Your Lying Eyes

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24 May 2006

American Nurses Apparently Just Don't Cut It

At least that appears to be what the U.S. Senate thinks. The NY Times notes that "a little-noticed provision in their immigration bill would throw open the gate to nurses and, some fear, drain them from the world's developing countries." Note how the Times, as the beacon of American elitism, does not concern itself with how this influx of foreign nurses might impact American nurses, but rather how this might affect the countries these foreign nurses would leave. But the Times is not above reporting some dubious economics:
The nurse proposal has strong backing from the American Hospital Association, which reported in April that American hospitals had 118,000 vacancies for registered nurses. The federal government predicted in 2002 that the accelerating shortfall of nurses in the United States would swell to more than 800,000 by 2020.
You see, American women just don't want to be nurses, and why should they? Your typical American woman is either some hotshot corporate lawyer or a pampered housewife instructing her Mexican gardener on where to plant the petunias. It's not like the old days when a middle class woman appreciated a job where she could work part time or weekends and nights to help with the family finances. Oh sure, there's lots of middle class women, but they're all meth addicts or poorly educated, certainly not up to the standards of Philippine health care workers, who'll just so happen to work for a lot less, too.

Now obviously the way to handle a labor shortage - particularly one being projected 18 years in the future - is to raise wages. That way more people would go to nursing school. Yes, that would raise total health care costs. I think it's unlikely that nurses' salaries are a significant chunk of health care costs. There's no reason to suspect that other industrialized countries have critical nursing shortages, and their health care costs are significantly lower than ours. Whatever is driving our high health care costs, it's unlikely to be nurses. (By the way, I googled like mad and couldn't find any stats.) Interestingly, following the 2002 study quoted above, Congress passed the Nurse Reinvestment Act to address this very issue. I guess the Senate would rather not wait around to see if it works.

But the whole shortage claim seems suspect. The Times tries to explain:
There are now many more Americans seeking to be nurses than places to educate them. In 2005, American nursing schools rejected almost 150,000 applications from qualified people...One of the most important factors limiting the number of students was a lack of faculty to teach them...Professors of nursing earn less than practicing nurses, damping demand for teaching positions.
So it must be really hard to find people to teach finance, law, or engineering - surely professor salaries don't exceed typical earnings in these fields. If our nursing programs are maxed-out, I can't see how this shortage can be real.

Back to the effect on foreign countries:
Removing the immigration cap, they said, would particularly hit the Philippines, which sends more nurses to the United States than any other country, at least several thousand a year. Health care has deteriorated there in recent years as tens of thousands of nurses have moved abroad. Thousands of ill-paid doctors have even abandoned their profession to become migrant-ready nurses themselves, Filipino researchers say. "The Filipino people will suffer because the U.S. will get all our trained nurses," said George Cordero, president of the Philippine Nurse Association. "But what can we do?"
What can we do, indeed.


Blogger Steve Sailer said...

The newspapers have been full of warnings about the imminent nurse shortage for as long as I've been reading newspapers.

May 24, 2006 8:31 PM  
Anonymous Anonymous said...

Are you aware of what nursing actually pays? Here in the New York metro area, hospitals start registered nurses at more than $60K per year. Nursing homes pay even more because the work's considered less desirable. Other parts of the country may pay somewhat less, in line with their lower costs of living, but there are no huge differences.
While some RN's get bachelor's degrees, it's possible to become fully qualified in a 2-year program at the local community college. This will enable one to outearn most BA-holding cubicle drones, all while enjoying much better job security. And nursing also offers fairly good opportunities for advancement.

Iron Rails & Iron weights

May 25, 2006 9:54 AM  
Blogger tc said...


Median annual earnings of registered nurses were $52,330 in May 2004. The middle 50 percent earned between $43,370 and $63,360. The lowest 10 percent earned less than $37,300, and the highest 10 percent earned more than $74,760.


Since our last survey, annual earnings increased for both salaried nurses and those paid by the hour. The average annual income for nurses paid hourly is now $47,445, an increase of $4,490 (10%) since 2001; salaried nurses, who typically work in management and administration, now average $65,125, a gain of $5,745 (10%). When the incomes of both hourly and salaried nurses are considered together, their average yearly income is $49,835—a $4,075 increase.

