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doctors becoming nurses

Posted

Foreign doctors graduate from FIU program that makes them nurses

By Hilary Roxe

Associated Press Writer

Posted December 15 2003, 6:27 PM EST

MIAMI -- Marceliano Marcias, a Colombian trained doctor, set aside his pride and his medical education when he arrived in the United States and took a series of odd jobs that included cleaning floors behind a supermarket meat counter to support his five children.

Marcias, 49, is one of 32 people who graduated Monday from a pilot program at Florida International University designed to train foreign-educated doctors to be nurses. For the health care industry, the program is a creative solution to a state and national nursing shortage. For many of the graduates, it is a way of re-entering a field they were forced to leave behind with their homelands.

When he came to the United States four years ago, Marcias said his biggest concern was providing for his large family, so he took any job, refusing to let his pride to get in the way of delivering pizza or working as a landscaper. Though he said FIU's program was difficult, it reignited his interest in medicine.

``The knowledge was there, just waiting to be used in a more appropriate way,'' said Marcias, who plans to work at Miami's Mercy Hospital.

Dr. Divina Grossman, director of FIU's nursing school, said Marcias' experience is common. She said foreign educated physicians are often limited by their English language abilities, or the difficulty of passing the medical board certification, and many work as hospital technicians or nursing aids. The program is designed to make better use of their medical knowledge in the midst of an acute nursing shortage.

A recent report from the Florida Hospital Association shows 10 percent of the resident nursing jobs in the state are vacant, and Florida may be short about 61,000 RNs by 2020.

Leslie Homstead, an RN and the director of professional practice advocacy at the Florida Nurses Association, said the demands of the profession and aging demographic of nurses are creating the shortage.

``The average age of nurses is in the mid to upper 40s,'' she said. ``Add another 10 or so years to that, and we'll be ready to retire.''

A partnership among Hospital Corporation of America, an organization that owns hospitals across the country, Kendall Regional Medical Center, Cedars Medical Center and Mercy Hospital provided the $600,000 necessary for the first class, Grossman said. The partnership stepped up again for the second class of 60 students, she said, but funding is uncertain past next December. More than 600 people have already applied for that class.

Jeff Prescott, a spokesman for Nashville-based HCA, said the motivation for funding the program is obvious, given an acute nationwide nursing shortage.

``In general, the issue of nurse recruiting is huge,'' he said. ``Anything creative that could be done is being done.''

Grossman said this program is the first of its kind in the nation, though she has gotten calls of interest from other parts of the country.

I had heard a couple of years ago about foreign doctors becoming nurses in The U.S.

Many of these docs are from very male dominated cultures.... how are they going to react to having females as their bosses?

How are they going to react to taking orders when they are used to giving them?

I feel there will probably be a lot of problems with these "nurses" practising outside their scope of practice, as in acting like doctors.

And as we ALL KNOW, there is no freaking nursing "shortage". This is just another way for those in power to avoid taking any action to address the real issue- working conditions.

So let me get this. If these foreign born doctors do not have the language skills to pass medical boards or function as physician's, we make them nurses! Perfect. I guess nurses don't need to be TOO well spoken (or good spellers). Do they have the knowledge to take care of the WHOLE patient (this means bedside manner and bedpans)? I take some offense to this! I don't know how they could pass nursing boards if they have such a language problem. Or are they just exempting them from the tests? This is nuts. Just makes me think of the public likening us to "less"thans or doctors who couldn't make the grade.

Weirdness.

We have a foreign doctor in our nursing program. She speaks excellent English and is very knowledgable, especially in patho. She tried to pass the boards for 10 years but had trouble getting a residency because she had just finished med school in the Phillipines and had not practiced independently. She has had a few issues but they are more cultural than nurse-doctor stuff. I think she'll make a fine NP. I do resent that bit about "swallowing their pride" though. We also have at least 3 people in my program who chose not to go to medical school and prefer nursing.

