H.R. 1001 - outsourcing nursing to migrant nurses

Today, the Health Care Blog has posted an Op-Ed called "Let's Pay Nurses Minimum Wage." I think it's in jest, but it brings up a real issue.

Congressional House Representative John Shadegg has introduced a bill to congress to allow foreign nurses--especially from India, China, and the Philippines--to obtain non-immigration visas to work in the United States.

The bill is H.R. 1001, "To create a new nonimmigrant visa category for registered nurses, and for other purposes," also known as the Nursing Relief Act of 2009. Rep. Shadegg introduced the bill February 11, and it was referred to a subcommittee of the House Judiciary Committee on March 16. The bill can be found in the Library of Congress' Thomas database. This link to Thomas should take you to the text of the bill:
http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.1001:

The implications here are not clear to me since I don't know the current laws covering migrant workers and those with foreign nursing educations. Would migrant nurses have to pass the NCLEX boards? Would they have the same scope of practice as American RNs? Could they be forced to join unions as American nurses are?

It seems to me there are some professional issues here. If foreign nurses aren't forced to pass national boards, it will throw into question any professional skill or expertise. If foreign nurses are forced to pass national boards, it will throw into question American nursing education (which might not be a bad thing--I can think of a few changes I'd like to make). If migrant nurses with less education come to America and perform as well as American nurses, will this undercut unions' ability to make the case that nurses deserve higher pay? If migrant nurses aren't forced to join unions, will this drive down nursing pay anyhow?

I'm sure this bill will be in the blogosphere soon. As of right now, after checking about 15 nursing blogs and the ANA and AACN sites, I find no evidence that it's been picked up yet.

Interestingly, the bill parallels some private efforts in the same direction. For example, the New York College of Health Professionals signed an agreement with China's XinXiang Medical University to increase the numbers of Chinese students who may come to the US, as reported by NursingWorld.com:

These Letters follow a formal visit by Marion Spector, Chief Nursing Advisor, and Dr. Ali Song, Dean, People’s Republic of China Affairs, on behalf of New York College to strengthen relationships between the College and Colleges, Universities and Medical Centers in China. Specifically to develop programs for both bringing Chinese nursing students and other health professionals to the United States, as well as having students from New York College of Health Professions take courses at those facilities.

New York College of Health Professions already owns a 35 acre facility in Lou Yang, PRC, and with these additions will begin to create a foundation for more international programs.

But lest you think this is all about health care, don't forget to follow the money:

As part of the larger research project the College is in talks to market and develop the products of the legendary Shaolin Temple, the home of Kung Fu along with the mastery of other holistic health forms, from the Monks in Henan.

I, for one, am opposed to H.R. 1001 for a variety of reasons, some of which go beyond professional issues. It will be interesting to see how things turns out.