EwwThat'sNasty

Some of us have "poop" phobia, others "blood" phobia, and others still, "writing phobia. Do the best you can but give up on that person. If you can't find a nursing instructor that you knew, go with the former boss. Sometimes if you ask an instructor that did not even know you well they'll still write one as they can review your grades and ask around. Sadly, these days, few nursing instructors/professors know how to write well. Good luck.

Absolutely. I tried to become a CNA and was refused by two county nursing homes because I'm older and have several degrees. "You won't be happy here, go become an RN" is what I heard. Now six years later, having been a ward nurse, an adult ICU nurse and an Occupational Health Nurse, looking back, I believe that even six months of being a CNA/LNA would have made life much, much more comfortable. As a CNA you learn how to "handle people." Thus when you go to college to become an RN or BSN that is one immense thing "not to worry about." Having had CNA experience I believe you will learn much more, in less time, and be a better quality student nurse all around.

It's a difficult position to be in, plain and simple and it doesn't need to be CNA to a RN, it can be MD to RN, staff secretary to RN, or RN to RN, but when this ugly monster rears its head it can get quite nasty. The proper term is "lateral violence." Sometimes we hear it as "nurses eat their young." The "giving me wrong information" is a classical symptom. I wonder if she makes it difficult on occasion for you to find items and supplies that you need? To gain an understanding of the why's and some insight in how to cope with such behavior I highly suggest buying a copy of "Odd Girl Out." This book will open your eyes regarding passive/aggressive behavior and why it occurs. Do not underestimate the passive/aggressive person, oftentimes they are highly skilled at being the bully, having had decades of experience. Sometimes the actual best answer is to simply find another job--sad but true. These highly skilled people often can confuse your bosses, and usually do NOT work alone. So your single complaint can get trumped by the perp and an ally. It's all about power.

Sure, figure out where you want to go. Write the Board there and see if you can be licensed there and then "travel." Find an apartment, find a job as a CNA (they are worked so hard that there are always jobs, albeit many at uh, less than desirable places) and when you want to leave, repeat the above and give proper notice. The above was said without any cynicism. The idea of a "travel CNA" really does not exist because the per hour rate is too low for an agency to take enough of a cut in the nurse's pay, so it is very unlikely that you will find an agency to locate jobs for you. Go travel, the world is your oyster! Bon voyage.

I am seeing safety programs being downsized. In a difficult economic environment especially if job security is an issue, workers' comp cases can increase exponentially, thus in my opinion, in this environment, the nurse has it over the safety people. However given the opportunity I think that RN; Advanced Nurse Practitioner; COHN-S; along with CSP and/or CIH would be absolutely dynamite. But CSP has a boatload of information to know, and so does CIH. Yet if it suits you, go for it! I've a BS in Safety and have worked as safety specialist extensively, and I am nowhere near knowledgeable to sit for CSP! I have decided it will be Advanced Practice Nurse or nothing, a simple MSN is definitely (IMHO) not enough in this environment. I do not anticipate a real economic rebound for at least five years. This year alone we are racing towards a triad of horrors: 50-100 billion in bank losses for Consumer Credit Cards, 'a bell curve rise' (bigger than the subprime) on variable rate mortgages, and Monster commercial real estate write-offs. Beware of student loan debt. There is a limit on deferment time and Sallie Mae is not kind to non-paying debtors.

