Why avoid Nursing Homes that are willing to sponsor you for a Green card?

starbin, BSN, RN · Mar 1, 2007

hi Suzanne and everyone else who would like to answer this ....
I created this thread so other newbies like me will easily be able to search for it. Its a spin off from another thread of mine.
My question is why is that a foreign RN has a high chance of losing their U.S. RN license if they decide to allow themselves to be sponsored by a Nursing home? (assuming no Retrogression)
In other words, why would it be a bad career move for a newbie Filipino RN to accept a petition for green card from a CA Bay Area Nursing home?
Thanks!

It all depends on what you want from your job. Whether you want to work in a nursing home or hospital.....the type of work you do in a nursing home and in a hospital is very different....

Nursing home has pretty much of same routine everyday but in hospital each day could be different...The documentation part is very crucial in NH, you have more documentations to do and you have to be willing to take care of 32 patients if working a day shift and 64 patients if working night shifts. However, hospital has relatively lower nurse patient ratio but again, it is an acute care setting. Mistakes are not accceptable in either facility.

i dont agree that you will loose license if you work in nursing homes. There are filipinos working in the same nursing home for more than 17 years and never had to go to the court and there also are people who were involved in lawsuit after only a few months of employment in the nursing home.....I guess it is the same in the hospitals too.

I work in a NH where a lot of filipino nurses were petitioned. They worked as a CNA for a year or more before they were eligible to work as RNs. Most of them took their NCLEX after few months of working in that NH, they had passed CGFNS before coming here. many of them could not work as an RN even after passing the NCLEX because the agency made them take the board in different state and had to wait for endorsement. They have a two years contract with the NH but the contract does not start until you start working as a full RN. You are underpaid for at least for a year...but the most interesting thing is even with all these exploitations these nurses are extremely happy.......therefore.....it all depends on what you want....

suzanne4, RN · Mar 1, 2007

It is not that you will automatically lose it but if you go and do a review of those that have lost licenses, as well as the areas that are the highest to lose them in, you will find the nursing homes at the top of the list.

Reasons:

1. You get usually three days of orientation, no more. This is not enough to prepare you. Especially coming from the Philippines, where the clinical training is slim. Many of you have had next to nothing as far as clinical training, especially second coursers.

2. Many hospitals will not take you after.

3. They do not fall under ratios, you can have thirty to sixty patients that you are responsible for.

And to the poster just above me (Starbin):

You are speaking of nurses that trained years ago, there is a big difference in the nurses that are coming out now from the Philippines, significantly different now from ten years ago in their training.

Things were different in the past, but now the training is not the same in the Philippines at all.

That is why I have said that.

suzanne4, RN · Mar 1, 2007

Language idioms are significantly different.

Salaries in the Bay Area for nursing homes are about $15 to $20 less per hour than a hospital, and they have ratios in the Bay Area.

I still stand by what I have stated. You cannot take a new grad, or someone new to the US and give them one week orientation and expect them to function as they should.

suzanne4, RN · Mar 1, 2007

Any of you are free to do as you please, but I was asked for my opinion. I have been working in nursing for enough years to know what I am saying and will stick by it. Have never changed it and never will.

You show me one nurse that is coming from the Philippines that is trained anywhere near where the ones were that came out twenty years ago. Just is not going to happen from there.

They need a solid orientation and there are not going to get it. It is also usually bad agnecies that are petitioning them as well.

starbin, BSN, RN · Mar 1, 2007

Any of you are free to do as you please, but I was asked for my opinion. I have been working in nursing for enough years to know what I am saying and will stick by it. Have never changed it and never will.
You show me one nurse that is coming from the Philippines that is trained anywhere near where the ones were that came out twenty years ago. Just is not going to happen from there.
They need a solid orientation and there are not going to get it. It is also usually bad agnecies that are petitioning them as well.

I agree with you on almost everything.

* Orientation is not enough at all...........you are forced to work beyond your knowldege, experience and your capacity. You take risk.........make mistakes and sometimes get fired too........(one of my co-worker who happens to be a filipino nurse and was working as a wound nurse assistant and was paid as a CNA for 15 months before becoming RN, used to tell me- "Each day I wake up- I wish i didn't have to go to work today. I try to do everything but always miss something or make some mistake and get yelled yet or written up". Despite working for 1.5 years in the same facility(As a wound nurse assistant and RN for 3 months) she is still not comfortable at work.)

