Recent Philippines BSN grad, also US citizen, looking to return to US.

mpgj83 · Jul 27, 2013

steppybay thank you so much for you replies. I'll review all of them and that list of previous threads carefully. There's a lot of reading to do!

I'm wondering if there's any way here on allnurses to possibly print an entire thread easily, without me having to copy/paste every page onto a single word file? Some of those threads were over 100+ pages in length.

Lots of busywork ahead..

Ginger's Mom, MSN, RN · Jul 27, 2013

The US does not mandate a number of cases to be done, only that clinical needs to be concurrent.US grads have 3x higher pass rate for nclex.For whatever reason you choose not to go to to school in the US, you thought it may have been quicker, cheaper, or easier to go to school outside of the US, now you have a very long road to practice in the US.

us students are more successful with passing the nclex,US schools carefully admit students to ensure there are enough qualified instructors and students do not share patients. instructor to student ratios are carefully monitored.If you have evidence based , peer reviewed data about how your education is equal to the USA present it to the board, and how the low pass rates of foreign educated students is in error please present it to the Board, you will save allot of heartache with your colleagues.

mpgj83 · Jul 27, 2013

The US does not mandate a number of cases to be done, only that clinical needs to be concurrent.US grads have 3x higher pass rate for nclex.For whatever reason you choose not to go to to school in the US, you thought it may have been quicker, cheaper, or easier to go to school outside of the US, now you have a very long road to practice in the US.
us students are more successful with passing the nclex,US schools carefully admit students to ensure there are enough qualified instructors and students do not share patients. instructor to student ratios are carefully monitored.If you have evidence based , peer reviewed data about how your education is equal to the USA present it to the board, and how the low pass rates of foreign educated students is in error please present it to the Board, you will save allot of heartache with your colleagues.

Our theory and clinicals are concurrent. It's just that the cases within those clinicals sometimes cannot be.

We have our didactics and then have clinical rotations within the same semester. For our two semesters in maternal and child nursing, for example, we have 510 total hours of clinicals spanning rotations in the delivery room, general hospital ward, and community. 1/3 of those hours (170 hours) are in the delivery room, wherein we have two semesters to accomplish our delivery room handling and cord cases. We are required to perform three of each hands-on. But sometimes because there are too few patients in labor, some students cannot do this within the semester, or even the year. And that's why some of them need to extend their clinical exposure with oncall duty. So is this concurrency issue all about concurrency with clinicals? or accomplishment with case requirements?

I am not arguing about which educational system is superior in terms of NCLEX passing rates. I would presume that US grads would statistically be more successful with the exam, in fact. But this is far from the point. Foreign grads wish only to be able to sit in for the NCLEX. If a foreign grad fails it, so be it; maybe he or she should reconsider becoming a nurse in the US. But my guess is that there are a number of potentially highly qualified, competent nurses who would be able to render care to patients in the US that meet, if not exceed, standards of practice. However, this concurrency issue, as unfounded as it may or may not be, precludes them from a chance even just to try to prove themselves.

ceridwyn · Jul 27, 2013

Posted in error

mpgj83 · Jul 27, 2013

The difference, in my humble opinion of nursing eduction in the Phillipines and western countries, is this: The Phillipino BSN is task orientated, in western countries it is often observing, knowing what is safe, evidence practise, knowing evertime there is a nursing procedure that you are not familiar with, knowing how to research information, assess, get mentor, clinical nurse and go through the procedure with safe evidence based practise.....this type of education cannot be taught in nursing evironments where there are upteen students to one mentor - and one patient, its impossible. It is a different nursing philospy and even more so in Australia.
We often have nurses from said country, completing nursing tasks and not knowing how, why, what ifs when you ask about evidence based practise they do however know with expert confidence, name of each piece of equipment, what it is made from and where they got it from, how many times they have done the procedure, what marks, etc etc.
Not saying this is not effective, its just not what many other 'western: countries nursing education follows.

We uphold evidence based practice as best we can. We know the reasons why we do things and do them not only with appropriate knowledge and psychomotor skills needed to carry them out safely, but with an attitude of compassion. I think any student nurse will be task-oriented at first; all novices are at the start. But if you mean to say that is all we are, blindly getting lost amidst the trees and losing sight of the forest, without thought or heart, I think that's an inaccurate evaluation of the Filipino brand of nursing.