I'm American, not Filipino. I just thought I'd chime in with my "two cents" as we say here. Nursing in America is odd these days. In certain States such as California there is a shortage of RN's, however this is not so in many regions. On the East Coast not long ago I heard an RN working in a major Boston Hospital who worked as a Registered Respiratory Therapist in the hospital's NICU and who had recently passed the NCLEX and who applied for a job there. She did not get the job and told me that there were 1200 applicants for a few jobs! RN resumes on job sites in states like Michigan used to be non-existent, these days there are quite a lot. Unemployment in America is probably much worse than you can imagine. Look at this graph: See: http://static.seekingalpha.com/uploads/2010/1/7/saupload_jobs_thumb1.png The red area is the number in millions of unemployed. At a normal "expansion of economy" rate this graph predicts that normalcy will not be achieved until 2016! I know many RN's who have been terminated due to closings or down-sizing, and locally no hospital that I know is hiring any nurses. I will be terminated from my job this coming summer as my unit is closing. I do not expect it to be easy to find a replacement job even having been a med/surge and an ICU (Intensive Care RN) and am qualified in a sub-specialty. There are very hard times. Some RP schools turn out highly learned, highly skilled RN's, as good as any in America or elsewhere. This being said there are a few things that I'd like to add. The NCLEX pass rate from all RP Nursing schools, if you look at the % of schools that have a 70% or greater pass rate, is abysmal. The majority of nursing schools in RP are scams, simply inadequate diploma mills that the BON should close. I mean no disrespect by this, but this statement is evident by RP's annual pass rate data. If you search you can find a list of all accredited Nursing Schools and last year's board exam/NCLEX pass rates. You will see that (if I remember correctly) only about 16% fit in the >70% pass rate. There was a surprising number with zero pass rates. Therefore, no matter how hard you try at these schools that have horrid pass rates, no matter how much time you spend studying, if these schools do not have the faculty or classes that are necessary to give you what you need you will be throwing money into the wind. This is very sad, I think but evident based upon statistics. If you are in a school with a According to the chart above, even if you are in one of the top schools jobs in America will still most likely be scarce and will become scarcer. Further it is likely that agencies will become more and more corrupt pushing pay grades down an demanding more and more from both foreign and domestic nurses who manage to get hired. (Though this may work to foreign nurse's advantage since the quality of the work environment, I think, is causing many American RN's to want to escape.) Even my former hospital DHMC.org now requires onerous (in my opinion) and very one-sided contracts such that if you leave for any reason you will be required to pay them a huge amount. It's shameful. The fact is that for America (and Iceland, Spain, Ireland, and Italy, and soon: Great Britain, Germany and many other countries this recession does not appear to be resolving quickly. If the world has a "double-dip" recession where countries get "hit" again in 2010, even Japan will be severely affected. I also suspect there will be more and more agencies who "offer" jobs (at a fee) and never manage to get you one, and there are no refunds. I don't mean to be overtly negative. Knowledge is power. Now for a more positive suggestion: When you do graduate, take the NCLEX as fast as possible, preferably within 8 weeks. Why? Because there is a very clear relationship that shows that the longer a person puts it off, the more likely they will not pass, or the more likely that they will no longer have the confidence to even try. The NCLEX does not (at least for Americans) have an "end date." As long as the person logs a certain number of nursing hours as a state licensed RN (I am not sure if volunteer work is ok) at a job every two years, it stays active. I wonder if obtaining the NCLEX and then working the requisite hours in RP is enough, I do not know. (Look for a thread that addresses this questin on the forum.) Also, different states here have different regulations. Nobody makes it easy do they? Still, even if you take the NCLEX as soon as possible and then cannot utilize it such that you have to retake it a few years later, the experience will be invaluable. Pass it once, and you will likely pass it again. Frankly with a decent education the NCLEX is not difficult. But American colleges (even very small "community colleges," are very well run. In my class of about 23, I believe that everyone who took it passed. As mentioned previously the MN will probably not be useful and could possibly be used against you as some hospitals are such that they must pay a premium for a nurse with a Master's. Exceptions to this would be an Advanced Nurse Practitioner Master's degree which is "golden," or some exotic Master's such as CRNA (Certified Registered Nurse Anesthetist) which is ultra-golden. IV experience might or might not be useful. When I practiced as an Adult ICU nurse, all IV's were initiated by a special team; all wound care was also done by a special team. In a smaller hospital this could be very valuable. What happened to Arroyo's NARS? (Nurses Assigned in Rural Areas) That seemed to me to be a good starting point if the program ever got off the ground. I wish you all the best of luck! Persevere.

