Nursing shortage is now a well known problem in the country and one that deeply concerns health care institutions nationwide. As these hospitals are doing everything in their power to retain and attract nurses, it is felt that in the next two decades, this problem is likely to persist and may even turn more serious. To fill the gap between job opportunities appearing every year and number of suitable applicants for them, United States is actively importing nurses from foreign countries.
Some important statistics might help get a better idea of how serious this nursing shortage really is and why US has resorted to attracting foreign qualified nurses. One study projects that as United States population continues to grow at 18 percent, the number of patients aged sixty-five and above are likely to triple that rate.[1]. It is now a grave concern since number of elderly patients will continue to increase while the number of Registered Nurses needed to provide them with quality healthcare is persistently on the decline. The U.S. Department of Health and Human Services (HHS) estimated that by 2000, United States had a severe shortage of 111,000 full time registered nurses and maintained that this number was likely to go up to 275,000 by 2010.[2] And in the next ten years, by 2020, this shortfall of 111,000 might move up to a staggering 800,000.
This serious crisis calls for desperate measures and one such action is recruitment of foreign nurses which is not something new but the scale of which it is being and the manner in which recruitment now takes place is significantly different than what it used to be a decade ago. Many of these nurses are coming from countries that already have a serious nursing shortage and are not suitably positioned to allow such massive expert of nursing staff.[3] While the world is concerned about the possible consequences of this kind of trade, United States has only increased its recruitment activities, even though it is not the worlds only or even biggest importer of nursing staff yet. The trend of recruiting nurses from other countries is almost five decades old and United States has been attracting foreign nursing staff regularly for past many decades. However the rate of recruitment has increased significantly and now 5% of the total US nursing workforce consists of foreign qualified nurses and unfortunately or otherwise, this number is consistently increasing. [4]
The Philippines has been actively sending its nurses to the US and by mid-1980s, almost 85 percent of all foreign nurses came from this part of the world. [5]This number declined when other countries also began participating in nurse export program. The number of foreign nurses employed in US hospitals grew steadily after 1998 and by 2003 it had reached 14 percent of the total US nursing workforce.
By 2001, along with the Philippines, the countries that were sending their nurses to the US included Canada, the United Kingdom, India, Korea, and Nigeria and some other smaller countries.[6] These nurses were absorbed in various setting when the came to the US and over the years, the employment of foreign nurses in US hospitals has declined from 79.9 percent to 71.5 percent as out of hospital patient care is becoming popular. Foreign nurses are now seen more in public/community health and ambulatory related jobs and their percentage in these settings are growing just that that of U.S.-qualified nurses. Foreign trained nurses are also opting more for jobs in nursing homes where their participation has increased from 7.4 percent to 9.3 percent.[7]
As more and more foreign trained nurses enter the US nurse workforce, concerns about their impact on healthcare local and abroad are rising. Most nurses leave their home countries for better job opportunities with more lucrative fringe benefits in the US. They are attracted by such perks as free lodging and boarding, better practice options and greater