Nursing skills can provide a ticket to many things, including the opportunity to work in the United States. Many foreign-educated health professionals (FEHPs) have very positive experiences, but others fall victim to unethical recruitment practices. Their experiences don’t match the promises recruiters have made.
You can protect yourself through knowledge. Here are some tips for you if you are planning to work as a nurse in the United States.
Some U.S. healthcare organizations recruit nurses directly. Some rely on third party recruiters. Recruiters may be either placement agencies or staffing agencies. If you are hired by a staffing agency, they -- and not the healthcare organization -- will be your employer. Nurses often feel safer working directly for hospitals and other healthcare organizations. Sometimes, however, they get confused by who their employer will be; unethical recruiters may actually try to mislead.
The Alliance for Ethical International Recruitment Practices can be a source of information about the practices of particular staffing agencies.
A contract describes, in writing, the responsibilities of both the recruiter and the worker. It's your right to ask about portions that you don't understand or that don't seem to match what you have been told. Make sure that any promises that were made in discussions are actually included in the contract. If the representative has told you that you will be working in a particular location, look for the location to be specified.
Ask for a copy of the contract you have signed. And don't sign anything on the spot -- take time to make sure you're making the right decision. The recruiter should allow you at least 48 hours.
Breach fees are designed to ensure that you follow through on your part of the contract and that the money the recruiter spends helping you get to the United States will be repaid if you don't. Up to a point, such fees can be reasonable. Make sure, though, that those in your contract are appropriate: that they are not out of proportion with what the company invests and that they are not higher than what other companies are charging.
Check that any fee is prorated. If you agree to work as a nurse for two years and something comes up after a year-and-a-half, you shouldn’t be stuck with the fee that you would have if you changed employers after a month.
If there’s no breach fee, so much the better. Some companies go for reward, not punishment. They take steps to ensure that the working conditions are reasonable, that you are prepared for the cultural shift, and that your experiences match the expectations they’ve given you. They feel confident that most nurses will want to stay with them, and they offer a bonus to those that do. If what they offer meets expectations, why do they need to go to great lengths to ‘protect themselves’?
Even if you are not a citizen of the United States, you still have rights as a U.S. worker. If you have signed something and it includes provisions that are illegal, they can’t be enforced.
The Alliance for Ethical International Recruitment Practices has created a code of ethical practices for international nurse recruitment. Among the expectations: that recruiters make reasonable efforts to explain the contract, that they disclose the location before travel, that they don’t hold onto your visa, that they provide assistance during transition, and that they don’t charge redundant fees. (Chances are that a healthcare organization is paying the placement agency to have you fill their vacancy; the agency shouldn’t charge you, too.)
The Alliance for Ethical International Recruitment Practices certifies recruiters that adhere to a code of ethical practices for international nurse recruitment.
Healthcare organizations and recruitment agencies that agree to be bound by the code are called Certified Ethical Recruiters and are distinguished by the Alliance Seal. They are subject to active third-party monitoring, which means you can feel more confident entering into a contract with a staffing agency that is certified.
The Alliance has also provided a free guide to help international nurses understand their rights (http://www.fairinternationalrecruitment.org/index.php/foreign_educated_nurses/understanding_your_legal_rights).
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