News Release: Doctors to Nurses (please read)

suzanne4, RN · Mar 31, 2006

Actualy, the hypothetical scenario actualy played out in real life, but the circumcstances were in a Hospital in Nevada, wherein a Filipino RN who was originaly a Doctor challenged the judgments of a Nurse Practitioner. So it is more than an 'urban legend'. Needless to say the said Dr- RN has been terminated and has lost his liscence as an RN, and is supposedely,possibly also being sent back home to the Philippines. The report indicated an investigation into the "nursing process" and nursing educational process in the Phils. It implied that there are "some" schools in the Philippines that "Fast track" , Doctors whose intentions it is to become an RN. I think the greater point here is that we HAVE TO ENSURE That the Quality of the Nursing "Educational" process and standards be upheld, especialy in the Philippines where the proliferation of Nursing schools have "produced" the numbers of RNs. Though some DRs can pass academicaly, the required credentials , CGFNs, NCLEX etc. Actual real -bedside Nursing experience seems to be missing. The Nursing schools in the Philippines today are producing 10-20K RNs ( Or are projected to produce that many in the near term) in a country where there are only 20,000 Hospital Nursing jobs. I think the problem may be more 'systemic' in the educational process. I think most of you will agree that that is something we cannopt compromise and that new standards will have to be defined.

You are still giving second hand information with no specifics.

Supposedly, possibly, that is all heresay and is still no proof.

Because of one incident possibly occuring, please do not say that it will happen with everyone. Funny thing is that nurisng in the US is so different from everything in your country, that the physicians turn RN that I have owrked with, most do not even offer that they were MDs in their won country, and are usually the shyest one on the floors.

Unless you can give actual specifics that can be followed up, please refrain from posting them. Until that time, they are still rumors, and there are thousands that I have heard that have originated in Manila. Every sinlge thing that you can think of.

And yes, there are some problems with fast-track programs but that is also in the US as well, and it happens with some of the second degree people here as well. And they were not physicians or even in medicine.

Not sure what you have against someone that is trying to do what you are trying to do.

suzanne4, RN · Mar 31, 2006

And just a little bit of information fo you to digest.

The US is a melting pot; of people from all countries, educational backgrounds, etc. If you are to be one of the fortunate ones to work in the US in nursing, you will find people from all different previous backgrounds in the field. Some were actually lawyers, medical technologists, x-ray techs, PhDs in something, science or non-science, etc. Right now, nursing happens to be the want of most people. To say that someone will not be able to handle it because they did something else in their previous life overseas, just doesn't cut it here. And to say that a physican is unable to function here and pointing fingers doesn't work either here. Nursing in the US is more similar to the way that medicine is practiced in your country, than nursing actually is.

Unfortunately, I can name many more nurses that have had issues with a physician, and they did not lose a license over it. I have been an RN in the US for too many years to count, and trust me; I will not sit quiet if I do not agree with something. And I can be very vocal about it. I am there to protect my patient, same thing that you should concern yourself with.

josie1 · Mar 31, 2006

Point taken. First I aplogize for passing "judgement" of Doctors becoming RNs, I was wrong to do this. I have good freinds who are DRs studying to become RNs.

On the described incident: This is not a "rumour" and I have contacted my source who is in the management at the facility in NV of this incident. I have been CCed the e-mails between the principal and their lawyer. I think it would be best if I clear it with them first before I share these notes.

They initialy contacted me regarding this because they wanted to get an "insight" into the Nursing process, curriculum etc. in the Philippines, partly because this incident has put their foreign recruitment program on "review" and they have in turn slowed down the processing of their other RNs. They are also "reorienting" and extensively retraining the Foreign ( They have more than just Fil. RNs) nurses that have arrived as a result.

