Increased demand for nurses in the United States is drawing nurses from Latin America who are increasingly leaving their homelands to seek jobs there. Nevertheless, supply has yet to meet demand and some experts are pointing fingers at complex legal hurdles.

Already, 820 English-speaking nurses from Mexico and Central America and 2,200 nursing assistants migrate to the United States every year, according to U.S. Department of Health and Human Services estimates.

Latino nurses, in particular, are needed to care for the Hispanic population, but as of 2004, they only accounted for 1.8 percent of the total nursing workforce, while Latinos represented 13.7 percent of the overall population, the U.S. National Sample Survey on Registered Nurses revealed.

"The need for bilingual and bicultural nurses is a necessity to meet the needs of Latino residents of all descents, who find themselves medically underserved," says Graciela Reyes-Salinas, head of the International Bilingual Nurses Alliance (IBNA).

In fact, a number of treaties do open the door to U.S. nursing positions for foreigners. Mexican nurses, in particular, have greater access to temporary visas, thanks to the "TN" program negotiated as part of the North American Free Trade Agreement (NAFTA).

The TN visa is similar to the H1B visa - a broader temporary visa program used for highly-specialized workers from around the world; however, TN visas are only available to workers who fall into one of a pre-set list of occupations determined by the NAFTA treaty - a list that includes nurses.

Still, experts cite a number of lingering problems that prevent Mexican nurses from meeting the U.S. demand.

"It is very difficult for Mexican nurses to get a job in the United States, especially earning as much as their U.S. peers earn," says Eva Reyes Gómez, president of Mexico´s National College of Nurses, an organization that gathers 10,000 nurses nationwide. "Though they are highly qualified, they are required to take different tests and to even know the language (English) ... it is not easy."

Just like any foreign health care professional who wants to work in the United States, Mexican nurses must obtain a certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS) or an equivalent independent licensing organization. The most common certificate is the one issued by the CGFNS, through its International Commission on Healthcare Professions, called the VisaScreen Certificate. Such certificates include both educational and licensure reviews, an English language skills assessment and passage of one of two approved examinations for registered nurses.

Since 1998, some 100 Mexican nurses have applied for the VisaScreen certificate, but only one-third of them have been certified, according to Kathleen Rohrbaugh, spokesperson for CGFNS.

The IBNA - an association of nursing organizations across the United States - strives to develop standardized curricula in an effort to help foreign nurses transition into the U.S. nursing practice, Reyes-Salinas explains.

"The path is long and difficult for foreign-educated nurses," she says. Nevertheless, IBNA programs "have reached an 85 percent success rate and have helped improve the pool of Latino nurses by adding more than 300 nurses nationwide, thus meeting the needs of our Latino communities across the nation," she says.

And while U.S. law dictates the same salary scale has to be applied to Mexican and U.S. nurses with the same educational training and experience, as stressed by Rohrbaugh, Mexican nurses often find that not to be the case.

"Not only are they often offered lower salaries (than what U.S. nurses receive), they are also asked to care for patients who suffer from highly infectious diseases," Reyes Gómez says. To address that issue, she believes international agreements, like NAFTA, should be enforced to ensure Mexican nurses are entitled to equal salaries and working conditions.

"I encourage Mexican nurses to get trained and qualified to be able to work in the United States and gain experience," she says. "But they should be entitled to the same salaries and working conditions as their peers in the foreign country where they work."