Six of one, half dozen of the other... A well paid temp contract position works for some and in some states termination opens (at the moment) ARRA protection such that you are covered under Cobra with the former employer paying 65 or more % of the premium fees. This is true even if you do not have company coverage. For instance, once you are resident in MA you are forced to obtain insurance. Then 4 months later your term ends, and you are unemployed. If you are considered "terminated" from the position MA and the prior employer will cover 9 months of insurance premiums, the former employer paying 65% (to be recouped as a tax rebate) and in the case of MA, MA kicks in 20%. But it is not the same in all states. Many contract agencies are squishing contract employees and this is what has happened to me. Nice long term (2+ year job) annual cost of living benefits, 401k matching, good medical/dental, good vacation, etc. Now all gone! Many contract agencies are sleeezy but I imagine some are not. Be willing to be skilled enough to say: "thank you but intstead of being impoverished by you reneging on your promises, I'm out'a here." The problem is that in this economic environment even RN-COHN/S is not enough. Industry is downsizing and that has been going on for decades. Twenty years ago there was one Occ-med nurse for ~200 ee's, now there is about ~600 employees. There are a glut of nurses (except in some areas) and contract agencies are living high off the hog. If you truly wish to obtain what it is that you enumerate the answer is simple: Become an Advanced Nurse Practitioner or PA. Why, because they can often replace an MD and $80k is much, much better to the profit line than $170k for a MD! Sad, but true!

On my first day of orientation a supervisor rushed into the office where I was learning the "paper work." "Come quick," he said. "Seven workers are down with poisonous gas exposure." Now that was not boring! Severed fingers, a crushed arm, that is what one faces in a paper mill. Currently I supervise a small Occupational Health Clinic in a factory, but we are downsizing and well, I do have time on my hands--to study for the COHN exam. I'd prefer something a bit more active, and intend to take the EMT-B course. I guess the answer is yes it can be boring, or it can be that you will wish you were bored--depending upon the job. The trauma background is ideal (especially if you were to go the EMT>Paramedic route) for industries that have higher rates of serious injuries. Refineries, Manufacturing and Mining can offer such non-boring jobs. With your qualifications vis a vis trauma, if you are not limited to one geographical location, you will find what turns you on.

In the state of NH there is a "bridge program" to move from LPN to RN in two semesters. There is likely plenty of funding to help also. You might want to look into this as an option. But if you don't, sure you can do Occ Med work as LPN but some of your abilities might be limited. I don't think that you can do vaccinations, for instance. I also do not think (but I'm not sure--perhaps someone else can answer this) that you can do post-hire physicals which is often intergal to most jobs. But you can do certain forms of drug testing (unless State rules apply) you can become COHC and do hearing tests, and respirator fit testing. I'd suggest that you look for a place that has a large employee base and which has a couple of RN's, then you could learn skills as you need to and there wold still be plenty of work that you can do. Good luck.

A lot really depends upon your insurance company (workers' comp) and the details surrounding the case as well as the state you work in. If you have children, see an occasional worker, and then are later diagnosed with H1N1 you will most likely be denied by WC. In the state of NH you probably would not prevail if you took it further. In MA or VT where the worker is almost always right, you probably would prevail. The problem is: how do you know that it was a work related incident that infected you? If it was, then all care including antivirals would be covered as well as mileage driving to get them. If though, for instance, your documentation on employee "x" noted: EE x presented to Health Services with sore throat and accidentally sneezed on me before I could put on an N95," and then four days later you developed symptoms, well, that's a no-brainer. You would likely be covered.

I agree with both of the recent posts. To become certified (COHN) I believe that the number of hours doing Occ-Med work has dropped to 2000 hours. I think it is best to look for one of the many small regional firms that do Occ-Med work. Some jobs are very elemental and really require little prior skill. Basic physical assessment is quite easy. Drug testing is easy to learn. Perhaps later you can find a job that is more challenging where there is Workers' Compensation case management, and perhaps a higher load and more potential acuity. The needs of an Occ-Med nurse are as varied as there are industries to work for. I've worked in a Paper Mill, a rough and ready, crushed arms, workes overcome by poison gas, or exposed to PCB's that included lot's of training. Another job was "light manufacturing," with a lot of sales staff. There was little possibility of a major injury to attend to short of a stroke or heart attack, or bee sting reaction. Some industries require you to be trained to do respirator fit testing; sound management and becoming COHC to do hearing tests, some do not. Start light, and move around. Many people poo pooh the COHN cert, but I don't. It is a broad body of knowledge, and if there are ten people applying to a job and you are COHN and the other nine are not, you probably will get it, not so much because of the cert, but because you know what needs to be known.

