Foreign nurses watch this...

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Guys, watch this...

What do you think when he said "importing nurses is absolutely nonsense"?

Do you mind clarifying what you meant by the "mid-level positions" you mentioned. Are these nursing administrative positions, case managers maybe? I just have never heard the word used in that manner. However, I've heard of "mid-level providers" and those are NP's, PA-C's, CRNA's, and CNM's - roles that are not utilized and have no educational pathways available for nurses in the Philippine setting.

I apologize for my use of the term. I used it for lack of something better and it has been misunderstood to mean something different.

I do not mean administrative positions.

I just meant that it is something a bit higher up than the entry level positions for new grads.

New grad positions are not available for Foreign RNs because they are required to have worked for up to 2 years before they will be accepted by a vast majority of hospitals in the USA.

Therefore the positions that foreign RNs are getting are those positions which the hospital deems a prerequisite of clinical experience which suits the hospital setting.

Many foreign nurses apply only to get rejected because the experience they have is considered insufficient.

I just want to dispel the myth that foreign nurses take jobs away from fresh US graduates.

I'm not saying I agree with this route, I am actually (gasp and shock) in agreement with you on this one.

USMLE is not exactly difficult on the exam side, but the problem is all the effort and expense that one must go through in order to take the USMLE as a foreign physician.

For that reason, many MDs choose to second-course as nurses because the same process for taking NCLEX and getting licensed is relatively easier. The goal is to work in the USA for a few years as a nurse and then take USMLE and become physicians.

Personally I feel that if you are a physician that you should focus on that and just accept the expenses and hassle involved with doing USMLE as a foreigner and this is what I advise when asked.

But like the old saying goes: You can lead a horse to water, but you can't make him drink.

As nurse or a patient I would not want a doctor who became a nurse since their heart is in medicine. It is not good for the patients, the staff the work with, the employer will be the looser since once the contract is up they will move on.

From what I have read the doc uses a credentialing company similar CGFNS to allow them to sit for the USMLE Part One. The other parts include a clinical component which is where the ESL doctors have difficultly. But wouldn't these same people have difficulty communicating as a nurse ? Also the USMLE is not as forgiving as the NCLEX and thanking the test more than once is looked upon as a failure and is a huge roadblock. Once completing residency they are all set and will be making money similar to what they would be making as nurse.

My point as another poster pointed out the AMA has a very complex process for foreign trained MDs why should nursing be any different. Also the foreign doctors I have seen never had 2 years of Nursing experience.

I believe the term is "experienced nurse" and according to the academic literature I have reviewed even a season experience foreign nurse needs an orientation similar to a new grad.

Second seasoned USA nurses are having problems finding positions.

From what I have read the doc uses a credentialing company similar CGFNS to allow them to sit for the USMLE Part One. The other parts include a clinical component which is where the ESL doctors have difficultly. But wouldn't these same people have difficulty communicating as a nurse ? Also the USMLE is not as forgiving as the NCLEX and thanking the test more than once is looked upon as a failure and is a huge roadblock. Once completing residency they are all set and will be making money similar to what they would be making as nurse.

The hurdle for physicians is not usually the EDL situation as most that I encounter speak English fluently and without heavy accent.

The clinical component is the difficult task since that can only be done in the USA.

Hence many feel the best option is to go to the USA as a nurse so they may be working while completing USMLE requirements.

I think it is spurious to state that MD/RNs are less effective than those who are only RNs.

The level of care and concern will vary from one individual to another no differently than it does with RNs.

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
I apologize for my use of the term. I used it for lack of something better and it has been misunderstood to mean something different.

I do not mean administrative positions.

I just meant that it is something a bit higher up than the entry level positions for new grads.

New grad positions are not available for Foreign RNs because they are required to have worked for up to 2 years before they will be accepted by a vast majority of hospitals in the USA.

Therefore the positions that foreign RNs are getting are those positions which the hospital deems a prerequisite of clinical experience which suits the hospital setting.

Many foreign nurses apply only to get rejected because the experience they have is considered insufficient.

I just want to dispel the myth that foreign nurses take jobs away from fresh US graduates.

