Ignorant questions by me

K+MgSO4, BSN · Jan 3, 2020

Here is my view on it.

Many Americans who want to work overseas only choose English speaking countries. This narrows it down to UK, Ireland, Australia, New Zealand and Canada realistically.

I am not sure about Canada but the rest of the countries have higher requirements for the amount of hours of didactic study i.e. formal class time and clinical placement hours than most American schools provide. Similarly, the ADN is not recognised by these country's registration bodies.

Getting registration is one thing, getting work is another. There is no such thing as L&D nurses (not speaking for Canada) , these countries have midwives who have either done a 2 yr post grad in midwifery or a full undergraduate degree in it.

None of these countries have the massive orientation periods I see referenced on AN. I give a week for new starters and that is being generous.

Nursing is basically the same but with many more nurses and less support staff nurses don't have the ability to delegate things to support staff and therefore have to wash patients, feed them etc.

The 4 counties I am familiar with (UK, Ireland, Australia and New Zealand) all have publicly funded health systems where most of the work is. This means that the government has a level of oversight which includes that positions go to dueley qualified local candidates and only then can an international candidate who needs a visa be appointed. To employ an international candidate recently I had to have the position advertised for 28 day externally on my hospital recruitment page and on 2 recruitment sites. I had to complete a 10 page form on why no local candidate could fill it. Then I had to fill in an affidavit that I was telling the truth!

* note "local" references someone with the relevant visas already.

OncologyCat, BSN, RN · Feb 5, 2020

On 1/3/2020 at 12:57 PM, direw0lf said:
I know this is ignorant but that’s why I’m asking so I learn!
it seems like it’s easier to go from a nurse in another country to a working nurse in the US than it is to be a US nurse who wants to work in another country. Is that a correct assumption? It only seems that way when I read that many nurses overseas are trained in specialty areas, making US nurses under qualified despite many years of experience?
I really know little on the topic but got curious! You know...sometimes I daydream about living abroad (not seriously). It seems hard for a US nurse to do that.

I wouldn’t say it’s easy to become a nurse in the US if you were already a nurse in foreign countries either. You still need to take the NCLEX, and have the hours (didactic and clinical) to qualify to sit for the NCLEX. Not to mention, sometimes the US don’t accept the training hours completed in foreign countries, and disregard your years of experience as a foreign nurse. Also, trying to obtain a work visa or immigration visa in the US is another can of worms; such a lengthy process! I used to work with a nurse aide who spent all her life as a nurse in Iran but she still can’t get her nursing license in the US.

Advanced Practice Columnist / Guide · Aug 8, 2020

On 1/3/2020 at 9:57 AM, direw0lf said:
I know this is ignorant but that’s why I’m asking so I learn!
it seems like it’s easier to go from a nurse in another country to a working nurse in the US than it is to be a US nurse who wants to work in another country. Is that a correct assumption? It only seems that way when I read that many nurses overseas are trained in specialty areas, making US nurses under qualified despite many years of experience?
I really know little on the topic but got curious! You know...sometimes I daydream about living abroad (not seriously). It seems hard for a US nurse to do that.

There are two separate hoops foreign nurses must jump to work in the US. One is licensure and the other is legal authorization to work in the US. Foreign trained nurses must meet US licensure requirements in all states but because each state nursing board makes their own rules, some states have more requirements than others though they all share a theme of needing to make sure that the education is similar or equivalent to a US trained nurse.

Some states use third parties to verify educational programs and a number of private entities offer this very service. Only when the foreign nurse meets the educational requirement would he/she be able to take the NCLEX. Countries like the UK, do not have a generalist nursing program like we do in the US and their graduates have to take additional courses in the US to qualify. Canadian RN training is probably the most similar to US and they now take the same NCLEX-RN exam we do here. Some states require a test of English proficiency for those whose primary language isn't English.

Legal status refers to citizenship or immigration status. Even when the foreign-trained nurse is US licensed, they must either be US citizens, legal immigrants, or posses work authorizations to acquire the ability to work. You will certainly see exceptions (especially in states like California) and there are a number Obama-era DREAM Act nurses who trained in the US but whose legal status is somewhat in limbo. Canadian nurses are able to work in the US through a previously approved NAFTA program that allows them to obtain a TN visa. The same agreement applies to Mexican nurses but I think it is harder for their nurses to qualify for the NCLEX-RN.

I think the take home message here is that any time we see a foreign-trained or non-US born nurse among us, it is not always fair to assume that they got in easy. Take it from someone who experienced it first hand.