Emergency Nurse Relief Act 2009- Update

Hushdawg · May 27, 2009

From what I read on the board, from posters in the Philippines is that conditions except for a few tertiary hospitals are primitive.

You are full of xenophobic comments lately aren't you?

I'm really surprised at your comments lately.. I didn't think you would be the type to talk this way.

While it is true that PH government and low-income hospitals are set at a much lower standard than US hospitals, there are many that are closer to US standard.

That being said, the nurses here are still educated in modern techniques and methods. Nurses are educated with the understanding that most will be going abroad to US, Australia, NZ and Middle Eastern countries.

You should also be aware that a very large number of PH nurses are working in hospitals in the Mid-East that are at or above US standards of healthcare. These nurses are the ones who are still trying to get to the USA.

It is very common for a nurse to get her license in the USA and then go to work in the Mid-East to get experience while waiting for visa applications and job offers in the USA.

In many ways this multicultural training scenario is what makes Pinoy nurses so attractive to US hospitals.

misplaced1 · May 27, 2009

This is the second industry I have been in with a "shortage". And of course it is the people from third world countries that come here to work because people in other countries, ie Germany, Sweden live in places where jobs go to the people that live their first and so they don't need to leave there home country to be employed. honestly, I don't see masses of Swedish people getting nursing degrees and immigrating to the US!

And as far as that goes because I wa already involved in one "shortage industry" I am used to working with lots of foreign born people. I loved it, I love them. The individual people I loved. But, the fat remains that it is not fair to anyone, including the countries where these people are coming from, actually mostly their home countries, for a great number of their best and brightest to immigrate. The key is to boost up the economies of these third world countries NOT create third world brain drain as we are doing now.

The difference between my old industry in nursing is that nurses actually help to replace themselves. At least other people in other industries, ie like in IT will shout out that it is not fair. Nurses are the perfect target because they will not even do that. They go on about patient care etc etc and dont even consider themselves like good little nurses. Other people in other professions think it is ok to look out for themselves. If you try to look out for yourself in nursing heaven help you. I am telling you I have a PhD in another field and I am thinking that if I decide to leave nursing, if I can, I better not put that RN behind my name or people will think they can take advantage of me. I never realized this before but it is the truth. I feel quite sad about it.

Not just for me but for so many of you that are being used, and defending the people THAT ARE USING YOU. This is not a patient care issue. American people are capable of being nurses and capable of giving GREAT CARE. I mean come on I dont know about you but my education was top notch. This is all part of the MATRY problem that is so prevalent in nursing. Only the BEST person should do the job to give the BEST patient care. Believe that there are BEST people out there that may do the job better than you yada yada. Well, I have news for you. Nursing is a job that LOTS of people can do. Just like MOST JOBS. And those LOTS of NURSES that are needed to do the job can be hired from the US or from somewhere else. If the MATRYS out there don't mind that the people that do these nursing jobs that LOTS of people can do are hired from somewhere else instead of here, well I suppose they don't mind living in cardboard boxes. I do. And since WE can also do the job why not hire us?

IMO everyone needs to stop with the self important marty act and cop to the fact that this is a job. you get paid for it. AND it is a job lots of people are qualified to do like MOST JOBS. If you want to be a nun be a nun but this is a job. It might be a job that you love, it might be a job that takes lots of time and that your willingly put your heart in but its still a job. Until you stop taking the paycheck its a job. But some of you can't admit that.

Heck, maybe these nursing positions should be 100% volunteer. That would fix thing huh?

i am with the other poster that said I feel like a rat on a tredmill. There are many nurses I know right now that don't have health insurance. Taking care of people with no job that are fully covered. something is wrong with this picture. It is just so wrong in so many ways. But becasue of the martry issue I dont see it ending.

Nurses are the perfect group to pick to take advantage of due to this attitude. It really was a stroke of genius on the part of some very smart industrialists. You almost have to admire their intelligence and insight.

I know one thing, thinking from a purely financial standpoint, this is what I would do if I wanted to have my hospital or other facility make money. I would have advance practitioners doing lots of the primary care and psych and anything else they could do. They can bill and be reimbursed so they are money makers. I would replace physicians with them in any role possible. I would put physicians in the high tech areas where I could advertise their expertise.

I would have a great deal of the jobs now done by nurses done by techs. Anything that doesn't absolutely have to be done by nurses I would have done by techs and nursing assistants. That way RNs could take more patients. There is way more in the hospital and other settings that can be delegated than is right now. Moreover you can have RN's supervise a number of these people and have the RN as the fall guy if something goes wrong. In fact since techs and NAs are unlicensed the hospital may even have less liability this way but I am not going to go into that here.

