Mobiusrain

They are probably specifically asking for the signed clinical case forms that students applying for Philippine licensure have to furnish to the Philippine BoN. Your clinical cases would be listed on them and would include the signatures of the hospital's chief nurse, instructors, and other officials.

It is a logbook kept by training hospitals in the Philippines at ORs and L&D units where cases are logged. Whenever a student nurse assists with a particular minor or major OR case, assists with or performs a lady partsl delivery, or performs cord care for a delivered baby, it counts as an accomplished case and counts towards clinical cases required by the Philippine BoN to take the licensure exam.

Like others have said, there are many other states you can apply to, although you will have to go through more hoops such as CGFNS, TOEFL, etc. Or you can apply as LVN if moving out of state is not an option for you. Frustrating, but better than nothing. Sorry to hear about your denial.

While you make some very valid points, the denial letters applicants have been receiving all point to the concurrency issue, about the cases being completed out-of-sync with theory. My impression now is that CA BRN is using this concurrency issue as an opportunity to turn down the graduates on the get-go. That just sounds...wrong... Also, it sounds unfair to judge nursing education in the Philippines as a whole. While there are many sub-par nursing colleges there, there are excellent ones also. I'm sure CA BRN has statistics of the NCLEX-RN pass rate for each international nursing college. Shouldn't they adjudicate every application on its own merit, not be partial because it's another foreign trained/Philippine graduate? BTW, I recognize you from one of my previous posts from years ago. Funny you mention about students leaving the USA for education, because that's what we were discussing back then also lol.

Wow those are harsh statements, but sadly all true. Going through these countless posts about frustrations with CA BRN denying applications is so depressing, especially when the problem is a TECHNICALITY. My heart goes out to all those Filipino aspiring nursing graduates trying to get their chance to sit the NCLEX-RN exam. They don't deserve to suffer the consequences brought about by these circumstances. This generally shouldn't be that big of a deal since there are 49 other states (49 Boards of Registered Nursing) where they can apply to. Unfortunately, not everyone has the luxury of relocating at will, be it because of family, finances, or other reasons. The technicality here is a very frustrating one. Just like what was stated in other posts, the Philippine nursing curriculum does have their theory and clinicals concurrently during the same semester. Students get supervised clinical training in the hospital setting with actual bedside care, while also having classroom lectures on the same nursing rotation they're on at the same time. The problem arises with the "25 cases" requirement for Philippine nursing licensure. Since CA BRN considers these "cases" as part of the "clinical instruction" component of the nursing curriculum, completing a case outside of the semester it was supposed to be done automatically deems it "not concurrent" with theory. Application denied. "Say what?! How the heck could I have finished all my cases on time?! This is unheard of!" Much of the frustration stems from this very situation. Speaking from my experience as a nursing graduate from the Philippines myself, BSN program enrollment in the Philippines peaked in the mid-2000's in the midst of the so-called "nursing shortage". Even colleges that were known for their computer degree programs opened their own nursing programs to cash in on the hype. Because of this, college-affiliated hospitals were squirming with nursing students. Too many nursing students + not enough patients = not enough cases. You're lucky enough if you don't go home from a day in the OR or L&D empty-handed. Students completing their set of cases before the end of the semester was very uncommon and they frequently had to attend "completion duties" just to obtain all those missing cases. They have to do this on their days off school, or if time does not permit, much later (explaining the lack of concurrency, sometimes even having cases completed well after graduation). So what happens to all future Philippine nursing graduates? Are they all automatically barred from CA nursing licensure before they even graduate? Unless things are changed, seems like the answer is yes. All involved agencies (PRC, BON, PNA, CHED?) have got to do something. I see three ways to solve this issue: 1. Have both boards of nursing discuss the issue Since the grounds for application denials here really appears to be a "technicality", I don't see why this can't be clarified or discussed somehow. Perhaps the Philippine BON can have correspondence with CA BRN to show how the Philippine nursing curriculum does indeed have their clinicals and theory concurrently and that the "cases" are a requirement for Philippine licensure, not graduation (since CA BRN doesn't require these cases anyway) and if that doesn't work... 2. Enforce completion of cases as requirement to advance to next semester With so many nursing students and little patients, I only see this happening if colleges decide to limit their number of enrollees per year. Ummm, yeah right... 3. Abolish the case requirement altogether This has been a requirement for Philippine nurse licensure since who knows when. I don't know if the Philippine BON would be willing to change this just because of one US state's standards. In the end, this is CA BRN's decision. They have all the right to uphold whatever standards they adhere to. We have to comply with their regulations; they don't have to change their regulations to be more convenient for us. It's just sad when a life-changing issue for many Philippine nursing graduates is the result of...I'll repeat it again...a technicality. I've also read other people's comments frequently bringing up the court ruling involving Excelsior College and comparing it to this issue. Please stop doing so. While both involve determination of nursing curriculum not meeting CA regulations, this particular college got a lot of negative attention because it offered an RN curriculum that had NO actual clinical supervised training and instead issued some clinical test every week. That's hardly the case here. Whew! So many thoughts I still want to dump, but I guess I'll cut it here, haha!

There have been past threads here talking about the same frustrations in LTC. It's nice to know that many of us share the same feelings about the poor work conditions in nursing homes. We are frequently misunderstood about the reason we hate LTC and come across to others as "elderly haters". I really loved my residents back when I was in LTC. Such a shame I couldn't properly take care of them because "I might not finish my med pass on time". Right now I'm doing private duty nursing, but I still look forward to being able to advance my nursing career and eventually make it to a hospital unit.

Yeah, SF Bay Area.

