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ANA urges Congress to invest in domestic nursing education, not immigration


ANA urges Congress to invest in domestic nursing education, not immigration

As the nursing shortage continues to weigh on hospital administrators and patient care, the need to resort to short-term fixes such as immigration continues to play out in the legislative arena. ANA has been working to educate Congress about the many pitfalls associated with the use of immigration to solve nursing shortages. Through this work we were able to secure an invitation to provide public witness testimony before the House Judiciary Subcommittee on Immigration for a recent hearing on the need for visas for highly skilled immigrants. ANA Senior Policy Fellow Cheryl Peterson, MSN, RN, represented ANA at this hearing.
Peterson explained that ANA supports the right of individual nurses to practice in the location of their choice, but opposes the use of immigration to solve domestic workforce shortages. “It is inappropriate to look overseas for nursing workforce relief when the real problem is that Congress does not provide sufficient funding for schools of nursing, the healthcare industry has failed to maintain a work environment that retains experienced nurses, and the government has not engaged in active planning to build a sustainable health workforce.”
Peterson also pointed out the fact that there are serious ethical implications to recruiting foreign nurses when there is a worldwide nursing shortage. She noted that the very real problems caused by mass emigration of nurses out of developing countries recently prompted the World Health Organization to adopt a resolution urging member states to address the negative impact of migration on health systems. These same concerns have prompted the International Council of Nurses (ICN) to revisit the issue of nurse migration. Last year, the ICN issued a position statement reaffirming the fact that the “ICN condemns the practice of recruiting nurses to countries where authorities have failed to implement sound human resource planning and to seriously address problems which cause nurses to leave the profession and discourage them from returning to nursing.”
Peterson encouraged the subcommittee to address the domestic roots of nursing shortages. ANA insists that any effort to address the nursing shortage must include resources to help increase the capacity of domestic schools of nursing and improvements to the American healthcare workplace. Peterson highlighted the fact that American nursing schools turned away 88,000 qualified applicants to entry-level programs in the 2005-2006 academic year. ANA’s testimony noted that the federal government was forced to turn away more than 93% of the applicants to the Nursing Education Loan Repayment Program and more than 96% of the applicants to the Nursing Scholarship Program last year due to a lack of funding. “Clearly, now is the time to invest in nursing,” stated Ms. Peterson.
ANA’s testimony also highlighted the fact that, “as long as nurses are driven away by hostile work environments, as long as the new nurse turn-over rate hovers around 25% per year, we will not have adequately addressed the root causes of this shortage.”
During the hearing, Peterson was asked for ANA’s position on the Emergency Nursing Supply Relief Act of 2008 (H.R. 5924). This bill would, for 3 years, increase the number of permanent employment–based visas available for RNs and physical therapists by 20,000. Healthcare facilities using these newly available visas to employ foreign-trained RNs would be assessed a fee of $1,500 per visa. The fees generated through this program would be invested in a newly authorized program that provides capitation grants to domestic schools of nursing.
Noting that H.R. 5924 was limited in scope and would support domestic education, Peterson explained that while ANA does not support the bill, we are not opposing it, either. However, she went on to say that ANA would oppose this proposal in the future if Congress continues to fail to invest in domestic nursing programs.
“We are 8 years into this shortage and Congress has yet to make any real investment in nursing,” she observed.
You can follow updates on nurse immigration legislation on the monthly newsletter Capitol Update, available at

Erin McKeon is Associate Director of ANA’s Government Affairs Department.

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