* Pay is less than that of the hospitals

* Your experience in LTC hardly gets any credits when you try to move to hospitals..you have to start from scratch............

* The training might have changed alot in the philippines...I don't have much idea about that.....

I did not mean to make any statement against Suzanne. I was just giving my opinion....These nurses are indeed happy...and possibly would have been happier if they were in hospitals........

They are happy because they get a lot of overtime....( i am talking about the NH I work at, not in general) I think this is another reason why they make more mistakes......

batasMTR_RN · Mar 1, 2007

i guess the more important thing to consider is that nursing home has a bad ratio... sometimeyou will get as many as patients........ but i guess you will still be hired by some hospitals if you then decide to quit nursing homes two of my co-wroker worked in nursing homes for 10 years and they are now in the hospitals.... DOU and ER respectively.... if that is the only agency that offers the best deal why not... but i am telling you... the work condition there would not permit you to give quality care

Rep · Mar 1, 2007

I work in a sub acute/rehab and LTC facility.

The reason why I work there in the first place is because it was my choice. I have not work as a nurse since 1994, had been to sales, and coming over here with out a US license and to work under an Interim Permit is a perfect choice for me.

I have been assigned as a wound nurse for a couple of months and gained a lot of experience from that though I still get assignments from time to time. I usually work on floor that is sub acute in setting. All the patients we have here come form El Camino and Stanford. Basically the sub acute setting is similar to the hospital setting that I experienced in the Philippines except with the high tech stuff and "limitless" medical supplies.

I agree with Suzzane that there are more risk in losing a license in nursing homes than in acute setting simply because of the volume of paperworks involved and the number of patients a nurse is handling. You missed a charting and that patient is on alert charting and you will be in trouble. Also consider the number of medicines that you are going to pass to an equal number of patients. Plus the demands from them/family members. There are no ratios in sub acute/LTC setting in my IMO.

But I also believe that a nurse a must be careful in everything and do things the right way instead of making shortcuts then the risks would be lessen same things with acute. I have seen a lot and talk to a lot o nurses who have been in a sub acute and LTC setting for a long time and they survived.

As for me, definitely I will go to a hospital setting and the experience I have with sub acute/LTC setting willbe my backbone in improving my nursing skills. I learned a lot from where I am working now.

Well. I am still on job hunting, this part of the of the BAy area are saturated with experienced nurses that nurses like me with no US acute experience are having a difficult time landing a job unless of course I move to a place 1 or 2 hours drive from here where hospitals are willing to hire. I'll be patience, I know some nurses, including my sister, with similar situations were able to find jobs here.

Rep · Mar 1, 2007

BTW, I was oriented in the facility for one month.

rookieq · Mar 2, 2007

Thank you Starbin, Suzanne and Rep, I understand it now. And i can see how agencies are part (or fully) to blame for this. They are getting a lot of bad press here in manila....their ads are really tempting when you read them in the papers... A folllow up question......why is it that US hospitals do not give you credit for working in a US Nursing home? Thanks!!

rookieq · Mar 2, 2007

2. Many hospitals will not take you after.

Hi Suzanne, can you share why this is the case for many hospitals? thanks!

suzanne4, RN · Mar 2, 2007

The skills that you use in LTC are very different from what you see in the acute hospital. You have very few IVs, very few respiratory treatments for example. It is just as it is called, long term care. If you had the skills in the first place, not using them for three years would take away from them being current.

That being said, the training programs right now are not up to the caliber that they were, ten years ago when Rep attended nursing school, or the five year programs that my contemporaries went thru there. I am seeing many that are coming over as second courses that lack even the basic training that we had in nursing 101.

Then the nursing homes are known for not providing good orientation in the first place, true there is the exception, but it is not the norm in that industry. So, if you add two and two together, it is a nightmare in the making. Take one nurse with minimal clinical skills, add in minimal orientation and it is a recipe for disaster.

Also depends on the area, and the patient population in the facility. But if someone would ask me, my blanket answer would be not to go that route. Rep knew what would work for him and researched it quite a bit, and had been out of school for ten years so did not even have much of a choice. But for those that have graduated recently, no way would I recommend that route.

Hope that I covered it well for you.