A Foreign Nurse's Guide to America

A Foreign Nurse's Guide to America

by Shirley Lorraine Franks RN BS MBA

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Author Shirley Lorraine Franks grew up on a beautiful chain of islands, but she decided that she wanted to be a nurse in the United States.

In this memoir and guidebook, she recalls the challenges she overcame to accomplish her goals, sharing what it really means to be a "foreign" nurse. Regardless of whether you are an aspiring medical professional or have

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Author Shirley Lorraine Franks grew up on a beautiful chain of islands, but she decided that she wanted to be a nurse in the United States.

In this memoir and guidebook, she recalls the challenges she overcame to accomplish her goals, sharing what it really means to be a "foreign" nurse. Regardless of whether you are an aspiring medical professional or have been in the field for years, you'll learn how to succeed as a nurse wherever you go.

Franks shares tips and strategies that help you

• Decide whether or not to move;

• Set goals and purse them;

• Avoid distractions and procrastination;

• Navigate licensure requirements;

• Get the best training available;

• Find employment in another country.

Join Franks as she examines how to succeed as a nurse no matter where you live. Break through cultural misunderstandings and misconceptions, and decide whether you should stay put or pursue your career elsewhere in A Foreign Nurse's Guide to America.

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iUniverse, Incorporated
Publication date:
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6.00(w) x 9.00(h) x 0.19(d)

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A Foreign Nurse's Guide to America


iUniverse, Inc.

Copyright © 2012 Shirley Lorraine Franks
All right reserved.

ISBN: 978-1-4697-3817-8

Chapter One

My journey As A Nurse To The USA

I relocated to the United States mainland from St. Thomas, Virgin Islands in 1985. At that time, I worked as an Emergency room nurse. I went to the "Big Apple," New York City. I worked a big facility as an emergency room nurse. It was exciting. I completed by Bachelor's Degree. I have since then completed a Master's in Business Association (MBA). Currently, I am working on the completion of a Master's Degree in Nursing (MSN) with a concentration in Education. My plans are to complete a PhD in nursing.

I have gained vast experiences during my nursing journey here in the USA. I have learned tremendously. I have networked with from paramedics and nurses from all walks of life. In addition, to healthcare, I have acquired some business experiences in network marketing. I have also done travel nursing as well as hospital-based nursing.

During my experience, I have nurses asked me questions about how did I relocate to the US. I have also heard and observed others being confronted about such issues. Many nurses were unaware on the relocation process and may still be uninformed of the facts. Some nurses were not quite sure back then how reciprocity works. Some were puzzled the reasons and rationale for relocation. There are questions as to why foreign nurses have left the exotic places such as the Caribbean and the Canada, for example, to relocate here to the USA. Times have changed. Hopefully it has. However, we reside in a diversified culture. The diversify culture is strongly seen in patients and healthcare workers. Some just did not get it all. Others were clueless regarding one's geographical location; others seemed concerned if one even knew how to practice nursing in the United States mainland. Sometimes I was puzzled myself regarding the questions that were thrown at you. In my mind, I kept thinking may be there should be a book or guide to educate other nurses. When I was in the Virgin Islands, I used to wonder why nurses would leave the United States mainland and come to Caribbean to work. Though their ability was never questioned; we welcome them. Most American travelled nurses would always work nights and spend days at the beach enjoying the sun and the Caribbean flavor. Many relocated from Canada as well. There were also nurses from the Philippines as well. In my experience, the relocated nurses were from the United States mainland, Canada, and the Philippines.

The nursing profession consists licensed professional nurses (LPN's) and Registered Nurses (RN's). The fundamentals stemmed on the nursing process. Florence Nightingale, the first nursing theorist, was born to She was the pioneer of nursing and was known as the "Lady with the Lamp" Florence was born in May 12 1820, in Florence, Italy (n.d. nightingale, 2011). She opened a nursing school in London. To this day, Florence is well recognized for her dedication to the nursing. National week is celebrated May 6-May 12 in honor of Florence Nightingale's birthday, May 12.

