Emergency Nurse Relief Act 2009- Update

I don't think this bill has a prayer. So the discussion is almost moot.

As a nurse I would prefer if I had a choice of working with a US trained foreign nurse or foreign nurse ( personality and experience the same) I would choose a US trained nurse.

But I do feel, the US has for years said to foreign nurses play by the rules and you will have a chance to immigrate to the USA. Then give foreign nurses who choose to come to the USA on a student visa the slot that US has made a foreign nurse who has waited patiently does not seem right. It gives the message break the rules and you will be rewarded. Just doesn't seem right. But allot of things the US government does is not right, because it looks like any reform will be geared toward illegal aliens.

First of all you are not a nurse, so how can you know what a nurse's life is like? All you know is second hand information. It is a personal gripe, it is like a man who tells his wife giving birth it isn't painful. I believe you have to walk in a nurse's shoes to understand what a nurse does.

It has been my experience any nurse who enters nursing as a paycheck do not make great nurses, this holds true for any nurse regardless of where they are from. It takes more than a desire to support your family ( doesn't everyone want that) to be a good nurse. And the journey for US nurses to get into and maintain good status is very difficult much sacrifice US Nurse make is taking out loans and their families have to alter their lifestyles.


When looking into migrating to another country, why don't they ask about the community ( how are the schools, how are the people, what is the climate like, what are the conditions a nurse works in ), the only question I see is how much do I get paid. Or worse yet, I want to go to the USA but there are no openings so how do I get into Canada?

Secondly, I don't think the NCLEX reflects a nurse's true understanding of the nursing profession. I have seen excellent nurses fail and terrible nurses who pass. What acts as counter balance is having a common education ( not transcripts translated) and the ability to interact with the educators. There is no way for a US hospital to know what school is good internationally and no way a hospital can call a local school and state we need the new graduates to have more experience doing XYZ ( this is done all the time). There is no opportunity to call and speak to the nursing educator personally an agency just like head hunting agencies here in the USA will paint the most positive review of the candidate the represent. This is not an objective reference.

Most of the international nurses who post here have zero nursing experience and sadly many of them have graduate numerous years ago which makes their knowledge soon to be outdated. Yet they have a currently passed the NCLEX. Experienced and highly qualified nurses can presently apply for an H1B visa.

Last Point, the state board is the lowest minimum standard for a nurse to practice, it is not a very high standard. New US Graduates have a steep learning curve, many of them have taken it upon themselves to work as nursing techs and CNAs, unfortunately foreign nurses don't have the opportunity to get this extra clinical input. I personally believe the the standard to become a RN is too low.

"Let's not get into a comparison of the kinds of sacrifices US nurses go through versus the sacrifices of foreign nurses. My bets are on foreign nurses for the level of family sacrifice."

Alexk49 response:
My students I know are hungry, they had to choose between tuition or supper. They are proud and won't take money from me. I often buy extra food and share with them . Some of my students are so tired since they are working full time and going to school at the same time they fall asleep when standing up. Many of my students don't have phones or internet access. Some don't have money to buy books and share with other students. Many students couldn't afford to buy an extra uniform when the school changed uniforms. They often wash the uniform by hand so they could wear it the next day.
The have to take public transportation and many of their zip codes are in very high crime areas. Some live in homes where they don't have a bed. Yet they never complain, they are grateful to be in school. And their family members are working overtime in low paying positions to get the student through school.

Alexk49 response:
SO if you can tell me the foreign students go to bed hungry often, work long hours and attend school, have no phones, live in very poor conditions, and don't have proper clothes. I apologize, I read on the boards here, most live in homes often with maids. Do not work while going to school and must have computer access since they post here.


"Should I apologize for not being a nurse? You often bring it up in discussion as though I should not even have an opinion because of that fact. Yet you are not a lawyer and I see you frequently criticize lawyers. Should not the same rules apply?"

Alexk49 Response
I don't believe I have ever been critical of lawyers on this forum and I don't know what you are talking about . I believe I have advised nurses to seek legal counsel when needed. But I don't think I would be qualified to go on ALL LAWYERS and give legal advice. Or try to recruit foreign lawyers to come to another country.


