What the US nursing shortage means for the country—and your family

The United States is suffering one of the world’s most severe labor shortages in one of the world’s most critical professions: nursing.

Analysts predict that as many as one million registered nurses will retire by the end of the decade. At the same time as the nursing workforce ages into retirement, the general public is also aging and requiring more and specialized care for increasing rates of chronic illness.

As these trends dovetail, US health care facilities are struggling to match demand for patient access with the availability of labor. This challenge is especially acute by systems operating in rural communities, where the labor shortage is even more pronounced.

To meet this challenge over the last half-century, health care organizations have begun recruiting and hiring foreign-educated clinicians with increasing frequency. By some estimates, as much as 15 percent of the U.S. nursing workforce was foreign-educated.

The numbers make plain: foreign-educated nurses keep our health care system alive.

But an immigration proposal to eliminate per-country employment-based visas—the same sort used by foreign professional nurses—in an attempt to ease the green card backlog for Indian nationals would have a devastating impact on patient care by making it virtually impossible for foreign-educated nurses to emigrate to the United States.

  • Per-country caps means that smaller countries like the Philippines, Jamaica, or Nigeria, which supply a significant share of the United State’s nursing labor force, are allotted the same number of immigrant visas as very large ones like India or China.
  • The Fairness for High-Skilled Immigrants Act would change that—and not necessarily for the better.
Government statistics show that very few Indian and Chinese green card applicants are nurses. Instead, they’re technology workers who are already allowed under existing immigration law to live and work in the United States before every attaining a green card. 

Meanwhile, foreign-trained nurses and other clinicians are now allowed to live or work here until they’ve secured employment and completed their permanent residency application while living abroad.

Because foreign-educated healthcare professionals represent a significant portion of immigration levels from small nations, tens of thousands of nurses would be forced into the back of line behind hundreds of thousands of technology workers from India and China—workers that can already emigrate to the US and work.

Today, it takes a foreign professional nurse roughly a year to emigrate to the US. Under the Fairness Act, it would take more than seven years.

Eliminating per-country caps, as the Fairness Act proposes, without also setting aside a special number of employment-based visas for critical need categories like nurses or physical therapists would devastate US healthcare, because it would mean that these healthcare professionals never come to the country.