I have acquired a vast amount of experience and knowledge nursing my journey as a nurse. I relocated from the Virgin Islands several years ago to New York City. A conscious decision was made after two years of nursing experience in the Caribbean. I applied at a local hospital in Long Island and set up for an interview. The interview went well except I was offered a position as a Telemetry nurse. I was young and loved trauma nursing; also the hours were too long; they offered 10 hour and 12 hour shifts. I called a city hospital in New York City and got hired on the spot that same day. I went back to the Virgin Islands to resume my position temporarily. The nurse recruiter kept calling. Somewhat reluctantly, I submitted my resignation with plans to further my education in the United States. I was always in love with books, especially inspirational books. To this day, if my peers were to describe me I would be described as always seen reading a book or a magazine. I recognized that habit was developed from my mother. At the age of five, my mother gave me an encyclopedia as a birthday gift. My mother relocated from the island of St. Kitts and went to Curacao after my father died from a tragic accident. She herself travelled to many islands from the islands of St. Kitts-Nevis, the United States, Virgin Islands, Curacao, Puerto Rico, Florida, and New York. She has later retired in the Caribbean.

At age five, I thought I was a good reader. My games as a child was find it. My grandmother kept me as my mother traveled and worked. Other siblings needs. Books that I have read as a child have pointed out to reflect what a person has done as a child creates was a passion for the child what your calling might be or what one's passion may be as adult. I remembered vividly childhood games played with my siblings and peers. My childhood games with my other cousins would be to read and find a book and find a word. The word will be selected from an inconspicuous place on the page while I counted in one's, fives, or tens. Whoever had the most words would win the game. My two favorite games would be to find it from reading and to sell. I would use my encyclopedia and read enhance my vocabulary. I would also practice how to read fast. Speed and accuracy were important. That was the purpose of find it words, reading a book. To this day it excites me. I have also taught my two children, Harmonii, and Sai to practice reading fast my doing that game.

Throughout my life I have read many books. I am a reader. I will go to bed with a book and wake up with a book. The late Jim Rohn, my most favorite author and philosopher, said "leaders are readers" (n.d. Jim Rohn). I have encouraged both my children to read at least 15 minutes per day. Both my children are excellent readers. Other authors who have influenced me are Anthony Robbins, Brian Tracy, Eckhart Tolle, Dale Carnegie, and Kevin Trudeau, and Zig Ziglar. Most of the books I read are business books, philosophical books, and inspirational books. Bibliography and history are important readings also. I am yet to incorporate more historical readings. In the past seven years, I very seldom look at television or read novels. Among important reading materials are bibliographies and histories of important people. I am not saying not to read novels; whatever one finds of interests is important favorable to them. My favorite magazines are "Success" and "Travel Guide."

As a child, I was obsessed with the idea of relocating to the United States before graduating from college, I remember a group of senior students gathered together to discuss plans. My plans were to relocate to the USA to practice nursing.

Before relocation, I worked in the ED at Roy Schneider's hospital as an Emergency nurse in St. Thomas. I had a one bedroom condo in St. Thomas. Life was great! I worked an eight hour shift. The commute was fine. The local bus transportation took about 15 minutes to arrive to work. Usually, I will walk home along the waterfront. This was my way of daily exercise. It was a casual walk, with the island breeze gently blowing into my face. Sometimes, I will stop at Palm Hotel located along the waterfront in Charlotte Amalie and treat myself to a Virgin Pina Colado. I remembered vividly consuming one Virgin Pina Colado then taking the other with me as I completed my journey home. For nurses who worked evening and night shifts, the hospital services provided transportation for those who needed it. If not, taxi services were reasonable, four dollars that I can remember. One major lunch was offered to all nurses free of charge. The cost price was $3.50. Anything over that cost were paid by the employee.

There were no real pressures to relocate. I wanted to explore life on the other side of the globe. I had relatives in New York. Throughout my existence here I kept asking myself why I really came here to the United States mainland. I left a beautiful island with friends and family; the working environment was great. I only realized it once I relocated here. We communicated well as nurses; the team spirit was excellent. The salary was not the same as the USA; however, when you compare the cost of living it may be turn out to be the same. Anthony Robbins says "do what you love." Donald Trump also said for one to do what one loves. In fact, most successful people would advise for one to do what one loves. It does not matter salary and living conditions, it is really about what one is happy with while helping others. Lifestyle is important; the true essence is happiness. Most people come to America seeking a better lifestyle; some seek true success because of unlimited opportunities that America has to over. Other reasons may not have been told, but it can be concluded about achieving "one's dream."

