Nursing shortages, Baby boomers and the immigrant nurse Part 2

[madwife2002]

Update on Nursing shortages, Baby boomers and the immigrant nurse

The opinion is almost equally divided between the main two options - please review poll thread for further information.

Now what we really should investigate is when we say 'foreign nurses' who are we really referring to? Are we referring to Green Card holder? Or are we referring to foreign born and trained RN's? Is there a difference I hear you contemplating? Well I could predict that this would alter the opinions because those who are finger pointing may well have Green Cards themselves, even though they have probably lived for most of their lives in the USA, or have parents who remain legal Aliens and not US citizens.

Nobody complains about legal Aliens who are not RN's in the same way yet the majority and I say majority loosely because it is my opinion that almost 100% of nurses in the US are either 'legal aliens' or are already 'US Citizens, the exception these days are some Canadians who are still on working visas.

I am pretty sure somebody will prove me wrong, but hey that is the fun of these blog's and hopefully initiates some good conversation in a safe environment.

It is also my belief that the ones who criticize have no to little complaints against British, Canadian, Australian, and any other English as a first language speaking RN? The main complaints seem to be against Filipinos, Indian, and any RN who has an accent. Ok now I will bow my head and wait!

So I leave you with a thought If you are a Green Card Holder who trains in the US to be a RN, are you taking the jobs from the American Nurses or is this acceptable????

[paddlelady, BSN, RN]

This world has become more international. We should all be ambassadors of good will toward those who come and work in the US as well as the Green Card holders and the Foreign nurses.

What I think should distinguish nurses is not where they were born but is the "individual qualified" to practice safe, ethical nursing in the United States. This is the question. This is where QA comes involved in the nursing arena. Also in the interview and hiring of all nursing applicants. I have been taken care of nurses from the US that I would not want to come near me again. It is an individual practice issue. Yes the cultures vary but we all need to be cross culturally trained and understand each other in the medical arena.

The current generation is becoming more international and will be more tolerant and understanding of the various cultures of nurses that are practicing. Again training and competience are the issue.

I worked in Hawaii for awhile and the Filipino nurses would speak their dialect while working on the different units. This made patients and the other staff very uncomfortable . Complaints were made to administration and the speaking of the native tongue was confined to the break room ONLY . Even then it was a bit uncomfortable. This is just an example and not meant to isolate the Filipino nurses. But however, I dont think they were culturally aware that speaking their native tongue in the hospital was uncomfortable to others. We need to teach each other the social mores. Not to critise a particular group. This is how we learn to adapt to specific places that have multicultural population.

Paddlelady

[momology]

I think that with the surplus of unemployed nurses already here we should stop the H1B visa program until the economy improves. It is true that the schools are misleading people that there is still a shortage and opportunity out there. They were really meeting the demand to get into school that was generated by the shrinking of other jobs. There have been ten or more applicants for every opening in ns school for some time now. If there ever was a shortage - and my professor told me it was only a projected shortage anyway- then why weren't our schools providing for that need instead of bringing in unverifiable degrees from other countries. there was also a large scale cheating on the nclex scandal in Manila wher they administer the nclex. I question draining medical professionals from other countries that actually do need them. As for the english issue, I have had many patients complain about this. Is that too much to expect to have nurses who are fluent in the language of your own country?

i hate to sound hopeless but I do not see any immediate improvement as many people are losing their insurance and the medicaid rolls are being shrunk because of budget crunches. California took way hearing aids from the deaf and vision and dental care. So, is this really the time to up H1b 50,000? are you suggesting that we leave our country? Where can we immigrate to and get their jobs?