The nurses you mention who do not know the hows, whys and what-ifs--yes, those are dangerous practitioners and should not be allowed to practice. My guess is all countries will have their share of incompetent practitioners. Some kind of licensing examination would presumably have weeded them out. But related to the select Filipinos you mentioned, they do not represent the majority of the quality nurses that Filipino schools produce.

Regarding student-mentor and student-patient ratios, at least from my experience, we have no more than 13 students in a given clinical rotation. I have experienced taking care of anywhere from 1-6 patients as a primary nurse, and 6-20+ as a functional nurse (i.e. being in charge only of meds, or only of vital signs, etc). I can't say I know what the standards are in the US. But it would be nice if someone could cite some numbers, just for the sake of curiosity. :)

mpgj83 · Jul 27, 2013

-- First and foremost, you must now have a valid SSN to apply into CA and into most states and one day soon, ALL states will require a SSN and for future renewals. There are zero to a handful of hospital sponsorships in the whole country now, don't count on those, you will have better luck winning the lottery odds. There are some states that will allow you to apply and take the exam if you pass all other requirements, BUT those same states will not issue the actual license and license number until you provide them a valid SSN!! Also know that many places of employment needs to verify your SSN as part of the regular hiring process and needed for their accounting dept.

I am actually a US citizen so the SSN will be no problem. Do you think my having completed a B.S. degree at UC Los Angeles and having had been once a California CNA will have any bearing with CA BRN's decision? After my first degree at UCLA I took a CNA class and became certified as a prerequisite to apply to certain CA nursing programs. But for a number of reasons I would end up taking nursing in the Philippines.

--- Don't forget that being a "new grad" in many of the States means that you must apply for the new grad position IF you are within ONE YEAR of your graduation, NOT the date and year you pass the NCLEX, this is a big factor that becomes the rejection for your submitted job application. This is true for any US new grads as well, it's across the board.

So does this mean that we would not be applying for "new grad" positions? What job descriptors should we look at?

**** The FASTEST, the EASIEST, the CHEAPEST state to apply into is the State you feel you will put your roots down for many years, the MINUTE you pass the NCLEX! If that state doesn't meet their requirements AND your needs and desires (weather, salary, etc) now then move on and research and travel to that state if you can. ****

This is definitely my most pressing issue at the moment. I'm really confused and could use some clarification. I've looked into the BON of five US states now and I'm under the impression that I would have to send my applications to them before taking the NCLEX. Is this accurate? But if so, you say we should pass the NCLEX first, and then pick a state to tackle?

When I left the US to take up nursing in the Philippines, I had no permanent residence in the US and so when I return I'm not really bound to go back to CA where I was raised. I can resettle in any state. So what I'd like to do first is process multiple applications, and then settle in a state whose board of nursing has deemed me eligible to sit in for the NCLEX. But a big problem is that sending out multiple applications is quite costly, especially when CGFNS is also involved.

If I can indeed take the NCLEX first before applying to these boards of nursing, I'd certainly welcome doing that now while my nursing knowledge is still quite fresh. Waiting as long as I might have to for a BON to process and evaluate my application would make me rusty.

Thank you so much for your counsel on here, steppybay! :]

