Leading International Nurse Recruitment for the US

Nurses: Get US Ready!

Support from recruiters should go beyond the placement.

That’s why we’ve engineered an education service that benefits the careers of our candidates and the clients they work for alike. From initial training programs all the way through continuous professional development during the assignment, we stridently advocate keeping our nurses up to date with best practice nursing practices in the US that lead to best practice care delivery.

Designed and delivered by our in-house clinical nurse educators, US Ready is our intensive, bespoke training program for placed candidates. It offers full access to training, preparatory classes and an extensive, world-renowned nursing resources library worth $5,000 - all for free.

But it’s only available to candidates who register and earn placement with us. So sign up today.

Breast Cancer Awareness Month

October is breast cancer awareness month, and people are wearing pink to raise awareness of breast cancer, and to raise money for further research and treatment of the disease. Breast cancer is the second most common cancer to affect American women (skin cancer is the most common). However worldwide, breast cancer is the most common cancer in females. National Breast Cancer Foundation Inc, 2019 at: https://www.nationalbreastcancer.org/breast-cancer-facts Men can also get breast cancer. The incidence is much rarer in men than in women, at a rate of around 1 in 1,000 American men. Although not all of the causes of breast cancer are clear, the most significant risk factor is age, with 80% of all female cancers being diagnosed after age 50 years, and age 60 years in males. Other risk factors are known to be having a family history of the disease, drinking alcohol, being overweight, and taking the combined contraceptive pill and hormone replacement therapy. Symptoms The first symptoms of breast cancer usually appear as an area of thickened tissue in the breast or a lump in the breast or an armpit. Other symptoms include: pain in the armpits or breast that does not change with the monthly cycle pitting or redness of the skin of the breast, similar to the surface of an orange a rash around or on one of the nipples discharge from a nipple, possibly containing blood a sunken or inverted nipple a change in the size or shape of the breast peeling, flaking, or scaling of the skin on the breast or nipple Most breast lumps are not cancerous. However, women should visit a doctor for an examination if they notice a lump on the breast. Stages Staging of breast cancer is done by using information about the tumour size and location, lymph node involvement, and metastases. There are stages 0 to 4, with some sub groups within these grades. Here is a brief overview of each stage and sub group. Stage 0: Stage zero (0) describes disease that is only in the ducts of the breast tissue and has not spread to the surrounding tissue of the breast. It is also called non-invasive cancer Stage 1A: The tumor is small, invasive, and has not spread to the lymph nodes Stage 1B: Cancer has spread to the lymph nodes and the cancer in the lymph node is larger than 0.2 mm but less than 2 mm in size. There is either no evidence of a tumor in the breast or the tumor in the breast is 20 mm or smaller Stage 2A: Any 1 of these conditions: There is no evidence of a tumor in the breast, but the cancer has spread to 1 to 3 axillary lymph nodes. It has not spread to distant parts of the body The tumor is 20 mm or smaller and has spread to the axillary lymph nodes The tumor is larger than 20 mm but not larger than 50 mm and has not spread to the axillary lymph nodes Stage 2B: Either