This has proved to be a very costly experience for them and maybe I may have been a bit too hasty in casting "Judgement" of some of the Doctors- For that I am TRUELLY SORRY. I didnt mean to put anyone on the spot. But I think I FEEL STRONGLY about the seeming "deteriorating quality" of Nursing education in the Philippines. Unfortunately because there are some scrupulous educational institutions that "target" Doctors who are able to pay a "higher" tuition and get the 2 year course compressed into 1.5 as well as provide the 'hospital' exposure and hands on bedside nursing experience- as this one such school that has been in Phil. media advertises. See links below ( Also check out related articles ):

http://www.ebalita.net/go/news/printnews.php?id=2405

http://www.panaynews.com.ph/archives/2006/0227/main%20news.htm

Suffice it to say that the PRC ( Phil. Regulation Com.) and the PNA ( Phil Nurses assoc.)are trying theyre best to hold the line on this and are under a "lot of political pressure" even from the congressman from the province that this university is based. Those concerned within the PNA are now coming out with a list of schools that are accredited by CHED are trying to "Define" standards of Educational performance for RNs. So this is "facing" a lot of resistance from people who stand from benefiting from the "shortcuts" of this process.

My concern is "shortsighted' actions like this will ruin the image of Phil. nursing in the long run if it is "prostituted" to those with the money & power. There has been the parallell anecdote of the "nata de coco industry" & how a good thing for the Philippines was lost to Taiwan and Malaysia as an example. We must make a stand!

pinoy_guy · Mar 31, 2006

On the described incident: This is not a "rumour" and I have contacted my source who is in the management at the facility in NV of this incident. I have been CCed the e-mails between the principal and their lawyer. I think it would be best if I clear it with them first before I share these notes.

I don't think you can post their emails here.

they shouldn't have CC'd you the emails, unless you were directly involved in this case.

you can, however, post more details about the case, rather than vague generalities.

what happened, what department, what approximate month/year?

what did the investigations show?

why did the MD/RN lose his/her license, what was cited as the grounds for revocation?

this investigation would have at least 2 reports: the hospital/facility report and the BON report.

where is this MD/RN now? if the RN license was revoked, I would expect him/her to be deported.

what new policies did the hospital/facility enact to counteract this problem?

They initialy contacted me regarding this because they wanted to get an "insight" into the Nursing process, curriculum etc. in the Philippines, partly because this incident has put their foreign recruitment program on "review" and they have in turn slowed down the processing of their other RNs. They are also "reorienting" and extensively retraining the Foreign ( They have more than just Fil. RNs) nurses that have arrived as a result.

excuse me for asking, but are you affiliated with a nursing school or nursing authority here?

why would they ask for your insight into the situation? did they ask anybody else for their insight?

no offense, just curious.

I haven't heard anything about this case. and news like this goes around fast.

I think this is vital information for nursing schools here.

But I think I FEEL STRONGLY about the seeming "deteriorating quality" of Nursing education in the Philippines.

yes, this had been mentioned again and again.

what's the basis for saying the quality is deteriorating? the passing rate? this would be an long discussion...have you taken the boards? how did you feel about the "alternate" questions? regardless of the passing rate, we still get tens of thousands of new RNs every year.

anyway, I wouldn't sweat it.

just go to a school with acceptable quality.

that's why there's the NCLEX exam--to weed out the incompetent.

and people who did not actually go through a nursing course will be found out when they get to the US.

there are working checks & balances in the US.

Unfortunately because there are some scrupulous educational institutions that "target" Doctors who are able to pay a "higher" tuition and get the 2 year course compressed into 1.5 as well as provide the 'hospital' exposure and hands on bedside nursing experience- as this one such school that has been in Phil. media advertises. See links below

thanks for the links.

I would like to point out that the case did not involve only MDs.

the one who filed the mandamus case was actually a nursing student who's also a Lawyer.

Suffice it to say that the PRC ( Phil. Regulation Com.) and the PNA ( Phil Nurses assoc.)are trying theyre best to hold the line on this and are under a "lot of political pressure" even from the congressman from the province that this university is based. Those concerned within the PNA are now coming out with a list of schools that are accredited by CHED are trying to "Define" standards of Educational performance for RNs. So this is "facing" a lot of resistance from people who stand from benefiting from the "shortcuts" of this process.

I'm not aware of any stand from the PNA.

the PRC (actually the BON) is currently investigating, but no official word yet on the findings.

My concern is "shortsighted' actions like this will ruin the image of Phil. nursing in the long run if it is "prostituted" to those with the money & power.

hmmm.

