Survey: Should nurses from other countries be recruited to aid in the nursing shortag

suzanne4, RN · Jun 23, 2004

I have been a nurse for over 25 years in the US and there have always been foreign nurses coming in. And there will continue to be. It is actually getting harder for them to come, they are definitely not making it easier.

I have worked with foreign nurses for years, many of them Filipinos and they have all done an exceptional job. I can't think of one that I would not work with again. I think a lot also has to do with the facility that you are working in and the area. I can only speak of my experiences which have been quite pleasant. But again, you have never heard my complain about nursing. I still ove it and always will. And when I started, I was making $8.49 per hour. Working on the line at Chrysler, with a high school education, was going to get you $11.50 per hour and much better benefits. I never went into nursing for the money, definitely not.

rstewart · Jun 23, 2004

I am currently precepting an RN from India. She has 6 years of nursing experience (in India) including 2 in ICU. She is clearly a very bright young woman. Unfortunately, I do not think she will be ready to take care of critically ill patients by the end of her orientation. Just prior to her arrival we had another nurse from India who experienced similar difficulties even after an extended orientation.

Communication is a major issue. Apparently the required language screening tests are not adequate because they clearly pass some whose accents are so thick as to be unintelligible;This is particularly true of telephonic communication. I have already received numerous complaints from patients, physicians, families, other departments etc.----- this is not about nonacceptance of diversity, prejudice and the like (although I am certain there may be an element of that as well.) And it goes beyond heavy accents, beyond medical jargon, beyond idiomatic expressions......there are times when I haven't the foggiest idea what she is asking.

Another major issue is the differences in scopes of practice between the two countries. Even placement of a foley catheter is done by physicians, not nurses in India. To a great degree assessment skills are the domain of the physician. Likewise aseptic/sterile technique procedures, IV skills etc. Although we are paying for an experienced RN, my preceptee is much like a bright woman who has completed the didactic portion of nursing school with honors but has had no clinicals.

I do not know if my experiences are in any way typical, nor do I know to what degree, if any, they may be extended to nurses from other countries. But there is no doubt in my mind that BSN preparation, ICU experience, successful completion of the NCLEX, and passing current required language proficiency exams in no way guarentees that a foreign RN can safely and effectively practice in an American ICU after a reasonable orientation. And when they can't, it makes for an unfortunate situation for all concerned.

As an aside, my new preceptee has already been introduced to our country's employer based health care system. She has just learned that she is pregnant but her hospital insurance had not yet taken effect. Her sign on bonus has been eaten first up by taxes and now by health care bills. When her insurance "kicks in" I don't know what will be covered, but for now this hospital employee has been advised to seek care at the County Health Dept.

totallytheresa · Jun 23, 2004

I don't think we're trying to attack foreign nurses, not at all! I think the point is actually that we should look home first, instead of looking to another country to fix out problem.

I have been a nurse for over 25 years in the US and there have always been foreign nurses coming in. And there will continue to be. It is actually getting harder for them to come, they are definitely not making it easier.
I have worked with foreign nurses for years, many of them Filipinos and they have all done an exceptional job. I can't think of one that I would not work with again. I think a lot also has to do with the facility that you are working in and the area. I can only speak of my experiences which have been quite pleasant. But again, you have never heard my complain about nursing. I still ove it and always will. And when I started, I was making $8.49 per hour. Working on the line at Chrysler, with a high school education, was going to get you $11.50 per hour and much better benefits. I never went into nursing for the money, definitely not.

S.N. Visit, BSN, RN · Jun 23, 2004

OOPs.......I made a mistake while trying to post :rolleyes:

S.N. Visit, BSN, RN · Jun 23, 2004

What is happening in the medical arena is happening in corporate America everywhere. Greed. Working conditions everywhere have changed dramatically. Is it any different than giving all manufacturing to 3rd world countries and then having our taxes bail out their unstable US investments there after NAFTA passed? When will America wake up?

Amen! I couldn't agree more :)

mamabear · Jun 23, 2004

Communication is a major issue. Apparently the required language screening tests are not adequate because they clearly pass some whose accents are so thick as to be unintelligible;This is particularly true of telephonic communication. I have already received numerous complaints from patients, physicians, families, other departments etc.----- this is not about nonacceptance of diversity, prejudice and the like (although I am certain there may be an element of that as well.) And it goes beyond heavy accents, beyond medical jargon, beyond idiomatic expressions......there are times when I haven't the foggiest idea what she is asking.

I say "Amen"! It's one thing to be able to read and understand English. Verbal communication is equally, if not more important. :rolleyes:

alleykat · Jun 23, 2004

Hospital Administrators, Nursing organizations, and Nursing schools are all well aware that there is no shortage. Nurses are working in other fields everywhere, they just refuse to work in hospitals. Short staffing, cost cutting, being bought and sold by "hospital corporations", being berated about the budget, productivity, and "Oh, by the way, can you work overtime", all contribute to nurses leaving hospitals. What about 12 hour shifts which have been proven in umpteen studies to contribute to errors and poor care? Do the hospitals really believe that we don't understand that two 12 hour shifts means paying one less set of benefits for the third shift that would work 8 hour shifts? We do not need foreign nurses, we need to address the problems imposed by the system currently in place. As long as the dollar is more important than the patient, we'll never go back to the hospital.

