? The nursing bill does not include LPNs only RNs. Period. You are adding other issues not related to the nursing bill and to this blog entry/thread...."

In my personal experience, LPNs/LVNs are jealous of the RNs coming from the Philippines. RNs are being paid significantly higher than LVNs/LPNs. For that reason, they don't want them coming over.

[Jim]

@F.Medina,

"Please, many Pinoy nurses could give a hoot about the nursing profession. They are much more interested in getting out of third world poverty and they know that a nursing license is their golden ticket out of the Philippines. I work with some great Pinoy nurses and I work with plenty who are only interested in making money and sending remittance back to their home country. "

- How does the first sentence correlate with the 2nd and 3rd sentence?

Why do immigrants migrate to other countries? Once you work for free, you can come back here.

And what is again wrong with sending remittances? Sending remittances are done by ALL foreigners working in other countries. This includes ALL Americans working abroad.

If there is one thing that American kids should learn and can learn from other cultures is how to take care of their old parents.

Do you even know that these remittances are not even that high?

"Most SNF/LTCs hire LPNs to work as floor nurses. LPN is a title that is not even acknowledged in the Philippines. There are greedy people in that country who know what SNF/LTC directors want and they are taking advantage their own country people. Are you aware of the fact that LPN training schools are opening in the Philippines and bilking students out of money? They do not inform the students that they cannot immigrate to the U.S with anything less than the BSN.They also do not inform these students that they cannot work in the Philippines as LPNs because the title does not exist in that country! This is just another way to cash in on the nursing gravy train. "

And what exactly does this has anything to do with the nursing bill and this thread or blog entry? The nursing bill does not include LPNs only RNs. Period. You are adding other issues not related to the nursing bill and to this blog entry/thread.

That's what happen when one butts in not fully knowing what is being discussed in the first place.

[Jim]

To HD,

I think I already know who you are in allnurses.com as I have seen a duplicate post of yours there.

Don't get swayed by alexk49. She is misconstruing everything just to make her case. A dirty tactic. Don't also be too sure that she does not have other accounts there in allnurses that she uses to agree with her other personalities. That is what trolls do. They start flame wars and play with emotions. If you don't play it smart you'll get pulled in again.

Greg is also the only immigration lawyer here as far as I know. Most are professionals here are from diff. walks of life.

As I previously said, try reading the whole flow of the discussion from the beginning and you will understand.

Also, try reading this other previous blog entry: http://blogs.ilw.com/gregsiskind/2009/05/are-we-playing-with-fire-when-it-comes-to-nursing-immigration.html

Hint: Long time US nurse there are the same persons making the same comments here and is also alexk49. The only new true people here is you and probably another one that only started blogging here the last 1-2 days. Now tell me, is Greg not justified? It's ok for someone to call a foreign educated nurses "inferior" then cry afterwards when some says that maybe they may even be superior? So, now you know how it started.

Problem is this alexk49, is trying to rouse everyone in the other site and only point to cherry-picked posts to make someone look bad.

Just always remember, regular readers and commentators of a blog or forum know if someone is still the same person but just using a diff. name. We know how to identify trolls. Authors/owners of blogs also have a way to know if someone is the same person or not.

[Greg Siskind]

Photographer? $75,000? It's always fun to argue with anti-immigrants because the facts are never on their side. Go to the US Department of Labor's job wage database (http://www.flcdatacenter.com/) for any city in America and a) find me a town where a starting photographer makes anywhere close to $75,000 and b) find me one where a photographer starts out at a wage higher than a nurse. Here's New York City, which should pay higher wages than most cities. By the way, Level 1 is entry level. Go ahead, I'm challenging you.

Photographer -
Level 1 Wage: $12.89 hour - $26,811 year
Level 2 Wage: $18.47 hour - $38,418 year
Level 3 Wage: $24.06 hour - $50,045 year
Level 4 Wage: $29.64 hour - $61,651 year

Registered Nurse -
Level 1 Wage: $28.54 hour - $59,363 year
Level 2 Wage: $33.24 hour - $69,139 year
Level 3 Wage: $37.94 hour - $78,915 year
Level 4 Wage: $42.64 hour - $88,691 year

[Jim]

"Also many of these foreign nurses don't have a high school education equal to the US"

- Just another ignorant comment. Do you know for a fact that part of the requirements for CGFNS is a H.S. diploma for assessment?

It seems that you do not get it that all the educational attainments of a foreign educated nurse are assessed.

It seems that you think that anyone can just go to the US automatically w/o their credentials properly assessed.

You are clearly ignorant and naive on how a foreign educated nurse is assessed.

Let me put it simple terms, everyone and everything are assessed. Not everyone qualifies. Period. Only those who are properly assessed are the ones that can come to the US.

I hope you also know that they go through the US State Board of Nursing.

[Jim]

Sorry for the abrupt cut from my last post. I know it's long.

But as I was saying trolls, uses emotions to start flame wars and this particular troll is using it to rouse a response from US nurses by trying to mis-construe someone as belittling the education of US nurses when it was actually her that started belittling foreign nurses eduction first.

Also, there is such as thing as Godwin's law in forums and blogs. The original Godwin's law meant comparing someone to a Nazi but actually Godwin's law can also be invoked when anything below the belt was said such as making comments such as "greedy lawyers" and so on and so forth. Anyone using such below the belt phrases automatically looses any debate in progress and even credibility.

[Jim]

To HD,

"I can - Photography. My first degree was an AA in photography and some of my classmates went on to get jobs earning upwards of 75K.

You treat Associate's degree like a garbage degree and it's just plain ignorant to do so.

AS or AA degrees are simply concentrated coursework, usually over the course of 6 semesters (no summers off for good behavior) instead of an expanded course which provides more detail and deeper information which one gains in a BS or BA degree.

You also criticize nurses for earning more than teachers.
I think it is terrible that nurses earn more than teachers... but the criticism is against the Education system; not the nurses.

Focus on your real argument... you're loosing on these points.

By the way, I support immigrant nurses; but not because I have a problem with American nurses. It is because I recognize that we are close to a dangerous nursing shortage.

By the way, I support immigrant nurses; but not because I have a problem with American nurses. It is because I recognize that we are close to a dangerous nursing shortage."

- First of all, thank you for your support for immigrant nurses and for recognizing that there is a dangerous nursing shortage.

However, it is a bit unfair to Greg to say the he treats Associate degrees as garbage. I'm sure he didn't mean it that way although it may have sounded that way to you. There are nuisances in posting comments in blogs and forums that when one only are able to just stumble upon and read the last few newer comments made w/o knowing how it may have come to be or what was the background, people can easily mis-construe things.

The background is one troll is belittling the education abilities of foreign educated nurses and and labeling them as "inferior". That is how it all started. No regular reader and commentator here ever started "belittling" American nurses' education.

People, including Greg just made sure that everyone knows that majority of foreign nurses are BSN holders and therefore are not "inferior" and just compared it to the fact that most domestic nurses are ADNs. The hospitals, different State Board of Nursing, CGFNS and USCIS recognize the BSN degrees as well. And you have to agree that BSNs are not the same as ADNs. That's just a fact everyone has to accept.

I implore you to read the blog from the beginning so that you'll know the background. It's quite easy to mis-construe someone if you only read the latter parts of the comments here and not know the background.

WE know that someone is already trying to mis-construe comments made here and passing it on different sites and pray that people don't actually read the background and just cherry picks certain comments or just believe what SHE says w/o doing some research first.

It's a bit strange that a few nurses who easily belittles the education of foreign nurses are easily hurt when the fact is made that majority of domestic nurses are really ADNs are just emphasized compared to the foreign nurses they are belittling as having "inferior" education that has BSN degrees

It seems for some, it's ok to belittle foreigners' education level then when people say no they are not and even have BSN degrees

That's called double standard. Don't belittle others first and it won;t go back to bite you in the butt.

Don't believe this alexk49 in allnurses.com and other usernames she uses in other sites, including here. That person is well known already in the world wide web to be a xenophobic trouble maker and constantly instigates mayhem in different sites. A troll like that are constantly monitored in the world wide web, so much so that even if she uses different usernames she is easily identified because trolls usually uses the same lines over and over again (like a fingerprint for them) and constantly and intentional misconstrues other people in the net. It is quite easy to do that in the web, esp. since most people only read the skim of most blogs and threads.

People who are smart enough, can easily identify such trolls but unfortunately there are some that are easily swayed by these trolls because they were able to use the emotional aspect of it such as intentionally misconstruing someone's comments as belittling US nurses. That will surely

[Tired of the whining!]

