My experience getting an Australian License as a US nurse

[espendean]

I'd always dreamt of taking off on an extended backpacking trip in another country. I could never afford to do it in my High School and College years, and afterward I had student loans running up interest fast. I was resigned to defer my dream until I paid down that mountainous pile.

A couple of years ago, we were visited by a relative who grew up in Australia. He mentioned that it is not uncommon for Irish and UK nurses get Working Holiday visas and live and enjoy the sun "Down Under" for a year or two while working as agency nurses. He encouraged me to look into the possibility of doing the same.

My research appeared to indicate that it was possible for US educated nurses to do the same thing. Some nurses had met with success, while others had their applications for a nursing license turned down. Applications for licensure in Australia are submitted to AHPRA (Australian Health Practitioner Regulation Agency), under the section for "Internationally qualified nurses." In my research and through speaking with people, US nurses sometimes reported difficulty in getting their registrations and that it is substantially more difficult to apply with a two year degree, even after a bridge program to a bachelor degree. I do have the 4 year degree, so I filled out the application and sent the sealed and approved papers to AHPRA. It is a little on the expensive side to apply but I figured what the heck, money's not good for anything if you don't spend it.

I found the AHPRA application to be pretty self-explanatory and I found that most of my questions were answered if I kept reading through the application. I would suggest reading through the entire application packet before beginning to fill it out. There were a few questions which I could not find the answers to, either in the application or online; but calling AHPRA clarified most of those questions.

One question which I remember being frustrated with finding an answer for, was if I needed to have my college and their accrediting agency fill out the forms: Letter template - Instructions to education providers and Letter template - Instructions to accreditation authorities, in order to satisfy Criterion 3 for internationally qualified nurses and midwives. When I called AHPRA, the representative that I spoke with said that it was not needed. I should just to follow the application (AGOS-40) downloaded from the AHPRA website and it would cover all the requirements. As a result, I did not send these two documents to their respective institutions when I sent my initial application.

After several months of waiting, I received the dreaded letter requesting more information. Some of the required information they had requested from my college; but I was the first person from that institution to apply with AHPRA so they required a bit of additional information. It was frustrating that two of the items which were listed as outstanding were the two forms related to the accreditation of my educational institution during my time of study. To be fair, my call and questions about the forms were made prior to my submitting any documents, so I did not have a Registration Officer assigned to my case at the time. The person I spoke with was answering general questions and the request for these two documents may have been specific to my case, but it was yet another delay in a long process.

After some follow up questions to the AHPRA letter requesting more information, the Registration Officer from AHPRA had stated that the most common reason that people were not approved was that they did not provide enough information about their educational institution. I spoke with the nursing program at my alma mater and they were kind enough to gather every syllabus from my time as a student in the program, over 100 pages of documents, and send them. I was incredibly lucky that they had these on record. The school also wrote a letter outlining the details of the program and filling any gaps left unexplained by all the syllabi.

Message to any nursing students who may want to apply for a license in any other country in the future: Save every syllabus and course outline you receive.

The second note is that Criterion 5 of the Nursing and Midwifery Board of Australia requirements for internationally qualified registered nurses requires 800 hours of workplace experience providing exposure to a variety of healthcare settings as a student. As a US educated nurse, my first thought is that this means clinicals. The problem is that most nursing programs won't get you that many hours counting clinical hours alone, there just aren't enough hours in the day. I don't know how the Australian and European countries run their programs or how they count these hours but US programs are often assessed to fall short of their standards, even highly competitive and recognized US programs. I think this must arise from some misunderstanding of how hours are counted.

You will most likely need to provide documentation of other clinical experience/exposure to fulfill this requirement. The specific regulations on what clinical exposure can be counted are listed on the NMBA website. Don't discount things like prerequisite CNA/Nurse's Aide classes or internships as a nursing student to count towards this requirement. If you are still in school and know you may want to work as a travel nurse Down Under, you would be smart to try and put in extra clinical hours to hit the 800 hour requirement if your program allows it, or look into extracurricular opportunities that would meet NMBA's standards. Do this before you graduate as they do not count any post-graduate experience.

