OPINION:
The pandemic changed American life. Technology raced ahead to cope with shutdowns, social distancing and remote work. Since then, some have gained flexibility regarding where they work. Numerous sectors, however, that don’t have that flexibility. Critical care workers — first responders, doctors, nurses, anyone in the supply chain from truckers to supermarket employees — must show up “in real life.”
If these essential workers decided to stay home, Americans would not be able to have access to basic services. Everything from the food supply to those who deliver packages would come to a halt. And most important, doctors and nurses would not be available for routine, urgent, or lifesaving health care.
If the United States’ nursing shortage was at a crossroads before the pandemic, we are now at a precipice. Through the pandemic, our nurses experienced high rates of burnout and turnover not seen in more than a decade.
This has led to a historic shortage.
No medical system has been immune. One of the most acute shortages is affecting the Department of Veterans Affairs. According to a 2022 VA Office of the Inspector General released late last year, the VA system is experiencing a severe nursing shortage at 91% of its facilities. Nationally, some reports estimate that nursing shortages will reach critical levels in the coming years.
With an aging population and the potential for more pandemiclike illnesses in the future, ensuring registered nurses are on hand to help those in need, something has to change to recruit, retain and expand the nursing corps.
Sadly, one of the most used routes to ensure the health of America’s workforce has closed. Foreign-born nurses — those who speak fluent English, have passed U.S. licensing exams, graduated from a U.S.-equivalent university, and carry a current license — are being shut out due to the current debate over immigration policy.
That’s because one of the most utilized routes to ensuring the adequate staffing of America’s health care workforce has closed. The result? Due to quotas, and an estimated 1 million-plus asylum backlog, those seeking to hire nurses from overseas will have to wait at least two years. For pending applications from India, it could take up to 12 years.
Immigration has become a lightning rod without any path forward. Between the southern border and patterns of illegal immigration, reform and expedited processing for immigrants in certain occupations, such as nursing, are nonstarters. But partisanship and bureaucratic inertia are no excuse for inaction.
There are bipartisan, commonsense steps that can be taken to begin smart reform. Tens of thousands of unused work visas expire each year that have been set aside for certain industries. These visas could be used reciprocally for another industry facing a shortage.
This is an easy fix via the Healthcare Workforce Resilience Act making its way through Congress, and was the intent of the original law enacted in 1990 to deal with another staffing crisis. There is no allocation increase, just using a different visa category to alleviate some of the burden on the current nursing workforce.
Study after study shows that patient care correlates with well-staffed nursing units. Nurses are the ones by the bedside, giving care and comfort to our loved ones. As Clara Barton, the “Angel of the Battlefield” and founder of the American Red Cross, said in the care of others, “that I might nourish the fainting, slake the thirst of the dying, and strive to staunch the lifestream as it ebbed away.”
With winter’s trifecta headed our way — COVID-19, the flu, and the common cold — it would behoove policymakers to ensure our hospitals, clinics and medical offices have the nurses they and we desperately need.
• Amy Mitchell is an independent consultant and a former State Department official.
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