Please forgve the many typos, lights are off and distractions are plenty :-)

[Tired of the whining!]

I can - Photography. My first degree was an AA in photography and some of my classmates went on to get jobs earning upwards of 75K.

That however is not the regular salary of a photographer. Exceptions ("some")donot prove the rule here. With the shortage of nurses, those salaries are becoming the rule.

You treat Associate's degree like a garbage degree and it's just plain ignorant to do so.AS or AA degrees are simply concentrated coursework, usually over the course of 6 semesters (no summers off for good behavior) instead of an expanded course which provides more detail and deeper information which one gains in a BS or BA degree.

Nobody is treating is like garbage. please follow the discussion and read the comments with some care. A Medina and her ilk insist that foreign nurses are poorly educated, poorly dedicated and in short not good enough. The point being made was that most foreign nurses have a BSN rather than just an AA. FYI the Bcahelors degrees abroad are not like those in the US. There is no liberal arts or elective course involved. Professional Bachelors degrees are highly focused and concentrated.

You also criticize nurses for earning more than teachers.
I think it is terrible that nurses earn more than teachers... but the criticism is against the Education system; not the nurses.

That's a valid point. However the fact is that the poor semand and supply euqtion is resulting in signifcant jumps in nurse's salaries, espacially older nurses. They run the unions and benefit most, leaving igorant youngsters like medina to complain about ratios. The younger nurses ge the worst shifts and simply the worst of the shortage. Bringing a limited number of foreign nurses in will solve the immediate issues of staffing.It's not a long term solution- nursing supply in the US must still be increased for the future- and if the process does not start now, this argument will take place again in a few years. Best of luck funding it in this economy!

Focus on your real argument... you're loosing on these points.

I do not think so. (Btw do check the difference between "losing" and "loosing")
There is really no point to the anti argument.
There is a shortage, That shortage is dangerous. It cannot be filled (for now) with American RNs that do not exist. Medina and co. keep whining about LTC/TNF. But the shortage is everywhere. I have seen it personally in regular clinics and hospitals. The notion of nurse unemployment is a red herring. RN jobs are easily available. But you have to go where the jobs exist. Can't sit in DC and keep whining.

FYI Medina and co: High schools in Asia are many imes more rigorous than those in the US. Pick up the Report card of any school district and check the Asian scores and those of every other group. It will tell you what standards the parents expect in a high schooler.

As for not completing an AA degree in 2 years- frankly if it takes you 4 years that's your problem. In the same 4 years foreign nurses finish a BSN AND they pass the same licensing exams that you do. The satndards required for licensing are not less for foreigners than for Americans. So why are you complaining about the time and effort?

As for the dumb complaint that foreign nurses are in it "for the "money"- Give me a break please. Every professional is working to make money. This bull really gets to me. If you don't want money, please do charity. The point of being a professional is not that you do not want money for your work. It is the desire and ability to provide quality services for that renumeration.

By the way, I support immigrant nurses; but not because I have a problem with American nurses. It is because I recognize that we are close to a dangerous nursing shortage.

Thank you. Those are the right reasons. No one has a problem with American Nurses.

[HD]

"F. Medina - I challenge you to tell me any other occupation that only requires an associate degree that pays as well as nursing.

Posted by: Greg Siskind | May 25, 2009 at 01:30 PM"

I can - Photography. My first degree was an AA in photography and some of my classmates went on to get jobs earning upwards of 75K.

You treat Associate's degree like a garbage degree and it's just plain ignorant to do so.

AS or AA degrees are simply concentrated coursework, usually over the course of 6 semesters (no summers off for good behavior) instead of an expanded course which provides more detail and deeper information which one gains in a BS or BA degree.

You also criticize nurses for earning more than teachers.
I think it is terrible that nurses earn more than teachers... but the criticism is against the Education system; not the nurses.

Focus on your real argument... you're loosing on these points.

By the way, I support immigrant nurses; but not because I have a problem with American nurses. It is because I recognize that we are close to a dangerous nursing shortage.

[Jim]

"Congressmen Wexler's state ( the one he represents not the one he lives in ) makes it very difficult for foreign nurses to get a license. According to the state's web site it will take months to complete and this is the time it will take for Practical Nurse to complete the RN training. So his proposal is not sincere. Perhaps he needs to read his local paper or listen to his local TV channel and see that the shortage in not that bad in the state he represents."

- Rep. Wexler only represents 1 district in Florida in w/c he was re-elected by his constituents in his district. If you want to complain something about the State, you should be addressing the Governor of Florida and his office.

Also if you are complaining about how long it takes to get a license in Florida, complain to the Florida Board of Nursing.

What does a congressman representing 1 district have to do with anything you said.

Stop drinking kool-aid. Bill O'Reilly already moved past this non-issue with Rep. Wexler. Guess you never got out of his spin zone or still having a hang-over from all the kool-aid you drunk.

[Greg Siskind]

I said I wasn't going to say anything further, but it is worth mentioning that there is a bill calling for staffing ratios that is separate from the immigration bill. It is quite possible both bills will pass separately.

[F. Medina]

"What is needed are laws enforcing staffing ratios and right now those don't exist in my area of the country."

Along with flooding the country with new nursing graduates including foreign nurses trained in the US on student visas and passing the required exams...

Honestly I would take a pay cut if I was guaranteed a decent ratio based on patient acuity that could not be fooled with by tricky administrators. As long as my salary isn't reduced to a point where I would need food stamps, section 8, or 3 jobs to pay the bills I'm fine with it. So I can concede with you on increasing the amount of nurses IF ratios are enacted. However, this bill does not do that so I'm against it.

Now the other issue. Why bring foreigners here to be trained in American schools on visa when the un-employment rate is so high? Why not train the people who live here first before we go recruiting? As far as the British go it's the stupidity of the foreign countries that accept their nurses w/o forcing them to return the favor that is the problem.

[George Chell]

"I am not afraid of paying higher taxes if it's going to bring me better services so I don't know where you are going with that argument."

That is what every anti-immigration American says when confronted with this fact..but they have nothing much to show for in places like California, do they? Why did not your nursing unions campaign for the Schwarzenegger budget in California? The defeat last tuesday means fewer tax dollars for education including nursing education...watch in the next five weeks...see the cuts sweep through education including nursing schools...but yet tell the same folks who voted against taxes for education and balancing the budget, they will say the same thing you said. I am saying put your money where your mouth is. It is not happening in real life!

[George Chell]

When I put the two and two together, it seems like the Americans just like the British want a one way street...

http://www.transitionsabroad.com/publications/magazine/0403/working_abroad_as_a_nurse.shtml

[George Chell]

"What is needed are laws enforcing staffing ratios and right now those don't exist in my area of the country."

Along with flooding the country with new nursing graduates including foreign nurses trained in the US on student visas and passing the required exams...

[F. Medina]

Nursing unions do not educate future nurses...schools do.

The most that a union might do is provide some form of tuition reimbursement. Most student nurses receive financial aid or take out federal and private loans to pay for their education.

The problem with training more nurses in the U.S is mainly two-fold.
1. There's a lack of nurse educators.

The lack of trained nursing instructors is due to the low wages that a teacher receives. A nurse educator is expected to have a minimum of a BSN to teach on the associate degree level and is expected to have an MSN to teach BSN students.

Why would anyone want to get their MSN when they will still have to work as a bedside nurse while simultaneously teaching?

2.The lack of clinical sites for students to fulfill the required hours of hands on training in order to be licensed. Everything isn't learned in the classroom. Student nurses must spend a set amount of hours working under the direction of licensed nurses in various settings. Acute care, OB/GYN, Psych, Peds, and Geriatrics before they can sit for the NCLEX exam and be licensed by their state of residence. You can open up 100 nursing schools with ten thousand students but if you don't have a clinical site for those ten thousand students then you're going nowhere really fast.

I am not afraid of paying higher taxes if it's going to bring me better services so I don't know where you are going with that argument.

Also what do nursing unions have to do with putting seniors who can't pay their healthcare bills onto the street? We nurses are not the administraors or CEOs of hospitals and other health care facilities. We do not determine who our patients are. Most of the time we don't even know how they are paying for the services. Clerical staff acquires insurance and method of payment information. Adminstrators decide who gets what level of care. Insurance companies determine what they will and won't pay. Nurses have nothing to do with any of those issues.

