The nursing shortage simply refers to the widespread lack of registered nurses in healthcare settings. This has been an ongoing global issue that negatively impacts the quality of healthcare patient populations receive. As a result of the nursing shortage, nurse migration has become prevalent in that it serves as somewhat of a relief to this public health crisis. Developed countries, such as the United States, actively recruit nurses from developing countries, however, this cycle of hiring migrant nurses seems to create a troubling pattern in that. From a Latin American perspective, some Latin American governments were indifferent to the reality of nurses migrating to pursue better economic, political, or social situations, while other Latin American governments modified their attitude regarding healthcare and introduced policies in an attempt to persuade nurses to stay. In contrast, Latin American nurses chose to migrate to more developed nations in pursuit of higher salaries, better career opportunities, and more favorable work conditions, as well as to escape poverty in their home countries.
This research paper will examine how nursing shortages in the 1990s influenced the migration of Latin American nurses and will include a discussion of the 'push' and 'pull' factors that contributed to this migration. It is crucial to bring attention to this topic, considering that. Why was there a shortage of nurses in this time period? What specific policies allowed foreign nurses to migrate to the United States? Why did some Latin American nurses choose to immigrate to the United States as opposed to other Latin American countries? What opportunities did the United States offer that made these nurses decide to leave their country and start a new life? To answer these questions, it is necessary to first explore the causes of the nursing shortage, as well as the immigration policies that made nurse migration from Latin America to the United States possible.
Since its identification in the mid-1980s, the nursing shortage has become an occurrence with a life of its own, and few topics in healthcare have been studied, analyzed, and scrutinized as much as this public health crisis. During the 1990s, the nursing shortage issue in the United States grew dire as estimates had shown that growth in the profession was not sufficient to meet the projected demand. Several factors were responsible for this shortage. There was a declining interest in the nursing profession in the 1990s. In addition, the nursing workforce was aging, and older nurses opted for less patient care, choosing to become administrators, supervisors, and nursing directors. In an attempt to solve the shortage problem, hospitals and colleges across the country developed incentive programs to attract high school and college students into nursing programs. When this strategy did little to solve the problem, the United States government began to view overseas recruitment as an increasingly attractive option. Luckily, the passage of immigration policies facilitated nurse migration.
United States policymakers often made use of immigration policies as a way to control the supply of nurses in times of shortage by allowing the entry of foreign nurses into the workforce. First, the Immigration Nursing Relief Act of 1989. This act also allowed for the creation of the H-1A visa, which was the first visa specifically for nurses. Responses to the act proved to be favorable in that H-1A nurses were hired to work in unwanted locations and shifts, and were not viewed as taking jobs from American nurses. Furthermore, the program did not seem to have adverse effects on the working conditions, benefits, or wages of American nurses. Next, the passage of the Immigration Act of 1990 provided another pathway for foreign nurses to be admitted to the United States. Requirements for receiving the H-1B visa include a bachelor’s degree, and the recipient must work in a position that required a bachelor's degree. As a result of these acts, approximately 74,000 foreign nurses worked in the United States, which was about 3% of the nursing workforce in 1992. Lastly, in 1994, the North American Free Trade Agreement was implemented and gave foreign nurses access to a new visa category. The TN, or Trade NAFTA, visa allowed qualified professionals from Canada as well as Mexico to work in the United States for up to 3 years. Within the first year of this program, roughly 6,000 nurses relocated to the United States. Ultimately, it is because of these policies that Latin American nurse migration took place with a contributing factor being Latin American nurses’ desire to escape the adverse circumstances they resided in.
The 1990s in Latin America were characterized by poverty and income inequality. Among the 'push' factors that drove Latin American nurses to leave their home countries were economic instability, poor quality of life, low salaries, and limited opportunities for professional growth. Meanwhile, better living as well as working conditions, opportunities for pursuing higher education and higher salaries were 'pull' factors that encouraged nurses to migrate to more developed nations. The migration of nurses became a problem for Latin America in that nurse migration generally had a negative impact on developing countries, whereas more developed countries benefited. In the United States, foreign registered nurses were able to fill in empty positions caused by the nursing shortage. In Latin America, however, migrating nurses may have been replaced in terms of numbers. This caused a shortage of registered nurses, which had adverse effects on the quality of healthcare patients received. While Latin American governments were aware of this growing problem, there was a lack of public policies in support of nursing and the regulation of nurse migration. This shows a lack of commitment to and recognition of the nursing profession’s role in keeping citizens healthy. These are general statements that can be applied to Latin America as a whole, however, it is of the utmost importance to consider nurse migration in specific countries, such as Mexico, in order to discover variations in nurse migration trends.
As previously mentioned, the North American Free Trade Agreement played a role in the migration of Mexican nurses by facilitating their move to the United States. Despite this, it appears as though NAFTA resulted in the Mexican government devising incentives for nurses to remain practicing in Mexico. These incentives outweighed the benefits of migrating for improved working conditions and higher salaries. Therefore, compared to other Latin American countries, rates of Mexican nurse migration were substantially less. Even with incentives in place, however, low salaries became a migration push factor. This is because the Comisión Nacional de Salarios Mínimos (CNSM) only recognized Mexican nurses with a bachelor’s degree in nursing as 'professionals' in their salary categories. Moreover, prior to the creation of NAFTA, Mexican nurses were politically marginalized in policymaking, and it is for this reason that Mexican nurses did not have many opportunities to grow professionally. As a consequence, the technical authority of Mexican nurses in the workplace was undermined and nursing leadership within the Department of Health was eliminated. This became another push factor although the number of Mexican nurses who chose to migrate was fairly insignificant. The implementation of NAFTA in 1994 seemed to have caused a professionalization movement within the Mexican government.
Altogether, there are common themes evident in the migration of Latin American nurses to the United States. Nurses left their home countries for higher salaries, better employment opportunities, and improved working conditions. Above all, they came to the United States in search of a better life. The migration of nurses in the 1990s was the result of a deficiency in the number of nursing personnel as well as unfavorable working conditions in the countries workers migrated from. The United States was a country with a large deficiency, and it is because of this that the United States government. However, on a global scale, immigration policies are just a temporary solution. The United States was subject to an even bigger deficiency due to higher standards in healthcare institutions as well as an aging population. Additionally, the home countries of Latin American nurses were losing qualified workers and as a result of nurse migration, also faced the issue of a shortage of nurses in their own healthcare systems. Overall, Latin America and the United States were seemingly caught in a vicious cycle and were in desperate need of more effective solutions to the nursing shortage.