of these conditions: The tumor is larger than 20 mm but not larger than 50 mm and has spread to 1 to 3 axillary lymph nodes The tumor is larger than 50 mm but has not spread to the axillary lymph nodes Stage 3A: The cancer of any size has spread to 4 to 9 axillary lymph nodes or to internal mammary lymph nodes. It has not spread to other parts of the body. Stage IIIA may also be a tumor larger than 50 mm that has spread to 1 to 3 axillary lymph nodes Stage 3B: The tumor has spread to the chest wall or caused swelling or ulceration of the breast or is diagnosed as inflammatory breast cancer. It may or may not have spread to up to 9 axillary or internal mammary lymph nodes. It has not spread to other parts of the body Stage 3C: A tumor of any size that has spread to 10 or more axillary lymph nodes, the internal mammary lymph nodes, and/or the lymph nodes under the collarbone. It has not spread to other parts of the body Stage IV (metastatic): The tumor can be any size and has spread to other organs, such as the bones, lungs, brain, liver, distant lymph nodes, or chest wall. Metastatic cancer found when the cancer is first diagnosed occurs about 6% of the time. More commonly, metastatic breast cancer is found after a previous diagnosis of early breast cancer. Breast cancer subtypes There are 3 main subtypes of breast cancer that are determined by doing specific tests on a sample of the tumor. These tests will help your doctor learn more about your cancer and recommend the most effective treatment plan. Testing the tumor sample can find out if the cancer is: Hormone receptor positive: Breast cancers expressing estrogen receptors (ER) and/or progesterone receptors (PR) are called “hormone receptor positive.” These receptors are proteins found in cells. Tumors that have estrogen receptors are called “ER positive.” Tumors that have progesterone receptors are called “PR positive.” Only 1 of these receptors needs to be positive for a cancer to be called hormone receptor positive. This type of cancer may depend on the hormones estrogen and/or progesterone to grow. Hormone receptor-positive cancers can occur at any age, but are more common in women who have gone through menopause. About 60% to 75% of breast cancers have estrogen and/or progesterone receptors. Cancers without these receptors are called “hormone receptor negative.” HER2 positive: About 10% to 20% of breast cancers depend on the gene called human epidermal growth factor receptor 2 (HER2) to grow. These cancers are called “HER2 positive” and have many copies of the HER2 gene or high levels of the HER2 protein. These proteins are also called “receptors.” The HER2 gene makes the HER2 protein, which is found on the cancer cells and is important for tumor cell growth. HER2-positive breast cancers grow more quickly. They can also be either hormone receptor positive or hormone receptor negative. Cancers that have no or low levels of the HER2 protein and/or few copies of the HER2 gene are called “HER2 negative.” Triple negative: If a tumor does not express ER, PR, or HER2, the tumor is called “triple negative.” Triple-negative breast cancer makes up about 15% to 20% of invasive breast cancers. Triple-negative breast cancer seems to be more common among younger women, particularly younger black and Hispanic women. Triple-negative cancer is also more common in women with a mutation in the BRCA1 or BRCA2 genes. Experts recommend that all people with triple-negative breast cancer younger than 60 be tested for BRCA gene mutations. For more information about treatment options for patients with breast cancer visit: www.breastcancer.org www.cancer.net/cancer-types/breast-cancer www.nationalbreastcancer.org

