Survey: Should nurses from other countries be recruited to aid in the nursing shortag - page 15

This month's survey Question: Should nurses from other countries be recruited to aid in the nursing shortage? Please take a minute to take answer our survey and please feel free to reply to... Read More

  1. by   Gromit
    Quote from StNeotser
    I wasn't really replying to any of your posts, but I was replying to "we don't need foreign nurses" "I'm always going to take an American over a non-American" and that type of thing. I just found it enlightening because nobody is ever likely to say this to my face, but instead they ask me as to why I'm living in their country and where did I get my education. For some naive reason I thought this might be because they were genuinely interested, but the statistics on the poll and replies to the thread prove otherwise.

    I'm not really that offended either, and I undestand the language barrier can be very dangerous.

    I've also now read up a little on the contracts some unscrupulous companies lock foreign nurses into. It isn't fair to take advantage of them.

    For the record, the UK also has to recruit from overseas. It isn't as easy to get into the US as you think, I waited 11 months to get a greencard as a spouse. My husband waited only 6 weeks for his to go to the UK. Also for the record, when I worked for the Department of Employment in the UK, application forms for unemployment benefit were written in 32 different languages including Urdu, Chinese, Hindi etc. So the US is not the only country that has immigrants that don't learn the language, nor is the USA as easy to get into as you think it is. Spain does not equate to the rest of the world when it comes to employment for foreigners.

    And yes, I realize I'm one of those foreigners that needs to sling my hook.
    Well, I'm glad I didn't really offend you -I can come off a bit sharp -especially when I'm passionate about something. I know what its like to have people not want to say things to your face, but say it behind your back or other ways (I really don't like that. And rest assured, if I have something to say, I've no problem saying to your (or anyones) face -bosses as well (once told the DON what I thought, gave my honest opinion -surprisingly enough, while she wasn't happy, she at least seemed to respect me for it -even to the point of asking my opinions (and reasons) on other matters -granted, I could have just as easily lost my job (and expected to, for that matter)).
    Well, as for the difficulties in getting into the US, many seem to NOT have as much difficulty, or have to take as long -guess you need a company to want to recruit you ? -I can also imagine that it has gotten a little more difficult after the 9/11 bit (probably no more secure, just more hassle -its about all our govmnt really knows how to do (hassle)).
    I've never had any honest trouble with foreigners (except for the language thing, and I totally despise the illegals -do it the HONEST way. My great grandparents did, and many do today. I really don't care what your situation is, you can do it in an honest way, or its dishonorable, period) .
    Well, just got off-shift, and traffic was interesting on the way home. so I'm outta here. Y'all have a good day
  2. by   UK2USA
    Quote from totallytheresa
    You know what? Instead of being critical of us US nurses before you even come here, why don't you take a look at what this whole topic is about!!!We're not talking about a few nurses coming here to work, etc... we're talking about the active recruiting of foreign nurses. Enough already!
    Apologies if my post has been taken as critical of US nurses, it appeared that many US nurses had responded to this discussion, that is why the direction was towards the US posters.

    My point was that in ALL developed countries the status of nurses has been devalued leading to an exodus from the profession by native nurses. The immediate response is to fill the shortage by foreign labour. However this does not relieve the larger problem - that of retention (this was the point I identified in my original post). The re-introduction of ex-nurses back to the bedside is hindered by the fact that the profession continues to be somewhat behind others in terms of development and reward etc. My point was that we should all (not just the USA) be appreciative of the skills that are being offered to us by these nurses. I don't know what it would take to get nurses to come back to work... but I don't think that we would have the luxury of short term contracts for foreign nurses whilst we retrain nurses who have left the service.

    The titile of the discussion was 'should foreign nurses be recruited to overcome the nursing shortage' and that was what I replied to. However, if it has become 'should the resources be in place to redevelop the nurses rewards in an attempt to train and hire native nurses over foreign nurses' then I feel that this is a different question.

    In an attempt to clarify what my initial intention had been, let me offer an example outside of nursing:

    If there is a lack of Volkswagon mechanics, but a surplus of Ford mechanics should they be recruited to cover the shortage in VW garages? My answer would be the same - yes. What happens further down the track is a different question.

