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
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Premium Processing: Is it Worth it?
We are often asked by nurses if we will file Premium Processing for their Priority Date (PD). We often give a lawyer-like response and say, “it depends,” because it really does. U.S. Immigration law is complex, and no two cases are the same. Sometimes paying extra for expediting a case is worth it, and other times it’s not. What is premium processing? Premium processing is a service offered by USCIS that expedites the processing time for specialized employment-based green card petitions, such as the EB-3. With premium processing, USCIS guarantees that your I-140 form will be processed within 15 calendar days of receiving the petition. We understand that the immigration process involved in starting your career as a nurse in the U.S. can be time-consuming. The waiting time between submitting your application and finding out if your application has been approved can be long and stressful. So, knowing the outcome of your application in 15 calendar days can certainly give you peace of mind. But for nurses making a new application, there are not many more benefits to premium processing. Here are our thoughts on the subject: Paying the premium processing fee ($,2500) does not give you an advantage in the selection process. Ok, so you may be given an answer within 3 weeks; however, there is no telling what the outcome of your application will be. You could receive an Approval, but it is just as likely to receive an RFE (Request for Further Evidence), a NOID (Notice of Intent to Deny), or a Denial. If the answer is a Denial, USCIS does not refund the cost of Premium Processing. Unfortunately, premium processing does not jump you to the head of the line; you still need to wait for your priority date to be current prior to receiving your EB3 Visa. Regardless of filing regular processing or premium processing, your priority date remains the same. The date your application is sent to USCIS becomes your priority date. There are circumstances however when premium processing is worth it. For example, if you have been abandoned by a previous sponsor and already have a copy of a previous Approval Notice with a priority date, we will file premium processing. Of course, some of our nurses prefer the peace of mind that premium processing offers. For those nurses who are willing to pay the difference between regular processing and premium processing, our Immigration Team will gladly file for premium processing. Our advice for nurses is to be patient, think positively, and rest assured that the Conexus MedStaff team will be there to support you, always. Learn more about how Conexus MedStaff supports our nurses on their immigration journey to the U.S. here, follow us on our social feeds, or start your application today.
History in the Making: How Naturalized Immigrants make up 1 in 10 U.S. Voters
The 2020 U.S. election is a week away and a record-shattering turnout is expected to vote. With more than 58 million Americans already submitted their ballots, it is clear to see that people are determined to express themselves and exercise their right to vote. Another record high in the 2020 U.S. election is the number of Naturalized Citizens eligible to vote. In this election, Naturalized Citizens make up 1 in 10 U.S. eligible voters. According to Pew Research Center, since the year 2000, the size of the immigrant electorate nearly doubled to 23.2 million, that’s an increase of 193%. So why has there been such strong growth in the foreign-born eligible voter population in the U.S.? First, the number of immigrants living in the U.S. has increased steadily since the 1960s when the Immigration and Nationality Act became law. In 1965, in the U.S., 9.6 million immigrants made up just 5% of the population. Fast-forward to 2020 and the 45 million immigrants living and working in the U.S. now accounts for about 13.9% of the population. Second, newly-naturalized citizens are one of the fastest-growing voting groups in the United States. The U.S. Department of Homeland Security states that between 2009 and 2019, around 7.2 million immigrants naturalized and became U.S. citizens. What is Naturalization? Naturalization is the process by which U.S. citizenship is granted to a lawful permanent resident after meeting the requirements established by Congress in the Immigration and Nationality Act (INA). Becoming a U.S. citizen has many benefits, with one of the most notable being that as a U.S. citizen, you will be able to exercise your right to vote and have your voice be counted– something so many people around the world don’t have the opportunity to do. The Pathway to Naturalization As part of the Conexus MedStaff Career Pathways program, we offer our nurses support to become an American citizen. Career Pathways not only focuses on the continued growth of a nursing career in the U.S., it also allows the option and support to become a naturalized U.S. citizen. If they choose to pursue citizenship, our Immigration Team processes Naturalization applications for our nurses and their family members to become U.S. citizens -- an average expense of anywhere from $3,000 - $5,000 per person. To learn more about our Career Pathways program, and your pathway to naturalization, get in touch with our Recruitment team here. Ready to get your U.S. journey started? Apply here.
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
The Visa Bulletin for Nurses: Your Place in the Line
With the October 2020 Visa Bulletin for the new fiscal year set to be issued in the coming weeks, we thought it would be a good time to recap what the Visa Bulletin actually is, how it works, and why it’s important for international nurses and international nursing students in the U.S. to understand how it can influence your nursing career in the U.S. The Visa Bulletin is released monthly by USCIS and the Department of State to determine when a sponsored foreign national can submit to work and live in the U.S. Essentially the priority date, released in the Visa Bulletin, establishes your place in the line to immigrate to the U.S. or to continue working in the U.S. as a permanent U.S. resident. For the September 2020 Visa Bulletin, the priority dates for the EB-3 visa showed no movement. Our Conexus Immigration team attributes no movement largely to the impact of COVID-19. As soon as the new Visa Bulletin is released, we will let you know here. You will also be able to find the latest update over on our Facebook and LinkedIn. What to do next? If you are ready to start your nursing career in the U.S. but don’t know what to do first, our advice would be to do some of your own research and find an agency that is not only currently filing visas for qualified international nurses, but an agency that will hire and match you to a healthcare facility that compliments your skills and career aspirations, like Conexus MedStaff.
