NCLEX For You

Beware of deceptive job offers, new nurses warned

2008-04-02T16:39:00.001-07:00

03/19/2008 | 03:17 PM

MANILA, Philippines – Newly-licensed nurses are warned against promises of good pay and stable jobs outside the country.

Iloilo Rep. Ferjenel Biron, senior vice chairman of the House committee on health, said the competition among recruiters sending nurses abroad has become stiff in view of the huge demand and the big number of graduates wanting to work overseas.

Dr. Leah Samaco-Paquiz, president of the Philippine Nurses Association, earlier estimated that roughly 80 percent of the latest batch of 28, 924 nurses licensed by the Philippine Regulation Commission were interested in working abroad.

Biron, a doctor of medicine, said the Philippines has been ‘overproducing’ nurses, triggering a stiff competition for overseas employment.

“Actually the output of nurses that we produce every year is beyond our normal requirements. Therefore, these nurses have to be employed somewhere else since there is little opportunity here (Philippine). But they should be very careful in dealing with their recruiters, and (should) study the (employment) contract very carefully," Biron advised.

Paquiz said economic reasons, such as the lack or absence of better job opportunities in the country and the low salary rates have been cited as primary factors for overseas migration.

"They want to earn more (while) they are young. They consider working abroad an adventure," Paquiz added.

Paquiz shared Biron’s advice to the new nurses. “Be very cautious in dealing with recruiters because of the numerous cases involving nurses working abroad who became victims of exploitation."

“Huwag silang magmadali. Pag-aralan nilang mabuti ang contract nila at magsagawa ng background check sa lugar na pupuntahan nila," Paquiz stressed.

In New Zealand, Dennis Maga, project coordinator of Employment Relation Education (ERE), said his group has been receiving reports about Filipino professionals, particularly nurses falling victims to switching or substitution of contracts and collection of exorbitant recruitment or placement fees.

Paquiz said the new nurses should learn from the experiences of the so-called “Sentosa 27++," a group of Filipino nurses and a physical therapist who are facing trial in a New York district court for endangering the condition of their patients.

The Filipino nurses, hired by Makati-based Sentosa Recruitment Agency
to work in the US, resigned en masse and walked out of the Avalon Gardens Rehabilitation and Health Care Center in April 2006 on complaints of unjust working conditions and labor malpractices by their NY employer.

Zambales Rep. Milagros Magsaysay, a member of the House committee on health, urged the nurses who will work abroad to give their best in rendering service to their patients.

“Do their best and show our Filipino hospitality, how we take care of our patients. They should establish goodwill para marami pang Filipino ang maha-hire," she said. - Fidel Jimenez, GMANews.TV

A Primer For All That Wish To Work In The US

2008-04-02T16:22:00.000-07:00

NCLEX-RN exam is required of all nurses, no matter where they trained to work in the US. It is a national exam, and the results are accepted in all fifty states, and never has to be taken again.

You must apply to a state for "License by Examination" and have your file approved before you will be permitted to sit for the exam. It requires an ATT (Authorization to Test) to have in your hand to take to the testing center. You will get this after you have been accepted by the state, and have paid the fee for the exam to Pearson-Vue. It is $200US if taken in the US, and $350US if taken out of the US.

There are a few states that require a local license, most do not. US Immigration does not require a local license in your home country.
CGFNS does require a local license to sit for the CGFNS exam.

The only thing that is needed for the GREEN CARD is a Visa Screen Certificate. This can be gotten by passing either the CGFNS exam or the NCLEX-RN exam, and the series of English exams, if you are not exempt from them. Requirement is based on where you did your initial nursing training, not where you have worked. Even if you are now in the US working on your MSN; but trained in another country for the BSN, you will still need to take the English exams.

Permanent residency, or green card, is what you will be getting. There are no temporary work visas being issued to nurses, and there have not been any for over two years. H1-B visas do not exist for nurses. If someone tells you otherwise, they are incorrect. Please list permanent residency on any application that asks for the type of visa, and include a copy of your passport with it.

All of the green cards for nurses are employer-based, which means that you must have an employer to start the process for you. You cannot apply to immigration for the green card on your own.