Esme12, ASN, BSN, RN · Jul 27, 2013

To go back to your concerns, really there's no need to use an agency, you can really do this yourself, just print the instructions and cross each one as you get it completed.
BUT......
Where's the EASIEST, THE FASTEST, THE CHEAPEST STATE to get eligibility: to AVOID the different (and can be somewhat difficult) English reading and writing requirements, who doesn't need to have their curriculums reviewed and evaluated, if you don't have a local PH license, etc....here's what I've been trying to tell you guys for months!
Kabayans, you have to look at the "bigger picture".
To everyone asking of the same question: just pick whatever state you wish to work in for the next 3-8 years or more. With the strong possibility, this State is where you will plant your roots and watch your babies grow from an infant till they go to college.
-- First and foremost, you must now have a valid SSN to apply into CA and into most states and one day soon, ALL states will require a SSN and for future renewals. There are zero to a handful of hospital sponsorships in the whole country now, don't count on those, you will have better luck winning the lottery odds. There are some states that will allow you to apply and take the exam if you pass all other requirements, BUT those same states will not issue the actual license and license number until you provide them a valid SSN!! Also know that many places of employment needs to verify your SSN as part of the regular hiring process and needed for their accounting dept.
-- Many states are now requiring a copy of PH local license, this is partly so that the BON's can verify if your license name and numbers matches the ones approved and given by the PH nursing board, to reduce those submitting false documentations.
-- Some BON's now require full copies of your entire and current passports with ALL the pages, this again is due to the BON's are finding out that they are receiving more false documents and to verify that one actually attended the courses during the years their transcripts are stating for a fact.
-- Personally, I think the concurrency issue came up when the CA BON's started finding more and more "pirated and false" documents that could be purchased in the Phils streets. So upon closer examination, CA BON staffers began to see some flaws in our PH college transcripts.
-- It makes NO sense to get a license in one state, when you really WANT to work in another, as you need to still PASS that state's requirements you wanted to work in the FIRST place. I see so many trying to go thru the back door but know it's being closed down.
-- You will be spending more MONEY by hopping around one state to another in extra fee$ and possible extra money for certain testing$ and wasting more months waiting and waiting, instead of looking for a job. Why pay double $$$ ??

--- Don't forget that being a "new grad" in many of the States means that you must apply for the new grad position IF you are within ONE YEAR of your graduation, NOT the date and year you pass the NCLEX, this is a big factor that becomes the rejection for your submitted job application. This is true for any US new grads as well, it's across the board.
**** The FASTEST, the EASIEST, the CHEAPEST state to apply into is the State you feel you will put your roots down for many years, the MINUTE you pass the NCLEX! If that state doesn't meet their requirements AND your needs and desires (weather, salary, etc) now then move on and research and travel to that state if you can. ****
-- Avoid the 13-14 states that are enforcing the concurrency now, The list of them are mentioned. Here you go:
see
[COLOR=#003366][COLOR=#003366][COLOR=#003366]state board licensure requirements here

these are states having concerns over concurrent theory and practicum, so i would look at other 37 states to obtain license:

alabama

arizona
california
georgia
illinois
kansas
louisiana
maryland
north dakota
oklahoma
vermont
virginia
washington
"
NV was recently enforcing it. Don't be surprised if FL and TX join the concurrency bandwagon one day, it's a very old requirement from years ago before most of us were born (25 plus years). NV recently started to enforce the concurrency rules.
-- Forget about trying to ENDORSE-TRANSFER any out-of-state license into CA or ANY of the current mentioned 13-14 other states that are enforcing the concurrency rules, it's NOT going to happen as again, you MUST submit the same college transcripts that already DENIED or will DENY the application, there's no way around to go around this! It doesn't matter if you have 2 years or more of US RN experience, my PH friend tried to endorse her FL into CA and was denied the licensure, citing the same concurrency issue. Same thing with our friend with her NY license, same bad fate.
-- As you may know or should know, that jobs for us international students are becoming very hard and pretty difficult to get our foor thru the door, as many hospitals even many clinics are hiring their own students that did their clinical time in that hospital or hiring more of that local students or those from the same State. It's known as hiring the "internals". So getting approved and passing the NCLEX-RN is nothing, compared to finding the real thing......a nursing job.
-- To find out what state you are interested in, the bottom of each page is the list of BON's and you can easily Google...STATE's name followed by "board of nursing"....BINGO! It's all there for the state's requirements, including every one of the Board's has a special ""INTERNATIONAL"" section.
Good luck, everyone, we can do this, but allow a lot more time than originally planned, be prepared to work in a State you really don't want to be in for several years, take any kind of job.

