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NURSES WHO TRAINED in the US and have years of professional experience are being denied access to work in Irish hospitals – despite a huge staffing shortage.
According to HSE annual report figures for 2016, nursing staffing levels have fallen by more than 3,000 since 2007 and the HSE has committed to increasing the nursing and midwifery workforce to deliver 1,208 additional permanent posts this year.
However, TheJournal.ie has heard from a number of nurses trained in the US who described being refused registration to work here because they were told they didn’t have the correct amount of clinical and theory hours from their studies – even though they have been working as professionals for years.
There are 65,000 nurses in Ireland: 51,000 are Irish, 4,600 are from India and 4,265 are from the Philippines, but only 270 are from the United States.
Rebecca Love, a professor at the School of Nursing Northeastern University and founder of American nurse recruitment website HireNurses.com, says she has been in touch with more than 5,000 American nurses who have shown an interest in working in Ireland since last year.
She says of those nurses actively seeking employment, many qualified in the US so are unable to register for work here despite Irish hospitals wanting to employ them.
TheJournal.ie has heard from more than a dozen nurses who say that the difference in their clinical and theory hours from their degree is the reason they have been refused or told to take an adaptation course. They also said that they were not told this information until after they applied – at a cost of €425 – even though it is a well-known issue.
Love said she has spent hours researching, calculating and reviewing the transcripts and documents of American nurses and she claims that nurses with a BSN (bachelor of science in nursing) from the US do have the correct theory and clinical hours needed.
I believe that there has been a severe misunderstanding and miscalculation of American credit hours to clock hours that may have wrongly denied American nurses access to a nursing license in Ireland.
Adaptation courses
The Nursing and Midwifery Board of Ireland (NMBI) is responsible for evaluating overseas applications from nurses and midwives who want to work in Ireland.
Some applicants will receive a flat refusal from the NNBI but others will be encouraged to take adaptation courses to ‘make up hours’.
The board told this website that “when overseas applicants do not have the required hours for registration, applications are refused or, if they fall slightly below, they may be offered adaptation/aptitude tests to support an application for registration”.
The only aptitude test available in Ireland is run by the Royal College of Surgeons at a cost of €2,800 per test.
According to NMBI standards, a minimum of 1,533 theoretical hours and 2,300 clinical hours are required for registration.
The NMBI provide nurses who have been told to do the adaptation course or aptitude test a list of NMBI-approved hospitals that can provide them, but they don’t give contact information or even tell nurses which hospitals are currently carrying out the courses.
The nurses we spoke to said they were unable to find any hospitals that were carrying out these adaptation courses.
The NMBI says it has no role in organising placements and it’s up to individual hospitals to run them at their discretion.
This website contacted the HSE to ask how many of its 21 hospitals – that are on the list the NMBI provides to nurses – are actually carrying out these courses. It said:
The HSE does not centrally monitor programmes provided by hospitals for their own new recruits.
The only other option for these nurses is a two-day aptitude test with the Royal College of Surgeons which costs €2,800. The expensive aptitude test only goes ahead if the college has at least 20 applications and US nurses who want to move here can’t pre-book a test.
The NMBI also imposes a deadline for overseas nurses told to find an adaptation course or pay for an aptitude test. It says:
“A decision letter recommending adaptation/aptitude test is valid for 12 months after the date of decision. If the process has not been completed and NMBI has not had any contact from the applicant for six months, the file is closed.”
George Russell, a director at Irish healthcare recruiting firm Epic World jobs, is currently dealing with a number of US nurses who are trying to get registered to work in Ireland.
Speaking to TheJournal.ie, he said:
Currently I’m working with more than 300 nurses and can get any amount of American nurses if the obstacles at NMBI were out of the way.
Ireland is very high on their radar and with over three million nurses registered in the US, Ireland’s nursing crisis would be eclipsed by the amount of American nurses that have a desire to work here.
“I think adaptation is a much better idea than taking the RCSI aptitude test. Many foreign nurses wanting to come here are unable to afford the test. It’s a deterrent.
I think the HSE should have its own centralised adaptation programme – it would make the process for candidates more fluid.
“Nurses are going to have to do orientation wherever they are hired and learn how things are done. I think that adaptation would help teach them how things are done here before they even start their new jobs. It would probably give them a leg up on adapting to their units.”
Where are the courses?