If you want to train American nurses, be my guest, pay up and urge the nursing unions to train more nurses. Convince the Americans not to roll back taxes when there is a surplus and instead to put their money where their mouth is. However, I have not seen that happening and I have to suspect that the goal of the nurses union is to run up the wages and salaries, drive health care costs up, put seniors on the streets after the insurance company refuses to pay the extra costs or the premiums become so high that they cannot pay, or worse still, overwork and end up killing someone.

[Greg Siskind]

I think the arguments have all been stated here and there is little left but to keep repeating ourselves. I'm moving on to commenting on other posts (and trying to catch up on a growing email pile).

[George Chell]

"The main point is that importing tons of nurses from abroad will NOT provide better patient care or better nurse to patient ratios unless laws are enacted to force nursing home administrators to do so."

Agreed! We need to put a limit on number of hours worked and at the same time flood the country with nurses both American and foreign trained. The composition will depend on the American willingness to pay to train American nurses instead of voting themselves a tax cut at a blink of an eye!

"I work with some great Pinoy nurses and I work with plenty who are only interested in making money and sending remittance back to their home country."

American nurses working in Singapore do the same thing! Is it ok for white American nurses in Singapore to do the same thing but not ok for the Filipinas? I think you believe it is a one way street just like many selfish Americans.

"This isn't what's going to happen in the future. This is what's going on right now. Why haven't the facilities that employ these foreign nurses at such a low cost increased staffing ratios yet? It's because they have no motivation to do so. For them it's all about saving money."

If they did, they will pass the cost on to the insurance corporation which means the premiums go up or the people on insurance rolls will be dropped and no longer will be covered. Remember health expenditures and debt account for over 50% of GDP.

I have a suggestion, let us exchange the 10,000 or so American nurses working abroad for foreign nurses working here. It is interesting no one complains about American nurses working abroad and taking jobs away from the nationals of those countries..plain selfish!

[George Chell]

"Once again bringing foreign nurses to the U.S does nothing to ease the shortage where it is greatest..in the SNF/LTC...because as soon as these Pinoy nurses pass the RN boards they leave. They just come to the U.S to work as LPN for a little while in the SNF/LTC until they can go work in a hospital or become a floor supervisor or some other role where they don't have to touch patients in the nursing homes."

If you want to train American nurses, be my guest, pay up and urge the nursing unions to train more nurses. Convince the Americans not to roll back taxes when there is a surplus and instead to put their money where their mouth is. However, I have not seen that happening and I have to suspect that the goal of the nurses union is to run up the wages and salaries, drive health care costs up, put seniors on the streets after the insurance company refuses to pay the extra costs or the premiums become so high that they cannot pay, or worse still, overwork and end up killing someone.

[F. Medina]

"That is what will happen if you dont restrict the number of hours and increase the number of nurses"

This isn't what's going to happen in the future. This is what's going on right now. Why haven't the facilities that employ these foreign nurses at such a low cost increased staffing ratios yet? It's because they have no motivation to do so. For them it's all about saving money. They aren't going to hire more nurses at a cheaper wage. Rather they will hire the same amount of nurses that they always have and make more money.

What is needed are laws enforcing staffing ratios and right now those don't exist in my area of the country.

First, when the 'you're just a greedy lawyer' argument comes out, readers know that the anti has given up and lost the argument.

Please don't put words in my mouth. I never called anyone a greedy lawyer. All I said is that this is your lively hood and in the interest of your own self-preservation maybe you are a bit biased about the issue. How is it that someone who is not a practicing nurse has so much insight into the working conditions of nurses and the person who is a nurse is full of baloney?

And given that nursing is the profession of choice for a sizeable portion of the brightest young people in the Philippines, I feel even more confident.

Please, many Pinoy nurses could give a hoot about the nursing profession. They are much more interested in getting out of third world poverty and they know that a nursing license is their golden ticket out of the Philippines. I work with some great Pinoy nurses and I work with plenty who are only interested in making money and sending remittance back to their home country.

Truly dedicated caring American nurses don't troll around the web spreading xenophobic, protectionist claptrap.

Hah! Spare me your own claptrap lawyer and save the your being xenophobic B.S for someone far more gullible than I. There are plenty of licensed American nurses. There just aren't enough who are willing to submit to the working conditions that persist in most SNF/LTC facilities. These are the places with the greatest shortages and this will only increase as the baby boomer population grows older. Tell me truthfully that you believe that is it possible for one nurse to take care of 40 people? Nursing home administrators WILL NOT hire more nurses regardless of wage unless laws are enacted that force them to do so.

My guess is you are blaming immigrants for you own shortcomings, something that is quite common with immigrant-badgers.

I don't know what shortcomings you are speaking of since you don't know me personally. I admit that my opinions do stem partially from protectionism. Why would I want to go from a living wage to a poverty wage if I can help it? The main point is that importing tons of nurses from abroad will NOT provide better patient care or better nurse to patient ratios unless laws are enacted to force nursing home administrators to do so.

Have you even considered that most nursing homes do not even hire RNs as floor nurses? Most RNs in nursing homes work as supervisors, directors, and floor managers, positions that do NOT involve much if any direct patient care. During evening, night, and weekend shifts it is typical to have only one RN in the building.

Most SNF/LTCs hire LPNs to work as floor nurses. LPN is a title that is not even acknowledged in the Philippines. There are greedy people in that country who know what SNF/LTC directors want and they are taking advantage their own country people. Are you aware of the fact that LPN training schools are opening in the Philippines and bilking students out of money? They do not inform the students that they cannot immigrate to the U.S with anything less than the BSN.They also do not inform these students that they cannot work in the Philippines as LPNs because the title does not exist in that country! This is just another way to cash in on the nursing gravy train.

http://americanschool-practicalnursing.com/

Once again bringing foreign nurses to the U.S does nothing to ease the shortage where it is greatest..in the SNF/LTC...because as soon as these Pinoy nurses pass the RN boards they leave. They just come to the U.S to work as LPN for a little while in the SNF/LTC until they can go work in a hospital or become a floor supervisor or some other role where they don't have to touch patients in the nursing homes.

[Dan]

"...None of this addresses the real issue - limiting the supply of foreign nurses is old fashioned protectionism. Except instead of just driving up the cost of nursing services for American employers, patients die. And all of the arguments you're presenting don't get you past this reality."

Greg, I think they are scared to compete. US is known as a "free-market" society. I can't understand why the so-called US educated nurses be scared to compete against foreign-educated nurses if they think they are better equipped with knowledge and experience. When it comes to self-interest, the concept of the free market is gone.

[Dan]

"...Also many of these foreign nurses don't have a high school education equal to the US, their high school ends at Sophomore year of US High School. So some foreign nurses have only attended school for 14 years for a BSN like a US nurse who attends high school and gets an ASN, ( Most nurses take more then 2 years to complete the ASN).."

High school in other countries is as rigorous as US high school or even better. Many sons and daughters of legal immigrants who are taking high school here in the US even got straight As,which ironically, they weren't even in the top of their class back in their home country. If you look at the statistics of those whose doing well in elementary and high school here in the US, many of them are foreign-born. So, don't bring that disparity. Maybe you should think why US students need 6 years (middle and high) in high school while other countries only need 4. The bright can even finish college at age 13 (heard of the news of the son of Indian immigrant who finished college at age 13?).

[Greg Siskind]

It is fine to talk about all of the risks that nurses take. But there are plenty of occupations that involve risk - fire fighters, police officers, lifeguards, teachers in a rough school, bank security officers, prison guards, etc. etc. Nurses stack up quite favorably to all of these jobs.

None of this addresses the real issue - limiting the supply of foreign nurses is old fashioned protectionism. Except instead of just driving up the cost of nursing services for American employers, patients die. And all of the arguments you're presenting don't get you past this reality.

[Proud to be a Self interested American RN.]

I see some real American Nurses have joined the debate. Another aspect of nursing that is forgotten is nurses are exposed to diseases often before other health care professionals are.

Also many of these foreign nurses don't have a high school education equal to the US, their high school ends at Sophomore year of US High School. So some foreign nurses have only attended school for 14 years for a BSN like a US nurse who attends high school and gets an ASN, ( Most nurses take more then 2 years to complete the ASN).

Congressmen Wexler's state ( the one he represents not the one he lives in ) makes it very difficult for foreign nurses to get a license. According to the state's web site it will take months to complete and this is the time it will take for Practical Nurse to complete the RN training. So his proposal is not sincere. Perhaps he needs to read his local paper or listen to his local TV channel and see that the shortage in not that bad in the state he represents.

http://wokv.com/localnews/2009/05/nursing-the-profession-and-rec.html
http://www.miamiherald.com/news/broward/miramar/story/1038025.html

Wow a one percent of RN positions, I can see the need for an Emergency Bill.

