Lyrics from the West Side Story reality for many nurses from around the world. The nursing shortage has created expanded opportunities for foreign nurses wanting to immigrate to the United States.
As the nurse shortage in the United States and other developed countries continues to grow, foreign nurses will become a frequent solution used by healthcare employers to ease the staffing shortages that confront them daily.
Many employers have learned that recruitment of foreign nurses is more cost effective than reliance on agency nurses and results in better quality of care. Additionally, virtually all the foreign educated nurses have at least a Bachelor of Science in Nursing, a higher level of education than many American born-American trained nurses.
The road to the United States, however, is a long, twisting highway for the foreign born and educated nurse.
Nurses who graduate from United States nursing schools are only required to pass a licensing examination to be licensed as a nurse by the state to which they apply.
On the other hand, the foreign educated nurse must pass the CGFNS Examination to demonstrate that they are likely to pass the state licensing examination, and an English language examination to demonstrate fluency in reading, writing, speaking and comprehending English. The only foreign educated nurses exempt from this requirement are those trained in the United Kingdom, Canada, Ireland, Australia, New Zealand and South Africa.
Additionally, all foreign educated nurses must obtain a Visa Screen to demonstrate to the United States Immigration Service that they have met the certification requirements to enter the USA as a health care worker.
Then, of course, there must be an employer willing to sponsor the nurse for an immigrant visa to the United States and file a Petition with the Immigration Service with the nurse as the Beneficiary.
The employer-sponsor files an Immigrant Petition for Alien Worker with the appropriate regional office of the United States Citizenship and Immigration Services Bureau, the successor to the Immigration and Naturalization Service.
The entire process for a foreign nurse to qualify and arrive in the United States takes ten to fifteen months if all qualifications are met in a timely manner.
Once the nurse arrives he/she must then take and pass the State Board of Nursing Licensing Examination (NCLEX in most jurisdictions) before working as an RN. Usually, they work as a nurse technician or some other capacity until full and unrestricted licensure is obtained.
The time frame from arrival to licensure is a difficult rite of passage for the nurse and the employer must provide a strong support system.
In many cases, the nurse has left their family behind while becoming established in their new homeland. They must learn a new social system, a new currency, a new neighborhood—its an entirely new life.
Concurrently, they must adapt to a new work environment while simultaneously studying for the state licensing examination.
It is critical for the employer to work with their current staff, as well as the migrating nurse, to insure that the new arrival has a smooth transition to America.
We recommend to our clients designating a “buddy” from their current staff (perhaps a native of the same country) to communicate with the foreign candidate by email while the candidate is still in the foreign nation preparing for departure.
Further, we recommend that the employer meet the candidate upon arrival at the airport in the United States to begin the process of making the nurse feel welcome and to “bond” the nurse to the employing institution. The foreign nurse needs a different orientation program than that typically given to American born nurses with heavier emphasis on assertiveness training and the American system of health care delivery.
Last, we recommend that employers enroll their foreign nurses in a review course that focuses on and recognizes the cultural biases inherent in a United States licensing exam for those educated elsewhere. At Nursing Resources International, Inc. we have developed such a program that has significantly increased first time NCLEX passing rates for the foreign candidates
The experience of bring a foreign nurse to work in the United States is richly rewarding for the nurse and the employer if done in the right way.