It's become a terrible job for some. Excluding ED; ER; ICU; CRNA, NP's; it's simply an extension of our economic and moral climate. Nurses currently are a dime a dozen. Most of us are "meat." Extreme pressure on "increase profit," exists, and we are the small fish. Work us to death with reversing rotations, keep us in horrid places with one-sided contracts, and import foreign (often good) RN's who "take what they get." This will only change some years out when a true shortage exists. In the meantime, burn-outs disappear, there are plenty new grads to fill the empty spaces.

Indeed, they did. They removed the day before Christmas, Christmas day, New Years eve day, and New years day from "paid holidays." They also now require that I pay for may own adult CPR card training, and do not help with license fee even though I have one in my native state and need another one for the state I work in. They have removed medical insurance. Downgraded dental insurance so that cost=benefits, and have removed a flexible medical savings account. So my Holiday "gift" was (-$946.00) (Overall the year's loss stands equal to a pay reduction of about $9,000. A better gift considering my happiness score would be a "You are terminated" note. And I'm being serious. At least I could collect unemployment and find another job with benefits. I won't even ski anymore as it's too risky--a broken leg would cost about $7k. A few years ago I crowed about how wonderful a nursing career was. Last year I stopped recommending it. This year, in light of the Healthcare bill I now recommend against entering the medical field as a nurse, a doctor, ect. for things appear to be heading in a direction that is not positive.

Hmm.... the stylelist.com is an unabashed "hire me" advertisement with little real substance. The other one is more helpful but consider please that a six million dollar fine is about 1/3 of one percent of Sears gross income in 2007. If a nurse earns $50k a year that equates to a fine of $176 dollars. It is wise to look at things in scale. Still it is nice that EEOC is holding Sears to the line! There must be some good links to what is appropriate for pre-hire and post-hire physicals from good sources--anyone know of some really good ones?

Generally lifting requirements vary from the question: (an example: "Can you lift and carry 25lbs 200 feet, ten times an hour?" To: Please pick up that box, and carry it to the end of the hall, and bring it back." So it depends upon what the requirements of that job can be. Here is an example of an accomodation recommendation that might be an outcome of such a test: To safely and competently perform required job duties the employee needs the pallet of boxes to be placed such that the bottom of the lowest box to be lifted is no less than 18" from the floor. In some cases this can be a very easy accommodation requiring maintenance to build an 18" "table." In other cases this could be much more difficult (as in an assembly line) or even impossible without extreme expense. In that case the worker is unfit for the job, however the company must attempt to find her alternate appropriate work. It might seem unfair that a person might actually lose their job because an accommodation might not be reasonably effected but think of the alternative. (Severe chondromalacia or patella-femoral syndrome due to stress caused by lifting with existing leg problems). It is better to have no job then be unable to walk and in constant pain, so as hard as it may be, sometimes being turned away creates a more appropriate outcome.