[George Chell]

"When rents for a 2 bedroom apt in the Bronx start at $1200/month and 1 family 3 bedroom 1.5 bath row house starts at 399k you tell me that I should take on all of the responsibility and liability of being a nurse for a wage that I can't even pay my bills with. You don't have a clue."

I have a clue. I move to Indiana or Colorado or perhaps Texas, as much as I may hate Texas! If I cannot find a job in DC I move to another part of the country or even abroad to the Middle East or South East Asia. Life sucks but that is life!

[George Chell]

"I hope that someday you will be a resident of a SNF with a 40:1 patient ratio and that you will have a foreign trained nurse making $14/hr who has just clocked in for her 5th straight 16 hour day."

That is what will happen if you dont restrict the number of hours and increase the number of nurses. The solution is sharply curtailing the number of hours nurses work in a day to no more than 12 (five days a week) and sharply increasing the number of nurses. Either you train more American nurses, which means convincing Americans to pay more in taxes and not ask for rollback of taxes everytime a state runs a surplus, or you import foreign nurses. The solution is to curtail the number of hours and flooding the country with nurses, American or otherwise. Singapore is precisely doing that and the results have been one death due to overwork during the past year. If you curtail the number of hours, you have to flood the country with nurses..if you want more Americans pay the taxes and dont support any more tax rollbacks especially for wealthy folks that the Republicans always seem to want or take in foreign nurses preferably foreign nurses on student visas educated in this country so that qualifications will not be an issue!

[Greg Siskind]

First, when the 'you're just a greedy lawyer' argument comes out, readers know that the anti has given up and lost the argument.

Second, my 'greed' has the happy result of saving patients' lives by alleviating the nuts shortage. Finally, I'll take a nurse with a BSN any day over a nurse with just an associates degree. And given that nursing is the profession of choice for a sizeable portion of the brightest young people in the Philippines, I feel even more confident.

Truly dedicated caring American nurses don't troll around the web spreading xenophobic, protectionist claptrap. My guess is you are blaming immigrants for you own shortcomings, something that is quite common with immigrant-badgers.

[George Chell]

"So what if nurses in the D.C area also make about 70k a year. What is the cost of an apt or the average house in D.C?"

I have been living off and on in DC now. I am now in DC. You can live pretty comfortably on $70.000 in DC and I know people who have purchased $250,000 apartment in the Arlington area making less than that amount!

[F. Medina]

Greg,

In addition your responses are equally if not more so ridiculous than mine. You focus on one aspect of my responses and refuse to address the majority of my comments. I do have to remind myself that you are a lawyer and you make your lively hood off of the fees of the foreign nurses so it's in your best interest to assist in bringing in as many foreign nurses as possible. It keeps your pockets lined and of course you justify it by claiming that it's for the greater good of the public. Spare me. I hope that someday you will be a resident of a SNF with a 40:1 patient ratio and that you will have a foreign trained nurse making $14/hr who has just clocked in for her 5th straight 16 hour day.

[F. Medina]

Also an associate degree in nursing takes longer than 2 years to acquire. It takes two years to complete the clinical portion of nursing education but before a student can gain entry into a nursing program there are pre-requisite classes that must be taken. Typically a nursing program requires courses in anatomy and physiology, microbiology, English, developmental psychology, math and chemistry. These are the minimum requirements and it usually takes a minimum of 1.5 years to complete these classes.

Very few nursing students complete an associate degree program in less than 3 or 3.5 years.

[F. Medina]

Greg,

My employers liability insurance covers the cost of damages from a lawsuit but it does not protect my license. You can't practice as a nurse if no one is willing to hire you and one lawsuit is enough to turn off many potential employers.

[Greg Siskind]

F. Medina - I give you credit for originality. But your answer is ridiculous. Unless you're malpracticing in your spare time, your employer's policy covers liabilty. Surely, you have something better. especially since your position results in the death of innocent patients. artificially perpetuating a shortage only increases the likelihood of making mistakes. recent studies on just this topic are scary.

[F. Medina]

George,

F. Medina - I challenge you to tell me any other occupation that only requires an associate degree that pays as well as nursing.

It's all about liability. An example is the use of Certified medical assistants and Certified nurse's assistants. A CMA works under a physician's license so they bear zero responsibility for the outcome of their work. Same goes for CNAs they are paid significantly less than nurses because it's the nurse who bears the responsiblity for ensuring that they do their job.

As far as teachers go I was a NYC public elementary school teacher before I became a nurse. While I was underpaid, overworked, and disrespected I never had the constant threat of a potential lawsuit or the loss of my license for making a mistake the way that I do now that I am a nurse.

Next, there are plenty of licensed nurses right here in the U.S who choose not to work in the profession because of the working conditions. Also, nursing salaries aren't the only reason that health care cost so much. Doctors salaries, the cost of drugs, all of the state of the art equipment that U.S patients expect also drive up the cost of health care.

So what if nurses in the D.C area also make about 70k a year. What is the cost of an apt or the average house in D.C? If it's anything like the COL in NYC then that's not a lot of money. So what you're saying is that the contribution that nurses make to health care is not valuable. When rents for a 2 bedroom apt in the Bronx start at $1200/month and 1 family 3 bedroom 1.5 bath row house starts at 399k you tell me that I should take on all of the responsibility and liability of being a nurse for a wage that I can't even pay my bills with. You don't have a clue.

[George Chell]

Greg:

Glad you have made most of the points. But, my beef is that the nursing unions did not fight for training more American nurses during the California budget referendum on tuesday. The result is we will have large cuts in education spending including nursing education spending which probably suits the nursing unions fine. However, I am furious at FAIR, CIS and the other antis such as Healther MacDonald at the Manhattan Institute who give lip service to training more Americans but nowhere to be found campaigning against budget and tax cuts which would hinder training of more Americans! It shows one thing..they are not interested in training Americans but they are a bunch of racists who want to keep a majority white America. So if the motive of the nursing union is to perpetuate the shorages and double the health care costs, resulting in our seniors being dropped from health insurance rolls, the motive of most antis is to keep America white even if it means killing fellow Americans due to medical personnel shortage! In fact, Governor Lamm was at least honest in 1986..he said that the only way to solve the problem of high medical costs and medical personnel shortage is for our seniors to roll over and die...that was the end of his political career.

[A PT]

A traveling Physical Therapist Assistant (PTA) position can get between $50,000-70,000+ depending on the geographic location. PTA requires an associate degree.

[Greg Siskind]

http://www.mysanantonio.com/news/local_news/45964682.html

Nurses are starting at salaries more than 50 to 75% higher than teachers for positions only requiring half the college. And jobs abound. Nurses pushing the notion that American nurses are out of work and there is no shortage did the same thing in the mid-90s when the H-2A bill was up for renewal and it was a huge mistake for which we are still paying. Shamefully, many nurses would rather perpetuate a shortage that is killing American patients rather than admit that we don't have enough nurses here and don't have the capacity to train enough in short order. And they want to kick Americans when they're down financially and already can't afford our health care by dramatically pushing up already high nursing salaries. Those costs get pushed on to the backs of Americans who already are having to shelf their health insurance because they can't feed their families. It only this were an exaggeration. Unfortunately, millions of Americans have their backs against the wall and members of one of the few occupations with healthy salaries and low unemployment want to make people with a whole lot less security subsidize their labor cartel.

[Greg Siskind]

F. Medina - I challenge you to tell me any other occupation that only requires an associate degree that pays as well as nursing.

[George Chell]

"Are you a nurse? Yo can't be and if you are then you have been away from the bedside for at least the past 20 years."

No. A patient who is fed up with the cost in the US and lack of service that I go abroad to another advanced country for medical check-up and treatment!

[George Chell]

I also know American nurses here in the DC area paid over $70,000 a year.

[George Chell]

No. I am not a nurse. But, it does not take the rocket scientist to tell you that shortage should be alleviated by more training and there is a shortage of nurses in this country depending on the area and it is bound to get worse. It does not take a rocket scientist to tell folks that if we need more nurses we either (1) train or (2) import. I am sick and tired of people who oppose foreign nurses not campaigning to increase the number of nurses enrolled especially during the current California referendum. If Americans want more American nurses they need to pay for it. They should have done this fifteen years ago. Instead every time they vote themselves a tax cut without specifying budget cuts and education gets cut first. If you want something pay for it. Otherwise no hospital or anyone else to obligated to anyone to hire based on race, citizenship, etc.