In the future I suspect that more videotape or voice recorders will be carried by employees to cut down on charting. Employes could be dedicated to translating the video and recordings to written charting if that was required. In the case of a lawsuit, the tape or recording could always be consulted. Right now I suspect hospitals don't want this but I can't see how it will be avoided.

Nurses are an expense. The best way to increase profits is to reduce expenses. I believe that nurses are the largest hospital expense. So they would be the biggest target for reduction. You can't bill for nursing services in the way you bill for doctors or NP or PA services. As long as nurses are an expense, even in a nonprofit, managment will be trying to do with less. Historically the best way to do with less is to hire immigrant labor. If it were not for the Chinese being worked into the ground, we would never have our railways. This is not to put down immigrants in any way. It is just the way it has always been historically. Check your history books.

It is just dollars and cents. If we want to give away our jobs. They will certainly be glad to let us give them to people who are desparate. ANd the sad part is from what I have seen in nursing, nurses are easily guilted into believing it is for the best, or the right thing to do as they often do not even consider themselves at all. The codependence in nursing is rampant and ingrained and I don't think its going anywhere soon. And that, from what I can see is what is destroying this profession. Codependence is destroying what should be a glorious profession.

HippyGreenPeaceChick · May 27, 2009

We have the richest most expensive healthcare system by far and above anywhere else in the world. Why does the W.H.O. rank us number 37th in the world as to quality. This has nothing to do with importing nurses. This has nothing to do with the care we give. So why are we 37th. This irritates me. I also believe in Universal Health Care or as some call it the Single Payment System. What can we do to return ourselves to being number 1 in the world. We lead the world in wars, let us instead lead the world in healthcare.

rainbow11 · May 27, 2009

To Alex49 and others who are against ENRSA,

I'm reading your comment and laughing, ha ha ha. I got my BSN degree from the States, I passed NLCEX the first time I took it, and I have a US RN license. I was the only foreign-student in my BSN program, in terms of my grades I was the 2nd from top. Anyway, I think the US Immigration system is all screwed up, it does nothing to attract foreign-born (many are US-educated) young, intelligent minds. Even though I went to the same school as my fellow American classmates, I have same RN license --- I am UNABLE to work simply because I'm FOREIGN-BORN and there is no damn visa for foreign nurses at present. So, please try to put yourself in my shoes for a second before you jump in a conclusion! I'm sure there are hundreds and thousands of foreign-born new grads from US nursing programs in a similar situation like me. Is that right for us to be "punished" and not be able to work, just because we are foreign-born?! Indeed I am always proud of where I am from (btw, I'm not a Phillipino).

Also, the Department of Labor determined a long time ago, that RN is one of professions in shortage. You guys keep argueing if nursing in shortage or not... I do not know, but I do not think they came up with these kind of stats out of nowhere http://www.govtrack.us/congress/billtext.xpd?bill=h111-2536

(2) Over the next 15 years, this shortage is expected to grow significantly. The Health Resources and Services Administration has projected that by 2020, there will be a shortage of nurses in every State and that overall only 64 percent of the demand for nurses will be satisfied, with a shortage of 1,016,900 nurses nationally.>> When I check any hospital web site in my area there are plenty of nursing jobs, that I can tell you for sure.

So, right now it looks like all my efforts, time and money, put into nursing career here in the States is thrown to "trash". I have a USELESS US RN license lying somewhere around. All I wanted is to work LEGALLY as a nurse in the States for a few years (since I went to school here) and see how nursing is like in real life...

You know what? Since I could not work and get paid like everyone else, I decided to work for FREE. I tried to do a clinical voluntary job, but I was told by many hospitals I could not do so because of HIPPA. I can go on like this, but I'm gonna stop it here. My point is do NOT look at this from ONE ANGLE only! I'm sure there are many different interests in regard of this issue. Try to look at the big picture and understand how some of us worked very hard and made all the efforts, but afterwall are being treated UNFAIRLY! I DO NOT CARE WHAT YOU GUYS SAY, I am hoping H.R. 2536 WILL BE APPROVED soon!! Because that will give people like myself opportunity to work legally in the States.

