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A
coalition of health-care groups recently unveiled a code
of ethics it hopes will protect nurses from other
countries from abusive employment practices when they
take jobs in the United States.
“It’s
our feeling that if we’re going to recruit
foreign-educated nurses, we need to do so responsibly
and ethically,” said Cheryl Peterson, director of the
department of nursing practice and policy for the
American Nurses Association, one of the groups that
helped write the guidelines. She called the code a first
step.
Since
the late 1990s, the United States has struggled to
recruit enough nurses to serve its rapidly aging
population. The Department of Health and Human Services
calculates that by 2020 the country will need about 2.9
million nurses, and will only have about 1.8 million—a
36-percent shortfall. The shortage has prompted many
hospitals, nursing homes and other medical facilities to
look overseas for qualified candidates. A 2004 survey
found that about 4 percent of all registered nurses in
the United States had been educated abroad.
But not
all who arrive in this country find what they expect.
The coalition that prepared the ethics guidelines says
that some are given jobs beneath their skill level—jobs
that American nurses are reluctant to do—or are not
placed in the hospitals or medical facilities they were
promised. Others may not be paid fairly compared with
their American counterparts.
“We’ve
heard anecdotal stories of nurses who are abused—there
are pay issues, working-condition issues,” Peterson
said.
The
four-page code of ethics lays out guidelines on those
issues as well as summaries of relevant employment laws.
The document offers examples of ways in which hospitals
and other employers can train and support nurses from
overseas. The code is designed to be used by employers
and recruitment agencies and as a primer for nurses
who’d like to work in the United States but aren’t clear
on what rights they might have.
The code
will be voluntary, but medical institutions that
subscribe must agree to independent monitoring. The
coalition, which included industry representatives as
well as unions, will begin work on how to monitor
aspects of the code later this year, according to
Patricia Pittman, executive vice president of Academy
Health. Her organization, which serves researchers,
policy analysts and practitioners, helped bring the
interest groups together to write the standards.
Archiel
Buagas, 28, who trained as a nurse in the Philippines,
said such guidelines will be invaluable for foreign
nurses hoping to work in the United States.
“Even
before they start the process, they know what to
expect,” said Buagas, a supporter of the ethics
code.”[The nurses] know that there are laws that protect
them before they even come here. There is someone
pointing them in the right direction.”
That was
not the case when Buagas came to the United States three
years ago. She said her recruitment agency did not
follow through on promises to have the proper paperwork
in place when she arrived to work. It also placed her
with a different employer than the one with whom she had
signed a contract.
Only
after she sought help from a lawyer, she said, did she
find that at least a dozen other Filipino nurses who
worked with the same recruitment agency had similar
complaints.
Today,
she works at a hospital in New York that offers training
programs and support for foreign nurses like herself.
According to the American Hospital Association, about 17
percent of US hospitals recruit staff from overseas. As
of 2007, there were more than 300 specialized nurse
recruiting agencies, a nearly tenfold increase over the
past decade.
Not
everyone in the health-care industry thinks that
recruitment abroad is the best way for Americans to
address the nursing shortage. Others have said the best
solution is to expand domestic training programs and to
improve working conditions for nurses.
And the
new ethics code encourages US companies to refrain from
recruiting in countries already facing severe shortages
of medical personnel, coalition members said. While most
foreign-trained nurses come from the Philippines, India,
the United Kingdom and Canada, others come from
countries that have been identified by the World Health
Organization as experiencing a “health-care workforce
crisis.” Most seriously threatened is sub-Saharan
Africa; for example, 34 percent of nurses trained in
Zimbabwe were working in richer countries in 2006,
according to WHO. |
