Tips for US Bound Nurses

Danny Fernandez of OFWGuide Forum shares useful information for Filipina nurses about to go to US to work for the first time.

Get Your Social Security Number (SSN): It is important to apply for SSN upon arriving in the US at the Social Security Office near your place of deployment. You may seek the help of the Human Resource Department of the hospital where you will work. Most State Boards requires the SSN to get your permanent nurse license, be a registered rurse and practice your profession. Without the SSN, you may not be able to secure your license and will not be allowed to work. Securing SSN takes between 10 to 30 working days while the processing for the RN License takes 30 to 90 days.

Don�t Overspend: The contract you signed in the Philippines may include a clause stating that for the first 90 days of your stay in US, the hiring hospital will provide for your needs and you will receive an allowance or stipend. The usual stipend is USD 1500 to USD 2000.

The stipend may seem like a large amount but the truth is, it will barely cover your expenses. Normally, the accommodation they provide is a one-room apartment with free water and electricity. It has a stove, ref, sofa, TV, and a bed. You need to buy your utensils, plates, spoon, fork, bed sheets, food, and other personal items. Some hospitals have these things included in the package but some do not. It is a must to inquire about these matter to your agency. You need to spend frugally until you earn your first paycheck. Until then, you have to live with the stipend unless you brought some pocket money before leaving the Philippines.

Learn to Drive in the Philippines: If you can, you need to learn to drive and secure a driving license in the Philippines. Knowing how to drive in the US is not a luxury but a necessity. There are public transport facilities available but it is very time consuming and inconvenient to wait for buses, and taxis at times. When you have a Philippine driver�s license, some State allows you to drive for one year as long as your license is valid. Another thing is, if you provide a Philippine driver�s license when you apply for a driver�s License in the US, you are exempted to take the drug test. On top of these, you will also have a big edge in passing the driving test. It is also lot easier and less expensive to learn to drive in the Philippines than learning it in the US.

Learn about the US Hospital Environment: The Philippine Hospital environment is totally different from those in the US, from the way they treat their patients, the patients themselves, the equipment used, and the procedures. Don't be fooled of the patient-nurse ratio of five patients to one nurse in the US against forty patients to one nurse in the Philippines. The procedure necessary for you to handle five patients in the US exceeds the procedure in handling forty patients in the Philippines. The documentations alone consumes so much time. You need to be ready for this. Orientation period is usually six weeks (on the floor) after the classroom orientation. You need focus and alertness on the work floor. It appears that it is during the orientation that you will experience difficulty but will soon get use to it in no time.

Practice Talking and Listening in English: You need to be adept in English comprehension. This should be easy because Filipinos are very good in English. However, the way Americans speak English is different from the way we do in terms of pronunciation and accent. Many foreign nurses find it difficult to understand doctor�s orders. The key solution is practice. The more you practice, the easier it would be for you.

RESPIRATORY CONDITIONS

Respiratory Conditions

Pulmonary Valve Stenosis - Pulmonary valve stenosis is a narrowing of the pulmonary valve, the flap that separates the lower right chamber (right ventricle) of your heart from the pulmonary artery. If the pulmonary valve is constricted (stenosed), your heart has to pump harder to push blood through the valve and into the pulmonary artery.

ARDS- low oxygen levels caused by a build up of fluid in the lungs and inflammation of lung tissue.

Respiratory Acidosis- Build-up of Carbon Dioxide in the lungs that causes acid-base imbalances and the body becomes acidic.

Respiratory Alkalosis - CO2 levels are reduced and pH is high.

RSV (Respiratory synctial virus) - spread by contact, virus can survive for various time periods on different surfaces.

Hyperventilation - or overbreathing is the state of breathing faster and/or deeper than necessary, thereby reducing the carbon dioxide concentration of the blood below normal.

Apnea - no spontaneous breathing.

Lung surgery

Causes:

Cancer

Lung abscesses

Atelectasis

Emphysema

Pneumothorax

Tumors

Bronchiectasis

Pneumonia - viruses the primary cause in young children, bacteria the primary cause in adults. Bacteria: Streptococcus pneumoniae, Mycoplasma pneumoniae pneumoniae (pneumococcus).

Pulmonary actinomycosis – bacteria infection of the lungs caused by (propionibacteria or actinomyces)

Alveolar proteinosis - A build-up of a phospholipid in the lungs were carbon dioxide and oxygen are transferred.

Pulmonary hypertension - elevated BP in the lung arteries

Pulmonary arteriovenous fistulas - a congenital defect were lung arteries and veins form improperly, and a fistula is formed creating poor oxygenation of blood.

Pulmonary aspergilloma - fungal infection of the lung cavities causing abscesses.

Pulmonary edema - most commonly caused by Heart Failure, but may be due to lung disorders.

Idiopathic pulmonary fibrosis - Thickening of lung tissue in the lower aspects of the lungs.

Pulmonary emboli - Blood clot of the pulmonary vessels or blockage due to fat droplets, tumors or parasites.

Tuberculosis - infection caused by Mycobaterium tuberculosis.

Cytomegalovirus – can cause lung infections and is a herpes-type virus.

Pneumothorax - a build-up of a gas in the pleural cavities.