I am a German nurse and passed the NCLEX-RN this year.
I studied a lot to pass this crazy test, but everything theoretic. Anyway, I heard that to work as a nurse in the USA is completely different compared to Germany. I am really scared to work in here. All this responsibility...
I have 4 year working experience in my home country but there are some things I never learned, like a full body assessment or drawing blood.. feel so stupid.
Does anybody has a advise for me what to do? Or somebody has the same feelings?
Gilly how did you transition from a 3rd world country nursing (I hope that's the right term) to nursing in the US where you have the high tech equipment? How well would you say that you adjusted to that change? When I float to other floors sometimes I look at those monitors and I'm like what the heck????....but eventually I got it.
Specializes in intensive care, recovery, anesthetics.
Could it be that it has changed because of so many bad nursing schools and too many students? Because the ones claiming are the new graduates from the last years, not the "older" ones, so I wonder.
Specializes in Neuro-Surgery, Med-Surg, Home Health.
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
I highly recommend that before you accept a job offer ask the recruiter if their hospital offers a comprehensive preceptorship program for "new grads". You may not be a new grad but you are new to this country therefore almost everything would seem new and different to you. I know of hospitals that have 8-12 weeks of orientation period for new grads. You will be followed closely by your preceptor for 4-6 weeks then followed less often once you become more trained and start to get the hang of your new job and professional environment.
Adjusting to a new country is difficult enough, imagine the adjustments you will have to endure to your new micro-environment that is the hospital unit where you will be assigned to. My advice to you is to be prepared to the difficult times ahead. Be prepapared intellectually and emotionally. You may even experience difficulty in sleeping initially. Your appetitite may go down, or up. You may even cry because of stress.
Your preceptor is there to help you, but if you think your preceptor is not helping you enough, or the chemistry between the two of you is not right, then inform your nurse manager. Maybe you need a new preceptor. Seek the advice of your new peers. Be friendly to them even though some of them appear less friendly, but don't take it personally. Some nurses are just too busy or are just having a bad day. Ask questions as needed, don't guess. Then little by little, things will be a little bit easier as days go by. Yes, "easier", but not easy. Just try to be prepapred all the times.
A very successful pharmaceutical representative I met said to me that his "secret weapon" is the smile on his face. He said do it even you have to fake it. Your peers will be friendlier and hostile or angry patients will be less so. It is pretty hard to ignore a smile on someone's face. I think it may even be contageous! With practice, I find smiling so easy to do in the work environment.
My working permit just arrived and I will start applying soon.
My plan now is to be honest on the interview and try to get a extensive and long orientation. Just hope that they give me a chance even if I will need a lot of support.
Just curious, how are other international nurses handle this difficulties?
I am sure I can learn how to do assess heart, lung, bowel sounds.
It's just I need some time and I am scared that I could make a failure assessment or any other mistake or I need to much time to learn all this...
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Gilly how did you transition from a 3rd world country nursing (I hope that's the right term) to nursing in the US where you have the high tech equipment? How well would you say that you adjusted to that change? When I float to other floors sometimes I look at those monitors and I'm like what the heck????....but eventually I got it.
Knowing the physiology of why patients become ill wasn't much of an issue for me because that's essentially the same wherever you practice, third world or not. Knowing how to operate, troubleshoot, and take advantage of technology and hospital equipment was definitely enough of a learning curve for me. However, once I got the hang of using the high tech equipment, it only made things easier for me. We, in the US are lucky that we have access to the latest technolgical advances in health care. And even the technology itself is rapidly evolving and there's always a new equipment or device to learn in the clinical setting. I know seeing ICU monitors with all the different colors and waveforms as well as alarms can be overwhelming to one who isn't used to working with them. However, it's not that hard to learn with a good preceptor's guidance. The only caution I have to anyone is that once you figure out what the numbers mean, always remember that there's a patient behind all those numbers and no matter how out of whack or abnormal the numbers appear to be, nothing beats looking at the patient and doing your physical exam.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Could it be that it has changed because of so many bad nursing schools and too many students? Because the ones claiming are the new graduates from the last years, not the "older" ones, so I wonder.
5cats
I know the curriculum did not change and the BSN program was even lengthened to 5 years to give more opportunity to learn nursing concepts and skills. However, there are probably a lot of factors in play with the newer group of nurses such as less opportunities to practice physical exam while in school due to large class sizes resulting in competition for actual patients, increase in number of newer schools some of which have substandard instruction from clinically-weak faculty members, etc. That has been discussed ad nauseam here at allnurses. I believe that the excellent nursing schools in the Philippines are still producing competent entry-level nurses. At the tail-end of the last wave of Filipino nurses who came right before retrogression 2 years ago, there are 2 nurses from the Philippines hired at our hospital and are are working in the ICU with us. Both graduated from 2 well-established universities in Manila. Their skills are definitely comparable if not better than the average new grad from the US. But then, I've also worked with some nurses from the Philippines who have been in the US for a while and it seems like they "haven't gotten it yet".
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Thanks everybody for the motivating answers.
My working permit just arrived and I will start applying soon.
My plan now is to be honest on the interview and try to get a extensive and long orientation. Just hope that they give me a chance even if I will need a lot of support.
Just curious, how are other international nurses handle this difficulties?
I am sure I can learn how to do assess heart, lung, bowel sounds.
It's just I need some time and I am scared that I could make a failure assessment or any other mistake or I need to much time to learn all this...
The length of orientation typically depends on the unit you're hired into. My first hospital job was in a medical telemetry unit where I had 6 weeks of orientation, a class on cardiac rhythm interpretation and arrhythmia management, and a class on intravenous lines and their management. It was sufficient enough that after the six weeks, I was on my own as long as I had a senior nurse as a resource person each shift I worked during the first six months. My orientation in a Level 1 ER was 8 weeks and included a 14-day Critical Care class on top of the 6 weeks, as well as ACLS, TNCC, and ENPC within six months. I transitioned to the ICU as a nurse practitioner with a very looong orientation period - that I wouldn't discuss here. I think you should be humble enough to accept to the managers that you need a lot of training but try not to give them the impression that it would take forever until you're ready to be on your own 'cause they might not like that.
I moved here about 2 years ago, I am in the RN program right now. Let me tell ya...just because nursing students have their degree and are registered doesnt mean they are experts at drawing blood...
What makes any nurse a great nurse is simply the routine and experience.
Anyway, I also agree that you should however take a refresher course. Cant hurt!
I agree with the other posters who reccomend taking a refresher course, if a refresher course is not readily available, then you may want to consider taking a health assessment course. I recommend an in class style health assessment course versus an online stule health assessment course. It will give you an opportunity to meet a study partner and you can practice assessments on each other.
I also encourage you to check out the bookstore of your closest nursing school to see which health assessment textbooks and companion products are available. I have used the Pocket Companion for Physical Examination & Health Assessment by Carolyn Jarvis in the past and found it helpful.
NurseCubanitaRN2b, BSN, RN
2,487 Posts
Gilly how did you transition from a 3rd world country nursing (I hope that's the right term) to nursing in the US where you have the high tech equipment? How well would you say that you adjusted to that change? When I float to other floors sometimes I look at those monitors and I'm like what the heck????....but eventually I got it.