I agree with you ! Unsafe situations coerced me to leave the hospitals and nursing homes. I, actually, contemplated leaving nursing altogether. However, I have found that I love doing Homecare... one on one patient care! This country has plenty of nurses!

suzanne4, RN · Jun 23, 2004

That is why communication skills are so important, and to the poster who is precepting the nurse form India: Be aware that India is a huge country, certain areas are known for excellent medical care, and others are quite poor.

Did this nurse obtain a green card on her own, or was it because of her spouse. Big difference in the language requirements then, and a slap on the wrist to whoever signed off on her English skills.

The foreing nurse should have classes in communications skills before being permitted to work in the US. Especially in communication skills. Interesting enough, the nurses who usually have the most difficulites with the speaking part of the exam are from India. Many of them do not pass. That is why when I hear that a businessman in India wants to bring over 10,000 nurses.....I sit back and laugh. I have worked with some Indian nurses in the past, their skills were quite good, and so was their english but I know that this is not the norm. I live in Thailand and there is a large Indian population here, and I have difficulites with some of the speech for even me to understand.

BaystateRN · Jun 24, 2004

I am not attacking foreign nurses. The question started with... should the government be recruiting foreign nurses. As an American no one will ever convince me that you shouldn't start at home. There are Americans who have lost their jobs and can be retrained. Someone responded that nursing is a calling, but some of them may have chosen another path at first and now would make a wonderful nurse.

We are a mulitcultural society, but I think they are over estimating their ability to slide into American health care. It takes me, with trying and a lot of exposure a few weeks to understand everything they are saying. Also, there is a lot of language differences that you would never learn in a text book.

If we don't find jobs for all of these unemployed workers, some of them very intelligent with college degrees, we will have foreign nurses taking care of people who don't have any health care. In Canada, no foreigner gets offered a job unless there are no Canandians who want the job.

rstewart · Jun 24, 2004

Did this nurse obtain a green card on her own, or was it because of her spouse. Big difference in the language requirements then, and a slap on the wrist to whoever signed off on her English skills.
The foreing nurse should have classes in communications skills before being permitted to work in the US. Especially in communication skills. Interesting enough, the nurses who usually have the most difficulites with the speaking part of the exam are from India. Many of them do not pass. That is why when I hear that a businessman in India wants to bring over 10,000 nurses.....I sit back and laugh.
The nurses were brought to the US through a company which facilitates the process. I do not know under which program she was recruited. But as I mentioned in my earlier post, we had similar communication difficulties with another Indian nurse so the problem may be more systemic rather than an isolated case. Your comments regarding the failure rate of Indian nurses on the speaking part of the exam concern me. With a lot of money on the table I would guess that there is considerable pressure to pass these nurses; perhaps the pressure has had its intended effect.

CHATSDALE · Jun 24, 2004

hi, at my workplace 80% of our staff are foriegn, they come from India, South Africa, Zimbabwe, Zambia, Phillipines and China, England, Scotland , Fiji and Australia. With a good orientation programme and ongoing support they do very well. I guess all the kiwi nurses are working overseas to pay off their huge student loans!!

we would welcome all kiwi nurses, love the accent and we could definitely understand themm.....you are welcome any time..you will love the food

suzanne4, RN · Jun 24, 2004

Did this nurse obtain a green card on her own, or was it because of her spouse. Big difference in the language requirements then, and a slap on the wrist to whoever signed off on her English skills.
The foreing nurse should have classes in communications skills before being permitted to work in the US. Especially in communication skills. Interesting enough, the nurses who usually have the most difficulites with the speaking part of the exam are from India. Many of them do not pass. That is why when I hear that a businessman in India wants to bring over 10,000 nurses.....I sit back and laugh.
The nurses were brought to the US through a company which facilitates the process. I do not know under which program she was recruited. But as I mentioned in my earlier post, we had similar communication difficulties with another Indian nurse so the problem may be more systemic rather than an isolated case. Your comments regarding the failure rate of Indian nurses on the speaking part of the exam concern me. With a lot of money on the table I would guess that there is considerable pressure to pass these nurses; perhaps the pressure has had its intended effect.
These nurses are not being given classes in medical English, nor in proper communication skills. Someone is just trying to make a fast buck and is essentially selling bodies, and that is not the way that it should be...
If the nurse does not have good communication skills, then she has no reason to be there working in the first place.
Were both Indian nurses from the same region, and from the same company?
That may your problem right there. Some locations in India have excellent English speakers, to a point that many American firms are having their phones answered off-shift by a company there and you would not even know that you were speaking to a foreigner.

Survey: Should nurses from other countries be recruited to aid in the nursing shortag

Should nurses from other countries be recruited to aid in the nursing shortage?