    Just to be absolutely clear about one thing, I don't apologise for holding my own views. I do apologise if I phrase them with any ambiguity (which in this case I guess I must have). Re-reading my original post I don't think that I said anything that was overly critical. Certainly not compared to some of the very passionate views expressed earlier on in the thread.

    The main point of my argument was that: in the majority the nurses that have left will never return, things will never be as good as on the outside world. The impetus to put student nurses through their training is simply not there, healthcare at our level does not generate the income (certainly in the UK) to risk the sort of investment that is needed. Therefore the answer is to get labour elsewhere (Phillipines, India, Spain, Sweden, etc etc etc).

    My comments about the spelling still stands! (Although this has been written in such haste in order to explain myself that there are probably plenty of mistakes here).

    Once again, I regret if I was originally misunderstood.
    Last edit by UK2USA on Jun 30, '04
  3. by   Rep
    On this thread, one has only to answer "yes' or "no."

    If one answered " yes" then fine. If one answered "no" then that is their choice. But never, ever, blame the foreign nurses for coming to America and working in the hospitals because US nurses can only blame themselves.

    The nurses on this thread should explain why they are against recruitment of foreign nurses to ease the shortage. Most of them said that with recruitment of foreign nurses, it brings down wages, it does not improve the working conditions in the hospitals, also language problems would occur between patients and the health team. These reasons cited are not valid enough because it blames the foreign nurses but do not address the problem.

    The problem that every American nurses should address is how to change corporate America. Corporate America those in particular handling the big hospitals, etc.

    Get your act together. Unite and serve an example by not running away from your job by changing careers because of poor staffing.

    Write to your congressmen and senators and show the the American nurses has a voice. But as long these are not happening, then don't blame the foreigners for coming here to work in your hospitals. After all they too want to have their share of the American dream that your forefathers had aspired before.

    As for the language problem, starting 1997, the US government has required every foreign nurses to take the TOEFL ( Test on English as a foreign language) and TSE ( Test on Spoken English).

    These English exams are requirements for the visa screen certiticate aside from the CGFNS/NCLEX. The visa screen certificate is a federal requirement before an immigrant visa is issued. No foreign nurse can immigrate to the USA without it.

    Even working visas for nurses, H1C or H1b, require the visa screen certificate.

    In fact, the US government has made it harder for foreign nurses to come and work in your country.

    By the way, the type of English that is given on these exams is college English, the kind of English we hear from CNN or Foxnews. Not the type of English that is spoken in the streets of New York or in San Francisco.

    As for contracts, the minimum wage given on foreign nurses are based on your labor laws on current legal wage. So. this means foreign nurses are not bringing down wages because they are paid the same as that of American nurses.

    Also, somebody mentioned the problem of spending money on the recruitment of foreign nurses instead on the education of Americans who want to take up nursing. Well, form a business point of view, will I invest in someone who has yet to take up nursing and with the high attrition rate in schools and the NCLEX? I don't think so. I would invest in somebody who has finished nursing school, who has a license and is willing to spend the rest of his/her life in nursing. That is business to me. Don't get me wrong on here but most of you would agree.

    So, UNITE AND GET YOUR ACT TOGETHER! In the meantime, foreign nurses are arriving in your country everyday.
    Last edit by Rep on Jul 1, '04
  4. by   rstewart
    [QUOTE=Rep]On this thread, one has only to answer "yes' or "no."

    If one answered " yes" then fine. If one answered "no" then that is their choice. But never, ever, blame the foreign nurses for coming to America and working in the hospitals because US nurses can only blame themselves.

    The nurses on this thread should explain why they are against recruitment of foreign nurses to ease the shortage. Most of them said that with recruitment of foreign nurses, it brings down wages, it does not improve the working conditions in the hospitals, also language problems would occur between patients and the health team. These reasons cited are not valid enough because it blames the foreign nurses but do not address the problem.

    Ahhhhhh.....But was the original question, "Who is to blame for foreign nurses coming to America?" I didn't think so.