There has been the parallell anecdote of the "nata de coco industry" & how a good thing for the Philippines was lost to Taiwan and Malaysia as an example. We must make a stand!

huh?

lawrence01 · Mar 31, 2006

Josie, I think you should step back a bit and review all what you've said on your posts. There are a lot of double-standards and inconsistencies. If I were one of you're MD-RN friends and I've found out that you're posting demeaning and discrimatory things about MD-RNs I wouldn't be your friend anymore and don't you think (you) posting rumors and hearsays about the state of the nursing educ. system here (in a public forum) does more damage to the reputation of the system as a WHOLE? Think about it (hard !). And what good is it to apologize, when at the very same post you said some nasty things again. In addition, you already heard from someone with years of experience in nursing in the US that what you're saying isn't accurate or at most just an isolated case. Fil. MDs aren't the first to go to US as RN you know. There are many Russian, European MD-RNs too and they did this a long time ago.

What good are your posts here?? What do you have in mind to achieve?? Don't you think this is the wrong venue or forum for those things? You're barking on the wrong tree !!! Most posters here ask for advice on how to go thru the process or give helpful info and help out fellow nurses. Yes, even ask for opinions that may differ from one poster to another but never to damage reputations to certain kind or groups of healthcare providers. There are no positive things that can emanate from your posts.

MD-Rns and other "2nd coursers" always maintains a very low-profile once they're employed abroad. They don't even let others know that they were MDs before. They're not trying to hide it from their american colleagues but sad to say they hide it from fellow Fil. nurses who have a "thing" for MD-RNs. This is their 2nd life so to speak and they wouldn't do anything to blow it.

Just get in and do their job well for their patient's welfare and for their employers as graditude for employing them and get out to enjoy the extra-time they have now for their family.

If you are so concern about the local nursing educational system then put all your energies in that. Since you are so active and passionate about this then write our local BOn and the CHED and the PRC. That's where you should focus your attention to. Not here.

Better yet, be part of the educational system. Some posters here are actually teaching and im-parting their knowledge in our nursing schools right now. Most of these are MD-RNs who will be going to the US and decided to make use of the extra-time they have now while waiting for the immigration process. I say, the Phil. nursing educational system right now is the BEST it has been in decades. And don't you dare say that this is a bad thing too.

You have teachers now that are both Mds and RNs, or lawyer-Rns, PHds-RNs as well as CGFNS and NCLEX passers unlike before. As far as lectures are concern, the local nursing educational system has the best teachers-lecturers now. Maybe you should also do your part and be a "clinical instructor" in the Phils. before you migrate to the US. The local industry would surely benefit from your 3 year experience in Med/surg. This way you'll make sure that skills-wise we are still producing highly-skilled nurses for both local and foreign consumption. You can't be "outside" looking "in" and pls. don't tell me that you actually teached because if you had you wouldn't criticize the system. The only thing lacking in the educ. system is the "technology" and we can't do anything about this unless, our hospitals and ORs goes "high-tech".

suzanne4, RN · Mar 31, 2006

Point taken. First I aplogize for passing "judgement" of Doctors becoming RNs, I was wrong to do this. I have good freinds who are DRs studying to become RNs.
On the described incident: This is not a "rumour" and I have contacted my source who is in the management at the facility in NV of this incident. I have been CCed the e-mails between the principal and their lawyer. I think it would be best if I clear it with them first before I share these notes.
They initialy contacted me regarding this because they wanted to get an "insight" into the Nursing process, curriculum etc. in the Philippines, partly because this incident has put their foreign recruitment program on "review" and they have in turn slowed down the processing of their other RNs. They are also "reorienting" and extensively retraining the Foreign ( They have more than just Fil. RNs) nurses that have arrived as a result.
This has proved to be a very costly experience for them and maybe I may have been a bit too hasty in casting "Judgement" of some of the Doctors- For that I am TRUELLY SORRY. I didnt mean to put anyone on the spot. But I think I FEEL STRONGLY about the seeming "deteriorating quality" of Nursing education in the Philippines. Unfortunately because there are some scrupulous educational institutions that "target" Doctors who are able to pay a "higher" tuition and get the 2 year course compressed into 1.5 as well as provide the 'hospital' exposure and hands on bedside nursing experience- as this one such school that has been in Phil. media advertises. See links below ( Also check out related articles ):
http://www.ebalita.net/go/news/printnews.php?id=2405
http://www.panaynews.com.ph/archives/2006/0227/main%20news.htm
Suffice it to say that the PRC ( Phil. Regulation Com.) and the PNA ( Phil Nurses assoc.)are trying theyre best to hold the line on this and are under a "lot of political pressure" even from the congressman from the province that this university is based. Those concerned within the PNA are now coming out with a list of schools that are accredited by CHED are trying to "Define" standards of Educational performance for RNs. So this is "facing" a lot of resistance from people who stand from benefiting from the "shortcuts" of this process.
My concern is "shortsighted' actions like this will ruin the image of Phil. nursing in the long run if it is "prostituted" to those with the money & power. There has been the parallell anecdote of the "nata de coco industry" & how a good thing for the Philippines was lost to Taiwan and Malaysia as an example. We must make a stand!

