Elizabeth Adebayo figured life in America could be great or it could be grim, but the nurse from Nigeria gave it a shot last fall.
The gamble has paid off: Adebayo said she found a place that really wanted her when she went to work for Christus St. Vincent Regional Medical Center.
“I was prepared for the worst, and I was prepared for the best,” she said of coming to the U.S. “The experience has been awesome.”
Many foreign nurses and American hospitals find it mutually beneficial to link up as the pandemic thins the already-depleted ranks of nurses in New Mexico and other states.
For some hospitals, the problem is they can’t sign up foreign nurses fast enough because of a sluggish visa process and other challenges.
It took Adebayo about three years to get through the visa screening, testing and credentialing requirements to work as a registered nurse in the U.S. She said toiling in health care in Nigeria was harsh and thankless.
She, her husband and their two small children have found a different life here.
“There’s a massive exodus out of Nigeria because the condition is not favorable,” she said. Relatives saw it as a great break when she told them about the opportunity to come here.
“You should see the jubilation,” she said.
Still, she felt wary about this new place. She relaxed with the welcome of the hospital, their Santa Fe church Ascent Bible and the kindness of strangers. Adebayo said a Santa Fe man who befriended them at the airport showed up at their residence a few days later to give them a television set.
“Everybody just rallied around us,” she said.
Christus employs 36 foreign-born nurses, about 8 percent of its nursing staff, including eight who have arrived fairly recently. The hospital hopes to acquire 10 more in the near future through a Tennessee-based global agency called Shearwater Health.
Gerald Champion Regional Medical Center in Alamogordo, with about 160 nurses, has 15 foreign nurses obtained through health care workforce agencies and is awaiting the arrival of 15 more.
“We really have to throw a wide net to try and fill the positions that are needed,” said Kerry Bolin, vice president of patient safety and chief nursing officer at Gerald Champion. “But nothing has been a quick fix.”
Presybyterian Healthcare Services Senior Vice President Tim Johnsen wrote in an email his system doesn’t track how many nurses are from other lands but added “we do know that our workforce includes many nurses who were born in other countries, and we honor their contributions during the pandemic and beyond. We could not have made it through the last two years without their incredible work.”
Patty Jeffrey, president of the American Association of International Healthcare Recruitment, said demand for foreign nurses is high.
“Our phones are ringing off the hook,” Jeffrey said. “We need nurses.”
Fortunately for U.S. hospitals like Christus St. Vincent, the desire to come here is intense, too. Statistics show that in 2021, 18,495 foreign-educated candidates took, for their first time, the National Council Licensure Exam to work as registered nurses in the U.S. and two other countries. That is up from 11,569 five years ago.
Besides that test, they must have nursing diplomas from their countries, possess visas, pass English proficiency exams, meet state board requirements and have professional experience.
“There’s just a whole list of things they have to clear before they come,” said Monica Leyba, chief nursing executive at Christus St. Vincent.
Bolin said her international nurses at Gerald Champion come with at least seven years of experience.
Christus St. Vincent spokesman Arturo Delgado said the Santa Fe hospital’s foreign nurses have bachelor’s degrees in nursing and at least five years of experience.
Going through the visa and credentialing process to practice here as a foreign nurse can take a long time. But closed or short-staffed embassies and consulates because of the coronavirus slowed the process more and created a heavy backlog.
And for a time last year, the federal government lowered the visa priority given to nurses, although that was corrected, Jeffrey said.
“Nurses go through a multi-year process to get to the United States,” she said. “But it remains the embassies that are the true challenge in this.”
Most are shepherded to the country by one of many companies that help foreign nurses through the system. Many have contracts of 2 1/2 to three years at their hospital.
“After that, the goal would be for retention,” Leyba said.
Their services aren’t cheap. Many American nurses have become traveling workers, using lucrative temporary contracts to work at hospitals around the country. International nurses also command solid salaries, especially at this time and particularly in comparison to their pay in their home countries.
Pamela Blackwell of the New Mexico Hospital Association wrote in an email that hiring foreign nurses, “while costly, has become a necessary standard business practice for our hospital leaders whose facilities would not be able to provide adequate access to healthcare services but for these internationally educated nurses.”
Christus St. Vincent’s Delgado agreed the current atmosphere makes it challenging to recruit and retain nurses and other hospital employees.
“During the pandemic, the demand for healthcare professionals has resulted in higher labor costs in general,” he wrote in an email. “The scarcity of available healthcare workers has further impacted the demand, also leading to higher labor costs.”
“I say that nurses are in the driver’s seat,” Leyba said.
One of Leyba’s longtime international nurses, Jenny Painter, has become a travel nurse for now and is working at a hospital in Fort Wayne, Ind. Painter, originally from the Philippines, said it’s nice to be well compensated for “the heavy things that we’re doing as a nurse.”
Painter, who is in her first assignment as a traveling nurse, said she makes roughly $3,000 a week, including a food and housing allowance. Her husband, David, is also a Fort Wayne traveling nurse who had been at Christus St. Vincent. They are living in their recreational vehicle now.
She said it’s interesting to see how another hospital functions, but the pandemic has made working anywhere as a nurse tougher.
“It’s like you’re going into battle,” she said. “It takes a lot to be a nurse, actually.”
Racquel Biadora came to Christus St. Vincent from the Philippines in 2006 and eventually became what is called a “nurse leader” at the hospital. Leyba said Biadora runs a 25-bed unit, supporting nurses, engaging with patients, helping with discharge and bringing new patients onto the unit.
“She was one of our first nurses that came” from overseas, Leyba said. She called Biadora a star and part of the hospital “family.” Biadora, her husband and their son became citizens of the United States a decade ago.
“For me, I’m looking after my son, who has a better future here,” Biadora said. “I would never think I could go this far.”
Both Biadora and Adebayo said they send money back to family members in their home countries.
“I’ve been supporting my mom since I started working,” Biadora said. She has helped three siblings complete their educations.
Adebayo said she sends money to “parents, siblings, friends.”
“It would be a great opportunity for any nurse in Nigeria to be here,” she said. “Coming to the U.S. is a huge difference.”
Adebayo dabbed at her eyes while telling her story to Leyba, Biadora and others in a Christus St. Vincent conference room last week.
Leyba called it a privilege to work with nurses who have made big sacrifices in leaving their countries to be here.
Leyba looked at the two nurses. “So, thank you for saying yes,” she said.