Let's first look at your terminology. In some companies there is a pre-hire physical and drug screening. In this case the nurse cannot (unless the person wants) even take a blood pressure reading. Then the person is interviewed, and if hired, there is a post-hire physical which looks to the need for possible accommodations. If this is truly a pre-hire physical and the nurse is asking detailed medical questions I believe that this company is acting improperly and could run afoul of ADA (Americans with Disability Act) and be liable in a Court action. Usually there is a post-hire physical only (except for the prior go/no go of a drug test) which is performed after the person is hired. I will assume that you are talking about this type of post-hire physical: You answered your question when you said she "is capable of the assignment." If your statement is true then what does lying get her? Management is never told "Oh Ms. X has cardiomyopathy." Management is only told one of two things: 1) Fit for the job description. Or, 2) Unfit for job description, but would be fit for the job with the following restrictions/accomodations: (example: not to carry more than 100 boxes per hour up the stairs with a maximum weight of 22lbs.") The company is bound by law to accommodate an employee that needs restriction(s), though there are limits. A 500 employee company where a worker needs a $1000 chair due to morbid obesity will simply have to pay for it. A very small company where a worker needs an accommodation that costs, let's say $50,000 probably will not and in that case the employee may be turned away. But that is not the issue as she "is physically capable of the assignment." It is wise to remember that the nurse is looking out in the best interest of the employee first, as well as the employer. Let's say the nurse says: "This employee needs accommodations and it will cost $1000." Well, the employer might grumble, but can quickly be shut up with the comment: "Ok, no accommodation, we'll just deal with the soon to be appearing Workers' Compensation case that will cost us $120,000, not to mention an "Americans with Disability Act" lawsuit that will cost us a quarter million.." Finally, though it does not seem logical, a wise Occ Health RN in some states realizes that cardiomyopathy could be considered (though it seems odd) to be what is known as a "Second Injury Opportunity." In the early part of the 20th century a worker in New York state was using a grinding wheel which blew up and blinded him in one eye. At a prior job he just happened to have been blinded in the other eye. If the Workers' Comp payout scale is (let's say) $120k for one eye, it is NOT $240k for both eyes (or the second eye loss). Total blindness is far more devastating that losing one eye, so the payout for the loss of the second eye might be $380k (the numbers are just a guess). Well, the company argued that they should not be responsible for the higher payment as the man had lost another eye elsewhere, so they contested the case. Later the NY Workers' Comp Board found for the employee. The next day, in New York State, thousands of one eyed, one armed, one legged workers were let go. There was a furor all around. The answer that came out of this was called the "Second Injury Fund." A small percentage of payments into the fund were diverted to this "held by the state" Second Injury Fund. When a worker had a prior injury or illness that "could" have been a factor one half of expenses was paid by this fund. This protected both the employee and the employer to a great extent. Many companies self-insure, and even for those who do not self-insure, a 50% reduction in pay out by their fund or by the insurance company for a claim translates into a big savings for the company. I have saved companies tens of thousands of dollars per year utilizing this fund in NH. Though cardiomyopathy is not likely to be the cause of, let's say, a slip and fall with a back injury, the medications "could be a contributing factor (possibly due to dizziness)." So a claim (in NH) probably would be allowed. (Remember only some states have a 2nd Injury Fund). So if your friend is deceptive the outcome could be destructive. Worse, if an employee is deceptive to the point to where a nurse would have advised accommodations but did not due to deception, and an injury occurs, the worker could lose the case for Workers' Compensation under the argument that if she were honest, the accommodations would have been given, and the accident would not have occurred. A worker that needs accommodations is likely to be hurt by not having them. Even if the company weasel's out of giving an accommodation they will have to, in essence, fire her. (And "at will" employment firing immediately after the post-hire physical will NOT get the company "off the hook," it will put them "on the hook.") Then I would suggest her calling the ADA people as they are very aggressive and will intervene and probably she would be promptly rehired with an apology and compensation in short order. Hope this helps.

Melissa (Mpittsrn) the NIOSH funds a lot of ANP in Occ health, though it seems hard to find a list of who offers what. H60Medic has talked about this in the thread and I have heard elsewhere that one can attain the degree for free and even with a living stipend if you research what is available (which does not seem all that easy as there is no "overall site." Additionally there are many grants in states whereby "if you work in the state for say two years," a loan is forgiven. Also there is the Nursing Re-investment Act which will probably remain viable and allows for (I think) a 25% write-off of loans each year for 3 years, reducing loan debt by 75% (and I think actually up to a reduction of 85%.) (One must work in a hospital, not just in industry but hospitals use a lot of Occ-med NP's. There are, I hear programs where one can get free tuition/stipend if she agrees to teach for a few years. I'd like to start a ANP program next September, and if I come across information I'll place it here and hope others will do so too.