EXCELLENT! advice!

steppybay · Jul 27, 2013

You're right, it's the law. And I understand it is the law and therefore a technicality we can't do much about. I was just curious as to the real reason behind it since I also understand that that law had been in place even before the falsified documents were submitted by foreign grads. So it must be in place for a good reason (and not merely to be more strict in terms of requirements for licensure to protect patients). In my humble opinion though, I just don't think it's necessary that theory and cases have to coincide within such a narrow time frame. The reason we can't get cases done right away sometimes is because there aren't enough patients to go around for all students in a particular shift to assist in a delivery or an operation. But we always do watch when a case is available and one of our peers is assisting (or even when none of us are assisting).
So if it is the case that some US nursing schools just allow their students to watch a delivery or an operation to fulfill their case requirements, then I wonder if CA BRN might consider documentation of such for Filipino students here acceptable to fulfill its caseload requirements. Whenever we witness a case, we would document this. We'd probably have 20-30 cases each for DR handling and newborn care, and OR scrub and circulating--80-120 in total in the span of our BSN education. Then there would be no problem for us here at all, at least in terms of the concurrency issue.

My two US educated nursing friends says that's really neat that we get to assist in baby deliveries, watch them, etc. but it's not a requirement in the States (at least in CA). There are legal reasons from what I understand that should a nursing student in the States do something wrong with a newborn in its handling, accidents do happen, but you can imagine not only the newborn's parents feeling angry but it will set up a very possible major lawsuit not only against the hospital, but the student would also be implicated.

In the Phils, if that happens, oh well, next! Plus they think it's a very cheap way for the PH hospitals to use the free resources to help relieve some of the nursing staffing with the big population boom.

With regards to your comment about the reconsideration of our caseload requirements, it's been reported by a couple that the CHED, PRC and PNA all came to discuss the concurrency issues with the CA BRN in Dec. 2012 and end of Feb. 2013. I'm sure nothing came out of those meetings, other than the three PH agencies were told to get their act together to better increase the low passing rate of the PH applicants.

You know the CA BRN monitors all the schools in CA and if the school's passing rate is low (not sure what that number is), but if that school does not improve their student's NCLEX-RN passing rate, they will close it down.

In CA, the average first-time passing rate is about 85% or better vs the PH's in the 30% or more (info based from the CA BRN website), with most of the CA grad students taking the NCLEX-RN within the first 3 months of their graduation. Due to the new grad application requirements, one will be considered a "new grad" if they place their application within the first year of their graduation date.

With literally 100's to 1,000's applicants going after a small percentage of open new grad jobs, they need to get in early. You will read in the CA Nursing forums, that many hospitals get so swamped from the minute the application process opens on-line, their computer system overloads and in many cases now, they will only accept the first 100 to 500 applicants and shuts down after that. So you can see if you get lucky to apply within, but the computer system picks out that you graduated over the year's allotment, it will reject the application and allow others who are okay with the time frame to be considered and move on.

steppybay · Jul 27, 2013

Arghh, my edited posting got wiped out by my computer freezing.

Anyways, the thing is that in the Phils, we do have a large number of PH students asking the poor patient and same questions, this is very as mentioned here, more task oriented. In CA (and other states), it's strictly one-on-one with an experienced hospital nurse that one "shadows" from the time of check-in to the time to go home, the student in CA sticks literally at the hips of the nurse (preceptor) and goes thru not only the task at hand but also made to do the "critical thinking", so one is basically tutored and no way, they can do that in the Phils. Plus many of the nursing "experts" in the Phils are simply students themselves who just had slightly better knowledge with many times, the new students may know more than the PH instructors, talk about the blind following the blind.

But this is why in the Phils, no one can really successfully do the concurrency as required and so done in the States. It's partly the fault of the CHED, PRC and PNA of overloading the schools, take all the money they can and who cares about the 33% of the PH students wishing to go aboard, the CHED, PRC and PNA have more of a commitment to maintain the status quo for the country of the Phils. At the same time, this is exactly why in CA and the other states LIMIT their students intake of new students, there's only so many qualified nursing preceptors (mentors if you will) and so many hospitals allowing this to take place without disrupting the normal flow of their business.

This way of critical thinking teaching in CA is why many of the CA new grads don't really bother with taking NCLEX-RN reviews or buy more books or take outside courses on the NCLEX, most are ready to go from the time they receive their degree, while things are still fresh in their minds. This is where part of the concurrency issue comes in, you'll find on the CA BRN site there's been studies done on why it's the clinical and theory sections must be taken together, the application of this makes for less mistakes and success in taking the NCLEX-RN.