[F. Medina]

George,

Are you a nurse? Yo can't be and if you are then you have been away from the bedside for at least the past 20 years. You can believe what you want about the situation but you really have no idea of what you're talking about. Yes it's true that 70k in places like NYC and CA is the average salary for an RN. However, that's not the going wage across the country. In the south and mid-west $25/hr or less is far more common. The COL is NYC is high enough so that 70k makes you barely middle class unless you have a spouse making the equivalent of your salary.
Also no LPN anywhere makes that as a base salary. You are talking about a wage for an RN working in a hospital. I'm talking about the working conditions in nursing homes and skilled nursing facilities (SNFs) do you even know what the difference is?

A hospital nurse (RN or LPN) has a patient load of anywhere from 6-13 patients depending on the facility and the shift they are working. SNFs/LTCs rarely staff less than 40:1 on any shift unless you are working at a non-Medicaid facility. These residents are not your average geriatric patient. Many are baby boomer age and are in the facility for re-hab from strokes, MIs, or surgery. Many are there because of uncontrolled diabetes, HTN, COPD etc. Some are there because they need long term care after CHI/TBI and are on vents and will remain in LTC for life. What do you think happens to people who aren’t well enough to go home but can’t remain in a hospital indefinitely?

We also take care of the demented, Alzheimer’s residents, elderly residents with psychiatric disorders and the list goes on. There is a reason it's called skilled care. It's because these clients require a higher level of care than the average aging person who mainly requires assistance with the activities of daily living. Many have complicated medication regimens, stage III and IV pressure ulcers that they’ve acquired outside of our facility, they require PT/OT/Speech and the list goes on and on.

Your way of thinking is that if an employer can get enough foreign nurses stateside and lower the wages of nurses that they will hire more nurses. I’m sorry but that’s CRAP. If an employer can staff one nurse for 16k instead of 40k then they will do that…staff one nurse. The ratios will not change and the care will not improve.

The problem is that non-nurses think that any trained monkey can do a nurse’s job. So they are mind boggled that anyone would pay 70k for what they consider to be an easy job. The attitude is that nurses are merely pillow fluffers and bed pan holders as your comparison with an RN wage vs. a pilot's wage clearly proves. So a pilot deserves a higher wage than a nurse why? Is it because they have a plane full of human lives that they are responsible for? Well duh when I go to work I am responsible for the lives of all 41 of my residents. A SNF/LTC is NOT a hospital. We don't have a bunch of medical students and residents on call 24 hours/day.

In a SNF/LTC one doctor is usually the doc for the entire unit. That doc comes to the facility one to two times per week during day time hours to do what are called monthly renewals. They briefly (if at all) examine the resident makes changes to their medical regiment (if needed) and complete their paperwork. The majority of the time they do so on the recommendation of the nurses because we are the ones who take care of the residents on a daily basis. For many physicians this is a second job. If I don't know what I am doing or seeing then guess what? The resident’s condition worsens or they just might die from what I don’t see.

My salary ranges in the 20s/hr so I am hardly overpaid for my area of the country (NYC). You’re correct I don’t have to work at my current job and in a very short while I won’t be. However, this does not solve the problem of the poor ratios and poor care that is delivered in many SNF/LTC facilities.

[George Chell]

"Yet these are the perfect nurses that are willing to work back to back to back double shifts and when the DNS says jump they say how high?"

Precisely why we need lot more nurses and not allow hospitals to make the nurse work more than 12 hours at a time! Either pay taxes and train Americans (next time a tax roll back referendum shows up dont vote for it and campaign against it) or import foreigners. Dont see the nurses union actively campaigning against budget cuts at the universities...why? they want the nursing salaries to skyrocket if they had fewer nurses, American or foreign. Dont see anti immigration groups campaigning against cuts in education..why? their goal is not education Americans but desperately trying to keep America white.

Talking about hiring foreigners, there was this guy at Harvard who will hire foreign citizens over me and some other Americans. I did not care about it and found employment elsewhere than work for the a.

[George Chell]

"I admit and I am not ashamed to admit that once I take my RN boards I am running for the hills because of the working conditions. If there is a shortage of American nurses at my facility it's for a good reason. I don't hate the foreign nurses and I feel sorry that they are being brought to this country and are being made to work like people in a sweat shop rather than the professionals that they are."

The goal is to reduce health care costs, not increase them. At this rate, debt and health care costs would be 100% of GDP.

"The bottom line is that the residents are suffering and importing foreign nurses is not the solution to providing better patient care."

Vote for a tax increase in the referendum and train American nurses. You know how that suggestion flew in California. All lip service, no action and no one wants to pay taxes.

"It's nothing more than a way for employers to undercut the wages of the nurses who are already here and to make us shut out mouths by saying that we are lazy whiners."

$ 70,000 a year is a good salary far higher than the payment made to some airline pilots without any foreign competiton. If the employers want to pay you $16,000 per year they will even without foreign competition. Just ask the mother of the frist officer Rebekka Shaw who died in Buffalo..she had no foreign competition. So blaming undercutting wages on foreigners is a bunch of baloney. Secondly, who is going to pay the higher cost of nursing which would be passed on to patients if your salaries are not undercut by competition? Are you ready to lobby the insurance corps to pay the higher costs?

"I really hope that the people who think that this is a good idea end up with a family member in one of these facilities so that they can gain a first hand understanding of what really goes on in the nursing home/SNF business. Better yet I hope the people who are responsible for creating these conditions end up as a resident."

There are problems with sleepy overworked American nurses..at this rate malpractice rates would go up and medical costs would increased further.

I dont buy any of the baloney you have written.

[F. Medina]

I can only write about my experiences. I work in a SNF and recently the DNS has hired 6 MORE foreign nurses via agency because we don't have enough staff. The DNS is from the same country as these foreign nurses and though they have been trained as RN/BSNs they are working as LPNs on permit. Meaning they haven't even passed the LPN boards much less the RN boards. The DNS and the administrator are crying to the union that the facility is desperate for nurses but is this really true?

One of our CNAs became an LPN recently and wanted a position at our facility. She had to go to the administrator with the union delegate and explain that she had worked in our facility as a CNA for 4 years with no problems and yet the DNS told her that there were no openings. Once the union delegate got involved and threatened to file a grievance because we were using so many agency nurses a position magically opened up for the new LPN. This LPN has also sent many of her friends, new grad LPNs, to the facility to apply for positions and not one of them has been hired. I have also sent LPNs that I know to my facility to apply for positions and they never get hired or even called in for an interview.

I have been told by the foreign nurses that they are working for an entire $8/hr LESS than what I as a union member am being paid. They have no health benefits and my employer justifies the wage by providing them with housing; if you can call living 5 to a 1 bedroom apt adequate housing. Why do they put up with it? They do it because there are NO jobs in their native country and most of them have left behind spouses, parents, and children in their home country and are grateful to be able to send money back home. The wage is not enough to live on with their families in the US but with the exchange rate they are able to live comfortably back home.

I don't give a damn if anyone thinks I am xenophobic this is inherently unfair. My children, parents, and spouse live in the U.S and $50 or $100 in US dollars per week isn't going to take care of the entire family the way it will in countries where the exchange rate is $1US to a hundred or more of the foreign dollar.

Another issue is the working conditions. The reason that many nursing positions are difficult to fill is because the conditions are absolutely horrendous. What I notice about the foreign nurses is that they do not complain about the ridiculous ratios or the impossible workload. Now this doesn't mean that they are getting the work done on anything but paper but it means that the residents continue to suffer because only a handful of us speak out and we are labeled as whiners.

Tell me that it's possible for one LPN to take care 41 skilled nursing home resident's and I will have no problem calling you the liar that you are. There is no way to pass out multiple meds for these residents, many requiring full sets of vital signs, within two hours to remain in compliance. There is no way for the same single nurse to provide trach care, wound care, blood glucose monitoring, dining room duty, and all of the paperwork that is required. Yet these foreign trained nurses manage to get it all done w/o complaint. Funny thing is that when I work behind these same nurse I see the clogged trachs/GTs, the vital signs that are just written in and the dressings that haven't been changed since the last time I worked. Yet these are the perfect nurses that are willing to work back to back to back double shifts and when the DNS says jump they say how high? Is it because they have such a great work ethic and I am a lazy American or is it because they are terrified of losing their positions and having to go back home? There is a good reason why I am not willing to cover as many shifts are the foreign nurses do. It's not because I don't like to make money or wear Coach purses (words from my DNS mouth) it's because when I go to work I actually bust my rear and DO the work. I can't work OT because I feel like collapsing after 4 weekly shifts and I know dang well that I would have to cut major corners if I worked the 8 or more that they do.