You have the perspective--it's simple, you hate your job and it will not change. Get out, or burn out. Within twenty miles of you there are dozens of places, most of which you don't hear about. If you are economically destitute you may be stuck. Realize that in reality, these days, there is no longer much in the way of caring, or loyalty. As sad as that sounds, it's the truth. Try a government funded place, a county home for the aged, try a Veteran's hospital, long term rehab, try looking for a small facility, avoid the "chains" or it'll be pass meds till you get so upset you pass gas instead. Try government positions, try the local unemployment office. As someone pointed out try home-care nursing, but NOT by a for-profit agency. "For profit" means not "FOR YOU." As this economic crisis continues and worsens, conditions for nurses will worsen. But there are islands of tranquility, and even fun. Try the state, they have entry level "immunization program nurses," and all sorts of nursing. Get a foot in someplace but Do the RESEARCH. Do not listen to the recruiter, visit the local small hospital, volunteer if you can, find the places where good conditions exist. They do exist. Near me there is a not-for-profit multi-medical-issue hospital for children, a not-for-profit long term care center for brain injuries, two small hospitals that are great, some elderly facilities that are wonderful, there is a great hospice and a great home care group (visting nurses). There are good jobs. There is also a large hospital that is not so great, a large chain elderly care facility that doesn't seem to care about burn-out; and a government nursing home who will make you do what you hate. These are rough times and it will worsen before it gets better. While you are young and new, look for the job that gets you up in the morning, not at the paycheck. If you want more pay, in a few years go back get a BSN and then a MN and become an ANP.

Would you kindly tell us or place a link to where one would find the NIOSH Centers.... Free with a small stipend sounds very good to me, and I really don't mind moving for a few years...

Nice to see the thread active again. Congrats on the BSN! Hard to believe that it was in 2007 that I wrote the first post. A few things have happened, the 4,000 hour OH nurse experience dropped to 2000 hours. Not being able to find an OC job in my area due to the non-compete agreement I looked outside the area and am working for a major corporation managing a small Occ Health Clinic. It's just me, myself and I, and a MD that comes in for a few hours a week. I started 14 months ago with about 125 workers, but that has dwindled to 80 and "the end is nigh." I suspect that around the end of the year or soon after, I'm history. I still would like to do the NP in Occ Health, but the 39K debt that I have well, freaks me out, especially in these odd and hard times. I've heard of agreeing to teach in exchange for school costs, but can find little on that. Ultimately I'd love to become a NP, get some experience in several areas (ortho, ED and Occ Health) and then teach. Wooo.....that'd be fun. Funny world we have. Shortage of teachers, but try to find an education that does not destroy you economically and it's hard to do. Worse, it is not just the amount you owe, now if your debt/income, debt payments to income, or debt to assets do not meet exactly within the prescribed limits of the omniscient and omnipotent Sallie Mae, or Freddie Mac, you we "don't have no banannas today for you," nor house, nor refinance, nor auto loan. So if one goes to school, in a way the debt becomes a strange sort of death sentence. I suppose since I'm turning 59 if I rack up enough debt to put it into a 30 year repayment plan, it is unlikley that I'll ever have to pay it...as I'll probably be dead. Heheee... how funny. I'd love to do Occ Health NP with a global bent. We simply have exported most of our RSI's and so many occupational hazards overseas it is pathetic. In India recently hundreds, if not thousands of workers have been diagnosed with silicosis, being "contractors" to sand blast jeans go give that faded effect. I'm not sure that I could make much of a living in International Occ Health, but I feel it is an exciting opportunity, if it exists at all. Hard economic times make for hard decisions, and sadly too, for delayed decisions. I'd like to hear from others how they are doing... Steve