I love reading and writing. I also love to sell. While here in the United States. I have joined a few network marketing businesses because of my quest for selling and helping others. I never told my up lines that I was a nurse for fear that they may not understand. Some people have asked why you are doing this when you are a nurse. Money is not always the objective of a business or one's career. Money may be a motivator; it is not about the money I would say. But when I look back as my childhood days, I would always be the seller when we play "family play." Go figure.

My mother also was a seller. She had a small shop. My mother funded my college fees. I did not owe any bills upon graduation. I give thanks and recognition to my mother and to God. Thanks Mom for the gift of an encyclopedia at age 4. Reading is one of my favorite hobbies.

Success must be sought after. It does not come by luck. Whatever one's religion, one should keep God's teaching in one's life. The Bible is a book that teachings us balance and God's word. We all need a balance. That balance includes a spiritual lifestyle. The late Jim Rohn recommended the Bible as a valuable teaching. One does not have to be a religious fanatic to read the bible.

In 1999, I was traveling on a nursing assignment to Nevada and while at the airport, I reflected on my life as a nurse. I pondered my reasons for here in the United States. I had my journal with me. In my journal I wrote a foreign nurse's guide to America. I made reflections myself I of the title A Foreign Nurse's Guide To America. An interested title to a book that could be a best seller, I thought. Yes! To this day as I write this book several years later, I am thanking God in advance for making "A foreign Nurses' Guide" to be a successful book seller and for also putting the vision in my mind. I am going to write that book one day—"A Foreign Nurses guide to America." Years later, the time has come. I give God the glory and praise

I was always in love with books. To this day, if my peers were to describe me I would be described as always seen reading a book.

I believed that there was a need for a foreign nurse to obtain a grasp of what nursing is like or can be like in America. The glitz, the glamour, the dread, the happiness, the wealth, the poverty may all be discovered. However, it starts with a decision. Maybe it will be help in their pursuit in their decisions to nurse in America. I hope this book would facilitate a foreign nurses' journey in American nursing. In an effort to educate foreign nurses I hope to accomplish enlightening other nurses as well.

My experience here has been extensive. I have learned in all walks of life. I have had life experiences, wake up calls, culture shock experiences. I have networked with networkers in the nursing and business industries. I have worked in nursing research and have travelled extensively in nursing. I have enjoyed the experience here in the USA.

Chapter Two

Make a Decision!

Writing A Foreign Nurse's Guide To America has given me the chance to vent slightly. One day, I may have to return to Caribbean. That is my heritage. I will pick up teaching and writing as a way to give back to my heritage. I think that my writing where I am can give me that start. The magic of "the power of now" (Eckhart Tolle) cannot be overly emphasize. In this phenomenal book, author Eckhart Tolle indicated that "time and mind are inseparable" (p. 48, Power of Now, 1999). We have to start with where we are and decide we plan to be. "Making a decision and act upon it." My 14-year-old son said to me one day, "Mom, make a decision and stick to it." I looked over at my son as I was driving, when he uttered those words to me, and reflected to myself: "That is it!" Wow!

I am proud of both of my children Sai and Harmonii. If were to be "childlike" and think the way children think we as adults can achieve so much. "Make a decision and stick to it!" (Harmonii, 2011) That was my 14-year-old son, Harmonii, told me. He does not know this, until he reads the book. From that day on, whenever I struggle it with choices of plans, I think back to: "Mom, make a decision and stick to it." I do not know if he heard this phrase somewhere or discovered quote he read somewhere, but it has become my guide in life now. Thanks, Harmonii, for your words of wisdom or sharing this statement with me. Thanks to my daughter Sai, a computer whiz, in her unique way.