[DEALYNSO]

Coming from a city where one hospital "merged "with another hospital and then within a year let go all of the LPN's who had worked at both of the hospitals I just shake my head. I am an RN in a private practice who occasionally has to call one of the three campus' owned by the one system. I do not like getting one of the imported nurses who may be very well qualified as a nurse but whose english skills are not. Trying to relay a message of vital importance related to one of my patients who has been admitted and having a nurse who cannot ,after several trys repeat back the information in an exceptable manner is negligent on the part of the hospital. I am pretty sure the information was not relayed as it was no where in the discharge information from the hospital. If a nurse cannot communicate acceptably with their english speaking patients how can they provide teaching and education that the patient may need on discharge.

[It'sMe, RN, BBA, MBA]

The recession is a double edged sword. It shrinks the jobs availability pool at the same time it increases the job applicant pool. With hospitals in particular, this is the time to take many actions that will improve the quality of care provided in their institutions to make them more competitive. One of the largest components of quality of care to the patient is the staff that takes care of them. The Registered Nurse is the hospital to the patient. Patients don't see or think about the other care providers. The nurse is the central figure in their perception of the care they receive in the hospital. Hospitals need to take the steps now to round out their staffs to have only the best and the brightest of RNs on their team.

Hospitals should take these steps:

1-Hire new graduate nurses at once. All of them. Create positions for them if you have to even if you don't have a slot. Attrition will pare down the labor costs. Hire from the highest to the lowest degrees first. Start with MSN, BSN, ASN.

2-Eliminate all agency.

3-Eliminate all visa nurses.

4-Eliminate all LPNs.

5-Install quality improvement programs that measure each RN based on their performance. Those with high customer satisfaction scores remain, those with low scores get eliminated. Happy smiling RNs should replace Nurse Ratchet who has remained an employee because there were no other nurses.

6-Fill up your PRN pools with as many RNs as you can get to sign up. Lots of RNs are looking for back up positions "just in case." Let them know that you are there for them.

7-Immediately employ RN retention programs that create an environment that is warm, caring and rewarding for your RN staff. If costs money to get them, it costs money to keep them but it costs even more to lose them.

8-Pay higher than any other employer that is competing for your staff. Stop planting rose bushes in front of the parking deck if you have to but improve pay for RNs across the board. RNs do stay at the bedside when the pay is high enough to make it hard to leave. A well thought out and well executed RN retention program will make sure that higher pay is simply the icing on the cake.

This is a start. This is probably the only time in the next 20 years you are going to be able to address the nursing shortage effectively and timely. Soon, you will be behind the curve and it will cost you even more.

Hospitals that did not do this have failed.

[inthealth]

I do not like getting one of the imported nurses who may be very well qualified as a nurse but whose english skills are not. Trying to relay a message of vital importance related to one of my patients who has been admitted and having a nurse who cannot ,after several trys repeat back the information in an exceptable manner is negligent on the part of the hospital. I am pretty sure the information was not relayed as it was no where in the discharge information from the hospital. If a nurse cannot communicate acceptably with their english speaking patients how can they provide teaching and education that the patient may need on discharge.

What about an 'imported nurse' who is qualified and Enghlish skills are there? would you get one of those?

[dmdmd]

I think this is a interesting reply. I work in Texas, and we have many, many non-English speaking patients. It puts me at a disadvantage to not speak other languages. We all try to learn, and a nurse that is multi-language competent is a definate advantage. Granted, if you live in the U.S. you need to learn the language. If I worked in Kenya, I'd want to learn the language. Give us all a chance, and learn other things. Multi-culturalism is a necessary thing these days.

[ton2]

Finally, there are some people who will make the whole argument out to be a racist thing, I really do not think that it is. If you were a nurse manager hiring a new graduate nurse, would you: A) Hire the nurse educated in the US with English as there first language? B) Hire the nurse educated in the US with English as there second language? C) Hire the nurse educated in Europe, who speaks fluent spanish with english as their second language or D) Hire the nurse educated in China with english as their second language?

Who would you hire out the the 600 applicants? My guess is that you would hire A or B.

I'm all for buying American, but so many "American" goods and services are made, assembled or trained outside the United States. There needs to be another option added: E. The nurse educated outside the US with English as their first language.