As per the government ruling, effective July, 2004, all health care personnel, foreign-trained, except physicians will have to have competed a Visa Screen in order to obtain a license. The language skills required are almost equivalent to being a native speaker. It is still much easier to pass our English exams and focus on that, than trying to prepare for US Medical Boards. Remember that when we took our board exams we were only tested on nusing care and knowledge, no complete pathophysiology of the human body. If you have been practicing as a neuro-surgeon for twenty years in your own country, how much are you going to remember but dermatological problems or gynecology for that matter.

Just take the above into consideration before making any assumptions.

I welcome utilizing all resources to solve the nursing shortage. One of my nursing school classmates had been a dentist in the Phillipines. Victor was told by the state board of dentistry that he would have to take two years of dental college and then sit for dental boards. Working as an nurse's aide, he decided that becoming a nurse made more sense.

I recall that a number of years ago I saw a story about a physician who worked as a nurse for a month. He gained an entirely new perspective about nursing.

In the letters to the editor a nurse correctly pointed out that he was guilty of practicing nursing without a license.

I was fired from my last job because DOCTORS (interns) do not like me. This is what the world needs to know. Doctors are NOT nurses. That's why they have a different licence than we do. In my state it is illegal for doctors to "waste" narcotics. A pharmacist told me that only nurses and/or pharmacists can do so? Nurses do a lot of other things that any physician has no clue how to do. When you have a difficult IV or blood draw do you call a doctor? I don't I try to find a phlebotomist from the lab, an EMT/aide, (if I can find one, I get somebody from oncology). When you can't get a foley or NG tube do you call the doctor? Not me. I call the LPN/aide from the nursing home.

The point is, if you do not hold a nursing license, you are not a nurse. Do these "doctors" pass the same test that I do? If they do not, they have no business practicing as nurses.

Jon:roll

live4today, RN

Specializes in Community Health Nurse.

Originally posted by Hellllo Nurse

........................................................................

And as we ALL KNOW, there is no freaking nursing "shortage". This is just another way for those in power to avoid taking any action to address the real issue- working conditions.

THAT's it in a nutshell! They don't care to address the REAL issues that are creating the "so called nursing shortage". :(

Another thing that I just remembered: While I was still working in the Detroit area in the OR, I had the pleasure of working with two surical techs, both who had been physcians in their own countries, but who hadn't taken their US Boards yet. Their English was perfect nad they actually had more compassion towards patients than alot of nurses that I worked with. So please don't be too hasty to judge someone before you get a chance to know them, or what their experience was or is.

Another simple difference, the nurses in the government hospitals in Thailand that work in Labor and Delivery do all of their own deliveries. The physicians actually come in for "special cases" only, so I would put the L and D nurses here on a pedestal first, above many others. Just with what they have had to learn, but we take for granted.

I think it's great. If you read the article, it's pretty clear that the swallowing his pride part referred to the sweeping supermarket floors. In the very next paragraph he says that the program was "difficult". It is a good day for nursing when a physician, regardless of national origin, acknowledges the difficulty of a nursing program.

Another thing to consider is that many of these physicians come from cultures that don't put medicine on such a high pedestal anyway.

Finally, please note that this was an educational program leading to a degree in nursing. So, yes they have to learn all that you did and they will have to pass the same boards as you before they can practice.

MobileLPN

"First they ignore you.

Then they laugh at you.

Then they fight you.

Then you win!"

-Mahatma Gandhi

CarVsTree

Specializes in Trauma ICU, MICU/SICU. Has 4 years experience.

FIU MD-RN Program

I went to the site and it is a regular BSN program.

teeituptom, BSN, RN

Specializes in ER, ICU, L&D, OR.

THERE IS NO nursing shortage, just a decreased number of people staying in the field. The nurses are out there and they are American also. Find ways to get them back and keep the foriegners out

I have to take exception to teeituptoms remark about keeping the foreigners out. Two Filipino nurses have described to me what their nursing education was like. In the Phillipines any nurse gets more clinical learning than most physicians in the U.S. When they practice in US, we think because they speak with an accent, (usually in English much better than mine) that they don't know what they are doing. That's why they tend to cluster in CCU's, and even have the NERVE to speak to each other in Takalog.

