A battalion of trained nurse reinforcements is waiting just outside the U.S. borders, eager to help alleviate the nursing shortage, but the system that lets international nurses enter and work in the United States is heavily congested. And according to the U.S. State Department’s June 2023 Visa Bulletin, the backlog is only worsening.

The State Department’s complex schedule of visa application availability is meant to prioritize eligibility for workers in high-demand occupations while keeping within the employment-based application limits for each priority class and immigrant’s country of origin. Thousands of nurses fall under the rule, and some from India, for example, have been waiting for an application review since 2012.

Internationally educated nurses currently comprise 15% of the U.S. nursing workforce, but visa backlogs could eat into those numbers and further strain the profession, which is already seeing higher rates of nurses leaving because of burnout, stress, and trauma. More than 100,000 U.S. nurses left the profession in 2022, and that number could increase to 900,000 by 2027.

“This is a whole-of-America crisis and we need a whole-of-government response, including a sensible loosening of licensing requirements, prioritize positive patient outcomes by modernizing the responsibilities and standards of nursing, supporting expanded educational opportunities, and enabling lawful employment-based immigration,” former U.S. Secretaries of Health and Human Services Alex Azar and Kathleen Sebelius wrote in a June 2023 op-ed.

“America’s nursing shortage is a malignant tumor, and you can’t ignore cancer; you’ve got to cut it out,” they added. “Policymakers need to treat this crisis with the urgency it deserves—if we can’t heal our ailing healthcare system, we can’t heal our patients who need care most.”

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