When asked which hospitals currently have available placements, a spokesperson for the NMBI said:
It is at the discretion of the approved health care facilities as to how they manage adaptation placements and queries regarding the numbers currently on placement in each facility should be directed to those institutions. NMBI has no role in organising placements.
However, as was already stated, the HSE does not monitor the programmes being provided by the hospitals.
TheJournal.ie directly contacted 21 HSE hospitals which the NMBI lists and asked if they were currently carrying out adaptation courses. Of the 21 only two replied; the Department of Psychiatry in Drogheda and Tallaght Hospital.
A spokesperson for Tallaght Hospital pointed us to information supplied on its website which states: “You apply to a nursing home for a position as a registered nurse, informing them you have a decision letter from NMBI and need to be assessed for registration. If you are successful in gaining a contract with the nursing home, they then sponsor you to undertake adaptation and assessment.”
The spokesperson for Drogheda Department of Psychiatry said adaptation placements are facilitated “pending the availability of clinical placements and nurse practice development coordinator as the under graduate nursing programme is also facilitated”.
Speaking about her experience of the process, a nurse who trained and worked in the US for nine years but has recently moved back to Ireland told TheJournal.ie:
None of the hospitals actually offer the adaptation course though they are approved to run them. From what I have found out, the Dublin hospitals will run them for people they have recruited in but I (and other nurses I have talked to) have yet to find other hospitals running them.
“The only adaptation classes I have heard of are either through agencies or if you have contracted to a private nursing home. Both of these scenarios mean you contract to either the agency or nursing home for two years.
Every hospital I called, including the hospital who wanted to hire me, said they cannot do the adaptation.
The HSE told TheJournal.ie that, “Most sites provide the period of adaptation and assessment to candidates whom they have offered employment (subject to successful completion and registration).
The HSE also provides the adaptation and assessment programmes for candidates who have been offered employment within the private nursing home sector.
The HSE said that 25 candidates who were offered employment within the private nursing home sector undertook adaptation and assessment in four programmes last year.
So far this year 10 candidates who were offered employment within the private nursing home sector undertook adaptation in two programmes.
‘Lack of help’
The Department of Health also encourages these adaptation courses to nurses with years of professional experience but who are lacking in college hours.
Mary Taaffe left Ireland for the US in 1989 and has been working as a nurse with a BA Degree in nursing since 2000. She has been employed in a hospital ICU and ER since 2012. She applied to the NMBI in January 2016 but was denied because it said she didn’t have the correct theory and clinical hours.
Taffe said she spent €425 ($479) for her first application. She was then told time had run out after a year and then paid another €355 ($400) and a further €133 ($150) to appeal. She said:
Nurses from the US are sending money to an organisation that has no intention of registering them, and this has been going on for years.
After complaining to Minister for Health Simon Harris’s office, a department spokesperson sent a letter to Taaffe describing the benefits of adaptation courses.
It may be of interest to you to note that of the 283 US-trained nurses and the 152 nurses who trained in Australia and who are now registered with the NMBI, the vast majority had to undertake and successfully complete either an adaptation course or an aptitude test as a pre-requisite to registration.
TheJournal.ie contacted the Department of Health asking if it was aware that many nurses cannot find hospitals that are carrying out the adaptation courses and if there are any plans to improve the registration services for overseas nurses trying to get registered to work here.
In a statement it said: “Resourcing and recruitment issues in the clinical environment are outside the NMBI’s statutory remit and NMBI has no regulatory role in organising adaptation placements.”
Many nurses who trained in the US aren’t even offered the adaptation programme as their clinical and theory hours are deemed to be too low.
One American woman who worked as a nurse for seven years told TheJournal.ie that she was told by the NMBI to complete another nursing degree here in Ireland.
She added that her emails were nearly always returned by an out of office, saying that the individual she was mailing was on leave. She described the lack of help and guidance from the NMBI as “just unbelievable”.
This is an issue that was described to TheJournal.ie previously, with another nurse saying: “The delay in response from NMBI each time I submitted additional documents or communications was extensive — many weeks to months each time.”
When asked about this, a spokesperson for the Department of Health said: “If an applicant who has experienced an unanswered call or email provides details to the NMBI the matter will be investigated.”
Another nurse who trained in the US, has a Masters Degree in Nursing and 30 years experience in critical care and primarily cardiothoracic ICU told this website that she has been “led on a merry dance with NMBI since 2014″.
