18. July 2008 by JenO.

The most recent update on the Emergency Nurse Relief bill is in the link I
have provided. Last month the bill HR 5924 had 10 bi-partisan co-sponsors,
now that number is up to 17. The support is mounting which is a very good
thing! This bill, when passed, will put an end retrogression for nurses. I
know people are hearing a lot of negative things, through blogs and the
internet especially in the Philippines, about how retrogression will never
end. Please know that rumors and misinformation are easy to spread and that
is exactly what those negative messages are. They are not based on fact!
The bill HR 5924 is a fact and it is counter to the rumor that retrogression
will never end. People involved in the Healthcare Industry know we have a
nursing shortage here in the U.S. Business leaders know that small business is negatively impacted by retrogressions as well. They, along with our government leaders,
are working hard to rectify the situation which is good reason for all of us
to be hopefull that these times will soon come to an end. if you have a specific question, seek proper legal advice, speak with an immigration specialist or send me a message here. Keep up the spirit!

“Hammond Law Group Blog”<

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19. May 2008 by JenO.

I am long overdue in giving you a retrogression/what’s-going-on-about-the-nursing-shortage-update. Some good things are happening out there. Back on March 1st the Dept. of State
(DOS)/National Visa Center (NVC) pushed the dates for Employment Based 3rd category (EB3) visa processing to January 1st 2005 in an attempt to utilize the visa quota for fiscal year 2008 before they go in the trash. The USCIS is processing petitions too slowly and as a result they don’t use all the visas available to them each year. They go unused even though we are neck
deep in retrogression. What this means is that any nurses with petitions that have a priority date on or before the processing date has a shot at getting a visa. It gets even better; the last I looked at the visa bulletin the processing dates jumped from Jan. 1, 2005 to March 1, 2006! I have started getting paperwork from the NVC for some of our nurses, let’s hope it jumps
forward even more so we can get some of our long awaited RNs in. This situation is volatile and could change at any time and the dates could go back again so pushing all the paperwork through quickly is required in order to get a shot at visas, and trust me, we are on top of it.

Now in regards to retrogression the song remains the same, we are waiting for the elections
to conclude, so attention can be directed back to the need for some kind of immigration change that will allow nurses to obtain visas and fill the ever growing shortage. This leads me to my next point. We are approximately 250,000 nurses short and this number will keep going up; statistics are saying that by 2020 we will be a million short (recent reports have reduced that estimate, but there will still be a massive shortage that threatens quality of care). There is a lot of noise about getting more nurses through increased enrollment in nursing programs and ways to make this happen. I agree that we need domestic solutions, but what stands out are the numbers I have seen for increased enrollment still only supplies a small quanity of nurses
compared to the hundreds of thousands of nurses we need. With an aging baby-boomer population, the health care systems will become even more strained, not to mention the baby boomer nurses who are retiring. More nursing programs and students is a good and important plan, but it will take 20+ years to fully reap the benefits. We need something that answers to
the crisis now. In my opinion, a good solution is one that is well-rounded; that includes a combination of domestic solutions such as more nursing schools, better working conditions for nurses, domestic recruitment, etc. and recruiting from abroad. We aren’t the only country that has a nurse shortage and we are losing out due to our restrictive visa program for nurses. Other countries are much more welcoming to foreign nurses and they are the ones getting them instead of us. I have attached an article that is about one domestic proposal for getting more RN Educators in order to increase enrollment through the military. It is very interesting. Please comment on your thoughts and reactions!
“RN Educators”

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26. February 2008 by Barb.

The number one reason nurses cite for leaving their jobs in exit interviews is their direct manager. This issue is not unique to nursing or healthcare by any stretch of the imagination. Most business people know that people don’t quit jobs; people quit people. Managers are any organization’s number one line of defense when it comes to maintaining morale and retaining good employees. If your managers have not been trained to do this, or if the organization has not made it clear that employee retention should be a priority for managers, then your organization is missing a significant opportunity. It is an opportunity that has serious strategic and financial repercussions.

Nurse managers have it tough. They have a lot on their metaphorical plates; patient care, managing teams of tired, stressed and potentially fried nurses, budgeting, managing schedules, to name just a few. Many nurse managers are not given formal training in core management skills when they make the transition from staff nurse to nurse manager. Nurse managers should not shoulder all the blame for for high turnover in hospitals. There are so many different reasons for high turnover rates that are beyond the immediate control of the nurse managers. However, it is still a legitimate reason for nurse turnover that hopsital administrators can and should address. They just need to look to the traditional business world for models and best practices.