"1) The USA has a reputation of having the best overall so the "American Dream" propoganda that the government has been selling for more than a century is very effective. Don't blame foreign nurses for that.
2) if they are going to another country while waiting for the "American Dream" then of course they want to make sure that they will earn enough money so they won't get stuck into an indentured servitude setup.
3) cultures in other countries are not the same as the USA. In many countries working overseas and then returing to the home country is a common way of life."


Alexk49 Response:
Shame on the Americans peddling this to poor people to spend more money they don't have. American Immigration has been successful when the immigrate embraces America as there home like my Dad did when he escaped communism. He was so proud to be an American and did everything to advance the American cause. What makes the US great is immigrants who desire to make this there home, not a place to work.



"Take that up with NCSBN, not foreign nurses. It seems to be good enough for American nursing graduates."

Alexk49 response:
You missed my points, there are checks when employing a US nurse, you can contact the school, instructors and previous employers. And I am taking this up with my state board. US students have an big advantage working in the field while going to nursing school. I also believe all new grads should have an extensive new nurse program to ready them for there career. I am basing this as a Mastered Prepared Nurse educator, do you have an education background at all ? Have you worked in the healthcare industry as a manager?



"If they have not passed NCLEX and they are US nursing school graduates then technically they are not nurses at all when they take; so how can they be "Excellent nurses"
Also, since NCLEX tests the ability to apply knowledge into a clinical/practical setting then I fail to see how a "terrible" nurse CANDIDATE could pass."

Alexk49 Reponse:
I am basing this on my experience where nurses could work at the Graduate nurse status. A terrible nurse is a nurse who passed the boards, but is unresponsive to patient care needs, not medicating their patients is a timely fashion, giving patient education, giving good hand off communication.



"Which is exactly why there is a credential evaluation portion of the application for licensure for foreign nurses.
You have no idea (obviously) what foreign nurses have to do in order to be licensed in the USA.
The entire licensure process ensures that the school is accredited and has provided sufficient information to the nurse to make her eligible to take NCLEX as the final stage of licensure evaluation.

I feel like a broken record.. I keep saying this and it keeps getting ignored, like I'm just making it up or something." I think you lack of understand about education is leading to this misunderstanding.

Alexkrn Response:
The credentalling maybe grueling but is not an ONSITE review, the foreign nurses instructors resume do not have to be filed with the board of nursing. The foreign schools are not accredited not by the BON or the NLN, or the CCE the process is not equal.


"You are in luck. If they haven't gotten licensure after a certain period of time the US nursing boards require proof of employment or continuing education in order to gain licensure in the USA."

Alexk49 Response:
Oh you have got to be kidding CEUs are so easy to get, I often get them on my lunch break, no testing involved" They are better then nothing but the CEUS do not prepare you for current nursing practices. This is not accepted as keeping skills up for any nurse American or Foreign.



Then you need to take that up with NCSBN. But the fact that only 16% of licensed nurses remain employed after 3-4 years is proof that those nurses are filtered out through atrition.
Foreign nurses who migrate to the USA to work as nurse, however, have a much greater staying power (70-80% remain nurses after 4 years) which may explain why hospitals like to look overseas for staff positions.[/quote]

Alexk49 Response
The hospitals I have been in contact with and I belong to a large nation wide network of hospitals which I have weekly conference calls do not share what you are saying. I think you are referring to for profit hospitals that don't invest resources in keeping the nurses engaged. I wonder what their CMS scores are, every hospital that I have researched that have large foreign nurse population score very low in these CMS scores. Many of the hospitals that the foreign nurses worked in have closed in the northeast.




I personally feel nursing issues should be made by nurses not recruiters or lawyers.

It seems to be this bill's life is almost over, since the push is for overall Congress Immigration Reform and there seems to be little interest in pushing this bill.

I am visiting DC today and ensured my voice was heard on Capital Hill.


I believe every American has a voice in every piece of legislation. The process usually includes subject experts, for a nursing bill that would be nurses, health care adminstrators and patients.

I agree with you Nurse Karen all Americans should be more proactive. Nurses to monitor and communicate their opinions to their reps, but more importantly vote. There is a saying you get the government that you elect. I would hope my government listens to Americans and what is in the best interest of all Americans.