As hospitals across the country face a shortage of nurses, two South Jersey hospitals are revisiting a method health systems have used in the past - recruiting nurses from other countries. Susan Nicolosi, a health-care recruiter at Our Lady of Lourdes Medical Center in Camden, and Grace Corteza, a registered nurse originally from the Philippines, recently went to that Asian nation to sign 26 nurses for two-year commitments. The hope is that they will make South Jersey their home. ' It's a very future-thinking thing,' Nicolosi said after her return. 'We are looking down the road. This nursing shortage is just going to get worse.

' Underwood-Memorial Hospital in Woodbury has contracted with a recruitment service to help it bring in 11 nurses from overseas. Despite the cost and immigration issues, recruiting nurses from outside the United States is a tactic many other hospitals and health systems are trying, or at least considering. ' Everyone is looking at it,' said Geri Moon, the New Jersey Hospital By 2020, there will be 20 percent fewer nurses than are necessary to staff hospitals, nursing homes, school infirmaries and other health institutions throughout the United States. The World Health Organization last year said the shortages amounted to a global staffing crisis. New Jersey Colleagues in Caring predicts a 30 percent shortfall of registered nurses in the Garden State - or a deficit of 24,100 by 2020. ' I think the most recent survey that we did found 168,000 nursing positions for which hospitals are recruiting and trying to fill, but are unable to do so with domestically trained nurses because the schools are not graduating them in the numbers they did 20 or 30 years ago,' said Carla Luggiero, senior associate director of federal relations with the American Hospital Association.

Health systems say the shortage is not affecting patient care, although some nurses' organizations say it does. There are now more nurses in their mid-to-late 40's than there are nurses in their 20's, the reverse of 20 years ago. Half the RN work force will be at retirement age in 15 years. Others are leaving the profession for more lucrative and less demanding jobs where they can use their skills. The problem is magnified by a significant drop in people enrolling in nursing schools and aging baby boomers who will soon barrage health-care providers. The health-care industry, alarmed at this convergence of circumstances, has few immediate options.

It can try to lure RNs away from retirement. It can recruit soon-to-be-graduated nurses. And, it can look abroad. ' Hospitals do feel that there are resources out there in foreign countries and they are using that to address the nursing shortage,' Moon said. 'The problem is the process can be cumbersome. ' N JHA is surveying the state's hospitals about their overseas recruitment efforts.

It wants to identify their biggest immigration hurdles and, hopefully, help cut them down to size. Federal immigration rules can mean a year or more between the time a foreign nurse agrees to work in New Jersey and the time he or she arrives. Nicolosi said she expects it will take at least 10 months before the men and women she signed will be working at Lourdes. ' My job now is to keep enthusiasm up,' she said. The nurses are getting the electronic red carpet treatment, trading e-mails with their future supervisors and Nicolosi. Competition is fierce for Filipino nurses, who have advanced degrees and are courted by recruiters from the United Kingdom and Saudi Arabia.

Richard C. Bella mente, the director of community relations at Underwood, says the nurses who " ve come to work at his hospital are highly skilled. Eight are working as RNs and three are on their way to passing the exam required for licensure. Just as important, he said, the nurses have been able to assimilate easily into a culture quite different from their own. The Philippine Overseas Employment Administration says 133,781 Filipinos left for land-based jobs in another country in January and February. Last year, 661,639 left for such jobs, with 4,689 choosing the United States. Filipino nurses have a shorter immigration lag when they move to Saudi Arabia and some other countries than the longer wait time to enter the United States.

Within the United States, health systems are vigorous at going after nurses, touting their locations and benefits to Filipino nurses, who make about $40 to $50 a week. ' The only other Americans I met (in the Philippines) were nurse recruiters,' said Nicolosi, who talked up her hospital, including its Catholic affiliation. About 83 percent of Filipinos are Roman Catholic. Filipino nurses will earn the same salaries as their counterparts here with similar experience. Starting salaries for area nurses start around $40,000. Nicolosi and Corteza met with 75 nurses in Manila and in rural areas in the north and central regions of the country.

One nurse traveled 12 hours by boat to meet with them. The nurses were men and women, single and with families. Some had experience patching up troops battling Abu Sayyaf, the Muslim group fighting for control of part of the southern region of the country. Corteza, who has worked at Lourdes for 13 years, said the new recruits are 'ecstatic' about coming to the United States. When she moved to the United States during an earlier nursing shortage, she and other nurses were granted work visas. Nurses today come on immigration visas, which lead to permanent residency.

' They have a chance right now,' Corteza said, who added nursing for many Filipinos is more than a paycheck. It's a vocation, a calling. ' We are hard-working and we do take our work seriously,' said Jurado, the state association president, who moved to New Jersey in 1984 around the same time as the wave of now- established Filipino nurses. Most have stayed with the hospitals that hired them for as long as 10 years, she said. In fact, her husband Leo- Felix Jurado - whom she met at an association meeting - was recently hired by his former recruiter to help review tests of the current group of Filipino applicants. When they arrive, Filipino nurses will find a familiar community in South Jersey.

Census figures show 6,276 of the 1.2 million people in the tri-county area are of Filipino descent. The state nurses association, which sets up educational and cultural programs for new nurses, has seven regional chapters, including one in Mount Laurel. As far as other local health systems are concerned, Virtua Health and the Cooper Health System say they may recruit from the Philippines in the future. Kennedy Health System says it has no plans to do so.

All the health systems here - including Lourdes - have outreach programs geared to local elementary and secondary school students. Of foreign recruitment, Nicolosi said: 'We don't see it as a permanent fix, but we certainly see it as an opportunity. '.