in the news

Time for yet another blog post from our continuing series of nursing industry news pieces we’ve “ripped from headlines”, a la Law & Order. It’s a great compendium of nursing topics making the rounds on Google News. We invite you to read our previous installments in this series here. In the international healthcare recruitment system, competent nursing is represented by two separate yet equally important groups. The quality foreign nurses we place, and the American healthcare providers who turn to Conexus Medstaff for their services. These are their stories. (Duh-DUH!). Monster: RNs among most popular jobs posted A legacy job post board in the US, Monster has been overrun with roles that are hard to fill among American applicants. Including nurses, as reported by Fox Business: Monster compiled a list of the top 10 jobs that have been posted on its website, and while several of the positions are technology-related, some roles are completely out of that field… Many employers are also looking for registered nurses, who make an average of $70,000 a year. The position has a 15 percent job growth over the course of a decade. Here’s a bit more insight on that 15 percent job growth. We’ve reported before about the growing need for qualified nurses throughout the US. This is due to in part to two critical factors. Aging workforce. Healthcare practitioners are increasingly approaching retirement age. Next generation shortfall. Statistics show modern students aren’t following the educational path to becoming a nurse. And as we’ve revealed in our free Guide to Delivering Healthcare Talent to the USA, healthcare practitioners are increasingly cosmopolitan in America. Healthcare practitioners from abroad went up 40% in the decade before 2015. 15% of all registered nurses are international and growing. The void in nursing talent is real, but many qualified candidates to ease the strain on overstretched hospitals, hospices, and HMOs. Clients and candidates alike should take heart. Filipino Nurses and the U.S. You’ll recall our recent insights into the new EB-3 visa update and its favorability for nurses from the Philippines. As a follow-up, a study of nurses from the South Pacific archipelago reveals a rather remarkable history. Here’s a truly incredible read from Anne Brice (and podcast listen to Cal-Berkeley professor Catherine Ceniza Choy) on the legacy of nurses from the Philippines working in the US. It’s one that started thanks to nothing more than Choy’s childhood in New York City, and the simple question Why? Read below from the Berkeley News. “(Choy’s) mom was an immigrant from the Philippines. And when they’d go to Filipino events, it was common to see a lot of nurses. 'I think when I was growing up, it was just part of the familiar landscape of home,' Choy says, 'and what it was like to be in New York City. I didn’t really question it as a child. It just seemed natural or normal to me.” Years later, as a graduate student at UCLA, Choy began to wonder: Why were there so many Filipino nurses in the U.S..? As it turns out, Cold War federal government programs that intended to curb the growth of Communism internationally played a central role. The result? Communities of Filipino nurses and their families in the US. “The Exchange Visitor Program was created in 1948 to bring people from other countries to the U.S.., where they would work and study for two years, and learn about American culture…Filipino exchange nurses and other health care workers soon began to dominate the program. But it still didn’t answer: why the Philippines? Please read or listen to it. You’ll be glad we didn’t give away the answer, as it’s worth the investment of time. More with less? Here’s how nurses and healthcare providers really cope. Nurses of all competencies have to (and do) make do with less, be it supplies or critical equipment. Hospice nurse Theresa Brown spared no words in a well-written opinion piece for CNN.com last week talking about the culture of maximizing resources. We’ll offer a slight correction afterward. From cnn.com: “When I worked at a teaching hospital in the UPMC system in Pittsburgh, my hospital floor usually had two or three of these devices, and though we nurses begged for more, we were always told the money wasn't "there" in the budget, despite our hospital system's obvious wealth (operating revenues of $14 billion in the first nine months of 2018). This is the paradox of modern health care: The clinical space where patient care occurs operates on a model of scarcity, while the back office of CEOs, pharmaceutical companies, and large hospital systems function in a world of plenty. I have been, at times, desperate for a pulse-ox. Watching someone fight for air evokes a primal fear in anyone, and it's important as a caregiver to know that (a) patient's oxygen level. Having to hurry around the floor asking where a pulse-ox device is compounding the stress and delays care when the patient struggling to breathe cannot wait." There's a lot to unpack here. No doubt, such horrors as the ones described by Brown here may occur on a given day. But a recent Kaufman Hall report found that supply expense per discharge grew 7% year-on-year in April. So while it's true that doing without may be a required job skill for nurses, how much they might do without from system to system varies. Secondly, Brown uses the word “revenue” instead of “profit”, which might’ve helped her drive home the “have and have-not” notion. In this instance, it’s misleading: hospitals - like any industry - often have to find the most affordable ways to deliver top-notch healthcare. Profitability is not a given for hospitals, according to Kaufman Hall Managing Director Jim Blake. As told to Healthcare Finance’s Jeff Legasse: "'Overall, the first half of the year (2018) was a very bad half...A lot of bad performance overall in various regions, by profitability, by volumes. 'Things turned around during the middle of the year -- June, July, and August were profitable months -- but nothing that would set the world afire. The industry as a whole was eking it out during that time.'" Cost-cutting measures occur in all sectors, and healthcare is no different. Finding the fine line (urban vs rural, rich vs poor, resourceful vs resourceless) is relative in addressing Brown’s points. It’s not to minimize them by any stretch; rather, it’s operative to wear the shoes of both management and practitioners when analyzing this complex issue. Above all, Conexus Medstaff encourages nurses to be resourceful, and healthcare firms to consider the best options available.