    In my view, many posters have been quite clear as to their reasons for opposing the recruitment of foreign nurses. You have simply chosen to reject those reasons. You believe that successfully completing the TOEFL and TSE exams guarantees adequate communication skills; From recent personal experience I would strongly argue that is not the case. You choose to believe that increasing the pool of willing workers at the lower end of the pay range does not have the effect of depressing wages; I could offer countless examples, both theoretical and in the marketplace that it does.

    I'll go one politically incorrect step further: In my opinion, the languages, appearances, religions and cultures of some foreign nurses are so radically different from those of their patients here, even a semblence of wholistic care is just not a realistic expectation. It is unfortunate when this occurs in the medical field, but for nursing it is a tragic loss. Indeed, if we accept that the nursing profession is primarily "about" safely and efficiently performing tasks, then I predict we are doomed to extinction.

    Does anyone truly believe that we are doing all we can to retain nurses at the bedside? Does anyone truly believe that we are doing all we can to educate nurses here in the US? Well, until we can answer "yes" to both questions I do not favor recruitment from other countries.
  5. by   fergus51
    Rep, I don't think anyone is blaming foreign nurses from coming here. But like it or not, foreign recruitment allows hospitals to ignore the problems they have foisted onto their staff. Nurses can be as organized and vocal as they like, but they will never be able to affect real change as long as they can be replaced by a cheaper, more submissive alternative. Fortunately I work in unionized environments and that does not happen.

    As an aside, how can you say that language barriers are not a valid concern? It doesn't matter if it is the foreign nurse's fault or not, but if she can't communicate with staff and patients (and that means the English that is spoken on the streets as well as that you hear on CNN), she is not safe to practice. Patient safety is a valid concern imho.
  6. by   Gromit
    rep:
    toefl ( test on english as a foreign language) and tse ( test on spoken english).

    these have absolutely nothing to do with medical communication, or "medical english" if you will.

    i spent six years in seville, spain. upon leaving the country for the last time, i was very fluent (and spoke formal castillian more correctly than most of the natives -as happens when its a true second language) but if i were to suddenly have been thrust into the medical community, and had to translate for a nurse/doctor/etc. to a patient, regarding their medical condition and treatment, i'd not have been up to the challenge. the "toefl" and "tse" fall into the same category. ok, they can understand cnn. big deal. they will be able to go for a night out on the town. but thats hardly preparing or even showing one is prepared, for the communication requirements in the english-speaking medical world of hospitalized patients, staff and ancillary care-givers.

    the question was answered in compliance with the rules or parameters set forth in the original post. don't go changing the parameters without fair warning.
  7. by   LadyBugRN
    Quote from gromit
    rep:
    toefl ( test on english as a foreign language) and tse ( test on spoken english).

    these have absolutely nothing to do with medical communication, or "medical english" if you will.

    i spent six years in seville, spain. upon leaving the country for the last time, i was very fluent (and spoke formal castillian more correctly than most of the natives -as happens when its a true second language) but if i were to suddenly have been thrust into the medical community, and had to translate for a nurse/doctor/etc. to a patient, regarding their medical condition and treatment, i'd not have been up to the challenge. the "toefl" and "tse" fall into the same category. ok, they can understand cnn. big deal. they will be able to go for a night out on the town. but thats hardly preparing or even showing one is prepared, for the communication requirements in the english-speaking medical world of hospitalized patients, staff and ancillary care-givers.

    the question was answered in compliance with the rules or parameters set forth in the original post. don't go changing the parameters without fair warning.
    so do you agree? that there is a shortage of nurses and should we have foreign nurse graduates to work in american hospitals and/or healthcare facilities?
  8. by   Rep
    [QUOTE=rstewart]
    Quote from Rep
    On this thread, one has only to answer "yes' or "no."


    In my view, many posters have been quite clear as to their reasons for opposing the recruitment of foreign nurses. You have simply chosen to reject those reasons. You believe that successfully completing the TOEFL and TSE exams guarantees adequate communication skills; From recent personal experience I would strongly argue that is not the case. You choose to believe that increasing the pool of willing workers at the lower end of the pay range does not have the effect of depressing wages; I could offer countless examples, both theoretical and in the marketplace that it does.

