We've known this for a while, but the Indian government confirms that they are producing well in excess of the actual number of nurses and physicians needed to supply the country's needs.

The Association of American Medical Colleges (AAMC) has issued a report summarizing the most recent research on the supply of physicians in the country. The report analyzes state reports as well as reports on particular specialties and there seems to be no good news anywhere in the physician supply area.

A group of 26 Filipino nurses lost two key battles in their fight with a New York nursing home chain over the nurses en masse resignation. The nurses claim that they were not employed as promised including being underpaid and working at locations not promised in their agreements.

On Aug. 31 the Justice Department's Office of the Special Counsel for Immigration-related Unfair Employment Practices dismissed the nurses' complaint that Sentosa Care discriminated against them.

The special counsel said there was "insufficient evidence" to bring the nurses' case to a departmental hearing officer who has the power to impose monetary damages.

On Sept. 4, Philippine recruitment regulators threw out the nurses' charges that Sentosa Recruitment Agency duped them into emigrating under false pretenses.

Sentosa, the employer, has aggressively fought back against the nurses and in an unprecedented move, law enforcement authorities are going after the nurses on the grounds that their resignation endangered patients. Furthermore, the lawyer for the nurses is also being targeted:

Of the nurses who resigned, 10 face trial in Suffolk on charges of endangering the welfare of children. Prosecutors said their resignations caused a staffing crisis at Avalon Gardens Rehabilitation and Health Care Center, a SentosaCare facility in Smithtown, that endangered the lives of six children in a ventilation unit there. Vinluan is charged with conspiracy for encouraging their actions.

From the Wall Street Journal:

Diagnosis: Critical

It's been reported in these columns and elsewhere that the dysfunctional U.S. immigration system contributes to labor shortages in agriculture. Less well-known is that low green card quotas have also left the U.S. with an undersupply of nurses that threatens patient care.

"The ageing U.S. population and low domestic production of nurses in the U.S. has created a nursing shortage that carries deadly consequences," says a new study by Stuart Anderson of the National Foundation for American Policy. "[A] shortage of nurses at U.S. hospitals is leading to increased death and illness for Americans."

Estimates of the looming shortage vary. The Bureau of Labor Statistics and Department of Health and Human Services project that more than a million new and replacement nurses will be needed over the next decade. Health analysts David Auerbach, Peter Buerhaus and Douglas Staiger cite a lower but still substantial 340,000, though even that "is three times larger than the size of the current shortage when it was at its peak in 2001." All agree that the coming retirement of 77 million baby boomers means something will have to give.

Wage increases in recent years have attracted more people to nursing. In California, annual average salaries for full-time registered nurses grew to $69,000 in 2006 from $52,000 in 2000, a 32% gain. According to the Bureau of Labor Statistics, the nationwide mean salary for registered nurses today is nearly $60,000. Better pay alone, however, won't solve the problem, or at least not anytime soon.

Despite more interest in the profession, faculty shortages and inadequate facilities have prevented nursing programs from expanding enrollment. More than 70% of schools responding to a 2006 American Association of College Nursing survey listed faculty shortages as a reason for not accepting all qualified applicants. In 2005 nursing schools rejected 147,000 qualified applicants, citing lack of classroom space and clinical placement sites for students.

When growers can't find field hands, food rots and businesses lose money. But when hospitals can't find nurses, patient care suffers. "The effectiveness of nurse surveillance is influenced by the number of registered nurses available to assess patients on an ongoing basis," concluded a 2002 Journal of the American Medical Association study. The study -- which looked at general, orthopedic and vascular surgery patients at hospitals -- found a 31% increase in patient mortality when a nurse's workload rose to eight from four patients.

"Given that even optimistic projections of raising wages and increasing domestic nurse production assumes a continued shortage of a decade or more," writes Mr. Anderson, "policymakers concerned about the impact of the nursing shortage on patient deaths and illnesses must consider relaxing current immigration quotas."

The long-term solution here is to increase nursing faculty and teaching facilities. But in the short run, Congress could help enormously by easing the limit on foreign nurses allowed entry to the U.S. That's what lawmakers did in 2005 when they allocated 50,000 extra green cards with a priority for foreign nurses. They were used up in 18 months. About 4% of U.S. registered nurses are foreign-trained, which means many hospitals couldn't function without them.

