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The Growing Role of Foreign-Trained Nurses in U.S. Hospitals and the Implications of Visa Restrictions

In 2022, there were 500,000 immigrant nurses in the U.S., representing one in six of the country’s 3.2 million nurses.

This report was published on July 10, 2024 by the Kaiser Family Foundation.

Drishti Pillai, Matthew Rae and Samantha Artiga

Registered nurses play a vital role in healthcare, contributing to the health and well-being of millions of Americans working in hospitals, nursing homes, doctor’s offices, and home health services. The profession faces shortages, which have been exacerbated by the COVID-19 pandemic and are expected to persist over the next decade as the U.S. population ages 65 and older grows, increasing healthcare needs. Demand for nurses is also likely to increase to meet new nursing workforce requirements in nursing facilities.

Immigrants could help meet these needs. As of 2022, there were approximately 500,000 immigrant nurses in the U.S., accounting for about one in six of the nearly 3.2 million RNs.1 However, immigration remains a hot political topic with continued anti-immigrant rhetoric and recent actions and proposals to restrict immigration and the role of immigrants in the labor market. These actions include the federal government extending its pause on processing new visa applications for international nurses through June 2024. The pause has been in effect since April 2023, and currently the government is only processing applications filed on or before December 2021. Legislation has been proposed to increase employment-based visas for nurses, though it has been on hold since 2023. Visa eligibility for nurses could also potentially be expanded through administrative action, such as through H-1B visas, though these would have limitations.

These visa restrictions could exacerbate existing nursing workforce shortages and negatively impact the U.S. labor market and economy overall, particularly given the growing role of foreign-trained nurses in U.S. hospitals. KFF analysis of data from the American Hospital Association (AHA) annual survey shows that the overall share of hospitals reporting employing foreign-trained RNs nearly doubled between 2010 and 2022, and a growing share of hospitals report hiring increasing numbers of foreign-trained RNs to fill vacancies over time.

Overall, 32% of hospitals representing nearly half (45%) of all hospital beds say they will have hired foreign-trained RNs in 2022, double the share in 2010, when 16% of hospitals representing about a quarter (23%) of all hospital beds said they had hired foreign-trained RNs. Additionally, the share of hospitals saying they were hiring more foreign-trained nurses to help fill RN vacancies increased between 2010 and 2022, compared with the previous year, from 2% of hospitals representing 3% of hospital beds to 14% of hospitals representing 22% of hospital beds.

KFF Health News is a national health policy news service that is part of the independent Henry J. Kaiser Family Foundation.

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