Statistics

There's plenty of talk about the nursing shortage and foreign recruitment as a solution, but what are the facts? We've pulled together a few facts and statistics you may find helpful in understanding the problems facing the healthcare industry.

FACTS: Foreign Recruitment

History

Foreign recruitment is not a new concept. American hospitals have been recruiting under different kinds of visas since the early 1950s. The foreign nurses, most of them from the Philippines, came under the J-I visa, a transfer of technology and training visa. They were given reciprocity licenses and many of them performed outstandingly and have achieved high-level positions in nursing here in the United States. Throughout the years, employers have used the H-1A visas for temporary work permits dedicated to nurses. Unfortunately, the H1-A expired in 1995 and nurses fell within the very competitive H-1B visa category, open to all highly skilled professions. The H1-B visas were predominantly used for information technology professions that boomed over the last few years. Currently, the employers are using the permanent visa (green card) to recruit nurses from other countries.

Education

The quality of training in foreign schools is extremely good. In the Philippines for example, the nursing curriculum, method of instruction, educational materials, textbooks, and educational and testing standards are the same as in the United States. The medium of education is in English. In fact, the educational system of the Philippines was established by the U.S. over 100 years ago. The nurses who come to the U.S. under the permanent visa must pass the NCLEX before working as RNs in the U.S. and must also pass the Test on English as Foreign Language (TOEFL); Test for Written English (TWE) and Test for Spoken English (TSE) as well as the visa-qualifying test called Council on Graduates of Foreign Nursing Schools (CGFNS).

Economics

Foreign recruitment brings stability by improving employee retention due to contractual agreements between the nurse and hospital. Typically, the contract requires a two-year minimum employment commitment by the nurse. The cost of domestic recruitment and retention is a major nursing department expense especially during a period of extreme nursing shortage. Therefore, cost containment in the area of recruitment is a significant important challenge during the current nursing shortage. The bad news is that an increasing demand for nurses is predicted until 2020. Foreign recruitment helps to minimize long-term recruitment costs and is, therefore, both a professionally and economically attractive option to meet current and future demands for quality healthcare professionals.

FACTS: Nursing Shortage

Image Problems?

The nursing industry is facing an image problem. The image of nursing has changed over the last decade from a field that offered many opportunities to one that is viewed as uncertain and often dangerous. Women have more career opportunities and many view the job as having unsatisfactory working conditions and low salaries compared to other professions.

Undervalued, Overworked and Underpaid!

The physical and emotional demands of the environment created by increasing workloads, decreased staffing ratios and mandatory overtime are contributing to increased turnover and nurses leaving the profession. Nurses reported feeling undervalued, overworked and underpaid.

So, what's causing the nursing shortage?

1. More nurses, please!
   Modifications in managed care and a new push for competitive quality is increasing patient days, hours of nursing care and the recognition of the role of the RN.
2. Fewer college grads
   According to the American Association of Colleges of Nursing, entry-level BSN enrollment fell 4.6 percent in fall 1999, dropping for the fifth year in a row. Without the new graduate pipeline, there are fewer nurses available to replace those who retire or leave for other opportunities. Currently, the ratio of RNs in their 40s to RNs in their 20s is four to one.
3. Generation gap
   The baby boom of 1946 to 1964 was followed by the 11-year baby bust, when the birth rate fell to a low of 146 births per 1,000. As of the 1990 census, there were 77 million American boomers compared with just 44 million Generation Xers, creating the smallest pool of entry-level workers since the 1930s. Projections from the U.S. Census Bureau show as one generation grows and the other shrinks, the boomer-to-buster ratio may fall from 1.74 in 1990 to 1.6 in 2010.
4. Strong economy = more care needed
   During an economic slump, many people delay healthcare because of finances or lack of insurance. As the economy strengthens, so will the demand for healthcare.

--Resource: www.nursesource.org

STATS: Nursing Shortage

• Between 1983 and 1998 the average age of working RNs increased by 4.5 years to 41.9.
• Thirty-five percent fewer full-time RNs are observed today when compared to similar age groups of RNs entering the workforce 20 years ago.
• Within 10 years, 40 percent of working RNs will be 50 years or older.
• As those RNs retire, the supply of working RNs is projected to be 20 percent below requirements by the year 2020.
• The Bureau of Labor Statistics reports that jobs for RNs will grow 23 percent by 2008. That's faster than the average for all other occupations.
• About half of the RN workforce will reach retirement age in the next 15 years.
• The average age of new RN graduates is 31. They are entering the profession at an older age and will have fewer years to work than nurses traditionally have had.
• RN enrollments in schools of nursing are down. In fall 1999, entry-level BSN enrollment fell by 4.6 percent, dropping for the fifth year in a row, according to the American Association of Colleges of Nursing.