Look close at what you have posted, they are investigating the program in the Philippines, not just the Dr to RN programs. And this is very true. And the way that it should be with each and every country. And yes, it should have been done before the Nursing Board there even granted approval to these programs. Apparently, they were not.

There still has to be much more to this story than what you are posting. It is definitely not illegal to refuse to carry out an assignment in the US if you think that it is detrimental to your patient. Especially with medications, etc.

And then something else sits funny with me. Not sure what your credentials are that would make you an expert witness on this, and that is what would be needed. And from a legal standpoint, if this issue is ongoing, it should never be discussed by you or anyone else that is involved in it, and especially on the world wide web. Where the entire world can see it.

This can actually cause issues for both parties involved, not sure if you are aware of this. And it could even get everything thrown out since it was being discussed beforehand. Not sure if you actually looked at the e-mails from the attorney's office, I am sure that it states that this is privileged information and is not to be shared. This is considered violating trust.

And three years of experience of working in the Philippines does not make you an expert in the area. If you are the one that they are using as the credible witness, then you caused a grave error in this instance, and caused more harm anything. You have direct experience with one school only, yours.

---------------------------------

The next thing that I have issue with is that you are telling me that they are rethinking their programs there for hiring foreign nurses. What programs did they actually have in place for providing adequate training for the foreign nurse? What type of training were they actually providing? Is this facility actually a hospital or an LTC? Big difference in the two. Any facility needs to provide at least one month orientation to a new grad coming in, and any foreign nurse coming in, needs the new grad orientation until their skills are checked out, etc. To do otherwise, I would blame the facility 100%, not the nurse. You cannot train in another country and expect to walk into the US and just jump in, it just does not work that way. There are differences in equipment, medications, English language idioms that you have never heard before. So, it sounds like there is much more to this story than perhaps you have even been told about.

But again, this is still up in the air, no final outcomes have come down.

But please let both parties know that you have shared this information on the World Wide Web. Before they read about it somewhere. Unfortuately for you, this bulletin board is the largest nursing bulletin board in the world, and can be Googled, etc. by almost every single search forum in the world.

Please do it, before they find this when they are researching for their case.

And again, so far this is 100% an isolated case. So please be very careful what you post, if you do not have permission in writing to do so.

nrswnabee · Apr 2, 2006

Whew, I thought I'm in doctors-to-nurses-to-lawyers thread...(kidding, smile!).

Josie, I'm sure you only meant to initiate a healthy discussion on a controversial what-if proposition... however what you posted rubbed many people the wrong way. (You had a bad day....., don't worry, people have them...) It seems to suggest that doctors-turned-nurses could be bogged down by the past medical background (or "Dr. ego" you'd call it..I'm not a Freud fan so it's really something I find hard to swallow, really...), making them not as effective as original nursing graduates.

I think the situation you suggest ISN'T entirely impossible however given how this popular career shift is greatly valued as a chance of a lifetime among many Pinoy MD/RNs today, it will take SO MUCH for them to consider risking their newfound license along with their new LIVES. Yes, it's A risk because as a Pinoy RN (whether former MD, second-degree or first courser) in the US, you have more than a handful adjustments to make to even think of challenging any licensed professional. I'd like to believe our Pinoy MD-RN's know better than being impulsive or careless. Of course, you CAN champion the care of your patients without having to sacrifice your own career.

