Need some advise: There's a high probability that I may soon be relocating overseas within the next year or so. My husband is expecting to get a job offer that would relocate us somewhere in Europe - likely France or a nearby country. He's not affiliated with the military or government, so we would be living amongst the local residents. And the move would be long-term. While I'm very excited about this, I'm also contemplating what this might mean for my career. I've been practicing as a FNP for close to 3 years, and also work part-time as clinical faculty for a FNP program. So I'm still fairly fresh.
Per my research, the countries we would likely live in don't recognize the APRN role. Even transferring my RN license wouldn't work because the credentialing, etc. is completely different. Not to mention, I wouldn't know the local language or culture! So I know that I wouldn't be able to continue practicing within my respective role.
Nonetheless, I'm trying to stay optimistic and open-minded with the hope that my education and experience will not go completely unused while there. Thus is why I'm reaching out to all of you. Anyone been in a similar scenario, or know of someone that has experienced this? If so, did you/they just let the FNP certification lapse since it requires at least 1000 clinical practice hours per 5yr renewal? What type of work did you/they do while abroad? For those that haven't experienced something like this, what would you do? I'm open to any ideas. Thanks in advance.
I'm both an adult as well as peds CNS. I work in a practice where I see pts from ages 18 on up (and occasionally a younger person). For my job I needed to be able to see those pts who were in their teens. As an adult CNS this was not allowed. I went back to school and got a peds CNS and was able to recertify with the 1000 hours practice as well as CME. I will be coming up on my second recertification in three years. However, I currently do not care consistently for anyone under 21.
I was unsure if I would have the 1000 practice hours. However, I do keep up with peds-specific CME including conferences, etc.. So, for me this is great news.
The other issue (not the topic of this thread of course) is that ANCC has "retired" both the adult and peds CNS exams so I no longer have the option of retaking the test which I would gladly do.
The issue of ANCC not mandating practice hours for recertification came up. It may have been ANCC's response to request from NP faculty who seek recertification but only teach full time and not practice in the clinical setting anymore. ... Whatever it is, ANCC has gotten soft and AACN was not planning on following suit with the ANCC policy at the time I met with the group.
Yeah, that was my assumption -- that the change was made to accommodate people who are teaching full-time and not practicing, but want to maintain their certification (since, in many cases, it is a requirement of the teaching job). Totally apart from the "safety" question already noted, I can't really see any rationale for being able to hold an advanced practice certification without any practice. The clinical requirement is only 1000 hours over five years, which is practically nothing -- five weeks of full-time practice a year, or four hours a week over the course of a year. When I've taught full-time in the past, I've had a limited clinical practice "on the side," and it was no big deal.
The ANCC has done this before (watered down the standards and requirements) -- back when I finished grad school, mumble mumble years ago, the requirement for CNS certification was (and had been, all along) that you have an additional number of hours of clinical supervision (500? 1000? I don't remember anymore) outside of school (like a residency!! What a concept!!), your school clinical hours didn't count, in order to be eligible for the exam and certification (like the generalist certifications that require some specific number of hours of clinical experience in the specialty in order to be eligible -- the point being that certification is supposed to indicate that you are experienced and competent in the specialty). A few years after I finally got certified, the ANCC suddenly dropped that requirement, because people were complaining that it was too hard to get first jobs out of school, employers didn't want to hire people who needed supervision and couldn't function independently in the role and only wanted to hire people who were already certified, and suddenly you could sit the exam and get certified as soon as you finished your graduate program. I was shocked and offended at the time, but that was a long time ago and, since I no longer really expect much in the way of integrity or standards from nursing, I'm not all that surprised that the ANCC is again watering down the standards and requirements.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Yeah, that was my assumption -- that the change was made to accommodate people who are teaching full-time and not practicing, but want to maintain their certification (since, in many cases, it is a requirement of the teaching job). Totally apart from the "safety" question already noted, I can't really see any rationale for being able to hold an advanced practice certification without any practice. The clinical requirement is only 1000 hours over five years, which is practically nothing -- five weeks of full-time practice a year, or four hours a week over the course of a year. When I've taught full-time in the past, I've had a limited clinical practice "on the side," and it was no big deal.
Agree that the requirement for practice hours is quite light to begin with. What worries me is that this move will just perpetuate the status quo in NP schools (not all schools, of course) where didactic content are taught by certified NP faculty who have been out of practice for years while the clinical content are the responsibility of preceptors who are practically unpaid volunteers out in the community who in some cases students have to seek out on their own effort. It would be great if we could aim for a more idealized version of NP school similar to medical school where faculty have existing academic practice.
