Strained hospitals seek foreign nurses amid visa windfall

With American hospitals facing a dire shortage of nurses amid a slogging pandemic, many are looking abroad for health care workers.

And it could be just in time. There's an unusually high number of green cards available this year for foreign professionals, including nurses, who want to move to the United States — twice as many as just a few years ago. That's because U.S. consulates shut down during the coronavirus pandemic weren't issuing visas to relatives of American citizens, and, by law, these unused slots now get transferred to eligible workers.

Amy L. Erlbacher-Anderson, an immigration attorney in Omaha, Nebraska, said she has seen more demand for foreign nurses in two years than the rest of her 18-year career. And this year, she said, it's more likely they'll get approved to come, so long as U.S. consular offices can process all the applications.

"We have double the number of visas we've had available for decades," she said. "That is kind of temporarily creating a very open situation."

U.S. hospitals are struggling with a shortage of nurses that worsened as pandemic burnout led many to retire or leave their jobs. Meanwhile, coronavirus cases continue to rise and fall, placing tremendous pressure on the health care system. In California alone, there's an estimated gap of 40,000 nurses, or 14% of the workforce, according to a recent report by the University of California, San Francisco.

Hospitals are filling the gap by hiring traveling nurses, but that can be expensive. And hospital administrators say not enough nurses are graduating from U.S. schools each year to meet the demand.

Some hospitals have long brought nurses from the Philippines, Jamaica and other English-speaking countries, and more are now following suit. And both longtime recruiters and newcomers are trying to take advantage of the green card windfall before the fiscal year ends in September.

The U.S. typically offers at least 140,000 green cards each year to people moving to the country permanently for certain professional jobs, including nursing. Most are issued to people who are already living in the United States on temporary visas, though some go to workers overseas. This year, 280,000 of these green cards are available, and recruiters hope some of the extras can be snapped up by nurses seeking to work in pandemic-weary hospitals in the United States.

The Biden administration, which has made moves to reverse Trump-era policies restricting legal immigration, has taken some steps to try to help foreign health care workers so they can assist with the pandemic. U.S. Citizenship and Immigration Services said it would speed the renewal of work permits for health care workers, which could help keep some foreign citizens already in the United States on the job. The State Department told consulates last year to prioritize applications for workers at facilities that are responding to the pandemic, an agency official said.

Faith Akinmade, a 22-year-old nurse from Nigeria, is among those hoping for a quick solution. After completing college in the U.S., Akinmade has been working as an ICU nurse for University of Louisville Hospital in Kentucky. But her work permit is set to expire in March. She said she needs it renewed, or her green card approved, to stay on the job.

"At this point and time, I just feel like I have faith that at the end of March something is going to show up to continue to work," Akinmade said. She said the issue affects many of her international colleagues as well as domestic ones, who may be pressed to take on shifts for colleagues if their immigration paperwork doesn't come through.

Dr. Roxie Wells, president of Cape Fear Valley Hoke Hospital in Raeford, North Carolina, said she started trying to bring over foreign nurses before the pandemic, but it wasn't until last year that these recruits started getting consular interviews in larger numbers. So far, about 150 were approved to come work, but Wells said they're still waiting on another 75.

"Obviously it has become more necessary during the pandemic," she said. "The 150, if we didn't have them, we would be in a precarious situation."

The surge in the omicron variant in the United States has made the strained staffing situation even more apparent in hospitals as health care workers, like so many others, have been sickened by the highly contagious virus and sidelined from work at a time when more patients are coming in.