When I see a physician for the first time I feel better if he speaks to me with an accent, particularly if it is Indian. One resident told me that they don't even have monitors, so they actually have to examine the patient!

Let's not make"keep the foreigners out" part of the discussion.

What we should be talking about is the "nursing shortage!"

Yes, it's all about working conditions.

When are we going to stop putting multimillion dollar "band aids" on a problem that requires major surgery?

I have no problem with anyone from ANYwhere coming here legally and studying to become an RN by going through a nursing program. My problem is when they are able to practice nursing without having an understanding of nursing. As for the compassion part, I know quite a few compassionate docs and a few horrid and inhuman nurses. I just know that I could not expect to go be a doctor in another country without going through that countries med school. Nursing and medicine ARE sepearate disciplines...it is a fact. I am glad that they want to go i nto nursing. Are they passing the same RN boards? If so, then I guess then they are to be welcomed like any new staff. If they are good, they will show it (just like any other new grad nurse):)

Originally posted by sharann

So let me get this. If these foreign born doctors do not have the language skills to pass medical boards or function as physician's, we make them nurses! Perfect. I guess nurses don't need to be TOO well spoken (or good spellers). Do they have the knowledge to take care of the WHOLE patient (this means bedside manner and bedpans)? I take some offense to this! I don't know how they could pass nursing boards if they have such a language problem. Or are they just exempting them from the tests? This is nuts. Just makes me think of the public likening us to "less"thans or doctors who couldn't make the grade.

Weirdness.

These were my thoughts exactly.

These foreign trained doctors that become nurses here still have to complete RN school, just as we did. They still must meet the same requirements AND yes, they have to take NCLEX, etc. They are also responsible for a Visa Screen just as if they were coming over here as a nurse. And the new rules are quite strict about how good that their English actually is. It must be comparable to a native speaker. Don't you think that people should have the right to live and work where they want? What if you had gone to medical school in another country, completed a three to five year residency, then because of some changes in the government in your country, left becuase of safety for your family. For these doctors to practice as a physician here, they have to start all over again with a complete residency after studying for their USMLE boards, which are a million times harder than NCLEX and then repeat an internship and residency. Some are just unable to put htose hours in again.

Just because we are used to a lot of American doctors not giving a d--- about their patients or what we do, but many doctors form other countries actually have a heart and their practice of medicine is different. They actually will put a patient on a bedpan and take them off, some centers have very few nurses, so the docs have to do lot of the actual physical care. Remember you are thinking just about doctors trained in the US, there are many more that have a different work ethic. Went into medicine because they love people, not the paycheck. Salaries for doctors in many other countries are quite different than ours. I live in Thailand, and my salary as being a member of a heart team, in the US, was much greater than any of the government-salaried physicians here. So just give someone a chance....................

Please go to the thread, "I'm hoping some one can help me" by caribeanfem.

You will clearly see from my post there that I am not anti-foreigner. Nor without compasion for those from other countries than my own. My response on this thread was a reasonable response to what was stated here.

When ever some one says something we do not like it is too common a practice to paint them as one dementional.

Language command s a legitimate concern in nursing. And it sometimes in NOT on a par with native speakers.

I admire and respect those who speak multiple language and can function in a foreign land and speak the language well enoungh to function effectively in a technical field.

If you do not have command you should not be licensed in the country that speaks that language.

A new law goes into effect in July, 2004, that will require all healthcare workers, excluding physicians thsi rule, that they be almost as fluent in English as a native -born speaker. Previously, you could get a job in the Us on an H1b visa and just pass TOEFL or another exam and actually not be able to communicate in English. Now they will have to also have a test of speaking in English, one on one with an examiner, and a test of written English to make sure that they can adequately pass these. This was only required before for a nurse applying for a green card, but no it will be mandatory of everyone.

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