I admit and I am not ashamed to admit that once I take my RN boards I am running for the hills because of the working conditions. If there is a shortage of American nurses at my facility it's for a good reason. I don't hate the foreign nurses and I feel sorry that they are being brought to this country and are being made to work like people in a sweat shop rather than the professionals that they are. The bottom line is that the residents are suffering and importing foreign nurses is not the solution to providing better patient care. It's nothing more than a way for employers to undercut the wages of the nurses who are already here and to make us shut out mouths by saying that we are lazy whiners. I really hope that the people who think that this is a good idea end up with a family member in one of these facilities so that they can gain a first hand understanding of what really goes on in the nursing home/SNF business. Better yet I hope the people who are responsible for creating these conditions end up as a resident.

Anyone who thinks that bringing in foreign workers doesn't have an impact on the ability of U.S nurses to get jobs and fight for good working conditions is smoking that green stuff. Just look at what happened to the IT field and if you think it can't happen in nursing then maybe you are smoking something even stronger than that funky green stuff.

[Kavitha]

Hi Greg,

Now the text of the bill is officially available and waitfor your expert comments.

I feel that Mr. Wexler and the team who were involved had really considered the immediate and long term shortage. Had the bill been specifically introduced with a limit of 60,000 RNS, America would have got only those International Nurses who are qualified as of today. The Hospitals, Stafing Companies etc. may not have invested in future since they have gone through a bad experience over the last three years. Needles to mention that no new international nurses would have even thought of writing NCLEX exam whe he/she cannot find a sponsor.

The way the the bill is worded looks like that the congress can review the demand every year and can change the law in such a way that the visas will be available only for those I 140 petitions or adjustment status are filed prior to enhancement of the new law, where they will stop new comers. This makes sence according to me. I am not a lawyer but an RN.

Will look forward to seeing your expert comments.

[George Chell]

"American Nurses Association and California Nurses Association are protectionists that don't want foreign nurses because as more nurses coming in, wages will go down. Their bargaining power will lessen as well."

They also really dont want to train more American nurses for the same reason. It is in the interest of the nurses union to ask their members to vote for the tax and budget cuts so that fewer American nurses are trained and the wages and hence the cost of health care goes up. This nonsense was prevalent among the doctors back in the 1970s until mistakes due to overworking and malpractice rates sky rocketing the doctors relented regarding foreign doctors and they also started training more US doctors.

[Dan]

American Nurses Association and California Nurses Association are protectionists that don't want foreign nurses because as more nurses coming in, wages will go down. Their bargaining power will lessen as well.

They kept a blind eye on the shortage by justifying that there's none. But if you look around, many hospitals and facilities are hiring, mostly night shifts and floating shifts.

A simple analogy is this. Joe the plumber would only like to work Monday to Friday from 8am to 5pm. Guess what, he can't find work because most households are empty during this period and won't allow Joe to work alone without their supervision. And here comes, Jose the immigrant...he's willing to work anytime of the day, any day of the week. He finds work because most household want their plumbing problem fixed while they're in the house, i.e. 6 pm. So Jose got a job, not Joe.

Jose adjusts to the schedule of the clients, while Joe doesn't want to get out of his comfort zone.

[George Chell]

"Another thing is, read the bill first and understand it. Someone pretending to be a nurse educator trolling foreign nurse websites, pro-immigration websites and websites that tracks bills do not even read the bill first and therefore do not know that the visas talking about is 1)very, very low to threaten domestic nurses, 2)not only is the visa numbers low but it is even divided into 3 years."

If they are making an argument as some Canadians make of luring back our US nurses from abraod and spending money to educate more nurses I shall take a look. If you look at the budgets of UCLA and Berkeley it is very clear that the vacuum left by American taxpayers due to tax rollbacks and budget cuts has been filled by foreign funds and even in nursing schools foreign numbers have been increasing. There are funds for Korean nationals, Japanese nationals etc. from foreign sources which cannot finance Americans. So why cant our citizens get off their high horse, stop giving lip service and put their money where their mouth is. Will they vote against the next tax cut? Will they repeal the two thirds tax law in California? Will future referendums have both spending and tax plans instead of just a tax cut? US citizens created this mess which has led to a lot of dependence on foreigners. It is upto them to rectify this mess. There are three alternatives: (1) Keep the tax base and educate the Americans; (2) Cut taxes and educate foreigners and keep them here; (3) Cut taxes, dont employ foreigners, send the health care costs higher and people like me will vote with their feet and go abroad for medical cheeck-up or for medical treatment. Make your pick!

[Jim]

"The fact remains that many nurses here are suffering to find employment, where is this shortage we are desperately trying to fix? "

Is this your new username?? : )

The fact is my dear. There is a national shortage. Just because your part of the US has no shortage, does not mean there isn't a national shortage. Are you willing to relocate to another part of the US where there is a shortage??

Also, try to read why freeze-hiring and even a bit of layoffs are happening and why it is all temporary and why when the recession ends, the shortage will be greater than ever.

Another thing is, read the bill first and understand it. Someone pretending to be a nurse educator trolling foreign nurse websites, pro-immigration websites and websites that tracks bills do not even read the bill first and therefore do not know that the visas talking about is 1)very, very low to threaten domestic nurses, 2)not only is the visa numbers low but it is even divided into 3 years

The same nurse educator trolling here and commenting on different websites thinks that once it gets approved that it will be opening a floodgate or something and every foreign educated nurse will be able to go to the US all in the year 2009 as if just booking a flight going to the US for a vacation. Talk about showing ignorance for the world to read. And s/he is all over.

NG? I resume you mean new grads? That is what is wrong with alleged nurse educators passing on their ignorance to students and new grads. If your county and your State does not currently have a shortage, then re-locate where there is. Florida has a shortage, Texas has one, border counties to Mexico has one and so on and so forth. If you don't look beyond your State and is not willing to relocate to areas that has a shortage and picky on schedules then one can really have hard time. Applying to nursing homes, LTCs, prisons and others health facilities not usually the first choices ar good options as well.

Unfortunately, so-called nurse educators do not even teach their students the above because they are ignorant as well. They are busy trolling websites; giving everyone a glimpse on just what a few nurse educators are teaching new grads or should I say not teaching.

There is a national shortage and it will become worse in the years to come. Do not hold posts in popular nursing forums posted by anonymous persons to be the be all and end all truth. Do your homework. Google is your friend. And what people are trying to fix are the projections or long-term prospects.

One other thing that foreign educated nurses bring is they compete. They take up slots and schedules that many don't want. They are not too picky as well as long as the working conditions and compensations are fair. So, that is another benefit in bringing them in as well besides from helping to alleviate the nursing shortage. Their presence is forcing domestic nurses to compete that unfortunately your a few nurse educators do not impart to their students. What a few impart instead are xenophobia, ignorance, superiority complex and the naive belief that a true shortage entails employers will hire anyone on the spot, no questions asked and if not then there must be no shortage.

That is why there is still an application process and interviews still being done.

[George Chell]

The reports on employment are mixed and vary from state to state...

http://www.dailyherald.com/story/?id=294412&src=120

"Specifically, hospitals, long-term care facilities, and other ambulatory care settings added 27,000 new jobs in February, the same month when 681,000 jobs were eliminated nationwide, according to labor statistics."

http://www.mysanantonio.com/news/local_news/45964682.html

[Greg Siskind]

"The fact remains that many nurses here are suffering to find employment, where is this shortage we are desperately trying to fix? I certainly don't see it. Perhaps a trip to the unemployment line is all that our good congressmen needs to schedule for himself."

Sorry, but I dispute this fact. There are persistent nurse shortages in every part of the country even with a downturn and the statistics do not support anecdotal claims like you're making.

[George Chell]

"The fact remains that many nurses here are suffering to find employment, where is this shortage we are desperately trying to fix? I certainly don't see it. Perhaps a trip to the unemployment line is all that our good congressmen needs to schedule for himself."

The situation is similar abroad where many Americans are taking jobs away from nationals of those countries. You have two choices: either look for work abroad or exchange the Americans working abroad for foreigners working here or wanting to work here.

