Michigan hospitals eye nurses in other countries to fill COVID shortage

Oct. 5: 400 workers out, 1,900 exempt after Henry Ford COVID vaccine mandate

About 1,000 openings for registered nurses and a severe shortage of applicants is changing how Henry Ford Health System recruits for these essential positions in an ongoing pandemic. 

Job listings already tout flexible hours and some come with $10,000 signing bonuses.  And Henry Ford is trying to attract newly graduated RNs from universities across the state, including through a new alliance with Michigan State University.

But the extreme shortage means Detroit-based Henry Ford still operates with 12.5 percent fewer registered nurses than it says it needs, at a time when COVID-19 is once again filling hospital beds and the outlook for hiring dims among reports of pandemic burnout in the nursing ranks.

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One solution underway for 2022: Hiring nurses from overseas. And other Michigan health systems may follow suit. 

Bob Riney, COO and president of health care operations at Henry Ford,  said the medical system has hired a recruiter to help it hire 500 nurses from the Philippines over the next few years. 

The first group of about 150 should arrive by the middle of 2022, Riney told Bridge Michigan, “but we’re hoping for (sooner).”

Henry Ford’s global search stems from a years-long shortage of workers across all areas of health care, but one made more extreme by the pandemic. 

“The current health-care workforce shortage is more significant and pervasive than I’ve seen in decades,” Riney said. “It requires us to look at broader solutions.”

The situation is acute for nurses.

“The exhaustion and burnout that’s come from 20 months of a worldwide pandemic has been incredible,” he said.

Some other hospitals in Michigan also are looking to the international workforce to fill registered nursing positions, but it’s unclear how many or whether they’ll proceed. Among those considering it is Beaumont Health, based in southeast Michigan, said spokesperson Mark Geary, who declined to provide details on its shortage.

Questions from member hospitals about international hiring are increasing as staffing shortages grow, John Karasinski, spokesperson for the Michigan Health & Hospital Association, told Bridge Michigan. That’s led the industry group to look at immigration policy as it considers overseas hiring.

12,000 RN openings

Henry Ford’s move to international recruiting comes as the number of openings for registered nurses in Michigan is expected to increase 9.8 percent through 2028, according to projections from the Bureau of Labor Market Information and Strategic Initiatives. That would mean openings for about 6,620 registered nurses, adding to the state’s base of about 137,000.

MHA does not yet have details on current RN vacancies, Karasinski said, but it is in the process of collecting data. “The shortage is equally impacting hospitals throughout the state, regardless of size or location,” he said. 

The job site Indeed.com lists more than 12,000 openings for RNs in Michigan, ranging from hospital settings to part-time staff coordinators, specialty clinic nurses as well as RNs to staff COVID-19 vaccinations in retail stores, such as pharmacies. About 1,600 of those openings are for nurses with mid-level experience or higher.

The state has identified the nursing field as among the highest-growth high-wage fields for people with bachelor’s degrees or higher, with an estimated pay range of $30 to $40 per hour, or up to about $83,200 per year. 

However, many nurses are making more than that as health systems seek to hold onto workers. Nurses at Henry Ford are seeing pay increases and increased job flexibility, including extended leaves of absence in the hopes they will return to Henry Ford when they’re ready to work again.

As it prepares to hire outside the U.S., Henry Ford is working through contract and immigration details with attorneys and the labor department in the Philippines, along with its recruiting firm, according to a spokesperson. 

Only physical therapists and professional nurses are designated by the U.S. Department of Labor as in extreme short supply, or Schedule A occupations, which can expedite the immigration process for workers in these professions, Karasinski said. 

But the process involves meeting several criteria set by federal immigration and labor officials, including posting the jobs for internal applicants first. And the U.S. limits the number of speciality visas, EB-3 green cards. 

In 2020, 42,821 were issued, representing a seven-year high after the decade-high in 2013. 

Long-term implications

International hiring isn’t new to Henry Ford. About 950 nurses already travel from Canada to work in its facilities, which include six hospitals and multiple clinics and service centers across southeast Michigan. Crossing the border from Canada happens on a smaller basis in Sault Ste. Marie, where War Memorial Hospital has counted on international nurses to staff during COVID surges. 

Staffing shortages also prompted Henry Ford to recruit internationally in the mid-1980s and early 2000s, Riney said. At those times, the total number hired was about 200.

A few industries in Michigan have long turned to overseas labor to fill hiring gaps, including for seasonal jobs in agriculture and hospitality, particularly in northern Michigan.

But today, the medical system joins business sectors all over the state in a labor shortage exacerbated by COVID-19.  In August, 2019, before the pandemic hit, Michigan had 228,000 more people in the labor force than this year. In the two years since, 5.3 percent fewer people are now in the workforce.

Among those who left are some Henry Ford nurses whose resilience was tested over and over during the challenges of providing care, and sometimes helping families say final good-byes, to COVID-19 patients, Wright Lassiter III, CEO of Henry Ford, said this week during a presentation at the Mackinac Policy Conference. 

The medical system saw many “nurses not at ‘retirement age’ retiring,” Lassiter said. 

The early retirements, along with a slowdown in applications across the medical system, made Riney and Lassiter recognize that they had to act with increased urgency to keep positions filled. 

“Looking at the future expectations for nurse retirement and current vacancies, we thought this is a very important time to … accelerate that path,” Riney said.

Henry Ford’s plight illustrates how today’s workforce gap may have long-term implications for the state’s economic growth, as Michigan’s population ages into retirement and employers seek to replace them. 

The state’s population grew 2 percent over the past decade, according to the U.S. Census, a rate that state officials and economic developers eye with concern.

“The working-age population is going to decrease by about 100,000 over the next 10 years,” Jeff Donofrio, CEO of Business Leaders for Michigan, told Bridge. “You combine that with decreases in workforce participation, and you're going to have an even harder time finding the right talent moving forward.”

Immigration has been offered as one possible solution by economic developers and policy makers. Part of the growth in the Grand Rapids area, for example, is due to international migration. Many come from Mexico, Guatemala and Vietnam. In 2018, immigrants were credited with saving 2,000 manufacturing jobs in Kent County, while contributing $3.3 billion to the west Michigan economy, according to a report by the bipartisan New Economy Initiative.

Earlier generations of Filipino nurses who’ve worked at Henry Ford created a similar path in Southeast Michigan, Riney said. 

“It’s a great story of positive immigration and adding value to our communities,” he said. 

As for the nurses and their training, “there’s a strong and significant nursing education program through that country, and the training is very similar to the U.S.,” Riney said. “It’s a very aligned match for recruitment.”