To Fill Nursing Shortage, Health Care Businesses Go Overseas

Article excerpt

Byline: Sarah Skidmore, Times-Union staff writer

In response to the overwhelming nursing shortage, many health care businesses are looking overseas.

If the shortage trend continues, the United States will need 1.1 million more registered nurses in 2020 than it will have, according to the Florida Hospital Association.

So hospitals and other companies are bringing nurses from the Philippines, Australia, South Africa, Canada and elsewhere to work in Jacksonville. Some say the only obstacle in the way of bringing more nurses over is the tedious immigration and licensing process that, even done speedily, can take about two years.

Shands Jacksonville is expecting 48 nurses from the Philippines by March. St. Vincent's hospital may have a group of Filipino nurses on duty next spring.

And nurse staffing companies have seen their business boom in the past half a year.

The Jacksonville-based staffing company PPR International expects to bring 20-25 nurses from other countries to the United States starting in December. PPR International President Keith Frein said he plans to bring over this volume almost monthly.

Lola Cruse, president and owner of Immigration Specialties, which acts as a mini-immigration service to handle paperwork, said the shortage has been an unfortunate blessing. Until six to eight months ago, overseas nursing accounted for only 20 percent to 30 percent of the company's business. But because of the nursing shortage, now it is 80 percent to 90 percent.

She said when many hospitals or businesses consider hiring from abroad they are intimidated by the paperwork and time that go into the process.

"The rules for immigration change -- they change drastically and quickly. Unless you have someone who can dedicate themselves to this -- it can cause them some heartbreak and delays," Cruse said.

She added that the average starting cost is $1,800 for a nurse processed through her company -- these fees can vary according to the necessary paperwork. Many times the potential employer will handle the costs, but some nurse hopefuls pay the fees themselves.

Nurses must pass English competency tests, a national credential test and approval of the Florida Board of Nursing and maneuver through the immigration process.

"I think some people are almost afraid of it because of the time and cost," said Lisa Filipowitsch, director of health care recruitment, for large staffing firm William Squibb and Assoc.

Shands Healthcare has an effort to recruit Filipino nurses under way that is being handled by an outside company because of the complexities.

Tijana Durdevic can attest to the challenges of simply getting approval to begin working. She came from Sarajevo, Bosnia, in 1997 when she was 18 years old because she lived on the frontline of the fighting taking place there. Fresh out of nursing school, her caseworker told her to forget about nursing in the United States -- it would be too tough to get approval.

"You come out of school and you are full of ambition," Durdevic said. "It was very difficult."

Even without having to face the immigration paperwork, Durdevic said the process was overwhelming. And she had the added burden of being solely responsible for herself, mother and grandmother who came over with her.

She worked as a nursing assistant, developed her English skills and took classes to fill out the curriculum the state said she was lacking. The process of classes, tests and credential approval took several years, but she now works at St. Vincent's as a registered nurse in the post-open heart unit.

Willa Fuller, director of member services for the Florida Nursing Association, is not surprised when she hears about overseas nurses having difficulty with being licensed as nurses in Florida. …