Dear Friends,

There seems to be a lack of awareness of what is going on with the international recruitment of foreign nurses and how these nurses are exploited at the expense of American nurses.

The truth is the International recruitment of nurses is dominated by Nurse staffing companies. The business model of these Nurse Staffing Companies is to bring in International Nurses, who are indentured by extremely restrictive employment contracts, with features such as:

  • Paying international nurses $18/hour less (over 40% less) than what US Nurses are paid ($71,400/year ~ $35/hour).
  • Multi-year commitments with liquidated damages and breach fees that can exceed 6 (six) figures trapping foreign nurses into debt-bondage and preventing foreign nurses from changing jobs.
  • No knowledge of where the foreign nurse will live or work when the foreign nurse signs the Contract with the staffing agency.
  • No control over where the foreign nurse will work after they have signed the Contract and immigrated to the United States.
  • No say over the location or work hours where the foreign nurse will work, for example, a nurse might have to choose between working over Christmas or breaching their Contract.
  • If the Staffing agency is unable to find a client for the foreign nurse, that foreign nurse is “Benched” without pay and a way to support their families.
  • Restrictive Non-Compete clauses in these contracts. If somehow the foreign nurse is able to escape these restrictive contracts (either through litigation or even by fulfilling the terms of the Contract), the foreign nurse often cannot work within 50 miles of a current assignment for anyone except the Nurse Staffing company. Essentially, the foreign nurse will have to leave the town their family might have settled in to find another job as a nurse for anyone other than the exploitative staffing company (underpaying them by $18/hour).

We think this is essentially a human trafficking operation and quite naturally, there is a whole array of people who are very upset with this exploitative business model, including concerned citizens, many labor unions, and Members of Congress. But there is not as much awareness about these abhorrent practices of the nursing staffing companies as there perhaps should be.

To protect the Americans who aspire to go into the Nursing field and to shed the light on the exploitation of the foreign nurses by these shady nursing staffing companies, recently, Senator Mike Lee’s Office invited Dr. Patricia Pittman, an expert in the field, to brief the Senate on this issue. Dr. Pittman has spent the last decade studying the international recruitment of nurses to the United States and was funded by the MacArthur Foundation to study the industry and, later, to convene stakeholders to discuss her findings. This work led to a series of peer-reviewed publications, as well as the creation of a multi-stakeholder voluntary code of conduct for the industry and the Alliance for Ethical Recruitment Practices, which manages this voluntary initiative. (You can find Dr. Pittman’s analysis at the bottom of this post.)

Sadly, even though Senator Mike Lee worked really hard to shine a light on this abuse, Senator Rand Paul has taken the side of these nurse staffing companies, which are trying to bring in more indentured Nurses instead of creating more nursing opportunities for Americans. Senator Paul has chosen his campaign donors (owners of nursing staffing companies) over his own constituents suffering under the discriminatory per-country caps.

Senator Paul is asking for preferential treatment as a set aside (“a carve-out”) for unqualified foreign nurses so the nursing staffing companies can bring in unqualified (with only a 2-year degree after 10+2) nurses specifically from the Philippines, degrading the healthcare standard in America and for specific nursing staffing companies owners can continue to make money.

One could ask Senator Paul, why are only nurses specifically from the Philippines are more important than doctors, aeronautical /space engineers (when we want to go to Mars), high-tech engineers, and professors?

Apart from being morally questionable, such a carve out is practically impossible for several reasons. As soon as a single Green Card is set aside for a foreign Nurse, immediately several Senators who are rightly concerned with labor rights and are already upset with the Nurse staffing industry will put holds on the bill. We will be trading one hold on the bill for more than ten holds on the bill.

Additionally, if there is a carve out for Nurse Staffing Companies, other folks like (say) a marine biologist group or space engineer group or Google Engineers or Physicians group will demand a carve-out because after all, it costs much more to train a Doctor, Scientist or Engineer than a Nurse. If we give the marine biologist, space engineer or google engineers, or doctors a carve-out, then the pharmaceutical companies could demand a carve-out, because after all, they create medicines that doctors and nurses use. If we give the pharmaceutical companies a carve out then the Universities will demand a carve-out for professors because that is where basic research is done. If the give the universities a carve-out, then the companies in every different sector will demand a carve-out, because, in the last 30 years, that is where the economic growth has come from. “Carve out” negotiations will continue for the next decade and go nowhere, while lobbyists will make millions of dollars and our members will rot in the backlog.

This is why no carve out is possible and it has to be fair system where everyone is treated equally based on their merit and there is no consideration for immutable characteristics like country-of-birth.

To overcome this menace of politically connected nursing staffing agencies doling out campaign cash for their favorite member of congress, you need to create awareness about nursing staffing companies and do the following:

  1. Please share the actual PDF document of Dr. Pittman’s study with your member of Congress and both your Senators
  2. Please share the actual PDF document of our actual write-up on the same with your member of Congress and both your Senators
  3. Most importantly, if you live in Kentucky, then follow the below action item and call Senator Rand Paul’s office (both in Washington DC at 202-224-4343 and Bowling Green at 270-782-8303). And if you have a friend or relative who lives in Kentucky, then please reach out to them requesting them to call Senator Paul with the following message:

“My name is __, I live in __, KY and I am calling to express my profound disappointment that Senator Paul is blocking S.386, the Fairness for High Skilled Immigrants Act. The only thing this bill does is to treat everyone who applies for an employment-based green card equally.Senator Paul should not block our bill simply to help cheap foreign nurses come into the country. Senator Paul—through his staffer Adam Salmon–specifically promised the Kentucky Immigration Voice Chapter that he would never do anything to derail Senator Lee’s Fairness bill.All we ask is that Senator Paul keep his promise to the people of Kentucky.”

Thank you,
Immigration Voice

PS: There is no moral equivalence between what we are trying to do and what the Nurse Staffing agencies are doing. We are advocating for a bill that removes discriminatory treatment on the arbitrary factor of the country of birth and giving people rights by getting them off temporary work visas and on to Green Cards. The nurse staffing agencies are attempting to continue bringing people in with fewer rights and abuse them. We are asking for equal treatment and they are asking for preferential treatment. There is no moral equivalence.

Dr. Pitman Analysis on the International Nurses

IV Write Up about Nurse Staffing Companies