    .

    Simply said, more of the responses here against the recruitment of foreign nurses are subjective in nature and therefore do not address the problem at hand.

    As for the English exams, when you passed it, it means you have the skills and capacity to communicate in English with your patients and fellow health colleages.

    From where I am now. English is our second language. It is the medium of instruction in schools, in the workplace, etc. As Filipinos nurses, we spent four years in nursing schools/clinicals and the textbooks we used are written in English. In fact, the authors are American. So we Filipinos nurses are familiar with the type of medical English spoken in hospital setting.

    As for wages, as an entry level nurse. One has to start at the legal lower end of the pay range. Foreign nurses with years of hospital experience are considered neophyte in the American setting therefore they start at the lower end of the pay range.

    Hope this info helps regarding us Filipino ( foreigners) nurses.
  9. by   Rep
    Quote from fergus51
    Rep, I don't think anyone is blaming foreign nurses from coming here. But like it or not, foreign recruitment allows hospitals to ignore the problems they have foisted onto their staff. Nurses can be as organized and vocal as they like, but they will never be able to affect real change as long as they can be replaced by a cheaper, more submissive alternative. Fortunately I work in unionized environments and that does not happen.

    As an aside, how can you say that language barriers are not a valid concern? It doesn't matter if it is the foreign nurse's fault or not, but if she can't communicate with staff and patients (and that means the English that is spoken on the streets as well as that you hear on CNN), she is not safe to practice. Patient safety is a valid concern imho.
    Fergus,

    We can only blame the system that foster this problem. Foreign nurses look this "nursing shortage" as an opportunity for them to come and work in the US. Nobody can blame them for that.

    I didn't say that language is not a valid concern. In fact, language is very important in this kind of job. How can a nurse communicates well with his/her patients and staff if he/she is not adequately prepare on this aspect of communication. Even one who has all the skills needed to become a "perfect nurse" can be a moron when he/she does not have good communication skills especially the use of medical language.

    Speaking for the Filipino nurses, we spent four years in nursing schools/clinicals. The language we used is English. The books we used in nursing are American textbook written by American authors. Therefore, we filipino nurses are familiar with medical English.

    I do appreciate your comments on me.
  10. by   fergus51
    Rep, I'm sorry, but I have to tell you that passing an English exam DOES NOT necessarily mean you can communicate in English well enough to practise nursing. I have never seen this as a huge problem with the Phillipino nurses I work with, because as you pointed out they were trained in English, but I have seen it with Asian nurses from HK, mainland China and India. It isn't just about medical terminology either. Some of them had such strong accents that patients and family members couldn't understand them.
  11. by   Rep
    Quote from gromit
    rep:
    toefl ( test on english as a foreign language) and tse ( test on spoken english).

    these have absolutely nothing to do with medical communication, or "medical english" if you will.

    i spent six years in seville, spain. upon leaving the country for the last time, i was very fluent (and spoke formal castillian more correctly than most of the natives -as happens when its a true second language) but if i were to suddenly have been thrust into the medical community, and had to translate for a nurse/doctor/etc. to a patient, regarding their medical condition and treatment, i'd not have been up to the challenge. the "toefl" and "tse" fall into the same category. ok, they can understand cnn. big deal. they will be able to go for a night out on the town. but thats hardly preparing or even showing one is prepared, for the communication requirements in the english-speaking medical world of hospitalized patients, staff and ancillary care-givers.

    the question was answered in compliance with the rules or parameters set forth in the original post. don't go changing the parameters without fair warning.

    since language is your outmost concern then i tell you something about us.

    speaking for the filipino nurses, we spent four years in nursing schools/clinicals. our language of instruction is english. the nursing and medical books we used are written by american authors. therefore, we filipino nurses including other nationalities whose language of instruction is english are familiar with the type of medical english used in an american hospital environment.

    by the way, the americans stayed in our country for fifty years and english is our second national language. nobody has a monopoly on the english language. cnn and foxnews are breakfast to us.
    Last edit by Rep on Jul 1, '04
  12. by   pickledpepperRN
    My experience is that young nurses from the Philippines cannot be distinguished from native US citizens.

