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January 31, 2017

5 Ways Trump's Travel Ban Could Affect Nurses

By Keith Carlson, BSN, RN, NC-BC     

No matter your political persuasion, the travel ban recently imposed by the Trump administration has a far-reaching impact that many are still grappling to fully comprehend. Arguments for and against the ban are legion; as of this writing there are multiple lawsuits being filed in federal court. We can assume this topic will dominate the news for weeks or months to come, especially as the short- and long-term effects are documented.

Nurses can choose to remain apolitical in relation to patient care and patient education; however, when a controversial law goes into effect that may affect patients’ ability to travel -- including leaving or returning to the United States for life-saving medical care -- nurses may find themselves in the position of assisting patients in navigating a new and disturbing reality.


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1. Hospitals Are Feeling The Pain

While the rhetoric out of Washington, DC may indicate that the travel ban has only caused inconvenience to a small number of people, hospitals throughout the United States are already feeling the pinch in terms of personnel.

According to an article on CNN , teaching hospitals in the United States post 27,860 job postings for new medical graduates per year, but U.S. medical schools only produce 18,668 graduates per year; the deficit of physicians is largely made up for by the employment of foreign doctors. In fact, CNN states that 30% of transplant physicians in the U.S. began their medical careers in other countries. The Migration Policy Institute website provides fascinating information about foreign-born healthcare workers , including the fact that 16 percent of American healthcare workers are foreign-born.

The cases of a Cleveland Clinic doctor being forced to return to Saudi Arabia and a Brigham and Women’s physician employee blocked from flying to Boston from Iran have both been documented on Politico . There are also reports of elderly or sick passengers being held for extended periods without access to necessary medications. The Mayo Clinic reports that 80 of its physician staff are connected to Yemen, Syria, Somalia, Iran, Iraq, Sudan, and Libya, the seven countries included in the Trump executive order.

Foreign-born physicians are more likely to work in urban, rural, and other underserved areas, and worries have surfaced that care of the underserved will suffer under the ban.


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2. Patients Are Often Immigrants

Depending on where a nurse is employed, many patients with whom nurses come into contact may be immigrants with ties to the banned countries. Additionally, patients may be fearful that their country may be added to the list in the near future, creating undue fear that further consequences are imminent.

From USA Today to Wired, news websites are reporting stories of patients directly affected by the ban. Patients from the targeted countries are now afraid to leave the U.S. for fear they won’t  be allowed to return in order to receive life-saving or life-sustaining medical care.

Meanwhile, the Mayo Clinic reports that up to 20 patients may be affected by the ban, and they are monitoring the situation closely. Stat News states that there are more than three dozen patients whose scheduled life-saving medical care has been negatively impacted, including candidates for neurosurgery and bone marrow transplants unavailable in their native countries.


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3. It’s Not Just Doctors

STATnews.com investigated visa requests and discovered that dentists, occupational therapists, pharmacists, and physical therapists from other countries are intrinsic to American healthcare, with more than 15,000 healthcare workers receiving H-1B visas annually.

With essential members of the healthcare workforce and infrastructure refused entry into the country or returned overseas, some facilities are at a loss and are finding themselves scrambling in relation to shortages of physicians and other crucial staff.

4. The Impact on Scientific Advancement

In terms of the recruitment of top medical and scientific talent, the new travel ban is also being felt in the wider scientific community. Reports of new hires not being able to enter the country and begin their critically important contributions to American scientific advancement is truly cause for concern.

Scientific education also relies heavily on foreign students and professors; there are reportedly more than 16,000 students in the United States from the seven countries in question.

Scientific and medical conferences are an important mechanism for the sharing of research data, new findings, breakthrough technologies, and novel approaches to vexing problems; the travel ban will most certainly prevent certain individuals from attending or speaking at key conferences around the world.


Related: What the Trump Presidency Means For Nurses


5. Healthcare Technology Not Unscathed

Finding the best talent for healthcare IT positions is a crucial component of the healthcare industry reliant on workers from outside of the United States. The Census Bureau reports that 24% of the overall U.S. IT workforce is foreign-born, with a percentage of those workers employed within the healthcare sector.

While the nursing and physician shortages are in some ways old news, a shortage of healthcare IT workers is also an ongoing concern; this ban may exacerbate the situation in the short- and long-term.

Nurses on the Front Lines

American nurses interact with a variety of patients from an enormous number of countries around the world. The U.S. is seen as a mecca for healthcare education, innovation, and delivery, and our healthcare infrastructure relies heavily on foreign-born talent to keep the engines running.

Nurses around the country are no doubt face to face with worried patients and family members; in addition, some colleagues may be either unable to reenter the country or are feeling at risk of being deported.


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What You Can Do About It

Nurses must attempt to keep their personal politics out of the way while supporting patients and families in navigating the tumultuous waters of the travel ban. The healthcare sector will doubtless continue to be buffeted by the fallout of the situation, and prudent nurses will keep their finger on the pulse of the far-reaching impact of immigration law on patient care and the healthcare infrastructure.

Next Up: How To Deal With Patients From Different Cultures

Keith Carlson, BSN, RN, NC-BC is a Board-Certified Nurse Coach, award-winning blogger, nurse podcaster, speaker, and author. Based in Sante Fe, New Mexico, Nurse Keith’s work has appeared in a variety of online and print publications.

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