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What Nobody Tells You: The Reality of Nursing Jobs for Foreign Trained Nurses

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One of the dreams of thousands of nurses around the world is to work in the United States or other first world country. Sadly, nobody tells you how is the process of getting a job in this country and what is the likelihood that you can get a job if you are not proficient in English, if you are not a permanent resident or a citizen, and if you do not have an sponsor. These three obstacles can be the rocks that make your ship full of dreams and desires wreck and sink. The fact that not everybody gets to this point where all the doors are closed might be one important factor behind the best kept secret in nursing.

What Nobody Tells You: The Reality of Nursing Jobs for Foreign Trained Nurses

I have never heard so many "nos" as I did today. For the first time in these four years I felt that I have been the biggest fool on Earth. I am a foreign nurse form Panama trying to get a job in the United States. Many people say, "There are plenty of jobs for nurses in the United States", "Bilingual? They'll eat you up! That's a plus!". However, there is something that people do not say about the reality of employment for foreign nurses in this country. If a foreign nurse is not proficient in English, a citizen or a green card holder, and does not have a sponsor, the likelihood that she gets a job in the country is one in a trillion.

In every employment opportunity that I have applied the requirements state "excellent speaking and writing skills" How can one know if her English skills are good enough for a job? The Commission on Graduates of Foreign Nursing Schools (CGFNS) states in the VisaScreen Visa Credentials Assessment Application Handbook that "You must take a series of English proficiency tests approved for your profession" (if your instruction was given in English, you do not have to present these exams). The exams that determine one's English proficiency are the TOEFL iBT (internet based test) and the IELTS (International English Language Testing System) Also, this handbook provides a chart with the TOEFL iBT required scores for Registered Nurses which are 83 as total and 26 in the speaking section (VisaScreen Application Handbook 3). Thus, if one want to get a job as a bilingual nurse, you must speak English very well.

In addition to the language nightmare, the fact that you are an alien with a Bachelor in Nursing Sciences does not guarantee that you will get your dream job. In order to apply for a job in the United States, one must be a citizen, a permanent resident, or have a "work visa" or H1-B. Without them, it is legally impossible to be considered as a candidate for a position where you might fit well.

Although the word "H1-B Visa" might seem the light at the end of the tunnel, it is not so easy to get it. The nurse needs a sponsor or employer willing to go through all the immigration process with her. Unfortunately, many companies are no longer offering sponsorship opportunities for foreign trained nurses and the ones who do it, are very selective with the person that they are hiring. Moreover, the United States Citizenship and Immigration Services or USCIS has a "limited number of H1-B visas" that can be given per year.

The question remains, why no one ever say these three aspects to a foreign trained nurse? Why working in the United States is the best kept secret in nursing overseas? Maybe the reason behind this secret is that not many nurses have gotten to this point where every door seems to be closed. The information about this topic is very limited, immigration laws change constantly and are not fair with those who can contribute positively to the country. In addition, people are not familiarized with the right procedures required in this long process. I feel that my dream is fading away and it deeply hurts me. I can do nothing about it, but tell everyone that the reality is not what people are saying here or in your country. It is not easy to find a nursing job in the United States.

Resources

U.S. Immigration Services - An easy-to-use, plain English, do-it-yourself on-line service to prepare and complete the U.S. citizenship application.

CGFNS International - CGFNS International serves the global healthcare community by providing a comprehensive suite of credential assessment products to meet specific needs. As a trusted source for over 35 years, healthcare professionals and organizations rely on our expertise to deliver accurate and dependable service.

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26 Comment(s)

BuckyBadgerRN, ASN, RN

Specializes in HH, Peds, Rehab, Clinical. Has 4 years experience.

Nursing jobs can be hard to come by for licensed nurses from WITHIN the US, I really wish that myth of "you'll get to CHOOSE the nursing job you want" would die, dry up and blow away!

Surely you're not suggesting that a nurse would attempt to seek employment as an illegal alien? I kind of got that from a couple of sections of your post: " However, there is something that people do not say about the reality of employment for foreign nurses in this country. If a foreign nurse is not proficient in English, a citizen or a green card holder, and does not have a sponsor, the likelihood that she gets a job in the country is one in a trillion. "

And: " In addition to the language nightmare, the fact that you are an alien with a Bachelor in Nursing Sciences does not guarantee that you will get your dream job. In order to apply for a job in the United States, one must be a citizen, a permanent resident, or have a "work visa" or H1-B. Without them, it is legally impossible to be considered as a candidate for a position where you might fit well."

And finally: " Maybe the reason behind this secret is that not many nurses have gotten to this point where every door seems to be closed. The information about this topic is very limited, immigration laws change constantly and are not fair with those who can contribute positively to the country. "

This line of your post rings true for many nurses here, not just those looking for the American dream: "It is not easy to find a nursing job in the United States."

Kipahni, RN

Specializes in Oncology, Ortho/trauma,. Has 8 years experience.

