By Roxanne Torres

Two guards stood outside the main entrance of Bellevue Hospital in Manhattan, the oldest public hospital in the United States. As two Filipino nurses in their blue medical scrubs walked by, they nodded to the two men in a show of familiarity.

These nurses have been working in one of the city’s busiest hospitals for 23 years. Once, they were immigrants, part of the great influx of nurses coming from the Philippines, drawn by America’s nursing shortage. These two nurses earned work visas within three months of applying and promptly found employment.

Two decades later, the nursing shortage is still prominent. But while some Filipino nursing graduates wait roughly two years to earn nursing positions, others wait far longer, as their hopes and patience diminish, because a weak economy and budget cuts have curtailed hiring.

Jennifer Cabero, a 46-year-old registered nurse at Bellevue, was an immigrant Filipino nurse hired by an agency during the 1990s. “The agency that I applied for took care of all the visa processing and all other papers I needed in order to come to this country and everything was free,” she said, as she turned the combination to her locker in the nurses’ changing room. “Even airplane tickets were paid for by the recruiter.”

During the early 1990s, 61 percent of trained nurses in the Philippines found jobs in, and migrated to, other countries, according to the Philippine Nurses Association. Close to 2,000 Filipino nurses found jobs in the United States at that time, according to the Philippines Overseas Employment Administration.

The numbers continued to increase until 1996, when the number of nurses obtaining jobs in the United States dropped to 270. These nurses not only passed the nursing exam administered by the Commission of Graduates of Foreign Nursing School but had experience in hospitals in the Philippines, which is part of their collegiate training.

The global demand for highly skilled nurses began to grow in the 1970s, according to the International Migration of Health Workers. Filipino nurses saw an opportunity to work overseas in such countries as Saudi Arabia and the United States. During that time, American working visas were a trade-off for lower wages and what were seen as dangerous working conditions, especially after the discovery — and growing numbers — of HIV/AIDS cases. To address these conditions, Filipino nurses formed nursing organizations, such as Philippine Nurses Association of America, to unite and protect themselves.

As of 2012, about 2.7 million registered nurses were employed in the United States, and roughly 7.3 percent of those were Asians, including Filipinos, according to the Bureau of Labor Statistics.

In recent years, the tide has turned. After the financial crisis of 2008, many hospitals scaled back or closed, including St. Vincent’s Hospital in Greenwich Village, North General Hospital in Harlem, and St. John’s Queens Hospital.

Anna Pineda, an honors graduate of LaGuardia Community College, feels the constant disappointment of rejections. At age 46, Pineda managed to complete numerous college term papers, study for exams and work at two part-time jobs to pay her bills, all before attaining her citizenship. “It was hard for me because being out of school for 15 years and not being able to speak the language like you know, the kids in my class,” Pineda said. However, despite her status as a nursing graduate and American citizen, she is still unable to find a nursing position. “Most of my classmates who were younger got a job, but the ones like me, who are old, don’t,” Pineda said. “Though I know hospitals now can’t hire as many nurses,” because of budget cuts.

“Back then, there were 11 RNs working during the day shift,” said Aleth Abadilla, a 50-year-old staff nurse at Bellevue, referring to the years before the recession. “Now, we are happy to have six or seven.” Abadilla is not only sympathetic toward her fellow Filipino nurses who are unable to obtain working visas, but she is also feeling the immense pressure of having her responsibilities increase from the time she arrived in the 1990s. Both Cabero and Abadilla are no longer serving the usual one patient at a time; they now dash between at least three patients at a time.

While Pineda continues to pursue her goal of finding a nursing position, others simply give up. This is the case for Joseph Lopez, a 23-year-old graduate of LaGuardia. “I said that if I keep pursuing nursing without getting the requirements, I would just be wasting time,” said Lopez. Like many other Filipino nurses, Lopez  migrated to United States to study nursing and find a job in the field. But he arrived in 2005, a decade after the boom.  Now Lopez is pursuing a different medical career path as a physical therapist’s assistant.

But not all Filipino nurses in America are stuck with the choice of waiting or changing paths. “Instead of coming to the U.S., Filipino RNs explore the possibility of looking for employment in other countries like, the Arab and European countries,” said a nurse who asked that her name not be used. A 56-year-old RN, she was once an assistant director of nursing at a New York hospital. Like many others, she is very much aware of the cutbacks and their impact on the hiring process. “There was an influx of Filipino RNs coming to the U.S., then a few years later, due to the retirement of RNs, the shortage became a problem nationwide,” she said.

For Anna Pineda and those who refuse to see their journeys end, the future is not entirely doomed. “Perhaps in the next 10 years, America will be in great need of nurses again like before, because many will retire, including myself,” Jennifer Cabero said, as she tied  her shoelaces and pocketed her ID.