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Dear Editor:
After reading the featured article by Brian Grutman concerning the death of tens of thousands of American citizens due to INS registered nurse policy, it baffles me why the INS has adopted this current policy. Keeping foreign registered nurses out of the US should be the last thing on the minds of INS and the Department of Justice personnel.

Overwork, including forced overtime caused by understaffing, has been the major reason for most of the nursing strikes that have occurred over the past few years. It is this same understaffing that is widening the stream of registered nurses leaving the profession and worsening the problem. In fact, the same JAMA article quoted by Mr. Grutman further states that for each additional patient added to a nurseís normal workload there is an associated increase of 23% in the chances of that nurse suffering burnout and a 15% increase in the chance of that nurse becoming dissatisfied with their job. It should be further noted that these statistics do not include forced overtime which can be reasonably assumed to increase those percentages drastically. Current INS policy exacerbates this problem. Foreign nurses, by their presence in the US, would ease burnout among US nurses, prolong nursesí stay in the profession and possibly save tens of thousands of American lives each year.

The current nursing shortage is putting an unbelievable strain on US Hospitals. Many hospitals are being forced to shut down certain units due to their inability to find sufficient numbers of nurses to work in them and keep them open. This is rarely discussed by the hospitals for obvious reasons. Despite the extreme shortage of nurses, this problem can not be solved in the short run by expanding the number of students accepted to domestic nursing schools. This is because at present time there is a shortage of trained nursing school teachers forcing nursing schools to turn away students wishing to become nurses. But the fact remains that we need more nurses. INS policy, if changed, would effectively relieve the problem in the short run. This will not solve the problem but will put a very effective band-aid on it and save tens of thousands of American lives each year in the process.

It is absurd to learn that the INS is compounding this problem by preventing highly trained foreign registered nurses from entering the country through the expedited H1B visa program. It is obvious that registered nurses working in critical care areas of the hospital are professional. They need specialized training, either through additional education or experience. This clearly appears to be a policy issue as the INS has approved H1B visa for registered nurses working in critical care settings in the past, and can immediately do so again. The current INS policy is killing Americans. It is denying much needed relief to overworked American RNís, speeding the retirement of American RNís from the nursing profession and reducing the overall quality of health care. The INS needs to change this policy immediately.

Matthew Zucker
New York, NY