Nurses Are Talking About: Concerns and Misconceptions About Foreign Nurses and Visas

Troy Brown, RN


June 02, 2017

In This Article

US Nurses Respond

Medscape readers had strong feelings about the use of internationally educated nurses in general, illustrated by over 200 comments on the original news story. Many wrote in to say that there is no nursing shortage and that using nurses from other countries hurts US nurses. A number of nurses said that poor working conditions and low wages keep US nurses from taking jobs here. Others said that expensive tuition for advanced degrees and cumbersome requirements of state boards of nursing make it hard for nurses to advance their careers.

"There has not been a true nursing shortage in the [United States] in decades; there are merely a large number that refuse to hire adequate staff, permit humane and safe working environments, and decline to pay a reasonable wage," one nurse wrote. "That way they can whine to media, 'There's a nursing shortage,' when there isn't one. It cuts into profits too much to hire experienced and quality personnel."

One advanced practice nurse said that it took 9 months to find a job after graduating. "The work environment in local hospitals is suffocating and workload unmanageable. The foreign nurses are not hired to help us. They are hired to replace us and do the same work for less."

Other nurses commented that they do see nursing shortages.

"Michigan has had a serious nursing shortage for decades and generally [has] ongoing position[s] available for external hire. Most border area hospitals have a large number of Canadians working, who commute daily. Americans are lucky to have this workforce saving their lives," one nurse wrote.

Nursing shortages exist in certain regions of the country, although nurses—including advanced practice nurses—have trouble finding employment in others. Physicians are increasingly entering specialty areas, which tend to pay better than primary care areas, and nurse practitioners and physician assistants are trying to fill some of those gaps as well.

Nursing shortages exist in certain regions of the country, although nurses—including advanced practice nurses—have trouble finding employment in others.

"Around the country there is a growing need for primary care services. This is especially true for rural and urban areas, and Michigan is no exception," Joyce Knestrick, PhD, CRNP, president-elect, American Association of Nurse Practitioners, told Medscape Nurses. "Outdated licensure laws have exacerbated geographic healthcare provider shortages. Thankfully, the Michigan legislature and governor passed a new law earlier this year that authorizes NPs to practice and prescribe most medications independently. [The American Association of Nurse Practitioners] anticipates this will help retain more NPs in Michigan and provide opportunities for NPs to deliver care in more areas around the state."

"We are seeing trends in licensure law and workforce. Since the 1990s, states where licensure laws authorize NPs to practice and prescribe independently have had more NPs in rural areas than those with restrictive laws," Dr Knestrick added.

Certified registered nurse anesthetists (CRNAs) were also caught up in the border situation. "In Wayne County, [Michigan], 60% of the anesthesia providers are CRNAs; and in Detroit, 52.6% of the anesthesia providers are [CRNAs]," Lynn J. Reede, DNP, MBA, CRNA, FNAP, senior director of professional practice at the American Association of Nurse Anesthetists, told Medscape Nurses.

"Demand for CRNA-provided anesthesia services is increasing across the country due to the aging population and other market forces," Dr Reede explained. "The American Association of Nurse Anesthetists has more than 50,000 members across the country working in every practice setting, administering more than 43 million anesthetics each year for procedural, surgical, and obstetric procedures, as well as acute and chronic pain management care."


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