More such green cards are needed now, before hospital understaffing contributes to more preventable illness and death.

Here's an article that shows what happens when a reporter is lazy. All too often, journalists simply quote stakeholders on an issue and don't actually bother to fact check. They write down the quote and then, voilà!, the assertion becomes the truth. It must be true, after all, if it's in print. In this case, columnist Dean Calbreath simply accepts as a fact that foreign nurses are depressing wages for US nurses based on complaints from nursing unions. What is the basis for this? Why if the nursing union represenative says it is so, it must be so.

There are a few statistics quoted in the article itself, however, that should give Mr. Calbreath a hint that the unions are on a different planet. First, average salaries for nurses in San Diego are around $67,000. How many entry level jobs requiring only an associates degree do you know that pay that kind of money? And as Mr. Calbreath notes, only 4% of the nurses in the US are immigrants while 8% of positions are unfilled all together. Logic dictates that the shortage is having a much greater impact on salaries than foreign nurses already here. How much are salaries inflated on account of the shortage versus deflated on account of the supposedly cheap foreign labor? Of course, there is no evidence either that foreign nurses make less, but that's probably not important either to Mr. Calbreath.

One is left to question the motivation of nursing unions in this case. Worsening an already bad shortage to artificially inflate salaries could actually result in people unnecessarily dying as was clearly demonstrated in the recent NFAP study on the subject.

Aside from the irrelevant brain drain quote (we don't actually get nurses from brain drain countries), the article fairly reported the report's devastating findings.

A frightening report from Stuart Anderson of the National Foundation for American Policy. First, the report reviews data on patient mortality rates and points out strong evidence to suggest that the fewer nurses per patient in a hospital, the more likely the patient will die. And it's not a slight correlation. Increasing a nurses patient load from four to eight, according to an American Medical Association study, is accompanied by a 31% increase in mortality. How much more blunt does the message need to be? The current blockade of foreign nurses is literally killing people.

Those opposing nursing immigration argue we should instead be training more American nurses, but Anderson's report puts to bed this as a a realistic solution. According to the statement released with the report:

The study recommends policymakers focus on the two most practical solutions to alleviate the impact of the nursing shortage on U.S. patients. 1) Increasing nursing faculty and school infrastructure and 2) Raising immigration quotas to facilitate the entry of foreign nurses.

So far, U.S. nursing schools have shown they do not have enough capacity to accommodate significant increases in their graduation rates. “In 2005, schools of nursing were forced to reject 147,000 qualified applicants because of shortages of faculty, classroom space, and clinical placement sites for students.” Given that even optimistic projections assume a continued nurse shortage lasting a decade or more, policymakers concerned about the shortage’s impact on U.S. hospital patients must consider relaxing current immigration quotas.

“Immigration alone cannot solve the nursing shortage but it can alleviate many of its most damaging impacts on patients,” said NFAP Executive Director Stuart Anderson, the author of the study. Anderson served as Executive Associate Commissioner for Policy and Counselor to the Commissioner of the INS (August 2001 to January 2003) and as Staff Director of the Senate Immigration Subcommittee.

Congress will likely be taking up a nurse immigration measure in the coming weeks. If this report doesn't convince them of the need to act, then they just don't care about what's in the best interest of the citizenry.

A report by Brandeis University Professor Martin Leutz and released by the American Immigration Law Foundation paints a grim picture of the need for more immigrants in nursing homes and other long term care facilities in order to meet a dramatically expanding patient population.

December 2006
January 2007
February 2007
March 2007
April 2007
June 2007
July 2007
August 2007
September 2007
October 2007
November 2007
December 2007
January 2008
February 2008
March 2008
April 2008
May 2008
June 2008
July 2008
August 2008
September 2008
October 2008
November 2008
December 2008
January 2009
February 2009
March 2009
April 2009
May 2009
June 2009
July 2009
August 2009
September 2009
October 2009
November 2009
December 2009
January 2010
February 2010
March 2010
April 2010
May 2010
July 2010
August 2010
November 2010
January 2011
February 2011
March 2011
April 2011
May 2011
August 2011
November 2011
December 2011
January 2012
February 2012
March 2012
September 2012
October 2012
November 2012
February 2013
March 2013
April 2013
May 2013
September 2013
January 2014
March 2014
April 2014
July 2014