The case you mentioned came across as a pathetic exemption. I can only speculate that this Pinay RN's challenging the NP caused the life of or aggravated a patient with her undoing otherwise there couldn't have been sufficient ground to revoke her license or dismiss her. She just made a mistake borne out of wrong choices and not because of being a former doctor or ego or anything like that. (Negligence? Bad attitude? Incompetence?) For her employers to react to her case by "rethinking" their foreign nurse recruitment and even go as far as digging up Phil. nurses' education is too much...as if they can predict the behavior of other nurses with this single error of a doctor-turned-nurse?

Anyhow, I can go on and on speculating and not really get anything useful out of it because as you say, it's still an open case. I hope and pray that it finds a reasonable resolution.

suzanne4, RN · Apr 2, 2006

this article was brought to my attention today, and you may find it interesting. it is about mds that are going the rn program in florida and what they are facing.

http://nursingadvocacy.org/news/2004feb/17_npr.html

suzanne4, RN · Apr 2, 2006

To say that the facility is rethinking their entire program based on this, is just not the entire story no matter what. If there is a legal case, and it has not been completed yet; by posting about it, there can be legal consequences for the poster to have to deal with.

Unless there are exact facts that can be researched and verified, it is not fact. It is still considered hearsay.

The same way that someone knows someone that has been deported from the US because they were coming to take the NCLEX exam. Trust me, there is always more to the story than is being told. There are just too many rumors flying around Manila, and until I actually see documentation from a US Government source, about a license that was taken away, or from immigration, they are just rumors. There are way too many flying around too count.

And I am not sure what most of you do not understand. There are employers that also read this forum, and for things to be posted that cannot be verified, actually makes it much worse for all of you. And can be very damaging for those of you that wish to work in the US. There is alot more to this story about the nurse in Nevada, you do not lose a license for not agreeing to do something. Not all is being told, if in fact is exists.

If you could get fired in the US for refusing to do something that a doctor or another provider ordered, that you thought was detrimental to your patient, then every single nurse in the US would be guilty of this at one point or another. If you do something and it causes issue with the patient, you are just as liable for the order as the physician or provider that ordered it. Please remember that. So until all facts are public knowledge, please refrain from speaking about it here.

Unless you have proof that can be verified, please do not post it as the truth.

dilimon · Apr 3, 2006

josie1 has a lot of angst.. what happened to u?

.. just curious..

josie1 · Apr 6, 2006

josie1 has a lot of angst.. what happened to u?
.. just curious..

I had been working my 2 jobs over the weekend through yesterday and have also gotten a response back from my management contact and client where I had been asked to provide insight.

You are right, Suzzanne- It looks like I may have gone too far to site this case, I had been consulted on, especialy with my limited knowledge. And pleading ignorance is no excuse. I am new to this World wide Web forum like this and did not know it had such a public view. I have been instructed not to talk about this case with anyone anymore, other than my clients and their attroney.

I started with a hypothetical situation and I just got carried away emotionaly and wrongly went beyond my limited and confidential knowledge of this case. For this I am sorry especialy to my client/ contacts and their attorny. I will see what I can do to erase - remove all my messages regarding this matter. My involvement, feedback and consultation had to do with the fact that I was involved in some of the interviewing and screening of my clients RNs before they were hired. I had also been hired for their perdeparture U.S. accluturation progam which I took on reluctantly because I had lived in the Nevada for only 2 years. When they called me again, I felt it was my responsibility to try to 'rectify' or fix what I thought was my failure to set up the right screening and hiring process. My client was very upset with me and I promised not to discuss this matter any further beyond this apology.

Let me just say that I think we need to hold each other and our standards of education and our nursing process in the Philippines - to 'higher' standards of integrity and transparency so that we can continue to provide the best RNs wherever we are needed - at home or around the world. We all owe that to ourselves, our families, our profession, our patients and our 'kababayans'.

suzanne4, RN · Apr 6, 2006

Thank you for clearing up any questions that we had about this.

And the World Wide Web, means just that. Anyone in the world can read it, especially when it is in an open forum. And we are the largest nursing bulletin board in the world, and are tring to set the standards in the field.

Thanks again..............I hope that you will continue to participate in these forums................