Here I want to mention that if you are concerned that you will not be able to meet this requirement you may want to consider applying for a nursing registration in New Zealand, as they do not have the 800 hour requirement. Once holding a New Zealand registration, you may then apply for an Australian registration through an accelerated process established by the Trans-Tasman Mutual Recognition Act of 1997. This is an agreement between these two nations to recognized each other's assessment to register an nurse and offers a cheaper and less in depth application process between those two neighbors, granted you hold a registration in good standing from the other. For US nurses this is a lot like the Nursing Compact States. I have not had to apply through this process yet myself but may consider doing so if I can find work and get approved for a working holiday visa in New Zealand.

After sending all of the additional information I was nervous. I worried that I would be turned down for some unforeseen reason. There are links on AHPRA's website to an external appeals process through the civil courts. International cases are held in the New South Wales Civil and Administrative Tribunal (NCAT) and can be requested to be done remotely. This would be the next step if AHPRA refused my application.

Without a refusal or a approval there was nothing to do but wait. At this point I was pretty disheartened with the arduous and lengthy process, and put it out of my mind for a while. Almost three months later, the wonderful email was in my inbox. There were no further issues or complaints. I had been approved.

By that time, I'd begun to settle in where I was living and working at the time, especially over the last few months while I waited for the final reply, and now, instead of seeming like a long time, three months, the time limit for presenting in person with ID, seemed very short. It was a scramble to get as many loose ends tied up as possible before my flight.

The scramble continued the day of my flight. The first leg of my journey was cancelled due to a snowstorm and I had to contact the airline and schedule a new flight. The only one available departed from a a town two and a half hours drive away. Fortunately, I had made an impulse purchase of Tripit Pro, because it was the app which altered me about the cancellation in time to drive to the alternate airport, catch the new flight and still make my connection for the flight to Sydney. The airline which cancelled the flight did not tell me about it.

Upon arrival in Sydney the customs officer wanted very little of the paperwork that I had prepared and I was let through without any issues. He did not stamp my passport, and I was too tired to remember to do so. I would later regret that omission.

The following day I arrived at the AHPRA office and delivered the paperwork they had requested for when I "presented in person" and I left there assuming all was well. However, later that day I received an email stating that the letter that I had submitted as an offer of employment, was not an original form letter, and it did not satisfy the requirement. I would an original formal letter in hard copy or emailed directly to AHPRA, a utility bill or a stamped passport, in order to fulfill this requirement.

A call to my future employer solved the issue. Thankfully they quickly arranged a formal letter offering employment and emailed it directly to AHPRA, but had my passport been stamped I would not have experienced that nerve-wracking ordeal. Upon further reflection I would have like to have an official record of my arrival date in general, as there was not telling who else may have a similar requirement. If I could do that part over again I would ask the customs officer to please stamp my passport.

After a day of worry and thinking about what I would do if everything fell apart now; now that I was finally standing on Australian soil, an email arrived finalizing my registration and giving me my registration number, online ID and temporary password. The relief was indescribable...

And that, ladies and gentlemen, is the exhausting and uncertain path to an Australian nursing registration. I apologize for being long winded but if this helps anyone else get through the ordeal, or helps streamline their application, I will be profoundly gratified. It was all worth it. Good luck!

P.S. - Bring some extra notarized copies of your passport. You may need one when setting up a bank account as you will be required to complete a W-9 form. Also, set up your phone service first and ask them to include your Australian address on the contract or receipt somewhere so that you can use it at the bank. I was required to have documentation of my address for the bank. It can help at AHPRA as well.

[Miriam80]

Congratulations of getting your registration.

I am an Australian educated RN. I am now living in the US and I have my US license.

I just wanted to comment on your need to have 800hrs of workplace experience. You are right, it does mean clinicals. In my 3yr Bachelor of Nursing degree in Australia I completed 900hrs of clinicals.