Once you have found an employer to do the petitioning for you, you will be given forms to complete. The one that you keep hearing about is the I-140, and this is what will need initial approval before you can go any further. Next, the visa bill will need to be paid, either by the employer, or you. DS-230 forms will come next, and will need to completed and returned. Your dependents must be listed here, or they will not be on your green card, and will need to go thru a separate process later on. And that can take about two years, so please make sure that everyone is on there.
If you have a baby, they can be added. But for others, there will be a wait involved. Once the DS-230 is received and verified, you will hear that your file is complete. Next step will the final step and that is the medical exam and the US Embassy interview. DS-230 is referred to as Packet 3, and the medical/interview is Packet 4. Length of time will be dependent on where you have to go to interview. the UK is currently about six weeks or so, Manila is on average about four to five months.

Anything that requires a notary, must be done at the US Embassy where you are. It does not need to be done in your home country, if you are not currently working there. If you are in the US, then a local notary is acceptable. There are some that have gotten by with local notaries in their home country, but many times they are not accepted and it is better to do things right the first time.

Reciprocity vs. Endorsement
The NCLEX exam has reciprocity, and is accepted in all fifty states. Once you pass it, you never have to take it again. Each state issues its own license, and you need to meet their requirements for it. Some have language requirements and some have additional courses required. Please check directly with the state that are seeking a license in.

Employment Contracts
These are binding legal documents and should be treated as such. If you were buying a home, you would not just sign it. Do the same with this. If it is not in the contract and written, it does not exist. Do not sign a letter of intent or employment, if you intend to look elsewhere and may break that contract. It makes it harder for others to get petitioned. Please be aware of this.

What to look for in a contract: Remember that you will be coming over to the US on a green card, all of you are college educated and with at least four year degrees. Do not sell yourself short.
You can request a specific state, or even city. If the agency doesn't have that one, then look other places. You can also do a direct hire with a hospital.
Make sure that length of orientation is included, this is extremely important. You should not be expected to be on your own in just a couple of days. Doesn't matter how much experience that you have in your country, things will be different in the US.

Never, ever sign a contract or letter of intent, etc., that has any blanks in it. It must be 100% complete; or your contract can be sold, and you are essentially sold to another company. Just like the slave contracts. And if you sign it, there is nothing that anyone can do to get you out of it. If something does not feel right to you about it, then do not sign it.

Canadian and Mexican RNs: You are covered under the NAFTA Free Trade Agreement and can be issued a TN Visa right at the border. You just need to present a Visa Screen Certificate and a job offer form an employer. This visa needs to be renewed every year. You can also go thru the same process as other foreign nurses to obtain the green card, if you wish. You mut actually hold a passport from that country, and not just have permanent residency there to qualify for this type of visa.

LPN/LVN:
This training is not accepted by US immigration for a green card. Statute states that the nurse must be a first level nurse in their country, and have RN after their name. There are no temporary work permits available for nurses.

The only way around the above is if you are married to a green card holder or an American, but you cannot get the green card on your own. It would have to be spousal only.

CGFNS:
Credentials Verification for NY is called the CVS. NY requires this, even if you are endorsing to there.
Regular Credentials Eval is called the CES.
Visa Screen Certificate is needed by all that are applying for a green card in their name.
Their website is www.cgfns.org.

Most states are now requiring the CES, and not the CGFNS exam. And this can be for endorsement as well. Please check the specifics with the state that you are applying to. Check out the initial licensure, as well as endorsement requirements.

English exams:
You have choice of either the TOEFL series, which includes TOEFL, TWE, and TSE. This is offered thru ETS, Educational Testing Services, and their website is www.ETS.com; or the IELTS, in the academic branch with the speaking section. This is available thru the British Council.

Consular Processing vs. Adjustment of Status (AOS)
Consular processing means that you follow the routine process and have all of your immigration details processed while you are still out of the US, and complete your interview at the US Embassy before you travel to the US.

AOS is done once you have been in the US for a period of 90 days, continuously. You are not permitted to leave during the processing time for any reason. It is actually in violation of US Immigration law to come to the US for the sole purpose of finding a job and staying however, it is done all of the time. But there are some things that you need to be aware of. You must make sure that you have about five months of funds available to you to live on while waiting. It is the 90 days before a petition can be submitted, plus about another 60 days before you are will receive the EAD, which permits you to work. Then you need to allow about one week for your SSN# to arrive after you apply for it. It is illegal to accept any type of work during this time, and if you are caught, you face deportation and not being permitted to return to the US for a period of at least ten years. EAD stands for Employment Authorization Document.

