Healthcare staffing shortages continue to burden hospitals and systems, yet immigrants, who are often looked to as a solution for the staffing crisis, appear to be facing more red tape and discrimination.
About 18 percent of the healthcare workforce is composed of immigrants, according to the Migration Policy Institute. Many systems have turned to international nurses and physicians to help fill the gap in staffing; but a federal administrative backlog will push back the number of nurses able to come to the country, and some immigrants are speaking out against illegal hiring practices.
No more visas until 2025
An administrative backlog prompted the State Department to announce that this year's allotment of EB-3 visas — a required document for overseas nurses to work in the U.S. — has been exhausted and no applications submitted after June 1, 2022, will be considered until further notice.
Many hospitals are in a holding pattern after setting out on the 10-month application and approval process, and thousands of international nurses are on standby until the hold is cleared up. The government said hospitals should not expect to see more immigrant nurses until 2025, assuming the application process reopens in October when the next fiscal year begins and more green cards are made available.
"If we don't have a steady flow of these international nurses to enter the country and provide services, this is dire for our hospitals who have become more dependent on this workforce," Patty Jeffrey, RN, president of the American Association of International Healthcare Recruitment, told The Hill.
Immigrant health workers stuck in contracts
The issues do not end there. Immigrants hired to yearslong contracts in thousands of U.S. healthcare roles said they are paid less than their co-workers, deceived about benefits such as free housing and, if they try to leave, threatened with tens of thousands in debt.
Many immigrant healthcare employees told NBC News they work in facilities with few staff members, work unpaid overtime and cannot fully meet patients' needs. However, they face losing their immigration status if they quit or can be penalized more than $100,000 for breaking their contracts.
The Labor Department deems these tactics illegal and mandates immigrant workers be paid a certain wage, however, these issues are widespread in healthcare facilities.
"These nurses are brought over, they're promised the American dream and it's a bait and switch," Magen Kellam, a Florida immigration lawyer who has represented dozens of foreign-educated nurses, told NBC News. "They get here and oftentimes the jobs are much different than the idea that they were sold. But that's where this debt bondage comes into play, where they can't leave even if the conditions are unsafe, and there's wage theft and exploitation of their work hours."
If these trends continue, the healthcare system and communities could suffer.
"One in 6 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," Ms. Jeffrey told Becker's.