I found this story about desirable immigrants in the New York Times today:
http://www.nytimes.com/...
The title of the piece is "US Plan to Lure Nurses May Hurt Poor Nations." Celia Dugger points out the serious ethical issues raised by this trend and in the legislation proposed by Sen. Brownback (R-KS).
(Warning: my poll has a serious snark factor!)
Anyone who has been in a hospital in the last few years or visited an elderly relative in skilled long-term care facilities knows that the nursing staff is usually run off its feet. CNAs usually do the bulk of the tasks: changing the bedsheets, bathing and dressing patients, helping them to the bathroom or changing a diaper, bringing food and drink, even feeding patients. Nursing staffs are asked to do a great deal, often with a short roster, and they do it as well as they can. Everyone knows we need more nurses -- LPNs, RNs -- for med-surg, psych, and rehab facilities. To the best of my knowledge, there's no argument against this point based on standards of care that can reasonably be made.
But my question for Sen. Brownback is this: why do we HAVE to import our nurses? Why can we not emphasize nurse education more? We know this is a problem, and dealing with it now is a necessity. Hell, we've known this crunch was coming over ten years ago! Nursing programs at US schools on all levels, from the Ivy League universities all the way down to the local community colleges, have had waiting lists of potential students for years. They cannot handle the applicant pool. Can we not come up with an educational policy that addresses our needs? Is it because our own, US-trained nurses would ask to be paid better than the American Hospital Association's members want to fork out in salaries and benefits? Whose lobbyists are you listening to, Senator? The AHA's? Maybe you should listen to the ANA, the American Nurses Association, instead.
This is hardly a peevish point. As you read further down the article, note that the ANA sees this bill as a lose-lose proposition for both US-trained nurses and for the health systems of developing countries. The plight of the Philippines is particularly severe. India will also likely find themselves in a major bind if their nurses start emigrating en masse for wages better than they will get at home. Others predict that Africa -- the last place on earth, given the AIDS crisis, that needs a nursing drain -- will also see losses in qualified staff. This does harm on both sides of the human equation. And is that not a violation of medical ethics?
Oh, silly me -- that's right, it doesn't violate current de facto Senate ethics, does it? Ooh, was that sarcastic? I'm sorry -- not.
It seems to me that there is a solution to this. Rearrange budget priorities a little bit, and let's do this instead: we expand the existing nursing programs, give the schools the funds they need to expand facilites and hire more faculty. We can accomplish the latter in two ways: improve nurse instructor pay, and allow nurses from overseas with sufficient experience to qualify as instructors to come on a medium-term guest worker program -- say, five years, which should cover RN programs, that usually confer a Bachelor of Science degree -- so we can train our own nurses!