Claire practiced nursing for four years in her native Philippines before coming to the United States a year ago. She was looking for greater challenges in her professional life and wanted to experience “something different.” She said half jokingly, half serious, “I think I got more then I bargained for in that regard.”
She continues: I had to take all the exams for foreign graduated nurses in order to be eligible to sit for the nursing boards (NCLEX-RN) in the United States. I prepared for those tests on my own by using review books. I also had to do all the paperwork for getting licensed here. When I finally became a licensed RN, I began working part time in a nursing home, and part time in a hospital on a telemetry (heart monitor) unit. Nursing is very different in the United States then in the Philippines. Nurses here have much more responsibility. For example, back home, nurses don’t start IV’s. In the Philippines, most hospitals are teaching hospitals, so the residents and medical students do most of the procedures. There, the charge nurse was the one who had primary contact with the physicians. In the United States, nurses are much more independent. Here, all the nurses have regular contact with the doctors, start the IV’s use more critical thinking skills and do everything. Nursing is also much more complicated here. In the Philippines, we were not so involved with families and discharge planning and case management. There are also much greater legal implications here. You have to be responsible for your own actions. So even though I have four years’ experience working in the Philippines, I am starting as a new graduate here because I have so many new things to learn. Plus I am dealing with cultural differences. In addition to all the new nursing skills I had to learn, I was also dealing with my new co-workers, who have different values from me. In the United States, you have to be direct and straight forward. You have to say what’s on your mind. We’re not so direct in the Philippines, so I have to adjust. I have to assert myself in terms of my job.