Thank you Dorzlei. It is quite possible that the typical Filipina's concept of beauty differs from that of an American man's view. And I wouldn't be offended as to women being from "far flung rural areas" as I too, own a house in a far flung rural town where I half jokingly say that there are more Moose and Bear than there are people. (Moose a wild animal like a deer but weighs about 8x what a deer weighs). I've raised animals, grown crops and have been a beekeeper for honey. I'm more like a rural RP farmer than I am like a person from Manila. I don't really even like cities much. It seems that in RP the far flung rural areas are often looked down upon and I think that is due to the economic disparity of the cities versus the rural areas. It is not that way in America and rural areas are desirable here. Yet the people that are rural are no less, and in some ways might be more desirable to a "rural" American. There are culture shocks both ways I think. Though I own a circa 1860 farmhouse in the boonies (very rural area) I also work near Boston, a huge city. But what I find attractive in a woman is not necessarily what another man might. I think that marrying for "money" is actually very true but perhaps a bit unintentionally crass. Does one "buy love?" Almost all will say: "no, of course not." Yet in fact, we all do, though the money might not be dollars or peso. It is counted in ways such as fidelity, reliability, compassion, intelligence and the ability to nourish and raise a family. Relationships are based upon win/win contacts, and when two people have what each other needs and desires then a relationship might fluorish. Every woman wants a man who has a decent job (money = security), who has no bad habits such as overuse of alcohol, or drug use, and who will value, complement and cherish her and her family. And different men have different needs and desires too. Lately here in America all women want is wealth and morals and family values often get swept aside. Fidelity is rare, and if another guy's paycheck is bigger, many American women think nothing of moving on. Though now with the economic crash, every one in five houses (MacMansions we call them) have or are being repossessed, so who knows maybe things will change over time. Come to America for a decade or two, and see what your children are like at the end of that time and then you might start to understand why I believe that there is a lot of value in the moral culture of RP. On the other hand you might bring a bit of your culture here and your children might well turn out to be amongst the best... And perhaps therin lies why foreigners might seek a Filipina as a wife.

Yes, I'm not sure where it is but retired military can go to schools under the GI bill for free, and there is a list someplace which tells which accredited schools an American studying under that bill can go to including foreign ones, but upon searching I cannot find it...

thank you silverdragon. see: http://travel.state.gov/law/citizenship/citizenship_778.html from that source: "potentially expatriating acts section 349 of the immigration and nationality act (8 u.s.c. 1481), as amended, states that u.s. citizens are subject to loss of citizenship if they perform certain specified acts voluntarily and with the intention to relinquish u.s. citizenship. briefly stated, these acts include: obtaining naturalization in a foreign state (sec. 349 (a) (1) ina); taking an oath, affirmation or other formal declaration to a foreign state or its political subdivisions (sec. 349 (a) (2) ina); i have been told that dual citizenship is no longer possible, but from silverdragon's information and the above, clearly that is not the case. however it still would seem very wise to obtain verification from a good immigration lawyer before doing anything that could compromise something as important as choosing a new citizenship. for instance if i were to seek citizenship in rp and took an oath pledging allegiance to rp (note: i have no idea what is required but were i to move there i would want to obtain citizenship there) then as the above source implies the oath could be used as a declaritive act of intent to relinquish my us citizen status. ok, i'm anally retentive when it comes to law, and that has been, on occasion, very, very useful to me. when it comes to law never think that you can apply logic. the logic of law often is entirely different than common logic. though i don't care for lawyers much, sometimes they are a necessity.

See: http://www.baldwinpublishing.com/article/siteCode/HepBInform/catgId/23/articleId/114/ However be aware that different "programs" have different requirements. For instance the hospital where I worked (I heard) required a person to be Hepatitis negative to enter their training program. (At one time they took in about 100 RP graduates a year). Since Hep B is a blood to blood transfer route, (though there are other routes that are not relative to patient care) and Universal Precautions block that route it does not seem that being a Chronic carrier would be an impediment. When I teach Bloodborne Pathogen classes I try to get my students to understand why chronic Heb B is not much of a problem in the US but is elsewhere. The answer is simply that most hep-b transfer occurs at or near birth in Asia. This is not the case in the US. Here Heb-B transfer occurs generally as an adult. Therefore the adult immune system is more competent to overpower the virus and here Hep-B chronic carriers are much less of a percentage of those who become infected when they were infants.