Well, we definitely do not want to be spreading myths in this forum. I'll have to agree with you that a nurse from the Philippines who have worked a considerable number of years (2 years maybe) in a tertiary facility (such as PGH, St. Luke's, Heart Center, and other hospitals of similar caliber) are probably good candidates for staff nursing positions in hospitals here in the US. However, regardless of the experience they have accumulated in the Philippines, a good amount of orientation and retraining are still in order for these nurses. There is a big difference in how nursing care is delivered in the US. I know, I know, I shouldn't be one to talk because I've not worked in the Philippines since the mid-nineties. Nevertheless, if I was a new nurse in the US, I would still ask for a thorough orientation (similar to a new grad from a US nursing program) even though I've had years of nursing in the Philippines. I would not want to be treated like I am ready to roll from the get go as I would fear this can be a disaster waiting to happen. This is the sentiment most US nurses feel. If the experienced nurse from the Philippines needs the same amount of orientation once in the US, then, they are no better than new grads who do not need the expense of having visas processed in order to come aboard.

Specializes in NICU, PICU, PCVICU and peds oncology.
The hurdle for physicians is not usually the EDL situation as most that I encounter speak English fluently and without heavy accent.

This is SO not the usual experience. The hospital I work at trains a significant number of international residents, people who come here from many parts of the world. Some of them have such poor English vocabulary and heavy accents that they're almost incomprehensible. This can be a huge problem when there's an urgent situation evolving and the physician cannot make him/herself understood. It certainly makes life difficult for the nurse who has to ask the physician to repeat what has been said 10 times so that it's understood. And that goes for simple things too. When I work a day shift I might interact with as many as a dozen residents and try to interpret as many different accents... Portuguese, Spanish, German, Dutch, Hindi, Chinese, Arabic, Urdu... you get the picture.

Are the MD/RN s in the Philippines taking away positions from the RNS ? When retrogression opens and these MD/RN come to the USA will there be more opportunity for the native nurses to get experience ?

Specializes in ACNP-BC, Adult Critical Care, Cardiology.
This is SO not the usual experience. The hospital I work at trains a significant number of international residents, people who come here from many parts of the world. Some of them have such poor English vocabulary and heavy accents that they're almost incomprehensible. This can be a huge problem when there's an urgent situation evolving and the physician cannot make him/herself understood. It certainly makes life difficult for the nurse who has to ask the physician to repeat what has been said 10 times so that it's understood. And that goes for simple things too. When I work a day shift I might interact with as many as a dozen residents and try to interpret as many different accents... Portuguese, Spanish, German, Dutch, Hindi, Chinese, Arabic, Urdu... you get the picture.

He may be referring to MD's trained in the Philippines. Typically, Filipino MD's belong to upper social classes in the Philippines because medical school cost is high over there as it is here in the US as well. Just by pure observation and without any research to back my claim, fluency in English typically is better among Filipinos of higher social classes which can be attributed to exposure to private school education where English is taught well and used extensively in the classrooms. However, I have worked with Filipino House Officers or Residents in US hospitals. I'd say they are fluent in English in terms of command of vocabulary and grammar but definitely still speaks with a typical Filipino accent that can be hard to comprehend by other native English speakers at times.

I'll have to agree with you that a nurse from the Philippines who have worked a considerable number of years (2 years maybe) in a tertiary facility (such as PGH, St. Luke's, Heart Center, and other hospitals of similar caliber) are probably good candidates for staff nursing positions in hospitals here in the US. However, regardless of the experience they have accumulated in the Philippines, a good amount of orientation and retraining are still in order for these nurses.

I completely agree and I would love to see a US-accredited orientation training put together here in the Philippines. Unfortunately what we end up with are guys who bring a lot of fancy equipment and con nurses into believing that they are accredited in the USA by showing a business license from the USA.

Yes, 2 years in an acute care setting is the best, the quality of the center is always borne in mind by the staffing firm or employer during the interview.

I've discovered that the most successful in obtaining jobs in the USA are those who have worked in US-established hospitals in the Middle-East since the level and quality of care is fairly similar to US hospital experience as opposed to a majority of the Philippine hospitals.

