SENDING FOR NURSES: FOREIGN NURSE IMMIGRATION TO AMERICAN HOSPITALS, 1945-1980.

Description

This study analyzes the recruitment and employment of foreign nurses to U.S. hospitals between 1945 and 1980, with a particular focus on the use of Filipino nurses. Foreign nurse labor use was one of numerous strategies used to increase the American nursing supply in the latter half of the twentieth century. A persistent phenomenon in American nurse manpower development, over one-fifth of U.S. hospitals today report that they employ foreign nurses on a regular basis to maintain adequate staffing. Drawing data from government documents, archival records, secondary sources and oral testimonies, foreign nurse migration is examined against the backdrop of post-war American nurse/hospital relations. Post-war hospital expansion in both numbers and magnitude, combined with new surgical advances and technological developments and shifts in consumer ideologies about health, created the demand for more nurses and eventually culminated in a critical and widespread national "nursing shortage." Hospitals, nursing leaders, and policy makers responded by rapidly developing inexpensive, temporary, and expendable means to expand the nurse labor pool. For example, LPNs, nurses' aides, and later, two year community college-trained RNs were produced to fill the gaps in professional hospital nursing staffs. These temporary measures, however, like the use of foreign laborers, failed to solve the ongoing problem of a professional nursing shortage. Moreover, national agendas to increase nursing supplies failed to consider the local needs of communities. Rather than simply increasing the supply of "nurses," the creation of more nurse workers generated a complex hierarchial nurse labor structure which divided nurses by race, class, ethnicity, and geography. Nurses thus became socially and spatially segregated, paradoxically perpetuating the shortage cycle. An historical examination of one group of nurse workers enhances our understanding of an increasingly complex American health care system and the persistent use of ineffective short-term solutions for recurrent nurse shortages. Analysis of the antecedent events and consequences of the long-used strategy of foreign nurse recruitment and employment may provide a basis for facilitating the development of socially responsible and cost-effective strategic approaches to future United States nurse shortages.

Subjects