LESS than three years from now, the US would be needing an additional 1.2 million registered nurses to meet the demands of the workforce and the $2.9-trillion health-care industry—this according to the Bureau of Labor Statistics’ Employment Projections 2010 – 2020.
In addition, there has been a dramatic increase in the aging, elderly population of the US and the percentage of practicing RNs who are over age 50 and are going into retirement as well.
Yet the US Congress has not created special for-nurse-only-visas such as the H-1A in 1990. Nor has the US government allocated a certain number of visas exempted from the 65,000 yearly allocations from the H-1B working visas. Then, on the immigrant visa front, the quota for the EB3 category for professionals and skilled workers (RNs) has not been increased from 40,000 a year.
Finally, the passage of the Affordable Health-care (Obama Care) Act increased the number of Americans eligible for health-care services, thereby further exacerbating the need for additional qualified, competent nurses.
The result of the inaction is a long line of Filipino nurses waiting for the issuance of their immigrant visas, and disappointment from nurses who continuously fail to get into the H-1 B lottery program year after year.
With the foreign nurses working and immigrant visas at a standstill in the US, what options are there for Filipino RNs?
USCIS policy allowing employers to file H-1B petitions for RNs
In Feb. 2015, the US Citizenship and Immigration Services issued a policy memorandum allowing foreign RNs to be sponsored through the H-1B visas provided the employer can prove that a bachelor or higher degree is a requirement for the position.
While this policy memorandum sparked a glimmer of hope among potential H-1B applicants, the fact is that sponsorships filed by employers are selected at random by computers. Hence, it is commonly known as the April 1 visa lottery. Even if an RN has an employer that submitted a completed application right after midnight of March 31 of every year, the applicant would still have be lucky, pray a lot and hope to be selected.
The most viable option is pursuing an advanced degree in the US, either a masters or a doctorate in nursing.
Advanced degree holders exempt from the 65,000 annual cap
In addition to the 65,000 yearly quota, 20,000 H-1B visas are exempt from this cap for visa applicant who “has obtained a US master’s degree or higher (commonly known as the “advanced degree exemption”).
However, if the USCIS receives more than 20,000 petitions requesting an advanced degree exemption during the first five business days, a lottery will be conducted to select 20,000 petitions. Those who are not selected for the advanced degree exemption will be entered into a second (the general H-1B lottery) for the regular 65,000 cap.
The advanced degree (masters or PhD) must have been obtained in a recognized US educational institution.
Nursing graduates in the US
According to the American Association of Colleges of Nursing (AACN), “nearly 155,000 new nursing graduates entered the workforce in 2015.” Assuming the number of nursing graduates remains the same, there would be 775,000 new nurses.
With a 69.87-percent passing rate for examinees in the 2015 National Council Licensure Examination (NCLEX), there were 229,459 new RNs for the entire year. This number included the first time US-educated and repeat US-educated applicants, as well as the internationally-educated RNs, first timers and repeaters.
If the passing rate remained the same, there should be 1,147,295 licensed RNs in the US, more than the 1 million projected shortages.
Shortage remains despite an increase in nursing graduates and NCLEX passers
The AACN explains that while the number of new nursing students and graduates is growing, the nursing-education system hasn’t kept pace, effectively creating a “bottleneck in which only so many aspiring nurses can access the training they need.”
In short, America’s health-care industry may have sufficient licensed nurses but lack academic qualifications and further training, which come with advanced degree programs that incorporate actual workplace experience.
Then there is the cost and lack of nursing faculty, especially for undergraduate and graduate programs.
The AACN’s report called the 2014 – 2015 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing shows that “US nursing schools turned away 68,938 qualified applicants from baccalaureate and graduate nursing programs in 2014 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. Almost two-thirds of the nursing schools responding to the survey pointed to faculty shortages as a reason for not accepting all qualified applicants into baccalaureate programs.”
As for the cost, most masters and PhD programs in the US could go up to $120,000, according to FinAid.org.
The cost varies depending on the university and the master’s program itself. The cost varies by program as well. The average cost of an MBA, for example, is $40,000. At most universities, this is what master’s degree graduates will have paid. Some institutions have programs for less, and MBA programs at Harvard or Stanford could cost in excess of $120,000
The bestmastersdegrees.com reports that the cost of full-time graduate tuition, at nine or more credit hours, per year at the University of Michigan for engineering students is $10,957 while out of state students will pay $20,616 per year.
Saginaw Valley State University, Michigan
Internationally-educated RNs intending to complete an advanced degree with Saginaw Valley State University (SVSU), in Michigan, may enhance their career earning potential or have a viable pathway to employment and permanent residency in the US by taking a Master of Science in Health Administration & Leadership (MSHAL). For complete details on MSHAL, visit this link: <https://www.visacenter.org/course/5/health-administration-and-leadership-master-of-science>
The MSHAL program includes theoretical and experiential learning opportunities, equipping regional health-care leaders with the knowledge required to fill more advanced positions within their respective agencies. SVSU has the lowest tuition of all public institutions in Michigan—an affordable price for the grand prize of a suitable career progression and permanent residency as a health-care professional.
Health care is the largest industry and the second-largest employer in the US. An SVSU MSHAL graduate can look forward to a career in a health-care setting, which includes:
Outpatient care centers
Public health departments
In-home health-care providers
Group medical practices
Managed care facilities
Nursing educators, on the other hand, could expect a “19-percent job growth by 2020, similar to the growth in the demand for registered nurses and other medical departments, but still much higher than the average rate of growth of other professions across the United States,” nursejournal.org says.
It also says that the “average income for this position ranges from $45,040 to $94,720, depending on the level of academics achieved and how much experience in the field has been accomplished.”
Getting an advanced degree, therefore, provides a common and viable route if a foreign nurse with a bachelor’s degree from his or her country of origin wishes to have a successful, good-paying job in the US and get a green card as well.
This is surely not the typical example for nurses, who may be described as those who can (practice), do; those who can’t, teach.
In this case, teaching gets nurses to be better in what they can do.
And that’s the prescription for having the best of both worlds, keeping both the US government and international nursing students from running around in circles.