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.
espendean
5 Posts
I have to admit that I don't know much about the Australian policies. I very fortunately have a predominately orthopedic/sports injury medical history so I have not had to research the policies surrounding mental health and I have not encountered any to my knowledge. If this is due to more or less disclosure, I could not say. Sorry to have not been of more help.