[Scooby-Dooby-Doo]

Wow. I'm a US-educated RN and I got my AHPRA easily in 3 months after lodging my application. It was tedious work, but I was able to provide the documents, every single one needed and my registration officer was very specific in what I needed next that I provided from my job and school. I got my BSN school to even send AHPRA that my education was conducted in English! When I got my registration in pending upon showing up to the AHPRA office, I used my friend's address in Melbourne and appeared to the AHPRA in VIC. Sent them my ETA VISA as a US citizen and voi-là ! It was fast. I didn't want to start off with NZ because I needed to do an English exam like IELTS or something like that. But, I'm going to be doing the TTMA though once I'm done with my working holiday visa in Australia, I'll be doing a working holiday in NZ.

[kips]

Thank you so much for the information. I have a situation too. My ADN clinical hours were 720, I did my BSN online so I didn't attend any clinicals at my bachelor level. I wanted to ask if anyone knows if my pharmacology lab hours and also assessment course hourse do count? AHPRA referred me to a bridging course in Australia for 3 months to fulfill my clinical hours but I'd appeal their decision if indeed the lab hours count since I have a total of 96 hours for my pharmacology lab practice and assessment course hours thus making it 816 hours.

[amchang89]

Thank you for sharing your experience! I am also a US nurse and I am planning to move to Australia next year. If you don't mind me asking which visa did you apply for? Did you have a job secured before you got to Oz? If so, did you use an agency or did you find work on your own?

I'm nervous about how this will work for me because I'm almost certain my clinical hours from school won't be enough. I'm waiting for the response from school to see how many hours I received in clinicals.

I think the reason US nurses have such a hard time with this is because we typically do preceptorships/residencies with our first employer instead of in school (6 month preceptorship gives us 850+ hours). I have a feeling I'll have to jump through hoops to get registered. I have been speaking to a agency who is telling me I might be able to get registered and if I do I will likely have conditions placed on my registration; for example, I might have to have a preceptor my first 3 months in Oz. Because of this, the agency is telling me I wouldn't be the best candidate for the hospitals. I contacted ANMAC and the nursing board for advice on how to move forward. I think this whole process will take months to figure out. Wish me luck!

[kips]

There are Hospitals sponsoring me innNSW and also an Agency. You should go to seek website once you had your license and I'm pretty sure you'll get some sponsorship. I have several offers even without my license yet.

[Scooby-Dooby-Doo]

Which hospitals are sponsoring in NSW?

[Ninar1993]

Hey!

I was just wondering if your university actually provided you with the entire 800 clinical hours? I completed a nurse externship between junior and senior year and worked an additional 260 hours. Do you have any idea if they would count this towards workplace hours?

Thanks!

[medisec]

Interesting post and perspective of both countries. I have worked more on the medical documentation and policy side of things, and just moved to New Zealand to pursue an academic lecturer track. I am curious, now that you are in Australia and working as a nurse, do you know if Australia or New Zealand have the same strigent workplace policies regarding nurses with disabilities e.g. monitor programs, penalities/stigma for (non)disclosure? I am finding that NZ is more compassionate with their policies, although there are some documented reports from some Kiwis who felt discrimated against or stigmatized due to mental health diagnoses.

[Whitts]

Hey I am in the same situation. I am from the US as well and I want to move to Australia next year. I called my school though and they said we only did 457.5 clinical hours during nursing school. Did you ever figure out how many you did? I'm not really sure what to do if that's the case because I really want to move there! How is your experience going with all this? Thanks!

[espendean]

I was in communication with Healthcare Australia. They were easy to work with and helped me get settled on arrival. I had difficulty getting shifts in the city (Brisbane but I've heard the same in other places) but the Rural and Remote team has plenty of 6+ week contracts which mean steady work and free accommodation.

The Visa was a 417 but I am a Norwegian citizen, so it may be a little different for you.

Yea, that is very frustrating. I was worried about having to do the bridging course. If you do end up having to appeal a decision, cite your new grad residency in you argument, it may be taken into consideration.

Best of Luck!

[espendean]

I had what amounted to an externship as well and it did count, we were strongly encouraged to find one by our school and the school wrote a letter saying so. It put me over the 800 hour mark. You may get lucky, that may very well count. It might depend of if your school recognizes it or if it was by your own initiative. This is all speculation on my part but there's a chance.