Sending for Nurses: Importing Care to U.S Hospitals

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DESCRIPTION (provided by applicant): Ebbs and flows in nurse supply and demand have plagued the United States (U.S.) for decades, spawning numerous strategies to increase the number of caregivers for the nation's sick. One strategy, spanning over sixty years, is the importation of foreign nurse labor to American hospitals and long term care facilities. Primarily women from underdeveloped nations, migrant nurses represent both a little understood labor diaspora stratified by gender, race, and class and a professional cohort unique among a growing pool of migrating women. Thus, the project's specific aims are to distill critical issues associated with enduring U.S. nurse shortages, provide a case study of professional female labor migration in the twentieth century, and explore the outcomes of importing care on the public's health. Using a wide array of primary and secondary source materials as well as interviews of migrant nurses, this comprehensive historical monograph will examine the intersection of gender, race, class, ethnicity, societal attitudes, medical/technological advances, demographic change, political and ideological shifts, and economic factors in shaping this ongoing nurse shortage resolution strategy. While specifically examining the consequences of international nurse recruitment for the domestic nursing supply, the nurse migrants themselves and their countries of origin, the health care systems that employ foreign nurses, and the associated quality of care outcomes, the project more broadly investigates the landscape of female migration from vulnerable to developed nations and how policies and interventions that promote individual and public health are shaped and implemented. This is a timely analysis given the current and projected critical undersupply of nurses in the U.S., evidence of marked expansion in international nurse recruitment from a greater array of nations, a global crisis in caring that engenders questions of ethics and equity, and U.S. initiatives to address determinants of health-including physical and social environments, policies and interventions, and access to quality health care. Using the long lens of historical inquiry, the proposed study will address the gap in our understanding of this phenomenon and provide important data from which to inform future nurse workforce planning efforts and help improve health care delivery to the American public.