And if you are going to come to the US with the idea that you are going to stay, make sure that you already have approval to sit for the NCLEX exam before you arrive here. Do not come with the idea that you will start everything once you are here. You are not going to be able to get things done in most cases, and will have to leave. You never want to apply for an extension after those 180 days are up, unless you have a very good reason. It must be done well in advance, not just a few days before it expires.

Foreign nursing students in the US
You can attend school on any of the visas that permit you to be in the US legally. The tourist visa will not alow you to carry a full load of classes.

CPT is available for you during school to get experience working in a hospital. The OPT is available for up to one year when you graduate, but yo umust apply for it before you actually finish your classes, or it will not be available to you. There are restrictions for both.

The only visa that you can apply for when you graduate is the green card, or permanent residency. H1 visas are not available to nurses, and have not been for over two years.

Exam Day Process

2008-03-22T21:56:00.000-07:00

The Day of the Examination

Exam Day Process

The following are procedures that will occur when a candidate arrives at the Pearson Professional Center for their NCLEX examination appointment:

Candidates should plan to arrive at the Pearson Professional Center at least 30 minutes before their scheduled testing time. If a candidate arrives more than 30 minutes after their scheduled appointment, they may be required to forfeit their NCLEX examination appointment.
If a candidate forfeits their examination appointment they will be required to re-register and re-pay the examination fee.
Candidates will be required to present their Authorization to Test (ATT) and a valid picture identification in English that includes their signature in English.
Candidates will be asked to provide their signature, and will have their fingerprints and photographs taken.
The test administrator (TA) will provide candidates with an erasable note board that may be replaced as needed during testing.
Candidates will have up to six hours to complete the RN examination, and five hours to complete the PN examination; total examination time includes a short tutorial, two preprogrammed optional breaks and any unscheduled breaks they may take. The first optional break is offered after two hours of testing. The second optional break is offered after three and one-half hours of testing. All breaks count against testing time.
After the candidates' examination is finished, they will be asked to complete a brief computer-delivered questionnaire about their testing experience. When candidates have finished the questionnaire, they should raise their hand to summon the TA. The TA will collect and inventory all note boards. The TA will dismiss the candidate when all requirements are fulfilled.
On rare occasions, technical problems may require re-scheduling of a candidate's examination. If circumstances arise causing a candidate to wait more than 30 minutes after their scheduled appointment time, or a restart delay lasts longer than 30 minutes, the candidate will be given the choice of continuing to wait or re-scheduling their appointment without an additional fee.

NOTE: Pearson Professional Centers administer many types of examinations including some that require essay-type responses. Pearson Professional Centers have no control over noises made by candidates typing during another examination. Earplugs are available upon request.

NCLEX Registration Information

2008-03-22T21:48:00.000-07:00

Registration Methods

Registration Time Limit

All NCLEX examination registrations will remain open for a 365-day time period during which a board of nursing may determine the candidate's eligibility. The time period begins when the board of nursing receives the candidate's registration from the test service. Once a candidate is made eligible, he or she must test within the validity dates printed on the Authorization to Test (ATT).

If a candidate's board of nursing is unable to make a candidate eligible within the 365-day time period, they must wait until their current registration expires before re-registering. A candidate may not have two NCLEX examination registrations (of the same exam type) open at the same time. If a candidate re-registers before their current registration expires, their second registration will be processed and denied, and the fee collected will be non-refundable.

Candidates who are not made eligible by their board of nursing within the 365-day time period will forfeit their registrations, including the candidate registration fee. Candidates who wish to take an NCLEX examination will need to re-register and re-pay the examination fee.

How to Register for the NCLEX Examination

Candidates must submit an application for licensure to the board of nursing where they wish to be licensed. Candidates must be sure to meet that board of nursing's application deadline.
Candidates need to register using one of the following methods: on the web, by mail or by telephone.

Candidates who provide an e-mail address when registering for the NCLEX Examination will receive all subsequent correspondence from Pearson VUE only through e-mail. If a candidate does not provide and e-mail address when they register then all correspondence from Pearson VUE will arrive only though U.S. mail.

Registering on the Internet

Go to the NCLEX Candidate Web site (www.pearsonvue.com/nclex) and select the "Create a Web Account and register" option. Answer each question as directed. Use the Candidate Bulletin (PDF 740k) as a guide to answering the questions.
Candidates must pay for their registration by credit card, using one of the following: VISA, MasterCard or American Express. Candidates should have their credit card ready when they begin their internet registration.