Turnover rate for nurses in LTC is relatively higher than nursing positions in acute/hospital settings, so newgrads are hired easily in LTC. Newgrad/no experience RNs here in the Bay Area start at around 31-33/hr.

I'm one of the posters who gave kudos to DNS on the go's post. I was so immersed with many of the points made and how much of them held true to my situation and how I felt. I must have overlooked the derogatory statements about LTC nurses not up to snuff. While I agree with everything else, I have utmost respect for LTC nurses, having been one myself. LTC is real nursing, but in very harsh and unsafe conditions IMHO. Having to handle such a large number of patients at a time is very daunting. Regardless of acuity, the medpass will still take so much of your time that you can't afford to slow down for other things or else you'll be way behind. Not to mention the piles and piles of paperwork you have to do as well. How other LTC nurses can endure such working conditions is beyond me, but I commend them for being able to persevere. Skills-wise, LTC requires its own set of skills, but accept it or not, hospital employers look down at LTC nurses. They won't hire me despite having nursing experience. Apparently it's not "acute" enough for them.

After being stuck with LTC for more than 2 years, all I could say is that i really do hate it! When I first started, I was oriented for about 5 days and then was put on the floor right after to fend for myself. The first month was absolutely horrible. I was struggling with identifying all the patients, getting their meds together and making sure the MAR is complete, doing Medicare documentation, reporting changes in patient conditions, writing incident reports, doing admissions, attending to resident/family complaints, answering phone calls, finding replacements for CNAs calling in sick for the following day...complete chaos. Even after the initial "getting used to it" stage I still struggled to do my job effectively. The medpass...probably the most hated aspect of LTC for me. One half of my typical shift is all med passing. And then you get the non-stop phone calls and incidents that come every so often, further cutting into your med pass time. Then you go rushing trying to finish passing your meds and blood sugars before mealtime. Then suddenly, a demented patient is reported to have fallen trying to go to the bathroom. There goes your whole day. Some GT patients in our facility have bolus feedings 4 times a day, so thats more time consumed. Admissions is another story. Sometimes we get admissions from hospitals 7:00 in the evening! Now you have to somehow sacrifice precious med pass time to do your admission and skin assessments, calling the doctor to verify orders and medications, transcribing the orders and meds to the MAR and TAR, complete pages and pages of admission papers, and you still wont have enough time in your shift to finish everything! And with management minimizing overtime, we have to work through our breaks and work past our shift unpaid just to finish everything. How can it be lawful to allow LTCs to have nurses have 30 patients under their care? I understand that the acuity is much lower in LTC, but the accountability and responsibility is the same nonetheless, but even more heavier since you have so many people to take care of! If something wrong happens to one of them, welcome lawsuit, bye bye license. There is simply no way to provide quality and safe care with this patient load. You're always in a hurry trying to make every second of your shift count. How can I establish a good working relationship with a patient if I can't even spend a bit more time with them to address their concerns? I am so sick of this kind of work. I love the elderly, but LTC does not allow me to provide the care and be the nurse I want to be. Coupled with the fact that hospitals wont even look at my resume because my experience isn't considered "acute care" just adds more salt to my wounds.

I have to agree with that. I'm currently working as an RN in a LTC facility because I have no choice at the moment. I'm still looking hard for hospitals that are willing to train because I don't want to be stuck here. I've been working LTC for about 8 months now, and I still hate it. I feel like I've forgotten everything I've learned in nursing school since all I do is pass meds, chart, do incident reports, and send out ailing residents. There's almost no time left to really do anything else. Working in LTC has made me almost ultimately regret choosing nursing as a career, but I know other fields of nursing aren't as bad as this and would be more suited for me.

Ah yes, the local license requirement by the CABRN issue...still a confusing matter up to this day. Sorry for the thread revive, but I can't help it because I'm in the same exact situation as the poster, except for my wife (not fiancee). Just got married a couple of weeks ago in the Philippines and am now back in the US, wondering the same exact things as the thread creator. My wife bumped into problems regarding her scrub case requirements, and she's not gonna make the deadline for registration for the NLE this November. I've started processing her visa paperworks. She'll get a visa in about 6-8 months probably, and I don't see the point in her taking the NLE next June if she's gonna be here in the US within a year. Since getting my RN license back in November, today I still don't have a clear answer whether CABRN is really strictly requiring a local license for all non-US citizens and dual-citizens...or that it is just simply getting exagerrated by other people and that providing a sensible letter of explanation would actually suffice as the poster stated after getting in touch with CABRN himself.

Really? Congratulations! When did you apply for the position you got accepted for?

I'm only on my 2nd day in LTC and I can already feel the burn . 4 days of orientation definitely isn't enough! My whole 8 hour shift is mostly med pass, can't even get to documentation and summaries without taking overtime. Everyone says it'll get easier as I go, but even after hearing that, I don't thing I would find myself enjoying LTC nursing in the long run. I might just try to get into something more enjoyable, maybe hemodialysis. At least I'll have better chances of getting into a hospital with that kind of experience.

Ask, ask, and ask. I'm a new RN myself who just started in LTC. I was oriented 4 days and now I just finished my 2nd day on the floor by myself...I take so long on med pass that I need to take 2 extra hours overtime to finish everything else. I'm completely burned out right now . It's hard when you don't know your residents yet and haven't developed a routine to speed up your med passing, but like everyone says, it would get easier as you go. Personally though, I'm looking for another job in a different setting. Maybe hemodialysis perhaps. Even if I get better at LTC, I just don't think this is the kind of nursing I would enjoy doing on a long-term basis...it's just too much redundant paperwork, too much patients for one RN, and no opportunities to use your med-surg skills (no IVs, trach care, etc...).