[Jim]

"In fact I will run into them in about two week's time at the Border's Book store there around 3:00 PM local time..and I bet they will be complaining about foreigners working in America!"

Keep us updated : )

[alleyb]

I think the problem here lies more in the fact that we are currently laying off our nursing force while GN's are unable to find work as well. Do we really want to dilute the job market more by bringing in foreign nurses. This to me isn't about whose education is what, and as a nursing student holding a 4.0 gpa that I work incredibly hard for I resent the thought that I am inferior to anyone else doing the same. I am certain that geography alone has nothing to do with the quality of the nurse.

I would also like to state that I may not have had to take an English proficiency test, but I did have to take an entrance exam and meet criteria in English comprehension. I also had to pass Comp 1&2. All of this non-sense of whom is better is ludicrous.

The fact remains that many nurses here are suffering to find employment, where is this shortage we are desperately trying to fix? I certainly don't see it. Perhaps a trip to the unemployment line is all that our good congressmen needs to schedule for himself.

[George Chell]

"Either that or s/he is totally ignorant that there are American nurses in other countries and which do not need to pay taxes on certain countries."

However, I must say the worst culprits are the Brits, who think it is a one way street. The racist British National Party has a foreign branches especially in places such as Dubai and Qatar. Every time I read something on immigrants to the UK, vitriol comes from Brits living and working in the Middle East about too many foreigners in England. There are many Brits in Singapore (including nurses, by which I mean white British nurses) who think along these lines but the Singapore government spies on everyone and hence they dont post crap on the website. They also complain about too many local women generally referred to as Sarong Party Girls marrying white British men! So compared to the Brits Americans have not matched up yet, although I did find a few American women in Singapore who will speak out against foreigners working in America while they sit on their husband's fat expat salaries in Singapore. In fact I will run into them in about two week's time at the Border's Book store there around 3:00 PM local time..and I bet they will be complaining about foreigners working in America!

[Dan]

Foreign-educated nurses took all the exams required to prove that they have the knowledge and skills needed to deliver a quality nursing care.

Some of them even took and passed NCLEX-RN exam at 75 items only, which means that they beat the exam easily.

I think some LVNs/LPNs just can't accept the fact that foreign-born nurses are mostly working as RNs, which command higher salary than them. They just don't know how difficult it was to get through the web of processing requirements to qualify and get eligibility to take NCLEX-RN exam. Despite of all these, foreign-nurses were able to take and pass the exam.

[Jim]

"Unfortunately I think "A Nurse not a lawyer" like many selfish folks in this country think it is a one way street!"

Either that or s/he is totally ignorant that there are American nurses in other countries and which do not need to pay taxes on certain countries. S/he is also not aware that certain countries have tax treaties or agreements with the US so that there can be no double taxations. Then there is of course the middle-east where there foreign nurses working there don't even have to pay taxes.

She is also trying to imply to be a nurse educator, yet in one of the links she posted she was trying to pass Licensed Practical Nurses (LPNs) as the same nurses that the nurse bill we are talking about. And this even after previous discussions with her already pointed out that most foreign educated nurses hold Bachelor of Science in Nursing degrees.

She thinks no one will notice it because maybe she thinks no one would know the difference.

[George Chell]

If "A Nurse not a lawyer" does not want foreign nurses, let us exchange the foreign nurses here for the American nurses in other countries, including those in the Middle East, Canada, Singapore and elsewhere. That would be a legitimate solution. Last I heard there were at least 5,000 American nurses all across the Middle East. There are already three in the clinic I visit in Singapore. This way foreign nurses in the US get to earn more in the Middle East, and the American nurses can have America back! Unfortunately I think "A Nurse not a lawyer" like many selfish folks in this country think it is a one way street!

[Kavitha]

correction: please read as "if you dont want foreign nurses"

[Kavitha]

If I understand correctly, in America a student needs to undergo only 2 years course to become RN. In most of other countries, the minimum duration of the course for a Diploma is three years and for B.SN it is four years.

In addition, the eligibility and credibility of the RN is assesed through examinations by IDP/British Council (examination is managed by Cambridge University), NCLEX examination and again visa screen by CGFNS/ICHP. America will not be taking all RNs from the world but only those who are eligible as per the law of USA and within the limit of visas allowed, if the bill is passed.

Hello "A Nurse not a lawyer" why dont you knock the doors of NCSBN to stop NCLEX examination for foreign nurses and also ICHP/CGFNS to stop issuing visa screen certificates. Please also go to USCIS to stop accepting I 140 petitions. If you dont foreign nurses to come there please ask your government first to stop collecting money from International Nurses. If you are straight forward you must also argue with them to refund the fees that the International RNs have paid to CGFNS/ICHP, NCSBN/State Board of Nursing, USCIS towards I 140 petition and preimum processing etc.

[Jim]

"It worked so well with the Sentosa Care nurses"

Like someone said, read the newspapers. The case is close and read what was the conclusion.

The NY State Nurses Association were 100% behind them and their victory is a milestone for nurses in the whole of the US both US educated or foreign educated as it is the first of it's kind.

http://www.nysna.org/news/online/011609.htm

Read also the American Nurses Association's (ANA) press release on it, found on the same link above.

Again, this just proves again that you only know the issues superficially.

Furthermore, this also proves that foreign educated nurses or any foreign workers for that matter do not take crap from employers and they are not mindless "cheap" labor.

As for Rep. Wexler. That was a non-issue and that Fox new's Bill O'Reilly did not further went for because it is really a non-issue.

http://en.wikipedia.org/wiki/Robert_Wexler

If it were a legitimate issue, he should have not been allowed to run again and his constituents should have not re-elected him.

Guess what? He got re-elected already which means his constituents are happy to have him as their Representative.

This was last year's news. You must be still drinking Bill O Reilly's Kool-aid up to now.

[Jim]

correction:
"hasn't been resolved a long, long time ago?"

Should be:
"has been resolved..."

[Jim]

"Your nurse is only concerned about sending money home to support her family, no investment in the community"

They bring in their spouses and children with them in America.
They are brought in as permanent residents as well.

The petty remittance you are complaining about are only for sending some money to their old parents. And again, it is not shortchanging America. They are not violating any tax laws either like you want it to appear.

What do you call renting or buying a house, paying their taxes, contributing to SS, medicare, contributing to 401(k)s or 403(b)s for non-profits that is handled by American mutual fund companies and buying everything in America? And some even set up small businesses in America. What do you call all those? Chopped liver? And you complain of an average monthly remittance of $500 or so that is fully legit? Remittances has been there for so long and has been used by ALL foreign workers working and living on another country. This includes Americans living and working in another country, by the way.
Didn't it occur to you one bit that the legalities, technicalities, taxes and so on and so forth hasn't been resolved a long, long time ago?

That notion of yours has been answered so many times here already and I am 100% sure it has been answered so many times on another site you troll as well and use to bash foreign educated nurses.

You have to have a learning disability or just thick-faced to not have those explanations not sink through your "superior" brain.

[Jim]

"Go ahead, insult me all you want....."

Wow, your hurt? Just because people are debating you and pointing and correcting your ignorance?

You have no problems bashing foreign educated nurses (and all immigrant groups with your generalizations) and immigration lawyers on their own blogsites and yet you cry that you are being insulted if people are correcting your ignorance?

You also keep contradicting yourself. You can't have it both ways.

Being unable to stick with one story for your excuses just means there are really no facts to back up all your claims.

Do you honestly think people don't see through the real reasons for keeping the nursing shortage at status quo?

[A PT]

Pls read as corrected;

All the foreign trained RN's/PT's go through the same licensure requirements as a US trained applicant, infact foreign trained have to go through a English competency requirement too which you "US trained" do not have to endure & probably fare poorly if mandated.

[A PT]

To all those anti's in this board who think foreign trained healthcare professionals are sub-par & poorly trained:

All the foreign trained RN's/PT's through the same licensure as a US trained applicant, infact foreign trained have to go through a English competency requirement too which you "US trained" do not have to endure & probably fare poorly if mandated.

[George Chell]

"If anything we would get to skim of the cream from abroad rather than make do with Americans that choose to work for 16K a year."

Probably United Airlines avoids employing more expensive pilots from Japan on the Japan-South East Asia route because American pilots undercut them and work for cheap...at perhaps $100K instead of $150K paid JAL pilots?

[George Chell]

"If the world abandons you just as you wish to abandon the world, you would be bankrupt, unhealthy and without a job anyway."

