A recently released Federal Reserve study shows that "for every foreign-born nurse that migrates to a U.S. city there are between one and two fewer native RNs observed working in the city."
It is a reminder from an unexpected source that immigration can have unanticipated — and negative — long term impacts on jobs and labor markets.
The study was released by the Federal Reserve Bank of Boston and was authored by Patricia Cortes and Jessica Pan, the latter a visiting scholar from Singapore. It is entitled "Foreign Nurse Importation to the United States and the Supply of Native Registered Nurses".
Among the other conclusions:
- "We find evidence of large displacement effects ... over a 10-year period."
- "An increase in the flow of foreign nurses significantly reduces the number of natives sitting for licensure exams in the states that are more dependent on foreign-born nurses compared to those states that are less dependent on foreign nurses."
- "We find evidence suggesting that some of the displacement effects [caused by the presence of foreign nurses] could be driven by a decline in the perceived quality of the workplace environment."
The quotations above suggest that the authors are using a cosmopolitan, non-U.S.-centric vocabulary. Many of us who write about immigration policy in the States avoid the word "native" in favor of citizen or resident and one usually "takes" an exam here. In short, the authors cannot be charged with a provincial, restrictionist bias.
The study is based on, among other things, the Current Population Survey (conducted by the Census Bureau) and the National Sample Survey of Registered Nurses, with the data starting in 1980. It is full of the latest 21st century social science concepts, including elaborate equations and use of regression analysis. In short, it is both very impressive and, sometimes, heavy going.
The authors found the displacement effects were not due to the physical departure of native RNs from cities with many foreign-born nurses but rather to the former "switching occupations or fewer potential nurses in a city choosing to enter the nursing profession."
They also detected — as opposed to what many of us see in the IT industry — "little evidence of declining wages in response the influx of foreign nurses", which they attribute to "the presence of monopsony power and wage rigidity."
I would put it another way: The people in those stiff white uniforms have a much better advocate in the American Nurses Association than the programmers do, and the nurses work in a people-serving industry that is less cut-throat in the pursuit of profits than Silicon Valley.
While I welcome the arrival of this study, I wish the authors had devoted their resources to another occupation. Thanks to the ANA, there is relatively little current international migration of nurses through either H-1B or the employment-based permanent immigration schemes, but there was much more earlier in the 33-year period covered by this survey.
As to the small current flow of RNs, a glance at the MyVisaJobs website shows that 84,505 H-1B labor condition applications were filed for computer system analysts in FY 2014, while there were only 494 for nurses; routinely only about one third of LCAs lead to visas, but the relative numbers are telling.
Most nurses have three-year certificates; one must have a bachelor's degree to get into H-1B, and then the hospitals would have to compete with the greedy IT industry for slots in the program.
Recently, USCIS — always on the side of more migration — has been offering advice on how H-1B can be used to bring in nurses with four or more years of education.