May 25, 2006 12:10 PM  
Anonymous Anonymous said...

My mother was a nurse. I even considered it for a while.

My mother talked to me about it and told me why she got "burned out". Nurses have to see very sick people for 12 hours at a time, day or night shift. They are the "primary" care-giver, not the doctor. They do the "ugly stuff". Changing YOUR baby isn't so bad. Changing (and worse) sickly, ederly adults just gets tedious. They interact with the patients much more than the doctors do. They face the wrath of patient's families (who are just plain mad that their loved one is sick and you are the one around to yell at) much more than doctors do also. Corporate-medical care has assigned ever-increasing numbers of patients per nurse not because of a shortage of nurses, but money for shareholders.
The emotional drain of seeing that much suffering up close wears on nurses. Thats why some get out if they marry a man who makes enough money, or switch careers later on.

The news entry really has pissed me off, however. There is no "shortage". This is not how economics were supposed to work. Returning to 8 hour shifts that are not so hard on your marriage, and less patients per nurse (like it was 15 years ago) are what is needed to keep nurses in their profession. Burning them out just ensures more turnover, thus less experienced care. I'd love to see this "shortage argument" extended to all professions. With Lee Raymond NEEDING 400 million in his retirement package, I suppose their must be a "shortage" of geology majors with some business courses to run oil companies. Since the average CEO is making 431 times what the average employee is making in corporations now, perhaps we need to import all those Pakastani-business majors to take their jobs at one-tenth the cost also. This "labor-shortage" argument can be extended to every single profession/job in America where an employer wishes that he could pay less and get away with it (i.e. all of them).

TC pointed out that the highest paid nurses make more than 74K. Thats right, surgical nurses who are in surgery after surgery get paid pretty darn well for their expertise (and so do the surgeons). This is THE area where you really dont want a mistake. Its also risky (HIV, etc), and traumatic. I think someone who was making 60K a year "selling something" would NOT want to trade places and help docs clear out clogged arteries of gunk with an instrument while watching someone's beating heart right in front of them covered in beaucoup blood. Its a yick job, and it yours................12 hours a day, 42 hours (on average) a week. Care to trade anyone?

That being said, has ANYONE contemplated the language difficulties of not being able to communicate extremely well with their care-giver at a hospital. Will these new foreign nurses be made to speak good english? Patients who often need 20 medications whose names are long-latin based amalgamations of medical terminology have a high threshold for miscommunication that could be fatal. And we want ESL-folks doing this kind of thing? Hope HCA reall has a crack legal staff, they will need it. But perhaps by then, politicians will be so sold out to corporations that patients wont even have the right to sue even if they get the WRONG artificial heart unless they are Kennedy's or something anyway.

May 26, 2006 3:25 AM  
Anonymous The Watcher said...

The reason for this vaunted "nursing shortage" in the US is quite simple-- #1, our government (and academic centers) are too lazy and stupid to actually set up more schools to train nurses here and make use of our homegrown pool of talent. #2 and even more so, our system fails to pay nurses a fair, sensible living wage for the hard work they do.

This nursing shortage crap is little more than a bullshit racket, as the 4th commentator here ("anonymous") points out-- the solution is just to train more nurses and pay them for the work they do, as any self-respecting free market would. But no, both the Democrats and the corrupt open-borders faction among the Republicans find it much easier to bring in foreign nurses who 1. have a substandard level of training relative to US nurses (and, being trained abroad, don't cost the US anything), 2. don't ask for fair wages let alone benefits since they're often sojourners prepared to return home (or, if settling here, don't mind living in squalid conditions that would repel any self-respecting American), and 3. don't have the capacity to vote and demand better benefits. It's the same sort of lowest-common-denominator crap that's motivating other pushes for mass immigration.

What makes this even worse, is that we'd literally be killing tens of thousands of our patients in the US every year due to screw-ups by the foreign nurses, over and above what our own trained nursing staff would make. I used to work in hospital administration, and while I respect the work ethic of the foreign nurses, the fact, is 1. they're not trained to anywhere near US standards (which is another reason that the "cheap labor lobby" likes them so much), which often leads to catastrophic errors on the hospital floors, and 2. they have all kinds of communications failures which are literally deadly to US patients.

