Bad Request (Invalid Hostname)

Louis Smith	More NurseWeek Features   Smoke-Free Zone   Nurses and patients tackle nicotine addiction   Bloodless Survival     Surgical techniques to use when transfusion drops out of the equation
Most international nurses in the United States come from the Philippines, but many others come from Canada and India. In the past few years, Africa and China also have provided more nurses for American facilities.

Four years after she flew to the Philippines and began the process that ended in 39 newly hired nurses, Mary Jane Brecklin, RN, MA, BSN, says foreign recruitment made her organization better in more ways than one.

“It was a life-changing experience for us,” said the recruitment and retention services coordinator for St. Louis-based SSM Health Care, a 23,000-bed network of home health, inpatient, and rehab services and hospitals.

Not only did SSM employees come together to create a generous start for their new counterparts, but the administration also figured out new ways to retain all staff members. Despite an estimated cost of $16,000 per nurse and the complications leading them through the thicket of immigration bureaucracy, administrators say the trouble of overseas recruitment was worth it.

Accreditation agencies have helped ease the process. In June, the National Council of State Boards of Nursing announced it would offer the NCLEX in three foreign countries — Hong Kong, England, and South Korea. The Commission on Graduates of Foreign Nursing Schools continues to open new locations of its NCLEX predictor test for the same reason; it recently branched out into China and India.

Most international nurses in the United States come from the Philippines, but many others come from Canada and India. In the past few years, Africa and China also have provided more nurses for U.S. facilities.

Fewer immigration restrictions in the late ’90s opened up a new market for recruiters who were seeking solutions to the nursing shortage. The number of overseas nurses moving to the United States, which has ebbed and flowed according to restrictions over the years, subsequently jumped. According to the national council’s figures, 16,490 nurses from outside the United States passed the NCLEX in 2003, nearly double the number in 2001.

A tough road to travel

In keeping with the times, Margie Lim, manager of patient care recruitment at St. James Hospital and Health Centers in Chicago, made a recruiting trip to the Philippines in the spring of 2001. St. James initially recruited without the assistance of an agency, so Lim learned firsthand how difficult the international recruiting process can be.

Lim and her director used their own resources, staying with the family of the director — who is of Philippine descent — and who had graduated from nursing school there.

“That was our tie,” Lim said.

The director’s family hosted the pair, and even showed them where to advertise for nurses to get the best results. For two weeks straight, Lim and her director interviewed 45 nurses in a recruiting marathon that Lim described as “nonstop.”

If Lim and her director were the only ones recruiting nurses in the Philippines, the process would have been easy. But as many nurses know, the United States isn’t the only country dealing with a lack of nurses.

The global nursing shortage meant heavy competition for the well-trained Philippine RNs, Lim said.

“There were nursing homes and other agencies there, too,” she said. “England was there and Saudi Arabia — it’s quicker for a Filipino nurse to go to those places.”

The Sept. 11 terrorist attacks slowed the process of getting into the United States even more, Lim and other recruiters said.

The list of credentials and documents that foreign nurses need to practice in America is long and, for some, daunting: a rE9sumE9, passport photos, diploma, and a nursing license in the Philippines. Other questions that must be answered are: Have they taken the NCLEX predictor test, which is offered outside the United States? What about the English language proficiency exams?