Pfffft... half a mil peso... don't say that too loud or you'll have every hunky male in RP in love with you in a flash! Now, I'm American and don't know diddly about the rules, but I'll give you my two cents, and it's up to you to check on the details. If you can stay with relatives your 10k will suffice, I believe, for even the newer 5 year program (which I think, if you can--avoid). The real reason for the 5 year program seems to be that here in the US High School is up to grade 12. In RP it's to grade 10, or so I'm told. You have the grade 12. I suspect that study will be very easy for you. Be careful about the dual-citizen thing. I believe that dual-citizenship no longer exists as part of the Homeland Security program! Further if you wish to become American and can stay a RP citizen in the interim, I would think that is the way to go. Why? Because your tuition will likely be higher if you are an American; further you will pay up to a $500 application fee, and there are other fees to obtain Student Visa status which are pricey and which are not applicable to a RP citizen. If you are American, you are rich (whether you are or are not (w/10k you are)) and therefore it is RP's duty to "fleece" you. (Remove you of as much money as possible). A potential pitfall in this is that it might be difficult for you to take the NLE, I seem to remember it is hard for foreigners to take it. Worse, if you do not take the NLE and study as a RP citizen you will not be allowed (I think) to sit for the NCLEX. Therefore you could get stuck in a Catch 22. Look thoroughly into that path! Course transfer is variable, though often, from what I have seen/heard "bleak." But if fees are per semester or year you could probably take loads of courses to include the ones you already have done. If you have done well, those will take little time for study, you might find that you could teach them. (54% pass rate does not imply an extremely high quality of education). MCU does not list fees on their website. Also be aware that many schools simply do not allow foreigners. Many also do not allow anyone over age 25 (laughing out loud). Age discrimination is so blatant in RP. To sum it up: I think that you have the $$ to do it, and I think it will be easy for you but you are in a minefield and need to carefully research such that you don't get caught in an impossible situation or accidentally lose the right to become an American citizen later. Another thing to consider: Student loans are easy to get here, plain and simple. Under TheNursing Reinvestment Act about 75% of debt disappears over about three years if you work in the right hospital. (Almost all hospitals are "right".) Most hospitals have education loan reimbursement plans such that in about 5 years you could have $0 debt. It must be a hospital! Nursing homes, doctor's offices, even clinics do NOT count. Research Nursing Reinvestment Act and realize it could change (but I doubt it). Even another thing to consider: In America even the tiniest schools have good access to clinical experience and the best modern equipment, this is not likely to be the case in RP. Now if you were planning to become a WHO (World Health Orginization) nurse working in Africa, the "get it done with what is available" point of view essential in RP might be truly invaluable. But if your plan is to go med/surgical to ICU the reverse is true and the lack of experience with good equipment and training could be damaging. There is no advantage for me to study in RP unless I am interested in seeing RP and nurse education from within (which I am), essentially as part of a study on international nursing and as I mentioned I have other things on my agenda. One last thing to consider: In America, I advise friends who ask: "what is the best way to get into nursing" to start as CNA/LNA (Nurses's Assistant), then after a year or six months join a college course of study for a one year LPN (Licensed Practical Nurse) then after 6 months or one year working as an LPN, do a transitional LPN to RN college program which takes one year. Then work; two years have passed and you are RN (ADN) and then if you wish, attain the BSN, or even jump into a ADN to MN. Benefits: A wonderful transitional program where it is often easy to get your company to pay for part or all of costs and one gets a truly excellent set of experiences. This path is a very, very comfortable path, I think. Further though many do not know about LPN to RN transitional programs abound and since you are going in "a back door" those often do not face a multi-year waiting list. Call the Director of Nursing office and aks about LPN to RN transitional programs. Often they are arranged such the the LPN can continue working (weekend/evening), and you get a great group of co-students that have "been there, done that." As far as being put on a "waiting list," consider doing something about it. If you are sincere, go visit the Head of the Nursing Program. Yes, you can talk your way in. When I started school (in med) I intended to become a MLT/CLS but was hijacked by the nursing students who said: "c'mon take a course with us." So I visited the Director of Nursing and it just turned out that there was "one space left." Well, I figured out a year later that there really wasn't and as unfair as it might seem I got in before others on the list (or so I think), though I had no clue. You see, faculty wants students that they believe will add something to the mix. Well, there are lots of stuff here to think about; persevere and you'll get there, and remember to have fun along the way! Too many nursing students forget to do that. But be very careful in the citizenship thing, lose it and you may never, ever regain that opportunity.