Registering by Mail

Candidates must enclose a certified check, cashier's check, or money order (made payable to the National Council of State Boards of Nursing) for $200 in U.S. currency drawn on a bank in the United States with their registration. Candidates can use the enclosed envelope to return their registration form and payment. Mail to: NCLEX Operations, P.O. Box 64950, St. Paul, MN 55164-0950.
Personal checks, cash, foreign currency, stamps, receipts or proofs of payment will not be accepted.
Credit cards cannot be used when registering by mail.

NOTE: Registrations that are not properly completed and/or are not accompanied by the proper payment will be returned to the candidate and will delay testing.

Registering by Telephone

Call NCLEX Candidate Services
Before a candidate calls, they should have the mail in registration form completed. The customer service representative will ask the candidate to provide the information collected on the registration form.
Payment methods: valid VISA, MasterCard, or American Express credit card.
Candidates need to have their credit card ready when they call to register. Candidates must supply the name shown on the credit card, the credit card number, and the expiration date.
Credit cards will be verified before registrations are processed. Delays may be encountered if credit cards cannot be verified.

About NCLEX

2008-03-22T21:09:00.000-07:00

The NCLEX-RN (National Council Licensure EXamination-Registered Nurse) is a computer-adaptive test (CAT) of entry-level nursing competence. Passing the exam is required of candidates for licensure as a Registered Nurse (RN) by all US state and territorial Boards of Nursing.

The NCLEX-RN® and NCLEX-PN® examinations are developed and owned by the National Council of State Boards of Nursing, Inc. (NCSBN®). NCSBN administers these examinations on behalf of its member boards which consist of the boards of nursing in the 50 states, the District of Columbia, and four U.S. territories American Samoa, Guam, Northern Mariana Islands and the Virgin Islands.

To ensure public protection, each board of nursing requires a candidate for licensure to pass the appropriate NCLEX® examination, NCLEX-RN for registered nurses and the NCLEX-PN for practical/vocational nurses. NCLEX examinations are designed to test the knowledge, skills and abilities essential to the safe and effective practice of nursing at the entry-level.

NCLEX examinations are provided in a computerized adaptive testing (CAT) format and are presently administered by Pearson VUE in their network of Pearson Professional Centers (PPC). Authorized testing centers are located throughout USA and in selected foreign countries, including the most recently approved the Philippines and Mexico. Click on external link and visit the NCSBN for a list of approved countries where the NCLEX exam is given.

The test is given only in English.

All items are developed and validated using the expertise of practicing nurses, educators and regulators from throughout the country. The content of the items of the NCLEX examinations is based on a practice analysis conducted every three years. There many well written preparation guidelines, manuals and textbooks on the how to score well on the NCLEX exam; all serve well and enhance the probabilities of the examinee when taking the exam. Some have been bilingually edited for foreign educated nurses. Visit NclexMasters.com and Nclex-Masters.com both site have some bilingual elements and/or website translators of acceptable quality. All students considering taking the NCLEX and/or CGFNS exams must keep in mind that the exams are about basic nursing intervention, and not about nursing intervention beyond the level of practice of any entry level nurse.

The two most important elements when considering and discerning the most correct answer are whether the answer is part of an intervention that is 'safe' and 'effective'. Student should use this as a guideline; if an answer doesn't have the elements of a 'safe' and 'effective' intervention, whether seeking the physical and/or pycho-social integrity of a patient, that answer cannot be the 'best' answer. It can be partially correct, but most likely is not the best answer of the multiple possible answers.

Exam content

The majority of test items are written at the application or higher levels of cognition but the exam may include items at all of the cognitive levels.

The exam's content is based on client needs:

Safe Effective Care Environment
- Management of Care
- Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity
- Basic Care and Comfort
- Pharmacological and Parenteral Therapies
- Reduction of Risk Potential
- Physiological Adaptation

Question types

Most of the questions of the NCLEX-RN exam are worded multiple choice questions. In recent years, however, the Boards of Nursing have added broader questions that don't involve choices. For example, some questions:

Require identifying and selecting a particular area of a drawn body part pertaining to the question
Involve selecting multiple correct answers (via check box)
Calculating an answer for a mathematical question (usually for medication dosages) and inputting the answer