Before she came from the Philippines to work as a nurse in Williston, N.D., Rema Maquiling knew North Dakota only as a frigid place where most people are white.
“When I told [friends] where I was going, they asked, ‘Where is that?’ ” she said. “But I wanted to come here for professional growth.”
Maquiling, 29, is one of eight Filipino nurses and medical professionals who work at the Mercy Medical Center in Williston, a community of about 12,000 people in the state’s northwestern corner.
She is one of at least 40 Filipino nurses who have been recruited to work in nursing homes and rural hospitals throughout North Dakota.
Recruiters say more than 100 more nurses are on the way, encouraged by an education requirement in North Dakota law that allows them to qualify for federal work visas much more quickly than normal.
About 10,000 Filipino nurses work in health care facilities across the United States because of a national nursing shortage, said Seny Lipat, president of the Philippine Nurses Association of America.
North Dakota is a favored entry point, officials say, because it is the only state that requires registered nurses to have a four-year degree.
As a result, the federal Immigration and Naturalization Service says foreign registered nurses who are coming to North Dakota qualify for a temporary visa, which takes about four months to process. Recruiters say a permanent visa can take 18 months.
North Dakota is unique because INS rules allow only nurses in skilled positions, which means a bachelor’s degree or higher, to enter the United States on a temporary visa.
Leon McKenzie, an executive at a Texas nurse recruitment agency, said his company is setting up offices in five North Dakota cities to take advantage of the state’s special status.
The four-year requirement has long been a sore point in North Dakota’s health care industry, which has been lobbying the state Legislature to allow people to become registered nurses without a bachelor’s degree.
Jeffrey Javier makes $15 an hour in his job as a radiology technician. In two days, he can match a month’s wages in the Philippines, he said.
“Even if it’s snowing a lot, just as long as I can get a good job and have even a little bit of a better life than I have in the Philippines, I’ll do it,” he said.
Rachel Corpus, who runs a Filipino nurse recruiting agency in Harvey, in central North Dakota, started her business about two years ago after observing a nurse shortage in rural hospitals and nursing homes in the region.
Candidates must have a four-year nursing degree, and must be certified by the Commission on Graduates of Foreign Nursing Schools, which is based in Philadelphia.
Corpus, a native of the Philippines, travels there four times each year to interview recruits and conduct a series of psychological, language and medical tests. Nurses work under a visa that allows them to work in the United States for three years, with the possibility of a three-year renewal.
“Everybody’s dream is to go to America,” Corpus said. “We’re just trying to help them obtain their dream.”
McKenzie said almost every state is bringing in nurses from countries like the Philippines.
“There is not an area in the country that is not experiencing a shortage at this moment,” he said. “Our intent is to really make it easier for the [registered nurses] across the country by providing them additional help.”
Hospitals say it is easier, and less expensive in the long term, to spend $5,000 to $10,000 to recruit one nurse than pay temporary nurses up to $60 an hour to fill in at their facilities.
HealthEast Care System, based in St. Paul, Minn., was short 11 percent of its nursing staff in 2000, said Trudy Knoepke-Campbell, the system’s director of work force planning.
She said HealthEast has hired 26 Filipino nurses to work in its hospitals and long-term care facilities. About 15 more are on the way, she said.
“Given our vacancy rate, it looked like a good initiative to try,” Knoepke-Campbell said. “So far, we’ve been pleased.”
The American Nurses Association believes importing foreign nurses is only a quick fix to a more complex problem. Cheryl Peterson, an association analyst, said nurse pay and working conditions must be improved.
“When you talk about nursing shortages, the first response is to open up immigration,” Peterson said. “We don’t believe that’s necessarily the answer.”
At first, some officials at Williston’s Mercy Medical Center worried about whether the new Filipinio nurses could do the work and adjust to unfamiliar surroundings.
But hospital workers say the nurses are quick learners, hard workers and compassionate caregivers.
“It’s amazing,” said Shirley Fender, manager of the hospital’s obstetrics department. “They have far surpassed our expectations.”
The Filipino recruits also have boosted morale, Fender said. About a year ago, Mercy Medical Center had 17 nurse openings, about one fifth of the hospital’s nursing staff. Full-time nurses were picking up an extra 12-hour shift each week.
“It was really awful,” Fender said. “Everyone was tired. People put their families on hold, their lives on hold. We basically lived here.”
Maquiling said the thought of moving into a completely different culture was frightening. North Dakota winters are brutally cold, and Williston doesn’t have the variety of fresh fish and vegetables Filipinos love, she said.
But she enjoys her job and her colleagues. Her bosses are kind and care about their workers, Maquiling said. One even helped one of her co-workers move to a new apartment, hauling mattresses and boxes.
“I’m starting to like this place,” she said. “It’s cold, but the people make it warm.
— Megan Boldt