Foreign-Born Nurses to Face Tougher U.S. Regulations

The Department of Labor on Thursday issued regulations that make it more cumbersome for health-care facilities to hire foreign-born nurses.

The regulations require hospitals to file documents with the government declaring that they would suffer “substantial difficulties” without the services of foreign nurses.

The rules are intended to pressure the medical industry into finding ways to recruit and train more U.S.-born nurses to solve a national nursing shortage.

In seeking to import more nurses, health-care facilities will have to file documents with the labor department stating that they have taken “timely and significant steps” to hire nurses who are U.S. citizens or immigrants “in order to remove as quickly as reasonably possible the dependence of the facility” on non-immigrant aliens.

The regulations issued Thursday were the second part of a two-step Department of Labor effort to cope with the shortage. In an effort to provide short-term relief to hospitals and other facilities, the department last spring issued regulations allowing foreign nurses working in the United States on temporary visas to apply for permanent residency. About 16,000 such nurses presently are working.

Both sets of regulations were issued in order to comply with 1989 legislation by Rep. Charles Schumer (D-N.Y.) Its main beneficiaries were Filipino nurses, who make up about 75% of the nurses working here on temporary visas.

Previously, foreign-born nurses were limited to a five-year stay under temporary “H-1A” visas. Now they will be able to apply for annual extensions. After three such extensions they will become eligible to apply for permanent “green card” status as resident aliens, a spokesman for the Immigration and Naturalization Service said.

The nursing shortage grew out of a surge in demand for health care, a flattening in the growth of the working-age population and the fact that nursing had traditionally been a high-stress profession with low wage growth. For several years, hospitals and employment agencies have been packing help-wanted columns of newspapers with ads promising nurses high pay and “signing bonuses.” Some nurses have earned salaries of $60,000.

Christine Hall, general counsel for the California Assn. of Hospitals, which represents about 500 hospitals, said the new regulations appear to be “a very workable solution.”

But Carl Shusterman, an attorney who heads a committee on registered nurses for the American Immigration Lawyers Assn., said he believes some hospitals will stop employing foreign-born nurses because compliance with the new regulations will be difficult.

Shusterman said that only those hospitals willing to fill out massive amounts of new paperwork will be able to import new foreign nurses and employ those already working.

“There is going to be a tremendous shift of nurses to hospitals that qualify” under the labor department rules, he predicted.