Sick and tired

ACCORDING to the US Census Bureau, there were 54.1 million residents 65 years and older with a million currently residing in assisted living communities. This is from a report by the National Center for Assisted Living (NCAL).

No doubt that there are quite a number in similar facilities, including skilled nursing homes and elderly care facilities.

The same NCAL study states that close to a million elderly are in some type of senior living community. That number is expected to double in less than eight years from now. Other highlights of the NCAL study: – By the year 2040, the 85 plus population in the US is expected to triple from the 5.7 million in 2011 to 14.1 million.

– An estimated 70 percent of people currently turning 65 will require some form of long-term care in their lifetime. Accidents happen.

Yet, in 2020, 31.6 million people of all ages were uninsured at the time of the interview. This includes 3.7 million children. Accidents and sickness, physical and mental, do not discriminate by age.

When tragedy strikes and medical care is urgently needed, or in the case of the elderly, long-term care, nurses are the most visible frontline health care workers.

The tired

But the Florence Nightingales in the US alone are leaving the profession in droves amid a critical nursing shortage that is expected to continue through 2030.

This from “Strategies to Overcome the Nursing Shortage,” a 2017 dissertation by Edward Mehdaova published by the University of St. Augustine for Health Sciences (USAHS).

Burnout and stressful environments accelerate the pace of nurse staffing shortages, as more than 30 percent of nurses plan to leave their current position by the end of the year.

The growing demand for health care services across a multitude of specialties is felt across all 50 states. USAHS projects a need for 1.2 million new registered nurses (RNs) to address the current shortage. Nursing schools and graduate nursing programs are working to accommodate the rising demand for skilled nurses and nurse leaders, but they also face challenges.

In June this year, Statistics Canada reported an “all-time high of job vacancies within the health sector as 136,800 positions were reported in the first quarter of 2022: a nearly 91 percent increase since the first quarter of 2020. Additionally, over 50 percent of nurses claim their mental health has become worse compared to what it used to be before the pandemic.”

Down Under, Health Workforce Australia predicted in 2014 that demand for nurses would significantly exceed supply. The projected shortfall was 65,000 nurses by 2025 or 123,000 by 2030.

In July 2022, the Australian Nursing and Midwifery Federation confirmed that “Australia is in the midst of a health crisis — one it cannot staff — as burnt out and fatigued nurses from the pandemic either frequently skip work or leave the industry.

Health force reserves: nursing graduates

Much like the conscription of more than 300,000 Russians for President Putin’s invasion of Ukraine, the government and private industry may have to get the nursing graduates early to work: first as nursing assistants while waiting for licensure.

The annual number of US RN graduates has stabilized at about 155,000 per year, according to the Bureau of Labor Statistics (BLS). However, 28,000 RNs per year are moving up from the sickbed trenches to a less stressful job as nurse practitioner.

From the new graduates and firsttime test takers for the US nursing exam, 51,057 passed (a good 82.44 percent rate). Only 6.569 international graduates, including those from the Philippines, exhibited a much lower passing rate — 46.64 percent. Repeat NCLEX international graduate takers fared even worse — 27.49 percent passing.

Registered nurses’ shortage by state: the difference between supply and demand expected by 2020 by University of St. Augustine for Health Sciences (USAHS). (See table)

Despite an increase in salaries “the share of nurses considering leaving the profession is also up as pandemic-related stressors continue to impact the workplace and exacerbate the nurse workforce shortage.” (From the findings of the 2022 Nurse Salary Research Report among 2,500 nurses surveyed.)

“The median salary for RNs was $78,000, marking a substantial increase from the 2020 median of $73,000. APRN salary was up $13,000 in 2021 at $120,000 and LPN/LVN was $3,000 higher at $48,000.”

One RN’s trash, another’s cash

The work-related stress, long hours and patient behavior are not deal breakers for Philippine nurses. Over the years, Filipino nurses have proven themselves to be kryptonite for “less than behaved patients.”

The main concern is how to get there — while the urgent demand persists.

A look back

A May 30, 2021 Time magazine article said that “since 1960, over 150,000 Filipino nurses have migrated to the US. In 2019, one out of 20 registered nurses in the US were trained in the Philippines.”

“Without Filipino nurses, the US health care system would have been paralyzed,” Leo-Felix Jurado, a professor and department chairman of nursing at William Paterson University, tells Time. “It would have been almost impossible for the health care system to have safely existed.”

Employers then and now agree that Filipino nurses are in demand because of the way they work and how they make patients feel special, especially the elderly.

As with their Asian counterparts, Filipinos show respect for the elderly with “certain gestures and honorifics they use before the person’s name. Calling someone older than you by their first name is considered impolite and rude. And sentences without “po” are impolite.

Getting there

Filipino nurses may apply for temporary work visas or permanent, immigrant classification.

The temporary work visa under H-1B is not a popular or logical choice because even with an employer, selection is by computer. Employers must first register an RN to be sponsored. Then the registration goes with more than 200,000 other applicants. Only 65,000 are to be selected. Another 20,000 may be invited but only for those who completed their master’s degree or higher in the US.

The immigrant visa route is more clear-cut. And the wait is even shorter than the family-based preference counterparts.

The third employment-based (EB2 professionals, skilled workers and other workers) are given priority interview processing at the US embassy in Manila.

Processing at the US Citizenship and Immigration Services (USCIS) Service Centers can be as short as 15 days — guaranteed. The premium processing comes with a $2,500 plus $700 basic filing fee charge. But the fast processing and assured response (provided all the requirements for employers and applicants are met) is worth the price.

For Filipino nurses who are sick and tired of being taken for granted — with low pay despite laws mandating increased salaries and cavalier treatment by local employers — getting that visa is the passport to respect for their profession and a better life and future for the RN and family members.