U.S. health care would collapse without foreign-trained nurses like me, so why did the House vote to ban us?

Fairness Act is anything but fair for immigrant nurses and their patients

The Fairness for High-Skilled Immigrants Act would only exacerbate America’s nurse deficit, Roy writes.(Bill Clark/CQ Roll Call file photo)
The Fairness for High-Skilled Immigrants Act would only exacerbate America’s nurse deficit, Roy writes.(Bill Clark/CQ Roll Call file photo)
Posted July 17, 2019 at 6:30am

OPINION — America’s population is growing, its workforce is aging and its health care system is straining under the weight of both. At the intersection of these trends is the very practical question of just who’s going to care for all these new patients.

Increasingly, the nurse answering that bedside call looks and sounds a lot like me, a first-generation immigrant.

Consider the numbers: U.S. medical facilities will need to hire more than 2 million new health care workers within the next six years just to keep pace with rising demand for care. If and when they can’t, the country will suffer an interruption of care so catastrophic as to threaten the well-being of everyone from school children and pregnant mothers to seniors and dialysis patients.

For decades, the U.S. has maintained a delicate health care staffing balance by relying on foreign-trained nurses like me. Without us, most U.S. medical facilities would collapse. Thanks to a popular immigration proposal that would unintentionally restrict access to foreign medical talent, that just might happen.

The Fairness for High-Skilled Immigrants Act, which the House passed last week by a vote of 365-65, would rapidly phase out per-country limits on employment-based visas in an attempt to ease the tremendous backlog for Indian green card applications. On paper, it’s all very complicated. In practice, though, it’s quite simple: It means passionate, qualified foreign nurses won’t be able to emigrate and deliver much-needed care.

America’s nurse deficit has been teetering at the brink for decades, but it’s only projected to worsen as baby boomers age into retirement. The plain reality is that the country can’t educate and hire enough U.S. workers to meet demand, forcing hospitals to recruit foreign talent to bridge one of the world’s most severe labor shortages.

Despite the urgency to hire more nurses, immigration rules don’t make it easy on either the hospital or clinician to fill long-open jobs. In fact, immigration laws require foreign-educated nurses living abroad to secure an offer of employment before they even begin the permanent residence application, which often takes a year or more and requires that they not enter the country until it’s been completed.

This lengthy process is unlike those for other high-skilled employment fields, like tech workers, who are already living and working in the country on work visas while awaiting green card consideration.

After years of waiting and seemingly endless forms, post-training credential certifications and English proficiency exams, I was finally able to emigrate to the U.S. in 2014 after having first secured a nursing position through a health care staffing agency.

My husband and children joined me, and together we found a community and built a life. We became Americans, all of us, but not without challenge or cost. After visiting the site of the 9/11 terrorist attacks in New York, my daughter heard and answered the call to serve her new country and enlisted in the United States Air Force.

Like her mother, she had hoped to become a nurse and earn her commission as an officer, but sadly, she wasn’t able to realize those dreams. Airman Patricia Roy died while on active duty and was posthumously awarded the Air Force Achievement Medal in recognition of her outstanding service.

Patricia had been recognized by her country and community with praise and awards, but her great dream of becoming a nurse had been denied. It was in her memory that my husband, who had previously had a successful career as a project manager, enrolled in a nursing program. He graduated with high honors last year and is now in a leadership role in the health care field.

Coming to America changed my life and not simply because of Patricia — it gave me the special privilege to care for people in their most tender moments. I know that I make a difference in the lives of my patients as do the hundreds of thousands of other foreign-educated nurses working in this country. Without us, America would be worse off. It’s just that simple.

The Fairness Act’s motivations are virtuous, but good intentions don’t absolve it of its profound unintended consequences. This will devastate patient access in virtually every corner of the country as it makes it virtually impossible for qualified nurses to come here. Unless the Senate acts to include a special carve-out for nurses, U.S. health care and patients will suffer.

America needs nurses now more than ever, but the Fairness Act will limit the country’s access to them. The bill might aspire to fairness, but it doesn’t deliver it for nurses and certainly not for patients.

Virgie Roy, RN, BSN, lives in Fairfield, Calif. with her husband and two sons. She was placed in her California hospital by MedPro Healthcare Staffing, a member of the American Association of International Healthcare Recruitment, which has advocated a clinician carve-out of the Fairness for High-Skilled Immigrants Act.