Hushdawg,
You make a living counseling RNs who wish to immigrate to the USA and you do not practice in the USA ( Much different then knowing trends) so I would say you have a vested interest in seeing this bill approved. Not that this is bad, but your viewpoint is very different than a practicing nurse.
My point is a nurse should get the education for the country they plan to practice in the country. Not having the proper education in the area and local you wish to practice is a disadvantage .
UK Nurse= UK Education
Canada Nurse = Canada Education
etc, etc.
The thing is some countries are trying to make a living by exporting nurses to other countries. In my opinion they only way they are going get an equal education is having a equal clinical experiences, this can happen by having hospitals and clinics that are set up to the country they wish to practice standards or have rotations ( that are approved by the BON) to meet their standard.
This has nothing to do with a nurse being different color or race only based on education and citizenship of the nurse.
For a long time, there was a thought a nurse is a nurse and you can float a nurse to any location in a hospital and the nurse should be able to function without any orientation. No one excepts that any nurse moving to have a detailed orientation yet this bill proposed that nurses from a foreign country can jump in and function at 100% , sorry I don't buy it.

Hushdawg · May 27, 2009

Why does the W.H.O. rank us number 37th in the world as to quality. ... We lead the world in wars, let us instead lead the world in healthcare.

I just want to say that I love you for this.

Hushdawg · May 27, 2009

I got my BSN degree from the States, I passed NLCEX the first time I took it, and I have a US RN license. I was the only foreign-student in my BSN program, in terms of my grades I was the 2nd from top.
....
Even though I went to the same school as my fellow American classmates, I have same RN license --- I am UNABLE to work simply because I'm FOREIGN-BORN and there is no damn visa for foreign nurses at present.

You should contact an immigration attorney and see if there is an alternative for you.

Some free advice: There are alternatives to retrogression; you need a lawyer and some patience but you can still immigrate legally and work if you fit certain qualifiers.

I understand how you feel. When I was in Chicago I was working with a community of Arab nurse graduates who were struggling to get legal status to work; luckily we were able to find ways to get them to immigrate legally because of the state of war and their inability to return to their defined "home" country.

So now there are a few dozen patriotic Arab-American nurses working happily in the greater Chicago metro area.

I hope you can find a solution soon for your situation.

Ginger's Mom, MSN, RN · May 27, 2009

You are full of xenophobic comments lately aren't you?
I'm really surprised at your comments lately.. I didn't think you would be the type to talk this way.
While it is true that PH government and low-income hospitals are set at a much lower standard than US hospitals, there are many that are closer to US standard.
That being said, the nurses here are still educated in modern techniques and methods. Nurses are educated with the understanding that most will be going abroad to US, Australia, NZ and Middle Eastern countries.
You should also be aware that a very large number of PH nurses are working in hospitals in the Mid-East that are at or above US standards of healthcare. These nurses are the ones who are still trying to get to the USA.
It is very common for a nurse to get her license in the USA and then go to work in the Mid-East to get experience while waiting for visa applications and job offers in the USA.
In many ways this multicultural training scenario is what makes Pinoy nurses so attractive to US hospitals.

You keep saying Pinoy nurses are so attractive to US Hospitals. That has not been my experience, in the 1990's many local hospitals tried experimental programs which failed miserably. In my area I have not seen an imported ( not a Pinoy nurse with lots of experience here in the USA) Pinoy nurse hired.

In another post, you stated the hospitals love Asian nurses since they have great customer service skills. My not scientific experience has been that the patients complain more. Recently, though, when I read an article that talks about using a group of foreign nurses in a large amount, I do go to hospital compare and look at the nursing measures, every time I do this I see these hospitals are below the national average for patient satisfaction.

As far as my comments I am only repeating what I have read here on this board, how there are no disposable gloves, the poor patient nurse ratio, the re use of needles with out autoclaving, the lack of IV therapy training. The nurses are not exposed to computer charting and modern methods of medication administration. The use of volunteer nursing, instructors with the lack of clinical experience, lack of clinical assessment tools ( perform by doctors). Are you saying all the posts by these nurses are false?

Is the Canadian government misinformed when they imported nurses ( the cream of the crop) and once carefully evaluated they are only qualified at the LPN level?

So should I discard my observations, my personal, the stats ( the lack of many foreign nurses being able to pass the NCLEX), the posts here, the news I read in the paper or believe immigration lawyers and posters like you.

The issue is there are been an explosion of Pinoy nurse graduates who have not been able to come to the USA since retrogression and many are not working as nurses, how do you think they can gain employment as time ticks on.

I do believe you are helping nurses in the Philippines, but the issue is that they are educating nurses to export them without consulting the countries they are exporting them to.

My last issue, I think there are good to great people in even culture, I find it offensive for you to state that Asian nurses have better customer service skills, my experience as a nurse and a patient is that they are the same as any nurse, I find that an offensive comment.

Hushdawg · May 27, 2009

So should I discard my observations, my personal, the stats ( the lack of many foreign nurses being able to pass the NCLEX), the posts here, the news I read in the paper or believe immigration lawyers and posters like you.

