An administrative backlog prompted the State Department to announce in its May 2023 Bulletin that this year's allotment of EB-3 visas has been exhausted and no applications submitted after June 1, 2022, will be considered until further notice. An EB-3 visa is required for an overseas nurse to work in the United States.
This means hospitals that set out on the 10-month application and approval journey of bringing foreign nurses to work for them in the U.S. are now in a holding pattern with those plans, and thousands of international nurses who have moved through the majority of the process, having passed U.S. licensure exams and English fluency tests, have to wait.
Sioux Falls, S.D.-based Sanford Health set out to hire 800 internationally trained nurses to help with the nursing shortage in all its system's hospitals. Erica DeBoer, RN, chief nursing officer, said the retrogression will definitely affect the healthcare system.
Sanford Health has already onboarded 270 international nurses. Another 400 were expected to arrive and assume the positions they have accepted from Sanford this year. Ms. DeBoer doesn't expect them to arrive stateside for at least six to eight months.
"This will exacerbate some of the staffing challenges in our skilled nursing facilities as well as our critical access hospitals.Those are the places I'm most worried about," Ms. DeBoer told Becker's. "However, with the 270 nurses already here, our [hospitals] in urban areas are looking forward to having a little bit of a break just because of the intense nature of onboarding a nurse from overseas."
Additionally, Ms. DeBoer said the health system has other strategies in place to fill in where needed, including robust partnerships with nursing colleges as well as upcoming recruitment events.
It takes about 10 months from start to finish for a green card application to be processed. The government said hospitals shouldn't expect to see more immigrant nurses until 2025 — and that's assuming the application process reopens in October when the next fiscal year begins and more green cards are made available.
"Immigrants account for disproportionately high shares of essential workers across the U.S. economy," according to the Migration Policy Institute. "Nearly 2.8 million immigrants were employed as health care workers in 2021, accounting for more than 18 percent of the 15.2 million people in the United States in a health-care occupation."
The American Association of International Healthcare Recruitment issued a statement on April 20 saying it expects the green card freeze to throttle the influx of international healthcare talent.
"Visa retrogression amounts to a catastrophic interruption of the stable flow of healthcare talent to the bedside, and it will be felt acutely by ordinary patients, from pregnant mothers to dialysis patients," Patty Jeffrey, RN, president of the AAIHR, said in the statement.
"One in six registered nurses practicing medicine today in the United States is an immigrant. American hospitals, particularly those serving rural populations, would have collapsed long ago without the contributions of international nurses," she said.