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Stankus moved into her own business after investigating
foreign nurse recruitment for Catholic Healthcare West,
which had nearly tripled its spending on nursing contract
labor between 1998 and 2001. Her employer, St. Joseph's
Hospital in Phoenix, did a cost-benefit analysis that
showed a return on investing in foreign nurses.
"It boiled down to 25 foreign nurse hires save
the Arizona hospital employer $1 million on nursing
contract labor," Stankus said, "and it's much
stronger and more dramatic in other states."
Hospitals pay Stankus nearly $16,000 to lead nurses
through the process of becoming a U.S. nurse.
That process often starts with the Commission on Graduates
of Foreign Nursing Schools exam, which has a 90 percent
success rate in predicting a nurse's ability to pass
the NCLEX. Even with two years' experience, Filipino
nurse Brenda Vilches, BSN and RN license pending, reviewed
carefully before she took the test. In addition to questions
about nursing, the test poses questions about American
culture, such as whether Jehovah's Witnesses can receive
blood transfusions.
Vilches passed the first time.
"That isn't the end of the story," the 33-year-old
intensive care unit nurse said. Nurses from non-English-speaking
countries also must pass tests certifying mastery of
the language. The first is the Test of English as a
Foreign Language, which includes a Test of Written English.
Then comes the dreaded Test of Spoken English.
"Most foreign nurses have trouble passing,"
Vilches said, adding she has heard of some people who
repeated the test four times. "If you fail the
first time, you must wait three months and that will
affect your application."
Stankus said an industry has grown up around helping
foreign nurses pass the TSE. Organizations teach nurses
to use phrases like "in summary," and "my
next point." The test requires nurses to speak
up, which puts people from soft-spoken cultures at a
disadvantage, she said.
Vilches passed her TSE, then waited a year for her
schooling, license and work experience to be screened
and certified by the commission before coming to the
United States.
The few foreign nurses who hold a state license may
skip the next step, which is to pass the NCLEX.
Vilches took the NCLEX and started her job Jan. 20
at Mount Sinai Hospital in Chicago. She is one of about
60 recruits, said Jackie Conrad, RN, vice president
of patient care services.
"We're so pleased with their demeanor and skills,"
Conrad said. Mount Sinai gives an extended orientation
to teach nurses about American culture and technology.
"But we're finding they are already familiar with
our equipment," she said.
That's in part because nursing schools in the Philippines
educate their students specifically for a U.S. market,
Choy said. In the 1970s, entrepreneurs there picked
up on the demand for nurses overseas, and the number
of nursing schools in the Philippines grew from 17 to
140. Subjects taught include English and skills more
commonly needed in the developed world, such as operating
room techniques, in addition to the basics.
While English classes can help foreign nurses to assimilate
into American culture, hospitals such as Mount Sinai
recognize that their facilities also can facilitate
an easier transition. The hospital pays airfare and
attorney fees. Then, as the nurses arrive, Mount Sinai
finds them housing and gives them two to three months'
rent, plus transportation costs.
For De La Cueva, Mount Sinai's help settling in made
for a happy ending to a long and rocky process. For
the first three months, she lived with one of the hospital's
nurse recruiters, who helped her set up a bank account,
obtain a state identification card and other basics,
she said.
"I was hesitant because I expected to be staying
with a Filipino family," she said. "But she
really helped me a lot. Everything was there."
Contact Heather World at H_world@yahoo.com
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