Back to the original post, if you want to keep up your skills as a NP and not do the ANCC thing where you just teach and do presentations to keep up your recertifications. What you can do is come back to the USA and sign up with a Locums company and do an assignment for 3 months. You will do a 3 month assignment 3 times in 5 years or more if you want to stay longer in the USA and then get it over with. You want to do it with a government facility so they accept any state license
40 hours a week x 4 (4 weeks in a month) = 160 hours of clinical practice in one month x 3 months = 480 hours. 480 hours (in a 3 month period) x 3 = 1440 hours of clinical practice which is more than what you need.
I know of a NP who does this because she lives most of the time in India running a non profit organization to help sex workers get off the street (completely non NP stuff) and a MD who used to live in Virginia and now lives in Chile with his wife who works for the government, they just come to the US to get their hours done and then go back to the countries. I think this is one of the best ways to do it. Most locums company will have malpractice insurance for you and if you need health insurance while doing a locums assignment there are certain locums companies that offer health insurance as well.
Hi there! I’m currently in this situation and I’m wondering how this turned out for you? Were you able to maintain certification with practice hours and how? Thanks!
Back to the original post, if you want to keep up your skills as a NP and not do the ANCC thing where you just teach and do presentations to keep up your recertifications. What you can do is come back to the USA and sign up with a Locums company and do an assignment for 3 months. You will do a 3 month assignment 3 times in 5 years or more if you want to stay longer in the USA and then get it over with. You want to do it with a government facility so they accept any state license
40 hours a week x 4 (4 weeks in a month) = 160 hours of clinical practice in one month x 3 months = 480 hours. 480 hours (in a 3 month period) x 3 = 1440 hours of clinical practice which is more than what you need.
I know of a NP who does this because she lives most of the time in India running a non profit organization to help sex workers get off the street (completely non NP stuff) and a MD who used to live in Virginia and now lives in Chile with his wife who works for the government, they just come to the US to get their hours done and then go back to the countries. I think this is one of the best ways to do it. Most locums company will have malpractice insurancefor you and if you need health insurance while doing a locums assignment there are certain locums companies that offer health insurance as well.
Great recommendations! And I love the arrangement that the NP in India has made - maintaining her NP career without sacrificing other important life callings. I admire people that can achieve this. Thanks for sharing aprnkate.
Hi there! I’m currently in this situation and I’m wondering how this turned out for you? Were you able to maintain certification with practice hours and how? Thanks!
Hi jennylynn_1983,
So my husband and I relocated to France, May of 2018 and are currently still here. However, we will be transferring back to the U.S beginning of 2020 because my husband accepted a new position. During the year + 6 months in France, I’ve continued my part-time remote faculty facilitator position. And I’ve been doing CEUs. Fortunately, the faculty facilitator role isn’t geographic dependent and has allowed me to keep a pinky toe in the field. With that said, I haven’t practiced clinically during this time. The main reason for this is the immigration process for non-EU spouses in France. It would have been too complex to do locum in the U.S. while also maintaining my life in France. And doing work I’m eligible for in France is quite minimal. I’ve done some volunteer english tutoring, but that’s about it. My AANP re-cert is due in 2020. Because of the FNP position I had prior to relocating to France, I have exceeded the minimum clinical practice hours.
Basically, I’ve turned this time in France as a partial sabbatical. When I’m not doing the remote faculty facilitator work, I’m immersing in the culture activities, learning the language, and/or exploring the country. Now that we’re moving back to the U.S, I’m glad I took advantage of the short immersive cultural experience because it may never happen again.
When we return to the U.S next year, I may enroll in a NP refresher course. I’ll attend a primary care conference. Because its been over a year since I’ve practiced in the clinical setting, I don’t feel 100% comfortable jumping back in. And I don’t know how employers would feel about hiring me either. I’m researching the where’s and how’s of a NP refresher course now, so if anyone has any information or experience with this, please share.
I’d love to hear more about your situation if you’re willing to share. What options have you explored to maintain certification while living abroad?
traumaRUs, MSN, APRN
87 Articles; 21,287 Posts
I'm going to present a different point of view:
I'm both an adult as well as peds CNS. I work in a practice where I see pts from ages 18 on up (and occasionally a younger person). For my job I needed to be able to see those pts who were in their teens. As an adult CNS this was not allowed. I went back to school and got a peds CNS and was able to recertify with the 1000 hours practice as well as CME. I will be coming up on my second recertification in three years. However, I currently do not care consistently for anyone under 21.
I was unsure if I would have the 1000 practice hours. However, I do keep up with peds-specific CME including conferences, etc.. So, for me this is great news.
The other issue (not the topic of this thread of course) is that ANCC has "retired" both the adult and peds CNS exams so I no longer have the option of retaking the test which I would gladly do.