Nursing Assistant Resources On The Web

I have worked with nurses AND aides from foreign nations such as China, Haiti, the Phillipines- and it hasn’t been an overwhelmingly good experience. There is a HUGE language barrier, real and at times used as an excuse for poor care. I don’t think foreign born nurses and aides give even half the quality care American counterparts do. They make a lot more mistakes, they cannot read and understand orders and care plans (nevermind asking them to write a care plan!)…they need far better education and supervison. I would rate a Chinese nurse to be equal to an American CNA…it’s scary to think these people are here working as RN’s.

WASHINGTON - Foreign nannies long have helped to raise American children. Now immigrants are moving into another aspect of caregiving in increasing numbers: tending to the needs of nursing home residents. And they are winning a larger share of the highly skilled positions, according to a report released last week by AARP.

The ability to recruit nurses and other trained health workers overseas, the report said, will be a critical factor in determining whether millions of baby boomers receive high-quality care in their old age.

“The quality of the long-term care received by older persons in developed countries will depend increasingly on the quality of engagement with the less developed countries that are likely to supply more of the workers in the future,” the report said.

In particular, by the time those in the baby boom generation reach their mid-70s and 80s, many nurses and aides may come from China, say industry officials, who regard that country as a recruitment frontier.

A growing trend
The U.S. trend is part of a worldwide phenomenon in which rich countries with aging populations are turning to immigrant caregivers from the developing world, the report found.

Immigrants long have occupied such low-paying U.S. jobs as farm work, and in recent years they have moved into higher-paying construction jobs. But in big cities they now account for more than one-fourth of the nurses and aides in nursing homes, the report said.

Hiring immigrants has helped nursing homes meet staffing needs, but also has raised concerns about language and cultural barriers between caregivers and elderly patients, some of whom suffer from illnesses such as dementia.

“We’re talking about the care of the oldest and frailest people in the country, so it does raise questions about training and cultural exchange,” said Elizabeth Clemmer, associate director of the AARP Public Policy Institute, which sponsored the study.

About 12 percent of foreign-trained nurses report problems understanding English-speaking patients and staff, according to research cited in the report. This is the case despite requirements that nurses be proficient in English.

Foreign nurses are seen as less likely to speak up if a doctor’s orders seem confusing or wrong. “American-trained nurses are more assertive,” said Louise Maus of the American Association of Homes and Services for the Aging, which represents nonprofit facilities. “The ones who are coming (from abroad) are well-trained clinically, but there still can be questions as to cultural differences.”

Worries from home
There also are concerns in the immigrants’ home countries. Many of these nations have weak health care systems, even greater shortages of skilled professionals, and a higher burden of illness among their citizens. The draining off of trained workers by developed countries that can offer higher pay and better working conditions is exacerbating all those problems, experts say.

In the United States, the demand for foreign caregivers is the result of historically low unemployment, said Ron Hoppe, a founder of WorldWide HealthStaff Association, a North Carolina company that recruits health care professionals from overseas.

Low-skilled jobs are particularly hard to fill. “Burger King is paying as much or more as the local nursing home is able to pay nursing assistants,” Hoppe said. “Employers just have a very, very difficult time.”

Nursing home work is demanding, and calls for overnight and weekend shifts. Many Americans see it as low-status employment. “These kinds of jobs are considered unattractive,” AARP’s Clemmer said. “If the United States were to treat these jobs differently, there would be less of a need for immigration.”

Foreign nurses come here under an immigration program for skilled workers. There is no equivalent program for less-skilled workers, such as nurse aides, although President Bush’s proposed guest-worker plan would change that. The number of illegal immigrants working as caregivers in nursing homes is thought to be relatively low, because states require employees who deal with patients to undergo background checks.

FOREIGN NURSES AND AIDES
Across the United States, the number of immigrant nurses has risen dramatically.

• Nurses: Since 1990, the number of immigrant nurses providing long-term care has nearly quadrupled. About 64,000 immigrant nurses were working in nursing homes in 2003.

• Nursing aides: The number of foreign-born nursing aides working in nursing homes nearly doubled to 145,000 in 2003.