Yes, it's only a test, just much like a doctor or architect or lawyer must take a test and pass it. It's a way to weed out those that aren't meant to be for what reason and don't want this topic here to take on a life of it's own. Yes, I know it doesn't mean one is a excellent nurse but a poor test taker or whatever, but this can be posted in a separate thread and has been hashed over so many times in the other forums.

steppybay · Jul 27, 2013

I am actually a US citizen so the SSN will be no problem. Do you think my having completed a B.S. degree at UC Los Angeles and having had been once a California CNA will have any bearing with CA BRN’s decision? After my first degree at UCLA I took a CNA class and became certified as a prerequisite to apply to certain CA nursing programs. But for a number of reasons I would end up taking nursing in the Philippines.
*** I use this same topic for my other replies and addressed to everyone, including those that have S/S#'s, that's one battle of requirements out of the way.
*** Having a BSN or PhD in any other field has zero influence on being assessed more favorable in the eyes of the CA BRN or any other state's evaluation, the only thing they want to see if where one obtained the nursing degree from (and from what state or country) and being a CNA doesn't mean a thing to the CA BRN, two different agencies, two different job responsibilities. Although, it may help in the actual RN job searching, having a CNA and some working experience behind it.
So does this mean that we would not be applying for “new grad” positions? What job descriptors should we look at?
*** You can certainly for them, just know if you don't get called or e-mailed back to go forward, you'll know why. You can apply for any nursing jobs, even those that say "experience required", but again, just know why if not answered back, you know the possible reason.
This is definitely my most pressing issue at the moment. I’m really confused and could use some clarification. I’ve looked into the BON of five US states now and I’m under the impression that I would have to send my applications to them before taking the NCLEX. Is this accurate? But if so, you say we should pass the NCLEX first, and then pick a state to tackle?
When I left the US to take up nursing in the Philippines, I had no permanent residence in the US and so when I return I’m not really bound to go back to CA where I was raised. I can resettle in any state. So what I’d like to do first is process multiple applications, and then settle in a state whose board of nursing has deemed me eligible to sit in for the NCLEX. But a big problem is that sending out multiple applications is quite costly, especially when CGFNS is also involved.
*** No, simply find out what state you will be the happiest in, to buy your first house in, to raise your kids and have them go to elementary to high school. Just pass the NCLEX-RN in one state then endorse over later, if it's not a concurrency enforcing state and you meet all that new state's requirements.
If I can indeed take the NCLEX first before applying to these boards of nursing, I’d certainly welcome doing that now while my nursing knowledge is still quite fresh. Waiting as long as I might have to for a BON to process and evaluate my application would make me rusty.
*** Go for it!
Thank you so much for your counsel on here, steppybay! :]

I hope the above comments helps you and others here. I wasn't sure how to post up on top of your comments, so I used the " *** " as my reply to you.

mpgj83 · Jul 27, 2013

Thank you steppybay! That info definitely sheds a lot of light and I'm realizing now one of the biggest differences between nursing here and there is that students in the Philippines don't get that one-on-one mentoring that US students get. That really would have been nice. Our clinical instructors do accompany us for "special procedures" most of the time for guidance, but we don't have a preceptor we can just shadow during the whole shift. Did you graduate from the Philippines and then work in the US? You seem to be so knowledgeable about all of this.

Just another clarification though. This is copied/pasted from the NCSBN website about the sequence of how to register for the NCLEX:

1. Submit an application for licensure to the board of nursing where you wish to be licensed. Be sure to meet the board of nursing's application deadline.
2. Register for the NCLEX with Pearson VUE using one of the methods below

So on here apparently we're supposed to apply for licensure first, but you said we could take the NCLEX first? Thank you, steppybay.

JustBeachyNurse, LPN · Jul 27, 2013

Apply for license then if you meet the requirements the board of nursing will give you the authorization to test via Pearson Vue.

If you are replying to states that require CGFNS (most other than CA) you apply to CGFNS first then to the BoN. BoN won't look at your application until your credentials are assessed by CGFNS.