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I am leading a project of palliative care in ICU now, and early implementation of palliative care for ICU patients are strongly encouraged due to uncertain outcome of recovery. After the pilot project, we found early implementation of palliative care in critical setting actually decreased utilization, length of ICU stay, and cost, however, mortality rate didn't change, but DNR was signed early and family satisfaction was increased (unable to assess patient's satisfaction). When we talk about the angery family in ICU, we talk about a 20-yo who left home this morning and end up in hospital with half of head left due to a car accident. We understand the sorrows from parents, but we also know there are tons of ppl waiting for organ transplants. How often does this happen in my career? At least once a week. Meanwhile, geri-psych and gerontology have been introduced to ICU nursing care many years ago due to aging population. The vent weaning, sedation, disease process are all different for this population. I had a 104-yo peritonitis with open bowel surgery combining VAC for 3 days, who was hemodynamic stable after closure then sent to surgical fl. After I experience all the excitment, I'd follow my roommate's pathway, working in a government funded LTC facility. Caude I want to save some energy for my family instead of getting exhausted after work, and the paid is the same.

My roommate works in a government funded LTC facility, and the ratio of RN and resident is 1:12 with the support of RCAs and volunteers. She is at the top of level 1 with more than 300 hrs vos and 1000 hrs of sick time. I work at level 3 trauma centre dealing with CRRT, organ transplant and ANGERY family. I am at step 8 of level 1 with MSN. I agree working in LTC requires special skills. However, I haven't heard ppl jump from LTC to critical care. My roommate worked in my unit several years ago. When she transferred to LTC, she didn't even need to get any certificate.

BC might be a good choice for you. CLPNBC authorizes BCIT for credential assessment, ICES, and the process timeframe is reasonable for me which was within a month according to my personal experience. You can check detail here http://www.clpnbc.org/index.php?dbq=9#4897

OPT is 12 months per person (combining BS, MS, and PhD). You can postpond your graduate to spring, then apply H1B in April. While you are waiting H1B approval, you are allowed to work under OPT.

I worked in both countries for a while. When I worked in the States, the currency exchange rate was USD:CND = 0.6:1. Although I made $25/hr in the States, it's actually $42/hr back to Canada. Meanwhile, US employers pay differently based on care setting. In Canada, working in ICU gets the same paid as working in LTC due to Union pay grid.

the state dept officially stated that the schedule a numbers (green card quota for rn & pt) will expire probably in october. there is a general consensus among employers and recruiters that additional visas will be made available maybe within 6 months to 2 years.

i wrote nm bon several weeks ago. the officer said ssn is required to renew rn license.

Hi msrclim, Did AZ BON issue you a hard copy of RN License without SSN? Or you already have had SSN before you applied it?

Nightngale, It depends on positions. But, regularly, It's close in Los Angeles area.

Nightngale, My international nurses don't contract with me. They contract with hospital directly. I am more like a head-hunter, not a staffing agent.

HarryHK, The main reason I started my business was tax purpose. I got some referral bonus from my international friends but I didn't have any idea for tax plan until I filed tax return last year. Then my neighbor, who is a CPA, suggested me to start a S-Corp, and my husband's best friend, who is an immigration attorney, showed me the legal issues about "how to do this formally". We three are not business partners. My husband insisted to "contract" them, not "partner" them........ I still have no idea why my husband insisted this, but he said I will understand later :chair: . Honestly, I am not a good businessman. I flied abroad and talked to every single international nurse who planed to work in the States. If I found out anyone was focus on green card and $$, I simply told them to find other recruiters. Cause I wanna recruite someone who is in love with nursing and wanna be a nurse for their career not $$. I believe if I was able to be more business, I would be one of the millionairs in Hollywood Hill now. You won't believe when I had several presentations in S. Africa, there were hundred people/nurses coming and wanted to work here.

Suzanne, You are right! Actually I have a contracted ESL school, which provides the courses of oral speaking (medical communication and accent) and writing (charting) to my international nurses. They were here on F1 Visa to begin with.

To Suzanne, Taiwan is my nationality, not where I'm located. As in my first post, I work for a hospital in the States that how I help international nurses relocate. I was getting referral bonus from my hospital before. It's why I planed to start a Nurse Recruit Agency. Since there's a demand in my hospital, and there are many international nurses wanna work in the States. I simply built a bridge for both of them. You are right, it does invlove alot of work, especially dealing with INS. But there's no free lunch. And I never think this would be an easy job. No matter what suggestions I got from here, I always think it positive. ^_^

Dear all, Thank you for the suggestions. Actually, I've started a Corp. for a while and recruited 6 international RNs already. 4 of them have been in the States and will start to work after getting EAD card. 2 of them will come to the States through CP cause they are unable to afford themselves during AOS. The reason I posted my question was I "thought" it must be very difficult to contract with hospitals since I didn't have any business experience. But, I simply wrote a business plan and discussed with the HR in my hospital. I guess I am the lucky one ^_^. But, which doesn't mean my dream come true from air. I have a contracted attorney, who is one of my husband's best friends, and a CPA, who is my neighbor and his wife is a RN too. We had hundreds meetings and I flied to Asian and South Africa several times within 2 months. It's not an easy work, honestly. Through the networking from my husband, I'll go to Hong Kong and Singapore for several RN presentations next month. I really appreciate Suzanne, Nightngale and all of you here. The idea of my work is from all of you, although I am unable to share my profit with you ^_^. BTW, I agree with 6four230 somehow. "Starting your business is very possible in America" is what I learn in the States. And, it's very true "Possible not easy".

Thank you, Suzanne4. You are very nice :) . My friend has a ITIN. We wonder could she use ITIN instead of SSN. It's difficult to get a SSN now and Emory U. doesn't offer any in-campus job. My friend has got her Certification Program from CGFNS. I was thinking could she apply NCLEX-RN in Vermont first, then endorse her Vermont License to Georgia. But, there's one more thing I am worried about, could she endorse her Vermont License to Georgia without a SSN? That's why I am hurried to reach Georgia BON. I tried to call Georgia BON twice. Someone did pick up my calls. But she seemed didn't understand my question and traferred me to someone else. Then unlimited waiting.....waiting....and transferring....transferring..... then ended up hang up.