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

[rosomebody007]

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.

[rosomebody007]

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.

[rosomebody007]

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.

[rosomebody007]

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]

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]

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]

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.

[JustBeachyNurse, LPN]

Just a correction North Dakota rescinded the legislation requiring BSN as entry to practice for nursing a few years ago.

[rosomebody007]

IAMNOMAD,

I have heard about plenty of nurses from the Philippines in this area. As you said, we have to seek for the right information before daydream in what would or would not happen.

[rosomebody007]

Silverdragon,

Thank you for your positive thought.

[rosomebody007]

BuckyBadger,

When I decided to write about this topic was because I have done my research and experienced by first hand all the process and visa information.

[Nola009]

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.

Okay. In short- This is not a 'fruitful land' for working people. Enough of us who were born and raised here don't have jobs. There is nothing wrong with us. Tell your friends to look at numbers. I think the link Esme12 posted is excellent. BTW there is currently an unemployed /underemployed trend overall in our country, not just with nurses.

[BuckyBadgerRN, ASN, RN]

BuckyBadger,

When I decided to write about this topic was because I have done my research and experienced by first hand all the process and visa information.

Never doubted that you did. What you said got me interested in the routes that foreign-born and seemingly sometimes unqualified nurses look to take in order to obtain a nursing job that a "local" is battling to secure. That led me to the article that I posted excerpts of in my last response.