Many of the foreign nurses do speak decent English, but the problem is that they don't have the far more important CULTURAL skills you need to take part in productive, mutually-understood, tacit communication between nurse and patient. Remember-- who is it that actually communicates the doc's recommendations to the patients? Who is it that actually writes out the specifics of the prescriptions and gives the medical advice itself as the patient is being discharged? It's not the doctors by and large, it's the nurses. The problem with the foreign nurses, is that they just don't have the sort of cultural connection that you get among people who've grown up in the same country, and they make little errors of communication (e.g. "take this drug, one pill 3X a day with meals but avoid milk") that literally kill people. So once again, for the sake of cheap labor and higher profits, the US government is literally willing to kill Americans.

On top of this, we're also royally screwing over the health care systems in the Philippines and other countries that desperately need their nurses there. They do all the work and train the nurses, which we don't do, while we take their trained staff away and deprive their patients in the Philippines. The poor countries assume the costs, we take the benefits. Yet another example of how this mass immigration bullshit really is just a racket, for both sides, with only already-rich idiots being the only beneficiaries in the process.

It's odd, because I used to like Sam Brownback (the sponsor of this bill to bring in foreign nurses). But now I despise him-- I absolutely, positively hate him. I hate him even more than John McCain. I hate him almost as much as I hate Hillary Clinton. (Speaking of which-- we'll probably have Hillary vs. McCain match-up in 2008. Disgusting. This is the one and only one circumstance in which I would actually vote for the repugnant McCain, if only to block Hillary from her dangerous plans for an all-powerful US Socialistic government which not even McCain, repulsive as he is, has put forward. If the Dems nominate anyone else-- and I mean almost anyone, e.g. Mark Warner, Evan Bayh, John Edwards, even Al Gore, then I vote for the Democrats in 2008.)

I will personally work hard, now, to defeat this bill, and to defeat Sam Brownback and trash his political career because of it. We don't need to be bringing in more foreign nurses here, causing trouble for both us and countries like the Philippines which train them. We should instead be investing more in the training of our own nurses stateside, and paying them for the important work they do. We also need to deck and humiliate any idiot self-deluded feminist who ever derides the nursing profession. It's one of the most honorable professions on the planet, and any woman who goes into nursing should receive the highest levels of praise and respect.

May 26, 2006 5:12 AM  
Anonymous Anonymous said...

Just a bit of information.....I have often heard that nursing programs are the most costly to run for undergraduate programs. This is because of the amount of clinical time that student nurses must do. I think this has made it even more complicated for universities to admit the surplus of students that exists.

June 20, 2006 1:09 PM  
Anonymous Anonymous said...

Lol, I stopped paying attention where you make the ridiculous comment that "most" American women are either corporate lawyers, or pampered housewives with gardeners. Then, you go on the say that most middle class women are meth addicts. WTF??

August 20, 2007 9:08 AM  
Blogger ziel said...

I think your irony detector is in need of a bit of an adjustment.

August 24, 2007 4:09 PM  
Anonymous Anonymous said...

Did you ever stop to think that many U.S. nurses are not women??? I guess that you are just too closed minded and ignorant to think that being a nurse is anyhting other than "woman's work." The U.S. has had a visa program specifically for foreign nurses since the 1960's. They still have to pass rigorous standards to practice in the U.S. I have worked with many nurses who were educated in foreign countries and their nursing and communication skills are excellent. And, speaking as a nurse working in a major urban medical center, the nursing shortage is alove and well!!!

September 27, 2007 6:53 PM  
Blogger ziel said...

Yes I'm well aware that there are male nurses, but the vast majority (over 90%) are women, so discussion of male nurses vis a vis an alleged nursing shortage will not be very informative. Plus, nursing is the fifth biggest field for women in the country, so keeping the concentrating on women makes sense. (see info here).

Foreign nurses may or may not be every bit as good as American nurses, I have no idea. But I do know that if there is a shortage of nurses, you can raise their pay and increase the number of available slots in nursing programs, or you can import foreign workers to fill the gap. I much prefer the former.

September 28, 2007 4:52 PM  
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