Nevertheless, if I was a new nurse in the US, I would still ask for a thorough orientation (similar to a new grad from a US nursing program) even though I've had years of nursing in the Philippines. I would not want to be treated like I am ready to roll from the get go as I would fear this can be a disaster waiting to happen. This is the sentiment most US nurses feel. If the experienced nurse from the Philippines needs the same amount of orientation once in the US, then, they are no better than new grads who do not need the expense of having visas processed in order to come aboard.

The employers that I have talked to all have these orientations; although I am aware that some do not.

Personally I advocate the orientation program.

All my years of experience in my field of expertise in the USA did not equate to being able to "get on the ground running" here in the Philippines. The social and market dynamics are entirely different.

I know that it must be much more of an adjustment when healthcare is involved.

However, once one makes those adjustments and orientation to the "other" way of doing things, the more experienced individual will definitely be able to take hold of the situations presented in a much more resolved manner than the inexperienced.

That is ultimately the key here, experienced and "secured" (by means of contracted employment) versus inexperienced and uncertain.

Hospital administrators who advocate the hiring of experienced foreign nurses to fill the non-entry level positions cite the fact that, although there is a period of adjustment, that in the long run the experienced foreign nurse outperforms the inexperienced local nurse and is a "safer" investment due to the contracted obligations.

What surprised me is that they continue to say this in spite of the reputation that some foreign nurses have of abandoning contracts.

This is SO not the usual experience. The hospital I work at trains a significant number of international residents, people who come here from many parts of the world. Some of them have such poor English vocabulary and heavy accents that they're almost incomprehensible. This can be a huge problem when there's an urgent situation evolving and the physician cannot make him/herself understood. It certainly makes life difficult for the nurse who has to ask the physician to repeat what has been said 10 times so that it's understood. And that goes for simple things too. When I work a day shift I might interact with as many as a dozen residents and try to interpret as many different accents... Portuguese, Spanish, German, Dutch, Hindi, Chinese, Arabic, Urdu... you get the picture.

Please note that I try to be conscious of qualifying my statements with phrases which indicate that it is within the realm or scope of my own experiences and contact. As when I stated "...That I have encountered..."

I am well aware of heavy-accented Indian/Arab/Chinese/European doctors... however native English speakers are just as equally burdened with heavy accents.

Having a wife experienced in Med Trans and getting to listen and work with Med Trans I have heard native English speakers that I have a VERY hard time deciphering.

Heavy Northeastern accents, Wisconsin nasal tones, Thick British accents of all the various flavors...

The only reason I could chew through the southern and Texan accents is because I'm southern myself; for a non-southerner I can definitely see how it would be a problem.

I don't think it is fair to marginalize non-natives by saying that they have trouble with the exams because they are ESL... that was my main point.

I am constantly under criticism for not being a nurse or a doctor.

I want to lay this to rest.

The main reason I am here is to share information and to help, in some way, any nurses who are on this board.

My job requires a lot of research and analysis of data. I deal in fact and I deal with a large number of medical professionals from multiple countries and multiple positions.

When I am stating an opinion, I will be clear.

When I am stating based on the experiences of the literally hundreds of people I deal with on a weekly basis then I will be clear on that.

When I am stating on facts then they are facts that I have gotten through at least three sources.

I recognize that even though I have checked these facts through multiple sources that they may still not show ALL of the picture, which is why I value the feedback here from nurses on the front lines.

Prior to this job I coordinated relief activities with medical response teams in multiple countries. I dealt with them on first-name basis and have been in the field hospitals in times of tragedy to assist in EVERY way possible.

My degree is not in medicine but I have experienced a lot that gives me insight and perspective into the world of medical professionals that many non-RN and non-MD hospital administrators sorely lack.

I have nothing but respect for nurses, that is why I am here.

I simply ask that you respect me in kind. Thank you.

That's completely the opposite of the picture I was given by a Canadian representative only last week. She informed me that the health care network in many provinces were in need of nurses and would be glad to take foreign applicants.

Interesting indeed...

You know what, sometimes you have to believe front line nurses and not "reps". If the "rep" was from any provincial government and NOT a recruitment agency the story would be very different. B.C., AB, ONT, are all having financial cut backs. The Maritimes won't be far behind.

Foreign nurses just aren't the right fit for outpost nursing up in the high north. So there might still be "some" jobs in SK and MB but with new grads from across the country looking for work and nurses moving with their partners, the demand for overseas hires is declining.

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