By including specific training for nurse managers that focuses on retaining, rewarding and motivating their teams, hospitals can have a significant competitive advantage when it comes to attracting and retaining talented caregivers. Training in core management skills should take place upon promotion and be included over time as nurse managers develop in their roles.

Skilled nurse managers know that they need to continually recognize and reward their staff, even or especially, in ways that are not about money. Most people thrive on acknowledgement of their work. It is easier to do a tough job when you know someone else values that you are doing it. Being consistent and even-handed about recognition is not as easy or as intiutive as the simple idea of recognition. This is where training can help a nurse manager go from good to great.

Less intuitive are the skills needed to build a performance driven team. This is where continuous training and reinforcement becomes critical. Being able to build strong alliances with staff, and earn their loyalty and commitment to department goals has a significant impact on job satisfaction and retetnion.

Nurse managers also need support from administration so that they have the time and freedom to develop those strong alliances with their teams; so that they have enough interaction with staff to be able to identify those team members who are at risk for turnover; so that they can help employees with key skill or performance areas; and so they can spend enough time recognizing and rewarding good performance among team members.

Hospital administrators not only need to take the steps to provide training to nurse managers in these areas. They also need to seriously examine the nurse manager’s workload. How can that workload be creatively realigned so the nurse managers have more time to actually manage? And there’s the challenge. How can you lighten the workload for nurse managers in a sector already in crisis due to a shortage of workers? Is there a way to work in non-clinical support for the nurse managers? If a hospital found that administrative load/paperwork took up 30% of their nurse managers’ week, they could create an administrative support pool to provide the nurse managers with back up. With their administrative load lightened, nurse managers could recycle that time into retention and team building activities. This is a place where hospitals can get creative with solutions beyond training. And don’t forget, the best source for these creative solutions is going to be the folks they are aimed at helping; the nurse managers!

Pairing new nurse managers with a mentor, a seasoned nurse manager who exemplifies the best practices and success you’d like to see across your organization, gives them an informal resource for ideas, as well as, someone to challenge and help them grow.

There are a ton of resources out there for management training and, increasingly, resources specifically for nurse manager training that focuses of leadership. Ideally, find a vendor with core expertise in this area. Ask for and speak with client references. See if they can provide you with success stories and before and after snapshots of retention figures. See if they are willing to talk about when their program didn’t work. This is such an important initiative, finding a vendor that shares your organization’s values and has a track record of success is serious business.

Some of the folks in this space that I really like are:
“Health Care Performance Institute”
” ABP Training”
“Dale Carnegie”
“The Leaders Toolbox”

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15. January 2008 by JenO.

Happy New Year! This is my first 2008 email update addressing the ever looming shadow of visa retrogression for nurses. I think the one thing I am fervently hoping for everyday is to hear media adress the nursing shortage and need for immigration reform. I have seen a few articles and briefs more recently, The National Foundation of American Policy published a couple of briefs last September and October and they continue to address the need for more legal immigration overall in the country and the nursing shortage. See these links for the articles. “deadly consequesnces” “nurses”

What I hope comes next is coverage of this issue from the more mainstream media and I am looking to see what the Presidential candidate’s stances are on the topic of more visas for nurses and immigration reform overall. It is too much to hope that they would even touch on the topic of the nursing shortage and the needs for visas but it is not too much to expect them to address their thoughts on making more visas available for employment based immigrants and reforming current immigration practices. Some seem to be only focusing on the border security and illegal alien problem and, in my opinion, that is not broad enough of a view. I hope for a President who understands the importance of changing the immigration system and removing visa caps for shortage occupations. Even if they don’t make this a campaign topic I am doing my research to see what their stance would be on passing legislation to help get nurses visas. Something good probably will happen before the election; I am hearing hopeful whispers that something may happen in the first quarter of 2008. Nevertheless, it is important to me, and probably all you affected by the current situation, to have a President who will work to change the system long term, so that this kind of situation never happens again. Hammond Law Group’s blog spot covers both the presidential candidates’ views and what is happening in the media among other immigration topics. I have included the link here for those who wish to read it through, I found it very informative. Thanks for your participation by reading my thoughts and let’s hope for some happy news in 2008.
“www.hammondlawgroup.blogspot.com”

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20. December 2007 by JenO.