    Those my age and up to 30 years younger mostly have a distinctive accent that appeals to me because it reminds me of so many nurse friends.

    I did have a patient tell me that because she is hard of hearing accents confuse her.

    The most difficult nurse for me to understand was from northern Scotland, an Enlish speaker since birth.
    As she worked and lived here she now has a pleasing easily understood brogue.

    Nurses in the California Nurses Association have negotiated pay based on years of experience, including foreign experience. One hospital (at least) gives one years credit for two years as an RN outside the uS. Another give 100% credit.

    Many people in Los Angeles would not be alive today if not for the Philippino nurses. We also benefit from our nurses from Asia, Europe, Canada, and both continents South of the equator. And a few Kiwis too!.
  13. by   LadyBugRN
    Quote from Rep
    On this thread, one has only to answer "yes' or "no."

    If one answered " yes" then fine. If one answered "no" then that is their choice. But never, ever, blame the foreign nurses for coming to America and working in the hospitals because US nurses can only blame themselves.

    The nurses on this thread should explain why they are against recruitment of foreign nurses to ease the shortage. Most of them said that with recruitment of foreign nurses, it brings down wages, it does not improve the working conditions in the hospitals, also language problems would occur between patients and the health team. These reasons cited are not valid enough because it blames the foreign nurses but do not address the problem.

    The problem that every American nurses should address is how to change corporate America. Corporate America those in particular handling the big hospitals, etc.

    Get your act together. Unite and serve an example by not running away from your job by changing careers because of poor staffing.

    Write to your congressmen and senators and show the the American nurses has a voice. But as long these are not happening, then don't blame the foreigners for coming here to work in your hospitals. After all they too want to have their share of the American dream that your forefathers had aspired before.

    As for the language problem, starting 1997, the US government has required every foreign nurses to take the TOEFL ( Test on English as a foreign language) and TSE ( Test on Spoken English).

    These English exams are requirements for the visa screen certiticate aside from the CGFNS/NCLEX. The visa screen certificate is a federal requirement before an immigrant visa is issued. No foreign nurse can immigrate to the USA without it.

    Even working visas for nurses, H1C or H1b, require the visa screen certificate.

    In fact, the US government has made it harder for foreign nurses to come and work in your country.

    By the way, the type of English that is given on these exams is college English, the kind of English we hear from CNN or Foxnews. Not the type of English that is spoken in the streets of New York or in San Francisco.

    As for contracts, the minimum wage given on foreign nurses are based on your labor laws on current legal wage. So. this means foreign nurses are not bringing down wages because they are paid the same as that of American nurses.

    Also, somebody mentioned the problem of spending money on the recruitment of foreign nurses instead on the education of Americans who want to take up nursing. Well, form a business point of view, will I invest in someone who has yet to take up nursing and with the high attrition rate in schools and the NCLEX? I don't think so. I would invest in somebody who has finished nursing school, who has a license and is willing to spend the rest of his/her life in nursing. That is business to me. Don't get me wrong on here but most of you would agree.

    So, UNITE AND GET YOUR ACT TOGETHER! In the meantime, foreign nurses are arriving in your country everyday.
    I am a Registered Nurse and not recruited from the Philippines. With a BS in Medical Technology, returned to school to be a Nurse. There was already a shortage fifteen years ago and the hospital where I was working paid for my nursing education. I was born and raised in the Philippines. We were taught English since Kindergarten up to college. In college, we had to take a course in Voice and diction. It was a mandatory course for every college student. When I came to America, because of my accent, the first year was difficult. As time went by I began to understand them and they began to understand me. I still have my accent (that will never go away). I consider myself a good communicator and a good nurse. I know because my patients tell me so. The family of my patients are happy when they know I am assigned to take care of their Dad or Mom. I have been a nurse now for 18 months. I noticed that Filipino nurses are respected for their diligence, professionalism, and caring attitude. I think that our schools of nurses have prepared us to be a real professionals. I think that hospitals should continue to recruit nurses from foreign countries like the Phillipines = worth the time and money. They usually pick the good ones.
    Last edit by LadyBugRN on Jul 2, '04

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