You have to also consider the country you come from weather or not the schooling is equal to the level of education we require for our students. I have known many nurses from other countries who come to america and have to go to nursing school again because their license doesn't transfer.

Hello Kipahni,

I went through the credential evaluation process by the CGFNS and my credentials from my country are equal to an BSN in the US. Thus, I can infer that my country offers the same education that the US do. I also passed the NCLEX RN examination in the state of NH two months ago. What varies is the nursing organization ( Nurse Practitioner, RN, LPN, LNA... We dont have LPN in my country, nurses carry on those activities), the laws in nursing, and the different jobs that a nurse can do here. The technology is a huge deal though. However, as far as I understand a foreign nurse is treated as a new graduate nurse regardless how many years of experience she has, the nurse will be new in a new place, consequently she must be re trained.

Thank you for your comment Kipahni

Hello BuckyBadgerRN,

I consider that nursing has plenty of myths that should be cleared off. As you said, it is difficult for an American nurse to find an employment opportunity in the country. The hospitals, homes, and other medical centers want nurses with more than one or two years of experience in nursing. This is sad! It seems that no one wants a new graduate nurse o a foreign nurse.

In regard to the illegal vs legal aliens and the nursing jobs, there is a new immigration law that gives benefits to illegal immigrants who have been in the country. Thus, if a foreign nurse fits in that immigration category and qualify for that benefit it is more likely that she can make it rather than a foreign student who has follow ALL the legal steps and respected all the immigration laws. More detailed information about this can be found in the USCIS web site. This explain my line about "Immigration laws change constantly and are not fair..."

We nurses have a HUGE work ahead of us in education. We have to educate our folks that things in nursing are as tough as in any other field and as an old science nursing is full of myths.

"If a foreign nurse is not proficient in English, a citizen or a green card holder, and does not have a sponsor, the likelihood that she gets a job in the country is one in a trillion."

Sorry if this sounds unempathetic, but of course that would eliminate your chances of gaining employment in the US, even in the field of nursing. BTW your comment makes it sound as if a nursing education would or should allow the rules to be bent in your favor. There are PLENTY of home-grown, bilingual, BSN holding RNs who find themselves unable to obtain employment. Guess the 'nursing shortage myth' reaches far and wide! It's simply not true! Employers of nurses know they are staffing short and remain unmotivated to change that fact.

beshacohen

Has 1 years experience.

Clearly, you are proficient in English. I don't understand why a nurse who is NOT proficient in English would think she would be able to work in the US. We speak English here. The doctors (even the foreign-trained) speak English. The aids speak English. The lab speaks English. The housekeepers speak English. Everyone speaks English, even the translators who are so vital to our ability to serve patients who DON'T speak English. They speak English too, so they can explain us to the patients and explain the patients to us.

I would not go to a non-English speaking country to work unless I spoke the language of that country pretty well and was taking steps to become truly proficient. I don't understand why anyone form elsewhere would want to come here without the skills required to do their job adequately.

And another thing, anyone who comes from outside the US is competing with US trained nurses for jobs. There are not enough jobs to go around. I don't want to compete with you for a job. None of the students currently pursuing degrees in nursing want to lose out on a job because someone from another country was hired to fill it. This market is competitive. Give up on the fantasy of America as a land flowing with milk and honey. I don't mean to be harsh. That's just the hard reality of our current situation.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

The new immigrant laws is not a sweeping blanket approval and for nursing you still need to be legal and have a social security number. blanket citizenship/benefits is not offered to all illegal aliens just because they are here.

No.......there is NO NURSING SHORTAGE in the US with many places having as high as 47% unemployment rate especially amongst new grads.

Take a look at this web site....every city that shows a plus...is a surplus of nurses.

Nurses Schools, Salaries, and Job Data

Well, what did you think? Isn't that clear that you have to be able to speak English in an English speaking country, and to be eligible for employment??

Hi Nola,

There is nothing unempathetic about your comment. That is the point that I am trying to make with this article. The country has highly trained professionals in the nursing field that are struggling because they have not been able to find a job. My intention with this article is not evoke feelings of pity for me or any other foreign trained nurse. I have to accept my reality and I am working towards it. My solely intention is to let other foreign nurses to know that it is a difficult task for everyone, and clear off the myth of the fruitful land.

Nurse SMS, MSN, RN

Specializes in Critical Care; Cardiac; Professional Development. Has 10 years experience.

The foreign trained nurses I work with are wonderful. However, until there is a job for every American nurse who would like one, I would certainly expect there to be no jobs for those who wish to immigrate here. I am regretful for those who want to come here but honestly not very sympathetic. We need to employ American nurses first.

Eta: my post crossed with yours. It is good that the word is getting out that the US is not a viable option for most.