I was born in the Philippines, and moved to the US when I was five years old. I eventually served in the US Army as a medic for 8 years. After 27 years, I returned to the Philippines and for a multitude of reasons I decided to pursue my nursing education there rather than stateside. When I graduate in 2011, I will fit in the aforementioned category E and fully expect to be marketable under any circumstances in the US. I am not an exception; there are many others going down this road.

[ton2]

there was also a large scale cheating on the nclex scandal in Manila wher they administer the nclex. I question draining medical professionals from other countries that actually do need them.

Are you referring to the scandal in 2006? If so, the scandal pertained to the local board only. The NCLEX had yet to be administered in the Philippines at that time.

I have no exact umbers to give you, but the Philippines has been exporting highly skilled nursing professionals for decades now. If any country can withstand the wide scale departure of nursing professionals, it is the Philippines.

[paddlelady, BSN, RN]

"all the american i know..have nothing to live for or nothing they wish to acomplish in life.after all..the americans..right."

I am not sure what you are trying to say in this sentence. We all have something to live for and look forward to. I have worked in many states and have travel and people have goals and dreams. I have worked with patients that have goals to live and see their children graduate from school or meet their first grandchild or to marry or continue their education.

None of us had it that easy in Nursing school no matter where we attended school . Obtaining jobs when first graduating from nursing school was difficult even 40 years ago we only made 3.05 and hour and worked very very hard.

I have been turned down for jobs because I am caucasian and some of the jobs I applied for they were looking for hispanic, black or other cultures. So I have been turned down and I have some wonderful cross cultural experience.

I think many of us have been turned down for various reasons.

I just wanted to make you aware that there are others that share your frustration. What I dont hear in this discussion is that landing the RN job isnt about the money or status it is taking care of the patients safely. Taking care of them as we would like our relatives or children taken care of . If it is just about landing the RN jobs for the money and status then I would reevulate your goals.

Regards

Paddlelady

[pej11uk]

" I do not like getting one of the imported nurses who may be very well qualified as a nurse but whose english skills are not. Trying to relay a message of vital importance related to one of my patients who has been admitted and having a nurse who cannot ,after several trys repeat back the information in an exceptable manner is negligent on the part of the hospital. I am pretty sure the information was not relayed as it was no where in the discharge information from the hospital. If a nurse cannot communicate acceptably with their english speaking patients how can they provide teaching and education that the patient may need on discharge. "

Well said Dealynso.... But please check your spellings, moreso, check whether the word actualy exist before you criticize your so-called imported nurses. Peace!

[tothepointeLVN, LVN]

If I was the manager I would hire the bilingual nurse, because the fact is, the patient thet do not speak English will always be there.

The hospital I am doing my final clinicals at have a wonderful way of doing things. They have different floors for speakers of another language. I am on the Korean/Japanese floor and I love how they have japanese and korean speaking nurses for the non english speaking patients. If we all work to our potiental as nurses there will be places for all of us.

It's about skills not nationality. However for those multilingual nurses when your around me and we both speak english as a common language I would appreciate it if you could speak it as if you don't I'm going to assume your talking trash about me If you speak german and maori well maybe those too. As long as I can participate in the conversation.

[tothepointeLVN, LVN]

" I do not like getting one of the imported nurses who may be very well qualified as a nurse but whose english skills are not. Trying to relay a message of vital importance related to one of my patients who has been admitted and having a nurse who cannot ,after several trys repeat back the information in an exceptable manner is negligent on the part of the hospital. I am pretty sure the information was not relayed as it was no where in the discharge information from the hospital. If a nurse cannot communicate acceptably with their english speaking patients how can they provide teaching and education that the patient may need on discharge. "

Well said Dealynso.... But please check your spellings, moreso, check whether the word actualy exist before you criticize your so-called imported nurses. Peace!

I guess that's what they call a criticism fail:D