She may want her gun rights as the NRA does, because then she has to hunt for a living!

[George Chell]

"Your nurse is only concerned about sending money home to support her family, no investment in the community. Perhaps in your world that is ok ( I doubt you would go to a hospital that depends on Foreign nurses, only the best for immigration lawyers."

Send all the foreign (particularly American nurses) home from countries such as Singapore and then we can talk about sending foreign nurses back. Ask one of these American nurses whether they invest in Singapore or is it a one way street?...there are are three out of thirteen on the list...as I said you are full of crap!

http://www.imc-healthcare.com/staff.htm

[George Chell]

"Foreign nurses don't have qualified nursing educators, what next foreign only Airline Pilots for US Airlines, foreign trained electricians, foreign trained lawyers, heck let's outsource everything!"

If the US pilots perform as well as the Colgain Air pilot in Buffalo did, perhaps we need to outsource those jobs too!

http://www.nydailynews.com/news/us_world/2009/05/17/2009-05-17_dont_weigh_cost_of_lives_vs_plane_fixes_crash_kin.html

Great American training and great American safety! Would prefer Singapore Airlines pilots or Qantas pilots flying our airlines..you would too if you valued your life!

[George Chell]

"And I think it would be fine to add taxes to support US Citizens getting US education. Better than giving to AIG, BOA, etc. Isn't that what tax money is for taking care of Americans? Cheaper to educate in the US than import nurses which cost an Average of $30K per nurse."

Talk is cheap. You did not answer the question. Did you campaign against massive budget cuts in California? Did you urge the California public to support the referendum? Answer this question and then talk.

[Sick of self interested American "RN"s]

"Cheaper to educate in the US than import nurses which cost an Average of $30K per nurse."

Make up your mind. You can't have it both way. Either foreign nurses are "cheap labor" or the cost much more.

"Foreign nurses don't have qualified nursing educators, what next foreign only Airline Pilots for US Airlines, foreign trained electricians, foreign trained lawyers, heck let's outsource everything! "

How do you know about foreign nurse educators? please don't make up stuff because you want to say something. Find better ways to vent your frustration. As for airline pilots, we are just witnessing the training levels of American pilots flying our commuter jets (please try reading a newspaper, it will broaden your mind). How could it be worse with foreign pilots? If anything we would get to skim of the cream from abroad rather than make do with Americans that choose to work for 16K a year.

[Sick of self interested American "RN"s]

Actually I have worked in hospitals with foreign nurses without any problems. That of course should not be construed to mean that American Nurses are in any way a problem. Greg, I have the greatest respect for American education. The point remains that if our "friend" is going to cherry pick stuff and paint all foreigners with the "cheap and inferior" stuff, (s)he is in for rude shocks. This is a global age. Either grow up and face up or you will spend a lot of your expanding spare time on these boards disparaging foreigners.

Plenty of "American" nurses failed to show up for work with the swine flu scare. "American" nurses failed to protect nursing home patients during Katrina. Should we tar you with the same brush? I choose not to.

I do not advocate a system that relies on foreign nurses. However, it will take 10 years to get more American Nurses into the market. What happens in the meanwhile? Is it worth the health of the populace to make incompetents who can't hold a job richer? The fact is that there is a well documented nurse shortage which cannot be filled immediately with Americans. So, with the imperative if training more American Nurses to avoid such situations in the future, there is also the urgency to fill the current shortfall.

I do not speak with imaginary ideas like the wonderfully educated, English communicating troll here. I have seen the effort it takes to recruit RNs and the difficulty retaining them. The US labor department has long certified the serious shortfall.

Feel free to boycott "outsources services". Know also that the surviving American industry is getting most of its profits abroad. Ford and GM exist only because of foreigners. Chrysler's survival depends on an Italian company. Yahoo and Google were the brainchild of the "foreign born". "American" multinationals generate large profits throughout the world and millions of American work abroad. The massive US debt is all held by "foreigners". Over half of new primary care doctors in this country are foreign born as well. If the world abandons you just as you wish to abandon the world, you would be bankrupt, unhealthy and without a job anyway. Sure, go ahead, feel free to usher in the end of the American age. The world you disparage will surely welcome it.

[A Nurse not a lawyer]

We subsidize auto workers yet you want to outsource nurses.Go ahead, insult me all you want, the bill itself is being brought forward by a Congressmen who has a problem with the truth ( he doesn't live in his district). Chances of it failing are high and not making through committee even with all the Democrats in Congress. It will be a hard sell to support bringing in nurses when US nurses are being laid off. And I think it would be fine to add taxes to support US Citizens getting US education. Better than giving to AIG, BOA, etc. Isn't that what tax money is for taking care of Americans? Cheaper to educate in the US than import nurses which cost an Average of $30K per nurse.

Cutting medical costs should not include inferior nursing education. It looks like your agenda is to cut nursing costs by importing cheaper labor. It worked so well with the Sentosa Care nurses. They did such a fine job abandoning sick children on vents. They didn't know how to protect themselves or their patients what a outstanding example of foreign nurses. I have not seen American Nurses walking away from sick children. It was a win win situation for the lawyers, think about all the billable hours this case generated!

Foreign nurses don't have qualified nursing educators, what next foreign only Airline Pilots for US Airlines, foreign trained electricians, foreign trained lawyers, heck let's outsource everything!

I only support companies that don't outsource technical support, many companies are finding these well trained superior workers time consuming and tiring. Any one who has spent hours on the phone with an outsourced support can relate. Imagine similar situation in nursing and you are now ill and can't communicate with your nurse. Your nurse is only concerned about sending money home to support her family, no investment in the community. Perhaps in your world that is ok ( I doubt you would go to a hospital that depends on Foreign nurses, only the best for immigration lawyers.

[George Chell]

"Unfortunately though, you are about to find out that foreign born folks do a lot of things better than Americans, reading and writing English included."

I have already found out..five of the last ten spelling bee winners were of Indian origin, of course some of them were born here!

[Kavitha]

Hi Greg,
I sincerely appreciate your comments.I am sure this will the view of majority of Americans as well as Foreigners.

[Greg Siskind]

Let me clarify that I think American-educated nurses, as a whole, are great and there are no issues with their qualifications. I suspect our anti-immigrant nurse who is trolling around here is probably having difficulty holding down a job for obvious reasons. Same for the anti-immigrant computer programmers who like to post hateful comments on this board. American programmers are, as a whole, fantastic. But the ones who can't cut it would rather blame immigrants than face their own shortcomings. So let's not disparage American nurses who are, as a whole, making the country proud.

[Sick of self interested American "RN"s]

"Americans need to educate Americans not import nurses who has inferior education and not providing care that is in the interest of American Patients. "

Sure, go ahead! Start voting for tax hikes and stop whining about medical costs. Then increase Nursing school slots and wait 10 years. You will probably extort a bunch of cash from all the shortages, and the patients you speak of will suffer for the decade. But what do you care? You think you got it made.

Unfortunately though, you are about to find out that foreign born folks do a lot of things better than Americans, reading and writing English included. Stop the Nurses, the Physicians will still be foreign born. So will the administrators. Maybe they will teach you some grammar- who knows?

[Sick of self interested American "RN"s]

Hey- I'm not a nurse, certainly not an American educated RN- and thank God for it! At least I can write a straight sentence in English. So much for "inferior foreign education" :-)

[George Chell]

To a nurse not a lawyer...

This is why foreign nurses and other foreigners will always be with us whether you folks like it or not. The problem with you folks is that all of you never put your money where your mouth is..

http://news.yahoo.com/s/ap/20090522/ap_on_re_us/us_california_day_of_reckoning

Twenty years from now either more and more foreigners will be working in America or the jobs would have been transferred abroad due to shortages of skills as a result of Americans not wanting to pay for education and other services..serves them right!

[Greg Siskind]

To A nurse not a lawyer -

How can you criticize the inferior education of foreign nurseswhen your own post is littered with grammatical errors? Is this supposed to reflect the superiority of American schooling?

[Jim]

"I have worked thousands of hours in a nursing department, your posts are self serving since you make money importing nurses."

As far as I know, Greg is the only immigration lawyer here.

There are economists here, nurses, people working in the IT industry and many more.

[George Chell]

"I have worked thousands of hours in a nursing department, your posts are self serving since you make money importing nurses."

I hope you did not work 48 hours straight as some nurses do in some hospitals in California..putting the lives of patients in danger..now that is more not in the interest of the American patients than the crap you are putting forward!