Immigration and the U.S. healthcare workforce: A system in crisis

For decades, the U.S. healthcare system has relied on immigrant workers—especially nurses—to help fill persistent staffing gaps. But as immigration policies tighten and more nurses leave the profession than enter it, the nation now faces an unprecedented nursing shortage with serious consequences for patient care.

As the United States honors nurses throughout the month of May, DHI is doing its part to turn the spotlight on nurses and their important role in using the latest digital health tools to deliver great patient care. This four-part series examines the complex factors fueling the workforce crisis, including education bottlenecks, workplace burnout, restrictive immigration policies, and the evolving role of global training pipelines.

Key Insights

• Immigrant Workforce: Close to 20% of US healthcare workers (nearly 2.8 million professionals) are immigrants, including about one in six registered nurses.
• Immigration Hurdles: Recent policies put more than 350,000 noncitizen healthcare workers at risk for deportation, while qualified international nurses who have passed US board exams face approximately two-year visa wait times.
• U.S. Education Bottleneck: In 2023 alone, more than 65,000 qualified applications to U.S. nursing programs were rejected due to faculty shortages, limited clinical sites, and inadequate classroom space.
• Record Attrition: The total supply of RNs decreased by more than 100,000 from 2020 to 2021—the largest drop observed over the past 40 years. Between 2020-2022, nursing turnover skyrocketed to 27% nationwide.

Article Series

Amid healthcare workforce crisis, US immigration policies fall short

Nearly 20% of US healthcare workers are immigrants, yet current immigration policies are inadequate to meet growing healthcare demands. This article analyzes how complex visa programs and xenophobic policies restrict the inflow of foreign-trained nurses, despite their critical role in addressing staffing shortages. With the US healthcare system projected to face massive shortfalls across clinical disciplines, the piece argues that strategic immigration reform is essential to maintaining adequate care standards.

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How foreign nursing schools prepare for the U.S. market

This installment investigates how international nursing schools, particularly in the Philippines, India, and Nigeria, are investing in cutting-edge technology to prepare “U.S.-ready” nurses. The article examines innovations in simulation labs, AI-powered tutoring systems, and virtual reality training that are revolutionizing nurse education abroad. Despite this sophisticated preparation, outdated immigration policies keep qualified professionals waiting, highlighting the disconnect between global training capabilities and U.S. workforce needs.

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Should the US create a healthcare-specific visa program?

This analysis explores the potential benefits of a dedicated visa program for healthcare professionals. Drawing comparisons with similar initiatives in Canada and the United Kingdom, the article examines how specialized immigration pathways could ensure a reliable supply of qualified foreign-born clinicians despite political headwinds. The piece details potential models, including expansions of existing programs like Conrad 30 and the National Interest Waiver for Physicians, as well as new categories for nurses, home health aides, and digital healthcare providers.

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How the nursing shortage exposes the cracks in the US’s healthcare and educational systems

This article examines how the nursing shortage reveals weaknesses in America’s healthcare and educational systems. Limited access to nursing programs, the rising cost of training, poor job support, and high burnout rates continue to drive workers out of the profession faster than new ones can replace them. The piece explores the impact of staffing ratios, educational constraints, and economic incentives on the sustainability of the nursing workforce, highlighting how these structural issues must be addressed for long-term stability.

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CompassionIT: A movement toward human-centered healthcare technology

We offer this special article series in conjunction with our inaugural CompassionIT Virtual Summit, scheduled for May 20, 2025.  Our CompassionIT initiative explores the evolving relationship between technology and compassion in healthcare, including how AI, UX design, accessibility, and clinical innovation can ease burnout and build a more humane, inclusive, and sustainable healthcare system.  The summit program includes Insights from Nursing Informaticists for CIOs on how informatics and innovation can unite to develop technologies that care for the caregivers. Also, be sure to check out all of our CompassionIT-related content.