in the news
Where has the ancillary support for our healthcare facilities gone? Ancillary support includes the critical position of Certified Nursing Assistants, or CNAs. These positions are vital to our staffing models, partnering with Registered Nurses to take on certain ratios or acuity of patients. Nurses rely on CNAs to support their work efforts and to support quality patient care and customer service to the patient and their families. Where did they go? Healthcare personnel makes up one of the largest groups of skilled workers. During this time of COVID, CNAs who are innately caretakers may be taking care of their families. Or, they may be cautious in potentially exposing their significant others to COVID. And another consideration may be unemployment payments available to them could potentially be more than what they were making in a care facility, working intense and laborious hours. Now, with schools resuming across the country, many CNAs may need to be home supporting their child(ren) during this time. What will the impact be on nursing? Healthcare facilities across the U.S. are scrambling to recruit critical CNA personnel to their facilities. This is adding to the heavy burden placed on Registered Nurses in a COVID world. Now, they have to manage higher patient loads, higher acuity, and longer days without support staff. This inevitably will contribute to the already high burnout rate of the Registered Nurse. What can we do? Acuity is higher, ratios that were considered pre-COVID, should not be maintained now. Additionally, the patients and their families need more emotional support or discharge care, which the nurse needs to be afforded time to properly do. Considerations by healthcare organizations should include training new staff to become CNAs, flexible hours for CNAs to allow the ability to care for family or to work with child(ren) for schooling. Healthcare facilities should also consider paying the CNA a higher wage. Another consideration could be to partner with nursing schools and offer work to the students on a per diem type basis. Or a healthcare facility can staff up with additional Registered Nurses. If we do not act, we will face an even greater shortage of nurses. Nurses will not stay in nursing and new nurses will not enter the workforce if we do not support our nurses. And all the strides that have been made in the last years will be reversed. Regardless of the support and recognition given to our frontline workers – “Heroes” will be for naught. Further reading https://www.wcax.com/content/news/Some-employers-desperate-to-hire-in-wake-of-COVID-19-569135211.html https://www.npr.org/2020/06/20/881285807/why-some-cnas-are-staying-home-during-the-pandemic https://www.npr.org/2020/06/21/880945464/nursing-homes-struggle-as-staff-choose-unemployment-checks-over-paychecks At Conexus MedStaff our values and mission drive our days and the way we work, we do what we do for the talented international nurses and international nursing graduates we support, and the healthcare facilities we partner with in the U.S. to help solve the nursing shortage. Learn more about our vision here
Karina - International Nurse Graduate on OPT
Like many international nursing students, Karina was worried about her future as a nurse in the U.S. after graduating. Karina, from Venezuala, had been looking for a job on her OPT but with very little success, especially in the midst of the Covid-19 pandemic. It wasn't until her Uncle sent her a job posting by Conexus MedStaff, that things started to look up. Karina, now working in Iowa, U.S., shares her journey with Conexus so far: "After looking for a job for months during the pandemic with no success, I was lucky enough to have my uncle send me the link of a job posting by Conexus. I did not hesitate and applied right away. I am so glad I did! I was reluctant at first because it all seemed just too good to be true but it turned out that it is 100% true. They are all so supportive and ready to help. I did not feel along, they are with you every step of the way. The deployment process was so much easier with the help of my operations manager (OM) Kristin. I was overwhelmed, scared, and nervous to start this new life and career; so having her there and the entire Conexus team, made all the difference. To be honest, I am actually glad nothing else worked out because I wouldn't want to start my nursing career any other way." If you're an International nursing student on your F1 or OPT and want to start your nursing career in the U.S., get in touch.
The Registered Nurse: The most trusted and celebrated profession
The results of this year’s Gallup poll show that nurses are the most honest and trusted profession in the U.S., marking the 18th year in a row that the nursing profession has topped this list. To many, this comes as no surprise. Nursing in the U.S is not only one of the most trusted professions, but it is now also one of the most celebrated professions too. What we’ve seen during the COVID-19 pandemic is that the nursing profession in the U.S. is being celebrated and respected more than ever. From neighborhoods around the U.S clapping at doorsteps to show their gratitude and appreciation for nurses to U.S. companies offering free PPE and a variety of discounts to health care workers; U.S. nurses are recognized as safety-critical, highly-qualified and compassionate practitioners at the forefront of healthcare in the U.S. At Conexus MedStaff we know nurses are frequently the first and highest-level providers for primary care. The reality is that nurses have always been our heroes; our expert professionals who provide skilled, compassionate care. As the pandemic moves through the different phases of a crisis and eventually ends, we will continue to support and celebrate our international nurses and graduate nurses, by focusing on their well-being and fueling their career growth in the U.S. In times like these, when an estimated 1 in 10 U.S. nurses is from overseas, we recognize the many contributions international nurses have made in filling the workplace shortages in the U.S. and improving the nation’s health. If you are looking for a life-changing nursing career opportunity in the U.S., fill in the form below: Form ID:2713