Importing Labor

The term importing labor describes a series of activities that bring laborers from a low-income country with an abundant labor supply to a country where labor shortages are severe by using illegal, informal, and legal channels. Most of these channels are created and maintained by labor recruitment agencies, ranging from small mom [Page 423]and pop shops to large, publicly traded firms. One of the examples that best describes this trend is international recruitment of health care professionals, especially the case of importing nursing labor to the United States from the Philippines. The definition of nurses has been inconsistently used among governments, recruitment agencies, and health care facilities. The category defined by the U.S. census as nurses, for instance, includes registered nurses, licensed practical nurses, and licensed vocational nurses. The number of foreign-born nurses is computed based on place of birth. However, the information based on place of birth could give a distorted image of imported nursing labor if a great number of these foreign-born nurses were actually trained in the United States, not in their country of origin. On the other hand, professional registers' data provide up-to-date information on foreign-born and foreign-trained nurses in the United States. These figures, however, do not accurately reflect the number of foreign nurses in practice because some may be temporarily working as nursing aides until they pass the state board examination for registered nurses.

The United States has a long history of international nurse recruitment from the Philippines dating to the early 20th century. The U.S. colonial government established a study abroad program called the Pensionado program to sponsor a small number of Filipino male and female elite students to further their study at American colleges and universities. The success stories of U.S.-sponsored nurses inspired young women in the Philippines to choose the nursing profession for their career. The presence of these returned exchange students was partly responsible for creating the cultural foundations of nursing labor migration because the nurses remaining in the Philippines viewed work and study in the United State as a prestigious path of professional mobility. After World War II, the United States started importing nursing labor from the Philippines and elsewhere under the Exchange Visitor Program (EVP). In 1948, the U.S. government launched the EVP to promote mutual understanding between the United States and other countries by allowing people from other countries to work and study in the United States. In reality, however, this program was utilized as one of the informal channels to bring in a cheap nursing work force from overseas to the United States. Most Philippine nurses who were hired through the EVP said that they had positive work experiences at American hospitals, whereas others said that they had exploitative work experiences. The nurses revealed that American hospitals paid EVP participants stipends, instead of full salaries. Although the nurses in the Philippines heard about these exploitive stories, the prestige associated with work overseas induced them to migrate to the United States.