EVEN BEFORE THE FIRST CORONAVIRUS CASE, AMERICA WAS SUFFERING A HISTORIC SHORTAGE OF REGISTERED NURSES.
Now, healthcare workforce surveys show that as much as one-third of clinicians are considering vacating the bedside from emotional and physical burnout.
This looming exodus comes as patients who deferred care during the COVID-19 crisis have begun seeking preventative care and non-emergent operations in massive new numbers. Unless hospitals immediately access qualified new talent, patient care will suffer.
Today, there are thousands of high-skilled international nurses who have already qualified for visas but their issuance has stalled amid unprecedented delays at US embassies and consulates, which have effectively de-prioritized green card approval for essential healthcare workers under US State Department rules. This priority schedule provides four tiers, with tier one being the most prioritized and four being the least. Nurses are considered tier four.
Because the processing backlog at embassies and consulates is so enormous after a year of pandemic-related delays, the State Department’s priority schedule has made it virtually impossible for qualified international nurses to emigrate and treat American patients. But this structure is not based on statute or regulation and thus can be amended at the secretary of state’s discretion.
The American Association of International Healthcare Recruitment and the American Hospital Association have called on Secretary Antony Blinken to amend the State Department’s April 30, 2021 Immigrant Visa Prioritization guidance to prioritize and expedite the visa-issuance process for eligible nurses.
Read the letter from AHA President and CEO Richard J. Pollack to US Secretary of State Anthony Blinken and sign our petition to fast-track visa processing for healthcare workers.
The Honorable Antony J. Blinken
United States Secretary of State
2201 C Street NW
Washington, DC 20520
Dear Secretary Blinken:
On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinical partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) requests that the United States Department of State solve the backlog of immigrant visas for eligible foreign-trained nurses who are critical to providing high-quality care to patients across America.
Specifically, we request that the State Department place registered nurses seeking immigrant visas in the First Tier of the Department’s current priority for processing. We understand that the priority structure is not based on a statute or regulation, and can be altered at the discretion of the State Department.
There has never been a more urgent need for the care that foreign-trained nurses provide than during the current COVID-19 pandemic and its looming aftermath. These professionals play critical roles in ensuring the health of the communities we serve. Moreover, they are highly qualified and required to meet our nation’s rigid standards of equivalent education, English fluency and state licensure, with no disciplinary record. Foreign-trained nurses do not displace American workers. At the same time, the demand for nurses continues to grow. Many foreign-trained nurses are recruited to rural and inner-city hospitals, locations that find it more difficult to recruit domestically. The Department of Labor (DOL) has recognized that there “are not sufficient United States workers who are able, willing, and qualified” to serve as nurses. The DOL has determined that any nurse brought to the United States will not affect “the working conditions of United States workers similarly employed” and will not “adversely affect” United States workers’ wages.
Eligible foreign-trained nurses are not currently receiving their immigrant visas because unprecedented processing delays at U.S. embassies and consulates have resulted in a failure to issue immigrant visas. The delays are certainly caused by the COVID-19 pandemic, both here and abroad. However, failing to prioritize these nurses with the still-limited consular staffing merely compounds the health care workforce challenges in the United States.
America’s hospitals and health systems continue to be challenged with maintaining an adequate nursing workforce. The backlog in processing immigrant visas for foreign-trained nurses exacerbates a shortage of nurses with which our country has been grappling for years. Maintaining and growing the needed nursing workforce has been one of the most challenging issues facing America’s hospitals and health systems throughout the COVID-19 pandemic. The shortage is now reaching critical levels because of attrition from the current nursing workforce, who have worked tirelessly through the pandemic.
All eligible foreign-trained nurses waiting for visas could immediately enter the United States and begin caring for patients; however, the issuance of these visas for which they have qualified already is the only remaining hurdle they face. In fact, each eligible foreign-trained nurse awaiting a visa:
· has been approved for immigrant visas by the U.S. Citizenship and Immigration Service;
· passed the United States nursing licensing exam;
· graduated from a university that is equivalent to a United States nursing school;
· passed an English fluency examination; and
· has a spotless overseas nursing license.
At the same time, the health and economic recovery places increased demands on hospitals and health systems and other providers, as patients who deferred care during the COVID-19 pandemic are now seeking preventative care and necessary surgeries. Visits to America’s hospitals and health systems’ emergency departments are increasing significantly. Overall, patient census is rising and stressing a health care system that continues to provide care to thousands of Americans infected with COVID-19. In addition, it is possible that COVID-19 variants will prolong the pandemic and result in an increase in COVID-19 hospitalizations. In light of all the challenges facing America’s hospitals and health systems, having an adequate nursing workforce is paramount to being able to provide the care that our patients and communities desperately need and deserve.
The AHA believes the State Department can solve the backlog of immigrant visas for eligible foreign-trained nurses by ensuring efforts are made to prioritize and expedite the visa issuance process for eligible nurses. However, the State Department’s recent actions move in the opposite direction. The State Department’s April 30, 2021 Immigrant Visa Prioritization update relegated visa issuance for nurses to Tier Four with “all other immigrant visas, including employment preference and diversity visas.” This is striking, since diversity visas are distributed by lottery and other employment visas include many occupations with far less urgent needs compared to nursing.
America’s hospitals and health systems respectfully ask that the State Department quickly revise the April 30 directive to move foreign-trained nurses eligible for immigrant visas to Tier One so that Americans can continue to have access to high-quality care.