No, you should not discard observations and statistics, but you should put them in place.

So what if nurses cannot pass NCLEX? You'll never see any of them! You'll only see nurses who are able to pass NCLEX.

You complain about poor education; yet you fail to understand that nurses who are going to junk schools are not going to pass local boards or NCLEX and therefore would not be practicing in the USA.

Problem solved!

So many of your complaints and "concerns" about healthcare conditions in other countries have absolutely NOTHING to do with whether or not nurses who are hired at your hospital are going to be good or not because they have ALREADY BEEN SCREENED ALONG THE WAY.

The issue is there are been an explosion of Pinoy nurse graduates who have not been able to come to the USA since retrogression and many are not working as nurses, how do you think they can gain employment as time ticks on.

Other countries are still hiring. As I've said before, many nurses go to work in the middle east to gain experience while waiting out retrogression. Others have immigration lawyers that have helped them with alternatives to retrogression and have been able to get to the USA and start working already (though these are a small minority).

I do believe you are helping nurses in the Philippines, but the issue is that they are educating nurses to export them without consulting the countries they are exporting them to.

Again untrue. Many of the universities here are coordinating with US hospitals and US colleges of nursing to increase the quality of education.

Many NCLEX schools are increasing the level of information by using only programs which are created and certified in the USA.

My last issue, I think there are good to great people in even culture, I find it offensive for you to state that Asian nurses have better customer service skills, my experience as a nurse and a patient is that they are the same as any nurse, I find that an offensive comment.

Did I say that all Asian nurses have better service skills?

Did I say that all Asian nurses have better experience?

No, what I said was that there are reasons which make Asian nurses more attractive to hiring hospitals in the USA. Those being the multicultural experience that Pinoy nurses often get by working in US-quality hospitals in the Mid-East as well as dealing with difficult conditions here in the Philippines.

I have also said that many hospital staffing personell have stated that THEY FEEL that Asian nurses provide better compassionate caregiving. I was careful to state that as it was the opinion of others that I have talked to.

If you want to ask my opinion as a patient, I have to admit that Asian (Pinoy, Vietnamese, Chinese and Korean) nurses have been much gentler and kinder to me than SOME American nurses. However I have also had excellent experiences with American and Arab nurses. The fact that I have had negative interactions with American nurses and not a single negative interaction with Asian nurses might tilt my view a little. Additionally the fact that the best blood draws I've ever had have been at the hands of Pinoy nurses (male and female).

I will never trash American nurses; it would be stupid to do so and I do sincerely apologize if you have been offended by any of my statements. Believe me when I say that I have the greatest respect for anyone who chooses an occupation of service, compassion and care.

Lastly, I know you have taken issue with me because I am not a nurse and therefore do not have a nurse's perspective. I am well aware of that. Please understand that I have worked closely with medical professionals for many years now. The current occupation I hold in the Philippines is only the last year of my life, before that I worked with doctors, nurses, EMTs and other assorted healthcare workers in many ways. I feel that my input is valid because of the diversity of persons and cultures that I've worked with in regard to various aspects of medical care and coordination.

Silverdragon102, BSN · May 27, 2009

Closing this thread for a cooling off period

Silverdragon102, BSN · May 28, 2009

OK. Reopening the thread and can we please try and keep this to a more constructive and friendly debate

Hushdawg · May 29, 2009

Yes Ma'am! Thank you for the gentle reminder.

I'd like to suggest that we stop using arguments of substandard education and healthcare facilities as a reason not to bring nurses in from outside the USA.

It is very demeaning to non-US nurses who do not fit into the stereotype that is being perpetuated.

Non-US nurses who are passing NCLEX and have been accepted as potential hires by US Hospitals are already going through massive screening processes at the BON level as well as the hospital administration level to ensure that only quality care providing nurses are being hired to work in the USA.

Let's focus on the real issue at hand which is NOT the imporation of nurses in general; but rather the extension of 20,000 green cards annually with adjustments as needed (under review each year) for RNs to fill the impending (not current) nurse shortage.

This of course will overlap issues of nurse employment in general in the USA and nurse working environments/conditions/treatment by hospitals/etc.

Fair enough?

lawrence01 · May 29, 2009

Let's focus on the real issue at hand which is NOT the imporation of nurses in general; but rather the extension of 20,000 green cards annually with adjustments as needed (under review each year) for RNs to fill the impending (not current) nurse shortage.
This of course will overlap issues of nurse employment in general in the USA and nurse working environments/conditions/treatment by hospitals/etc.
Fair enough?

Don't forget to mention that it's only good for 3 years then it stops.