So you are a foreign-educated nurse and you want to come to America? Congratulations! Associated Press reports that demand for international nurses reaches up to 400% since the pandemic started. If you are ready to take that big step, this practical guide is written for you.

Here is the podcast of this blog post: https://open.spotify.com/episode/3FbPs2jM9tUdmm5bMogC0s?si=100e6018d7464c6a

The Immigration Process

Understandably, the process of immigration is long and tedious. It requires the passing of the National Council Licensure Examination (NCLEX), verification of nursing education, etc. Luckily, there are many agencies that help nurses find employers. Aside from taking care of the legal side of things, some even help nurses settle down in the US during their first few weeks.

Needless to say, you have to also do your own preparation. After all, you are literally uprooting yourself and starting life anew in a foreign land. Below are 15 practical tips on how to navigate those changes and keep your sanity!

Before Arrival

1. Be aware of the legalities that will impact your practice.

While waiting for your departure date to the US, review laws and regulations that govern nursing practice in your destination state. Familiarize yourself with important federal laws such as the Health Insurance Portability and Accountability Act (HIPAA). If available, look into the policies and procedures of the healthcare facility that you will be working in.

2. Be proactive.

Research the technological tools that you will be using once you start working in the States. For example, be aware of your prospective employer’s electronic health record (EHR) system. Search for online educational materials that you may use to have at least an idea regarding that system. Depending on where you are coming from, using tech tools and applications may be challenging.

During Orientation and Beyond

3. Be empowered to ask questions.

Patient safety is of paramount importance, so you would want to practice according to the safety protocols of your facility. Some cultures predispose nurses to stay quiet, but this is not the time for it. Speak up if you need clarifications. This is both for the provision of safe and quality care and your professional benefit.

4. Be receptive.

Do not compare your old practice and your new one. Allow the relevant lessons that you learned from the past to guide your current job. Again, your knowledge of the facility’s policies and the state and local laws should be taken into account.

5. Be knowledgeable.

Stay abreast with the latest evidence-based practice that can enhance your delivery of care. Attend seminars/webinars. Earn continuing education units. Pursue higher education. Ask your facility if they have tuition reimbursement programs.

Money, money, money

6. Be aware of taxation.

Have an idea of how taxation works in the US, so you won’t be shocked when you receive your first paycheck. Some people tend to do math in their heads and end up disappointed seeing completely different numbers in their pay stubs. Anticipate more deductions if you are also paying state taxes aside from federal taxes.

7. Be in the present.

You are here now, so please don’t keep on converting everything to your home country’s denomination. Sure, it is awesome to know that you will be making 100,000 Philippine pesos (PHP) (roughly $2000) per month. However, you realize that half of that will go to your rent. Of course, PHP50,000 rent is unheard of back home because most of us live rent-free with family. What are you going to do, then?

Case and point? You will drive yourself crazy if you keep on doing this. And yes, that is speaking from experience.

8. Be smart about investments and retirement plans.

Consult a financial planner if you want to start investing. Maybe you want to save up for a house or your child’s college funds. It is hard to do it on your own if you don’t have the slightest clue.

Also, it is never too early to prepare for retirement. Inquire about 401K or 403B and other financial benefits that your workplace may offer. Even saving a penny a day adds up. Just start somewhere. Ask people in the know to guide you through this process if you aren’t sure where or how to start.

Expectations versus Reality

9. Be prepared to do everything for yourself here.

In some countries where extended families share residences, chores are divided amongst members of the family. Chances are if you are working a shift that day, then your parents may not expect you to wash the dishes, for example. Here, you make your breakfast, drive yourself to work, stop by the grocery on your way home, and make dinner all by yourself. If you immigrated with your immediate family, make sure that they have realistic expectations about life in the US.

10. Be honest.

Speaking of realistic expectations, your family left in your home country should also share those expectations. While you may be compelled to help out whenever your family needs help, you need to learn where to draw the line.

I knew a nurse before who got into a car accident because she worked 24 hours one day between her two jobs. It was her utmost desire to send a good amount of money back home. Thankfully, she wasn’t injured. Unfortunate accidents like these should never happen just because we want to provide for our families!

Adjusting to Your New Life

11. Be open.

Associate with people from different backgrounds. Listening to others provides us with the opportunity to understand them better. If we don’t share a similar point of view, be respectful and agree to disagree. We learn and become better people that way.

With that being said, also seek out communities of like-minded people. Maybe you came from the same locale and you feel that they will be able to guide your adjustment. Most people want you to succeed. However, there may be a few who may be jealous of your accomplishments.

12. Be your own advocate.

Don’t allow people to walk all over you! Some people may be rude and may make fun of your accent. Being shy because of that is never an excuse to not speak up when something is wrong, especially concerning patient care.

Always remember that speaking perfect English is not a requirement. Voice out your concern in a tactful and respectful manner. After all, respect begets respect.

13. Be proud of who you are.

Acclimating does not mean that you will turn back on your own culture and traditions. Just as you are curious to learn about others, they are just as excited to get to know you, too. So yes, during potluck dinners in the unit, bring that arroz con gandules, pot roast, or lumpia. Our individual uniqueness is what makes that tapestry more colorful and that dinner table more appetizing.

Nurses, you matter, too!

14. Be determined in maintaining your work-life balance.

Mental health days, breaks, and vacations are musts. Work-life balance is very important, especially during the early days of adjustment to foreign practice. Go to the gym. Hike. Meditate. Attend a yoga class. Visit a museum. Drive to a national park. Do something to enrich your and your family’s shared life.

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15. Be good to yourself!

Taking care of yourself is not selfish. Your body, just like your car, also needs maintenance. Go to the doctor for preventive care. Have a massage or acupuncture just because. The options are limitless!

Tying it All Together

Migrating to another country is difficult. Most of us have gone through that. It does get easier, though, especially if you have a supportive environment.

While these guides are specific to those who are coming to America, others may find this useful in their own situations as well. Some experiences may be similar. Others, not so much. Nevertheless, having a tool kit on how to deal with those challenges makes that transition a little smoother.

What about you? Do you have any relevant experience or tips that you can share with the readers? Please share them through the comment or the Contact Me section.