Nobody believes me when I tell them I cannot get registration as they are so many ‘foreign-trained’ nurses in our local hospitals.
Of the 247 US applications received since 2013, less than 10% (24) were registered and 77 were refused.
Just nine US nurses were registered last year, despite the NMBI dealing with 101 applications from the US. The NMBI also noted that some of the registrations may be from applications from the previous year.
TheJournal.ie asked the NMBI what the number one reason for US applications being refused registration is, but none was given.
This comes at a time when the HSE says it’s implementing a “a broad range of retention measures” to get nurses to stay in Ireland and hospitals are spending thousands on overseas recruitment drives.
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Anyone who is available in Drogheda today, please go out and meet our Taoiseach in your town. Be vocal,, let the six one news headline tonight be Leo scrambling into his car as the people of his country shout their disapproval at him and his inept performance since he has got his job, crime rampant, hospital crisis, housing nightmare,, a nice little run up to his election……
@devils avacado: sorry, but I don’t think that’s the right thing to do during this tragedy!!
@Denise McGowan: while I understand your point, these gangs seem to operate with impunity, shooting each other in hotels in broad daylight comes to mind.
Time the Garda got tough or more tragedies like this will happen. Needs to be addressed at government level.
@Denise McGowan: you might be right,, they should probably leave it till the next time he plans to go to crime ridden town that Drogheda seems to have become…..
@Denise McGowan: why?
@Denise McGowan: it’s the perfect time to do it
@Euro McPúnty: since it appears that those involved are well known in the area, the better course of action is for those with information to give it to the Gardai. Stunts like this suggestion won’t bring anyone to justice.
@milton friedman: what do you mean by ‘time the Gardai got tough’? I’ve heard this phrase used plenty of times but nobody seems to elaborate.
@devils avacado: If convicted criminals with 50 to 100 convictions were kept behind bars for longer periods of time instead of being given suspended or a gentle slap on the wrist sentences, they would not be out on the streets as much in order to commit more murders and to terrorise the citizens of this country.
@devils avacado: Drogheda is battling with a reputation at the moment and the last thing they need is to show a hostile reaction to an invited guest.
@Pat O Brien: Would probably mean a heavy handed approach to dealing with this s(um. Fight fire with fire and squeeze the life from them. Confiscate everything they have, even the clothes off their backs. And when I say ‘they’, gards know every last one of them.
@Daniel Kevin Sullivan: “ stunts like this suggestion”?? For years the people and Garda of Drogheda have been saying that the town is rampant with crime and it is a boiling pot that is going to spill over,, the barbaric murder of a child this week has highlighted what many people have known for years, the people of Drogheda need help, the town they have grown up in/moved into is in the headlines for all the wrong reasons, thugs are running the show with zero fear of the law. The people should take to the streets today if Leo is in town, and show their support for that boys loved ones by letting the Taoiseach know what is happening is unacceptable, enough is enough, the people need to get out and use the media presence today to tell our leaders that they want their town back….
@Rochelle: nonsense.
@Michael Lynch: I’m sure the gardai do know who’s who. But I still don’t know what ‘getting tough’ and ‘heavy handed’ mean. I’m asking a genuine question. Where I’m coming from is I take it nobody wants the Gardai to go outside the law, which I don’t want them to, but in that context, what do people mean by the above two phrases?
@George Vladisavljevic: how about ‘more than one’ conviction…?
@Pat O Brien: while I know it is a platitude but in its simplest form, you assess what resources and intelligence the Garda have, and then you strategize how to improve results i.e. convictions, confiscation of fire arms and drugs.
Basically make it so these gangs can’t operate.
@Shane McGrath:
The law profession wouldn’t allow it. The revolving door system keeps up employment and assures wages for the sector.
@Pat O Brien: i think many people vent their frustration with out outdated criminal justice system with the sentiment ‘time for garda to get tough’ – -its just people sick of the soft touch , suspended sentences , lack of new prisons , oitdated garda tech ( pulse is not fit for purpose ) – not enough visible garda etc etc – its just a way people vent a complex area – whatever party gets SERIOUS about building more prisons and making a tougher concerted overhaul in criminal justice – not just false promises – the people would welcome that.
