Light at the end
of nursing shortage

IF the current bills before US Congress become law this year, Filipino nurses could find themselves looking for other countries to work or migrate to instead of the United States.

That would mean nurses would have to pay for the sponsorship and recruitment costs. Nursing school graduates may have to shift to other courses. Nursing enrolment would drop and a lot of Johnny-come-lately nursing schools will fold. How soon?

The Immigrant Visa Center reports at least nine major bills in both the US House of Representatives and the Senate seeking to radically reduce, if not immediately eliminate, America' nursing shortage. If one bill or a combination of the features of all bills becomes law, the need for foreign nurses may abate in 5-10 years from enactment.

The nursing bills are:

1. Grants to Associate Degree Nursing Schools and Professional Nursing Organizations to improve nursing education -- HR 2053. With the Subcommittee on Health as of May 20, 2003. Funds or grants to be used for recruitment of nursing students, scholarship for nursing students and hiring nursing faculty.

2. Nurse Loan Forgiveness Act of 2003 -- HR 501. Encourages individuals to enter and continue nursing education. A nurse who has been working for a year in a designated facility shall have her/his student loan shall be assumed under this program. With Subcommittee On 21st Century Competitiveness as of March 3, 2003.

3. Recruitment Diversity in Nursing Act of 2003 -- HR 920. Scholarship program for nontraditional (minority) nursing students who agree to serve as nurses for two years in a designated healthcare facility. The bill seeks to increase the number of nurses from among the nontraditional students and reduce the average age of nurses in the US by (1) providing members of the minority and immigrant communities increased access to nursing education and (2) increasing the awareness of elementary and secondary school students about careers in nursing, through the use of nonprofit organizations (NPOs) that will assist in recruitment of nontraditional nursing students. With Subcommittee on Health as of March 10, 2003.

4. RN Safe Staffing Act of 2003 -- S. 991. Registered nurses in hospitals throughout the United States are being asked to work overtime due to shortage of nursing staff, thereby compromising the health, safety and well being of patients. The bill seeks to limit the number of hours nurses can be asked to work by employers; reduce nurse resignations due to job dissatisfactions; eliminate medical errors due to work fatigue caused by extended shifts, non-availment of days off and other toxic work conditions. With Committee on Finance as of May 5, 2003.

5. Rural Urban Health Care Act of 2003 -- HR 87. H-1C visa program for RNs. Nurses issued H-1C visas could take the NCLEX twice and could take the exam without SS number. 195,000 proposed allocation yearly for 3 years from date of enactment. With the Subcommittee on Immigration, Borders, Claims as of March 6, 2003.

6. Safe Nursing, Patient Act of 2003 -- HR 745. Limiting mandatory overtime for RNs. With Subcommittee on Health as of Feb. 26, 2003.

7. Safe Nursing Patient Care Act -- S. 373. Limiting mandatory overtime for RNs, Senate version. With Committee on Finance as of Feb. 12, 2003.

8. Teacher Nurse Support Act of 2003 -- HR 934. Loan forgiveness, cancellation of loans of RNs and teachers. Teacher with loan must be employed as secondary or elementary school teacher, teaching in a specified subjects. A nurse with a loan must be working full time in a clinical setting or a member of nursing faculty at an accredited school. With the Subcommittee on 21st Century Competitiveness as of March 17, 2003.

9. VA Medical Workforce Enhancement Act of 2003 -- HR 1951. Provides better pay and benefits to RNs in the Veterans Health Administration. With Subcommitee on Health as of May 21, 2003.

Long list of shortage data

o According to 2001 statistics from the American Hospital Association, 126,000 nurses are currently needed to fill vacancies at our nation's hospitals. Today, fully 75 percent of all hospital personnel vacancies are for nurses.

o There continues to be a 28-percent decrease in national licensure examination for all entry-level registered nurses.

o The US Department of Labor projects a 21 percent increase in the need for nurses nationwide from 1998 to 2008, compared with a 14-percent increase for all other occupations.

o The General Accounting Office estimates that 40 percent of all registered nurses will be older than age 50 by the year 2010. Of those registered nurses in 2000, an estimated 18 percent have chosen to pursue other career paths.

o According to a 2001 issue of Health Affairs, many nurses report they are dissatisfied with their current position. One out of every 3 hospital nurses under the age of 30 are planning to leave their current job in the next year.

Teacher Nursing Support Act

For teachers:

Issues: The National Center for Education Statistics says that over the next 10 years, the United States will need more than 2,000,000 new teachers to replace the teachers who are retiring or leaving the classroom for other careers; 20 percent of all new teachers leave the teaching profession in three years.

Solution: Providing loan forgiveness or loan cancellation is one step that would help retain high-quality teachers in schools that need teachers.

For Nurses:

Issues: The American Hospital Association has reported more than 126,000 unfilled registered nurse positions in hospitals in the United States; the vacancy rate for registered nurse positions at nursing homes throughout the nation is approaching 20 percent; college loans are more of a burden than ever for students and families. According to a recent United States Public Interest Research Group report, average student loan debt almost doubled from 9,200 dollars in 1992-93 to 16,928 dollars in 1999-2000.

Solution: By forgiving and/or canceling student loans of nurses currently practicing their professions, the bill seeks to retain them while encouraging more students to take up nursing.

VA Medical Workforce Enhancement

Issues: The critical shortage of nurses in the US is affecting the quantity and quality of healthcare being provided to clients of the Veterans Health Administration (VHA). The shortage is compounded by the fact that the RN workforce of the VHA is aging, retiring, underpaid and overworked.

Solution: The bill seeks to increase the retention rate, recruitment, salary of nurses within VHA, initiate and maintain a nurse preceptor program designed to help nurses pursue their careers.

Crispin R. Aranda may be contacted at usvisasnow@yahoo.com or at the Immigrant Visa Center, Prestige Tower Condominium, 10th Floor Unit 1001, Emerald Avenue, Ortigas Center, with telephones +632 684-8717, +632 683-0615 and +632 683-0617. In San Francisco, California, his telephone is +415 834-1052.