New Delhi: Shinu, a 30-year-old nurse working in New Delhi, can’t wait to board the plane to the US, where she’s been hired by a North Florida hospital. With good reason: she is being recruited at about $4,000 (Rs1,76,000) a month—nearly 15 times what nurses make in the Indian Capital. And muggy Florida could well make the former resident of Kerala feel at home.
Indian nurses have always gone abroad in search of better-paying jobs. Over the past few years, health-care firms, usually attached to hospital chains, have entered the business and are gradually displacing small mom-and-pop outfits that have been sending out boatloads of nurses from Kerala and other Indian states.
The health-care firms, also called nurse-staffing firms, usually place nurses at hospitals in the US, Europe and West Asia.
Shinu, who gave no second name, has been placed in Florida by Max HealthStaff, an affiliate of the Delhi-based hospital chain Max Healthcare.
The relatively new staffing units of health-care chains will train and place as many as 2,500 Indian nurses in the US in the next year. Apollo Group, the largest of Indian healthcare chains, created a staffing firm, Apollo Health Resources, in September 2006 on the heels of a similar company set up by smaller rival Fortis Healthcare. Max HealthStaff has been training and placing nurses since 2003.
The move into staffing is primarily targeted at stemming attrition in the core hospitals business of these firms, say executives in the health-care business who do not wish to be identified.
Indian hospitals face a shortage of nursing staff as demand for caregivers from the US and other countries grows.
Hospitals in the US currently face shortages of about 2,00,000 nurses; this is expected to double by 2010 and touch a million by 2015, says Neeraj Basoor, chief executive officer, Max HealthStaff.
“The deficit will mount with most nurses in the US nearing their retirement age and the fresh crop preferring clinical research organizations and drug makers over conventional bedside nursing,” says Basoor.
Given the shortage, the US immigration department has been more liberal with the cross-border movement of nurses. Its EB-3 Visa allows nurses to work in the US for as long as they can.
Coupled with huge jumps in salaries, it is not uncommon to see nurses with just a couple of years’ experience leaving their jobs in India for better prospects in the US.
The staffing companies help both overseas recruiters looking to hire nurses and the Indian hospitals (to which they are attached) that lose nurses to better-paying overseas jobs. They train nurses for free to take two exams—one for English language proficiency and the second for nursing standards—that are mandatory to be able to work in the US. The training lasts for anything between 12 months and 24 months.
Such trainees are a ready pool for hiring internally at hospitals.
And, when foreign hospitals hire the nurses, the Indian health staffing company and its US partner get a fee—up to $8,000, or Rs354,000, according to one industry source, who prefers not to be identified—from the US hospital. “We are actually making money out of nurse attrition. We have a 28% attrition rate and when nurses want to leave, we can offer them a job in the US,” says Sri Harsha, chief executive and director, Apollo Health Resources.
Max has 600 nurses in the placement process right now at its seven branches in Delhi, Chennai, Chandigarh and Kottayam (in Kerala). Apollo Health Resources has thus far placed 520 nurses in the US and aims to place another 1,500 this year.
Fortis HealthStaff, with training centres in Delhi and Kottayam, has 400 nurses at various stages of training.
“We have begun with placing the nurses in the US but we will gradually move into other categories of health staffing as well,” says its chief executive Sumanjit Chaudhary. The company has lined up an investment of Rs100 crore to set up 40 training centres across India in two years.
The aggressive expansion of the health-care staffing companies will push out smaller nurse-recruitment firms. Roshan Jacob, who ran a placement service in Bangalore through his company MedicosHelp, was quick to exit after placing just eight nurses.
“I couldn’t withstand the pressure as the newer bigger players were offering the same training free of cost. The nursing curriculum here is 1% of what is expected in the US; bringing the nurses here up to the qualifying level in exams alone is a daunting task,” says Jacob.
He now runs an agency that provides nursing care to the aged in Bangalore.