Imported Care

Written by Sara Iqbal • November 2010

4-1 As U.S. health care facilities struggle to fill current registered nurse staffing vacancies, a more critical nurse undersupply is predicted over the next few years. In response, foreign nurses, particularly Asian nurses are increasingly being sought in America, where many institutions are doubling their efforts to attract and retain trained nurses.

While President Obama opposed the idea last year of inviting overseas nurses to fill up the huge shortfall the United States is facing, legislation was introduced in the U.S. Congress at the same time to create a special category of nursing visas, which would facilitate immigration of trained nurses from across the globe. Called the “Nursing Relief Act of 2009” the legislation proposed to make provisions for the new category of visas for registered nurses with an annual limit of 50,000. According to the statistics from the American Nursing Council, there is a shortage of 22,000 nurses per annum in the country. This current level of shortage of nurses may rise to 80,000 by 2020 if the trend continues.

South Asian nurses are well-known all over the world for their trained skills and an equally well-reputed professional training background. The fact that India, besides Philippines is currently leading in the export of trained nursing manpower to the U.S.A. is just one bit of the entire picture. Equally sought after are nurses from Bangladesh, Nepal and Sri Lanka who make up a considerable percentage of the nursing market share across the globe, most importantly in the U.S.

Nursing in South Asia is a very sought-after profession after medicine and engineering. Considered as a highly skilled profession, nursing has always held attraction for the South Asian women. Back in the 1980s and 1990s, the nursing staff in almost all hospitals and private clinics in the Middle East comprised of South Asian nurses, particularly nurses from South India who worked long hours in a stretch. The start of the new millennium saw an unprecedented trend amongst the nursing professionals to migrate to the Western lands in search of better opportunities.
They were enticed to leave their home countries by promises of better pay and working conditions, improved learning and practice opportunities, free travel, licensure, and room and board. The nursing force has also been allured for having easy opportunities for wages unequaled in their own countries and thus become the means for substantial remittances. In 2004 the U.S. Department of Labor reported median annual earnings for foreign RNs (registered nurses) in 2002 as $48,090 in hospitals and nursing homes where foreign nurses worked. These figures contrast sharply with the $2,000–$2,400 annual salaries paid to nurses back home in 2001.
Viewed from a pure economic angle, remittances sent by migrant nurses to their families back home illustrates the financial obligations they maintain while working overseas. These remittances make a huge difference to the lives of their family members ensuring that they have access to better health and education services thus helping in uplifting the economy of their nations.

However, donor countries in South Asia today increasingly question the impact of this huge percentage of migration of nurses on their already fragile health care systems. There are doubts about the region’s struggle to keep health care facilities open in the rise of this loss of skilled personnel frequently referred to as Brain Drain. The export of nursing market in the region is feared to face issues including loss of economic investment and high turnover rates where the migrating nurses leave behind inexperienced personnel, thereby creating not only a domestic shortage but also forcing the present lot to work alone in poor conditions.

As long as the necessity of supplementing family incomes provides South Asian migrant nurses with a powerful incentive to migrate, the Brain Drain cannot be stopped. Although they do contribute to their national economies by sending in foreign remittances and working for social uplift of their communities, it is high time that the South Asian governments do more to accommodate this intelligent lot, providing them with better facilities and incentives so that the nursing force can contribute domestically to their respective health-care systems.