I’ve been waiting a long time to write something so I’d have some good news to share. Unfortunately all the Retrogression updates I’ve read recently report that nothing much has been happening. There are still no visas available for nurses and health care workers, in fact the longer this goes on the more it will have negative effects on patient care. Some believe the reason for all of this is that there is a political war going on within our own government which is paralizing us and that there is a strong anit-immigration sentiment currently.

It is a fact that Bush vetoes many bills that Congress passes. Congress may gain some leverage to get something passed because there is a need for Congress to pass legislation giving more financial support for the war in Iraq, so there might be some compromise. It is a historic truth that legal, employment based, immigrants are an important factor in the U.S.’s economic growth. Not having enough people to fill jobs, ANY jobs, causes economic stagnation or worse. There is always hope, I have seen an increase of communication on this topic in the media and slowly it should start to reach the general American public who are for the most part unaware of the level this nursing crisis has reached. Once it is common knowledge, there will be a lot of noise that will be heard by our law makers. I have tacked on some articles for reference.

The first one gives us a glimmer of hope that the bill HHS Education Appropriation Act of 2008 which was passed by Congress and that Bush vetoed may be amended by Congress to add a provision for nurse visas and that with the Bush Administration’s need for Congress to work with him to get him war funding, it may pass. A point to note is this article on American policies and issues is written by a Filipino and published in a Filipino paper. The second piece is an example of how businesses, etc. are hurting because of lack of immigration reform which results in a lack of workers and thus reinforces the fact that we need a legal immigrant worker population and the current caps on visas hurts business and economy. The last article exemplifies the fact that the nursing shortage has deadly results and discusses the shortage in a manner that matches the conclusions I have come to from much reading and research on this topic.

You all can help with this cause by speaking out and raising people’s awareness of the personal impact this shortage can have and then perhaps it will drive us toward a positive change in immigration and help to lift retrogression.

“www.globalnation.inquirer.net”

“www.businessweek.com”

“www.foreignnurses.net”

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14. September 2007 by Barb.

“N.C. faces nurse shortage of 30% by 2020″, “Nurses’ time at bedside may be trade-off for IT efficiency”, “Globalized nursing market may suppress pay, exacerbate shortage”, “Nurse turnover fueled by stress, poor management“. These are just a sampling of some of the headlines about nursing pulled over just 3 days. There are more, but they all have one thing in common; they’re all about how bad it is in nursing. They paint a negative picture of nursing as a career. This negative picture will impact anyone who is considering becoming a nurse. Who wants to invest time in becoming a nurse when the only rewards broadcast at us incessantly by the media etc. are a fast track to ulcers, bunions, an aching back and being under-paid? Sign me up!

Now, to qualify the above, I am NOT saying we should not be engaged in open honest discussion about the challenegs surrounding the nursing shortage and working conditions for nurses. All of those headlines are dead on, and to hide those issues or pretend like radical change is not required, would be foolish and short sighted in the extreme. What I AM saying is that collectively, anyone involved in nursing is part of the global nursing on boarding team. Everyone in, related to, who hires for, or who writes about nursing has a responsibility to present the good, now more than ever. (Remember the days when media policed its own photographers and wouldn’t let anyone photograph FDR in his wheelchair? The message:”We stand united. We stand together.” Ah, the good old days…) We need to engage future nurses before they even start thinking about becoming nurses. How have we, as a nation, branded nursing as a career option? What are the rewards? Why did you get in to nursing? What do you love about the work? Is it a job or is a calling? What was the last thing you felt proud about at work? When was the last time someone thanked you or offered a simple “Good job?” Some of the big rules of on boarding are to inspire pride and collect and tell your stories, help build a personal connection in those you are trying to reach.

We need more headlines like “Nurse Retires After Over 60 Years At Work” or “Grants to improve quality through nurse training in California” or “Ga. nurses take lead in reducing infection risks in children“. We need more coverage about the wins and about why nursing is a great, rewarding career. We need to work together, united, to solve the problem of pay and working conditions and push the rewards into the spotlight in order to get nursing back on the career A list.

Next entry: how hospitals can create better environments for nurses…

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21. August 2007 by Barb.

Welcome to Nursing blog! We’re excited to be here and pleased you’ve joined us. Here we’ll be providing insight, ideas and generally commenting on the world of nursing, work and career. Check back often for updates!

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