Hello Beshacohen,

It does make sense. As you said

Anyone who comes from outside the US is competing with US trained nurses for jobs. There are not enough jobs to go around. I don't want to compete with you for a job. None of the students currently pursuing degrees in nursing want to lose out on a job because someone from another country was hired to fill it. This market is competitive.

I don't want to compete with my friends either.

Hello Notdoneyet,

I think nurses have a wonderful personality. I understand very well your position as a citizen and as a nurse. However, if this information does not reach the dreamers, the reality of nursing employment in the United States will never be understood.

Hello Esme,

Thank you for the link. Again, that is the point that I want to present. The reality of employment for foreign nurses. With a 47% of unemployment among new graduates, it does not make any sense to believe that a foreign has an opportunity.

About the immigrant law, it is like energy... It is in constant transformation.

Well Pegkyzina... I obviously was not thinking thoroughly. If I had thought about it, I would have never left the hospital in my country to see the world...

BuckyBadgerRN, ASN, RN

Specializes in HH, Peds, Rehab, Clinical. Has 4 years experience.

The most common type of working visa for entry into the United States, the H-1B, is generally not usable for employment of professional nurses. To qualify for H-1B issuance, an occupation must require a bachelor's degree in a specific field as the minimum qualification necessary to enter the occupation. Whether the nurse actually holds a Bachelor of Science in Nursing (BSN) or equivalent foreign degree is irrelevant, because the occupation of "nurse" does not, generally, require a BSN for entry into the profession (indeed, the only state licensing authority that requires a BSN in order to obtain a nursing license is North Dakota). Hence, the only categories of nursing professionals who are able to obtain H-1B status are those whose positions, arguably, require at least a bachelor's degree (for example, nurse practitioners, nurse anesthetists and professors of nursing).

There used to be a special category of temporary visas just for nurses, the H-1A category, but that category was allowed to expire in 1996. A recently enacted replacement program, the so-called "H-1C" category, only applies to nurses who will serve in acute care facilities in "medically underserved areas," so is only potentially useful to a dozen hospitals in the entire United States. Restrictive attestation requirements also make the H-1C category somewhat unattractive, even for those Strategies for Immigrant Professional Nurses locations; the visas are also strictly numerically limited.

There is one temporary visa category that does allow employment of professional nurses, called the "TN" category. Because this visa category was created by the North American Free Trade Agreement, only nurses who are Canadian or Mexican nationals may enter in this category. For Canadian nurses, procedures are straightforward, as the visa may be obtained at the border as the nurse enters the United States. For Mexican nurses, a petition must first be approved by the INS, which may take 30 to 90 days, and then the nurse may obtain a visa in Mexico and enter the United States. For Mexican nurses, the employer must also make certain attestations regarding the wages and working conditions offered to the Mexican nurse, and must offer at least the prevailing wage for nurses in the area where the nurse will be employed.

Now of course you made me want to read up on what you've written, LOL! I'm not sure the H-1B is even what will work for you. Correct me if I'm wrong?

Silverdragon102, BSN

Specializes in Medical and general practice now LTC. Has 33 years experience.

Nurses for several years have been able to go direct to EB3 employer driven green card. There is also the E3 for Australian citizens. I haven't heard H1a being used for nurses as that is a seasonal work visa and H1c I think no longer used much and even when it was it had a cap of 500.

Nursing over the last few years has become an area which is no longer in demand with many countries but what I would like to say although into impossible it is hard and may take time. If you keep aware of current issues, look at gaining experience which makes you more attractive to employers and don't give up the dream will eventually come true.

To all that try, give it your best and don't give up

iamnomad

Specializes in Acute Care. ER. Aged Care/LTC. Psyche. Has 5 years experience.

I guess because at one point we encountered someone or know someone who made it successfully in the United States as a nurse and thought we also could be like them. Well, in the Philippines it is mostly true. We either have aunts, friends, neighbours who migrated to the US. They usually encourage you to take up nursing and assured you that there are demands. Whilst it was true before, it gradually became a nightmare for most who are caught up between retrogression and recession.

When I finished nursing school in 2008, the situation was disappointing. Nurses couldn't find any job ANYWHERE, even in the Philippines. And yet, there's still a huge number of nursing students. I did not lose hope. Whilst hopefuls like me focused on finding jobs in what I call popular states of Texas, NY, California, Florida, where most Filipinos reside, I took the road less travelled and searched for jobs in states that most Filipinos have not heard of. I ended up in Kansas and stayed there for almost three years. I was on H1B visa from 2009. Even with that, I was aware of the fact that it's a temporary visa and I would face a very difficult situation of trying to extend it. I was right. So before my visa expired in 2012, I applied for nursing registration in Australia, got approved, sponsored for a working visa subclass 457. Now, I am an Australian permanent resident. And I'm afraid that the same situation, the same false hope, will be faced by foreign nurses here if they will be given wrong information about immigration and employment.

I guess what I'm trying to say is that we can persevere and pray to secure our lives and we have to seek the right information in realising our dreams. Good luck to everyone.