@devils avacado: It sounds like you don’t give a damn about Drogheda and you’re just another Dub wanting to use a crisis away from your own doorstep as a political opportunity.
@Dave Hammond: I agree with you on both your points.
@milton friedman: but it is my understanding that all of this is being done. Hence my question.
@Rochelle: yes, ok, that’s fine Rochelle,, whatever you say, spout as much nonsense as you like. It doesn’t make it true thou….
@Denise McGowan: sorry but what happened is not a tragedy. The boy was involved in gangs and has probably done awful things to innocent people. It’s sad that he got involved with the wrong people but he would have grown up to be a very dangerous man I’m having trouble having any sympathy for him
@jason traynor: protesting at Leinster house might be more appropriate. Not where a young guy has been murdered.
@D: it’s a tragedy that his family are grieving through. He we only 17
@Pat O Brien: I imagine Gardai will say the resources are not there to do it sufficiently, so there is one way to address the issue.
I’m calling for action from those in charge, who are paid to make these decisions, I do not have all the answers.
Where was he for all the other murdered? Easily know election season is in full swing.
@Craig Clancy: All those other 17yr olds chopped up? This is one of the most vicious and disgusting murders this country has seen so it is right imo that he is showing his face there.
@Sal Paradise: another leo supporter.
Taoiseach shocked by drug dealers death…..wow
Suit him far better to visit the local hospital and see first hand how under staffed the hospital is
@John Joe Bridie: he knows. He is an MD and his partner practices.
I wonder will he say.. “but he was known to Gardai” and shrug his shoulders in the same way he said about the homeless guy injured in the tent being known to authorities
@Hughie Lynch: he will also bring up fg’s brilliant success on tackling crime and how fg are working on new measures to tackle crime then he will try and slate ff and sf while thinking quietly to himself “these fools will believe anything i say, i hope my socks look good in this”
@Hughie Lynch: are we supposed to feel sympathy for a lad that firebombed people’s homes and attacked known murderers on the streets and got his comeuppance?
“will consider” chances are probable that he won’t. Leo is not one to mingle with us common people.
Taoiseach travels to Drogheda as DNA results due on remains. Is Leo a suspect?
Leo standing hopelessly by a stable door as a horse gallops past him again.
This is truly tragic but it’s interesting how criminals always seem to get the most attention from politicians. Why is that?
@Morning Gus: because unlike for example the homeless guy where they can deflect blame to another party or person and quickly move on, they can talk about criminals all they want, because he doesn’t think he is to blame and plays on the notion that we as a society don’t care what criminals do to each other, which is I suppose is largely true.
I’m still Taoiseach, so I do still have my responsibilities and obligations as Taoiseach. So I’m obviously trying to campaign around them but, you know, I certainly give it consideration.
Leo’s biggest responsibility and obligation is to protect the citizens of this country,all other issues pale after that.
@Fabio Dillon: I think you’re doing a disservice to the people of Drogheda, the majority of whom want nothing to do with this feud. Far more people are killed in other parts of the country, yet you’re happy to jump upon a media fueled bandwagon. This is the biggest town in the country, maybe if it hadn’t been so neglected by successive governments and had some investment they wouldn’t have such problems. They have a sitting FG TD for many years, with little to show for it.
These people couldn’t give a f___ if every town in Ireland held a rally , action is what’s needed by the government , guards and especially the judicial system .
This country is decending fast into complete lawlessness every day now we have a murder or a serious assault it’s that common now it doesn’t even make the news .
The next government should stop bowing to this racist card and call it as it is , it’s about time we starting deporting people who commit crimes in this country and give proper sentences to our own all ot our own .
Leo’s pledge to put killers behind bars …… forgive me for being cynical , but put that in the intray leo with your USC, Hopistal crisis and homeless crisis pledges!!
Just another soundbite from you, in the Tragedy thats going on .
He’s only making use of the event for his own gain. A PR stunt to win the hearts of the people or so he hope. He has never and will never give a $hite about common people.
Leo’s pledge to put killers behind bars …… forgive me for being cynical , but put that in the intray leo with your USC, Hopistal crisis and homeless crisis pledges!!
Just another soundbite from you, in the Tragedy thats going on .
Good God, does this man’s arrogance have no bounds? Much better for the Drogheda march if he doesn’t attend-his clear lack of understanding would mean he’d have the gall to use it for canvassing.
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