Immigrants and the health care workforce crisis

One Response to Immigrants and the health care workforce crisis

1. Sylvia Peterson says:

   July 10, 2025 at 11:43 AM

   Trump’s immigrant raids and apprehensions are despicable, even while the labor of immigrants profits many employers. Yet it hurts to read the NEJM authors’ romanticized over-simplification of immigrants in health care settings: “people who dedicate their lives to caring for others.” For too many immigrants, just as for many non-immigrants, work in, particularly, long term care settings is a rescue from unemployment, not a dedication. And for both nurses and nursing assistants can be a real power trip. To land a position of control over vulnerable residents is an authoritarian personality’s satisfaction.

   Exploiting this willingness of some desperate job-seekers to control the vulnerable is the employer who knows to create a “family” of such employees – a TEAM. And toward this end, enter a couple of trade organizations. Pointers and “worst practices” are shared at conferences, online and by word of mouth. If you are reading this you know these organizations by name. Regardless….

   There are trade secrets shared only with a select few interested parties. I figured I was one such party when informed of one employer’s secret of success hiring immigrants.

   When moving an elder from one nursing home to another, I was amazed to see so many similar behaviors by the staff at the two facilities. Yet at one facility the nurses and aides were largely recent immigrants of the same country.

   It was not that the staff spoke to each other loudly in the halls in their common other language, as they did at the hospital where I recently had surgery. (I’ll spare you the details). English was probably required in common areas.

   What I was told by an authoritative staff member was that these employees with so much in common were hired from among just three large families on one island.

   There are many forms of immigration. But whether native or born elsewhere, “dedication” might not be an employee’s motivation. Especially if you are accustomed to a highly authoritarian regime, whether governmental or familial, paying neglect and abuse forward might enough to satisfy your continued employment.

   I respectfully request we look more closely at how all workers get trained and maintained. We have a continuing great need for good workers and good workplaces.

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