NURSE Visa Act Could Help Maintain ‘High Standards of Care,’ Legislator Says

• Rep. Don Beyer, of Virginia, introduced the NURSE Visa Act in July 2024.
• The measure would create 20,000 nonimmigrant-visas per fiscal year to employ nurses in areas with a nursing shortage and facilities with staffing ratios in place.
• The Health Resources and Services Administration projects the nursing industry will have a workforce shortage until 2036.

A Virginia legislator wants to make work visas available to foreign nurses so they can work in U.S. areas deemed to have a workforce shortage. 

Rep. Don Beyer introduced the measure in late July and stated in a news release that it would fill gaps and ensure “that hospitals and clinics remain adequately staffed to maintain the high standards of care that Americans expect and deserve.”

This is one of the latest moves to address the nation’s nursing shortage, while acknowledging freezes on immigrant work visas that also have potential ramifications for the industry.

What’s the NURSE Visa Act?

The National Urgent Recruitment for Skilled Employees (NURSE) Visa Act (H.R.9079) would “create 20,000 nonimmigrant visas per fiscal year” to employ nurses in areas with a nursing workforce shortage and facilities with staffing ratios in place.

“Nurses are the backbone of our nation’s health care system – they deliver lifesaving, quality care despite unprecedented challenges,” Beyer said. “As our health care system grapples with an increasing number of retiring nurses and high demand for skilled nursing professionals, we are approaching a critical tipping point where acute nurse staffing shortages are driving burnout leading to a compounding cycle.”

A national nursing shortage is projected until 2036, according to a Health Resources and Services Administration (HRSA) Healthcare Workforce Analysis from March 2024. Non-metro areas are expected to see higher shortages than metro areas: 

“Despite national shortages of RNs and LPNs, significant geographic maldistribution remains a large issue for the nursing profession,” the analysis stated. “Projected supply adequacy of RNs varies considerably across states, ranging from a shortage of 29% in Georgia to a projected 42% oversupply in North Dakota in 2036.”

If approved, the NURSE Visa Act would amend the Immigration and Nationality Act, changing “the number of such visas issued for employment in each state in each fiscal year” from 500 to 20,000.

The measure was introduced July 22 and has been referred to the House Committee on the Judiciary. No additional actions have been taken as of Aug. 2, 2024. 

Impact of the Visa Freeze

Earlier in 2024, the US. Department of State issued a freeze on work visas that allow international nurses to work stateside. Roughly 140,000 employment-based visas are issued every fiscal year, and by mid-June that limit had been met for the current fiscal year. 

Nearly 400,000 applicants are still waiting for an interview as part of the visa process, according to the State Department’s Immigrant Visa Interview-Ready Backlog Report. 

Shortly after the visa freeze was announced, advocacy groups and various healthcare organizations renewed their push for Congress to approve the Healthcare Workforce Resilience Act (HWRA). Separate from the NURSE Visa Act, the HWRA would amend the American Competitiveness in the Twenty-first Century Act of 2000 to allow up to 40,000 employment-based immigrants (including 25,000 for professional nurses) and their families to have visas approved within three years.

Members of the Healthcare Workforce Coalition (HWC) met with legislators in late July 2024 to continue their push for the HWRA’s approval, along with two related bills.

“It’s important we advocate for bipartisan, common-sense policies that address our nation’s worsening healthcare workforce shortage,” Caitlyn Obrock, System Director of Clinical Recruitment at SSM Health, stated in a HWC news release. “We must ensure a strong pipeline of competent clinicians to care for patients during their most vulnerable and greatest time of need, which should be a top priority for all lawmakers.”
 

What’s the Current Landscape?

Hospitals that reported hiring foreign-educated RNs nearly doubled between 2010 and 2022, according to a KFF analysis of American Hospital Association data. And roughly 16% of RNs practicing in the U.S. are foreign-born.

Some hospitals, like Munson Medical Center in Michigan, are actively recruiting from an international pool of candidates.

UpNorthLive reported in July 2024 that the system planned to hire “up to 200 international nurses from the Philippines.” Current and former nurses who spoke to the outlet anonymously said that’s not a long-term solution.

“They’re going to face the same challenges that the current nurses are facing,” one nurse said. “Staffing ratios, lack of affordable housing. They don’t meet the cost of living for this area. So, like I welcome them into our community and I’m excited to have help, but I fear for them. Just like I fear for everyone else who’s working there.”

Jennifer Standfest, Munson’s chief nursing officer, told UpNorthLive that hiring internationally adds to the system’s recruitment tools and retention strategies.

“We want to make sure that we have great people who are part of the team here who contribute to excellent culture, great quality care, and then that in turn, inspires people to want to be part of our team and stay here,” she said.

The Commission on Graduates of Foreign Nursing Schools (CGFNS) International said the U.S. “relies on worker migration” to supplement its domestic nursing workforce. 

“In addition to helping with the effort to alleviate nursing shortages, these workers bring experience and diversity to the health workforce, expanding access to healthcare through cultural awareness and language,” CGFNS International stated in its August 2023 “The Economics of Nurse Migration” report. 

CGFNS International broke the path for foreign-educated nurses to practice in the U.S. into four steps: 

1. Pre-departure: Choosing a pathway (six months) 
2. Migration: Meeting all requirements and obtaining a visa (upwards of 10 years) 
3. Arrival: Moving and getting oriented (three to six months) 
4. Integration: Setting into a new life (minimum of one year) 

And a 2023 study from the “Journal of Nursing Regulation” found that foreign-educated nurses bring more “human capital” to the workforce, particularly in the long-term care setting.

Roy Thompson, the study’s author and a postdoctoral fellow in the University of Missouri Sinclair School of Nursing, and his team discovered that immigrant nurses were “far more likely” to be multilingual and be licensed to practice in more states that U.S.-born nurses.

“I wanted to show that immigrant nurses often have a wealth of transferrable skills, are more mobile and adaptable given their experiences practicing in different long-term care settings,” Thompson stated in a news release. “Immigrant nurses are crucial for diversifying the nursing workforce, as they bring a different cultural lens, a different racial lens, and a different linguistic lens.”

The Bottom Line

The recently introduced National Urgent Recruitment for Skilled Employees (NURSE) Visa Act is the legislature’s most recent attempt to alleviate the nursing workforce shortage. It would increase the number of allotted nonimmigrant work visas for areas deemed to have a shortage — and for facilities with an established staffing ratio. In the meantime, advocacy and healthcare organizations are urging Congress to take action to alleviate the strain on the current population.  

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