When one makes a decision to relocate to the USA as a nurse, embrace that decision. Do not be here half-heartedly. America is one of the best nations to live. Vast amount of knowledge and experiences are available to anyone's advantage. When we arrive here, as nurses, we must remember to stick our mission and accomplish our goals, whatever they may be.

Chapter Three

Your past may be question

Questions have been asked of foreign nurses regarding English has been learned to how arrival was made to America. I too have been personally have been asked questions about where I learned English, to how many languages I speak, how I get my nursing license—is there television there. Sometimes it may be asked naively. Other times, it often appears condescending. Times have changed. Several years ago it could have been the case. The universe appears to in and around us, thereby affecting the way in which we think and believe. Was several years ago. There is a wide variety of commercial advertisement, along with the increase of travel and exposure to foreign nursing. There has been a greater understanding and adaptation to the nursing diversification and lifestyles. It may not be 100% understanding; however, it has gotten better.

Many foreign-trained nurses have had questions ranged from being funny, outrageous, and ignorant to plain insulting. To no fault of anyone, here is it is suffice to say ignorance is not really bliss. Do not take any negative or naïve comments personal. The advantage here is that as foreign nurses, we have the edge. In addition, we have to give respect to others, especially when residing in a different country.

I attended an accredited nursing school. I am a proud graduate and alumni of the school of nursing in St. Thomas, USVI. Information can be retrieved from the University of the Virgin Island's website. I completed the same NCLEX nursing exam offered here in the United States. There are two schools of nursing in the Virgin Islands, one in St. Croix, the other in St. Thomas. The nursing curriculum has the same syllabus as in the USA. The University of the Virgin Islands has two nursing programs, Associate Degree in Nursing, and Bachelor's Degree in nursing (n.d. UVI, 2011). The nursing program in St. Croix has a two-year nursing program. Residents from local neighboring islands, such as, St. Johns, Anne Garda, Virgin Gorda, and Tortola commute to St. Thomas and St. Croix in pursuit of the perspective nursing degrees.

Residents of Puerto Rico perform their nursing degree under the Republican State of Puerto Rico. Puerto Ricans and students who pursue nursing degrees perform their National Council Licensure Examination (NCLEX) exams in Spanish. For that reason, Puerto Rican nurses must retake NCLEX exams in English to be eligible to practice nursing in the mainland as well as the United States Virgin Islands.

I relocated to the United States mainland from St. Thomas, Virgin Islands as an Associate Degree registered nurse where I worked as an Emergency Department nurse. Here in the United States pursued a career in ED nursing as well. In addition, I have done travel nursing as well. I have learning has been extensive as nurse as well as socially, spiritually, and educationally as well.

In 1997, I was travelling to the Nevada, the thought came to me to write a foreign nurses guide to America. I believed that there was a need for foreign nurse to obtain a grasp of what nursing or the relocation experience may be like here nursing in America. Of course that experience is relative. The purpose of this books address issues that foreign nurses may encounter on their relocation here to the United States mainland. Some of the issues may be simple as well as being minor. The book is written in a light conversation piece. In addition, I hope that some of the questions that American nurses may have had may be addressed as well. However in hope of achieving some enlightenment, I trust that this book may serve as such a tool. I hope that may facilitate a foreign nurse's' journey in America. In general, nurses are well accepted in the work environment. However, many times foreign nurse may encounter changes or resistance if not well prepared. Being prepared puts a "foreign" nurse out in the forefront, thus decreasing any potential resentment, anxiety, or confusion.

Chapter Four

Differences in training identified

There are Differences in training found in many of the geographically trained IEN. The United States Nursing Boards determine who is qualified to work here based on the foreign nurse nursing curriculum and state board examination.


Being from the Caribbean, I can relate more to that region best. Caribbean trained nurses, the majority are either trained under British or American nursing philosophy. Some are trained under French, Dutch, and, Spanish philosophies. The Caribbean is very much afro-eccentric, with some influence of African, Dutch, British, French, Portuguese, Arawak, Indian, and Caribe descent. However, nursing was influenced from Nightingale's theory and so was handed down from the London.


Excerpted from A Foreign Nurse's Guide to America by SHIRLEY LORRAINE FRANKS Copyright © 2012 by Shirley Lorraine Franks. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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