Use of immigration policy to manage nursing shortages.

PURPOSE: To examine long-term implications of using temporary, nonimmigrant nurse programs to manage fluctuations in the demand for registered nurses. ORGANIZING FRAMEWORK: This discussion is located in the full context of migration--reviewing theories and concepts of labor migration--referring to experience with guest-worker programs worldwide, outlining recent nursing shortages in the United States, describing the Immigration Nursing Relief Act (INRA), and raising questions for nurses in the United States and in the global marketplace. SOURCES: Review of scholarly literature on international migration, existing studies on nurse migration to the United States, and original research, conducted between 1992 and 1994, for the Immigration Nursing Relief Advisory Committee (INRAC) Report.
METHODS: Policy analysis of theories, concepts, and perspectives related to nurse migration.
FINDINGS: In the United States, highly skilled foreign nurses tend to complement rather than displace local labor. Yet recruiting foreign-educated nurses for entry-level jobs perpetuates patterns of dependency in the sending country and delays creative solutions to staff development in the host country. Nonimmigrant status creates a vulnerable workforce. There may be a disparity between the ideal of nurse migration as collaborative exchange and the reality of institutionalized occupational migration networks.
CONCLUSIONS: While foreign nurse recruitment might solve short-term needs, repetitive temporary nurse migration programs create long-term consequences that are not in the best interests of the profession. The absence of consistent policy creates an opportunity for nursing to take an active role in developing the rules and direction of future nurse migration.