Inspirational Stories of Nurses Overcoming Retrogression

Good morning, good afternoon, good evening to our friends here in the United States and around the world you’re watching onwards and upwards everything a global nurse needs to know to live and work in the United States. My name is Luciana Da Silva I'm your host. Please remember this is an interactive show. Put your name in the chat let us know where you're from. We love hearing from people all over the world and seeing where everybody is watching from. We have a wonderful show for you today coming up. First of all, we're going to check in with Deirdre dream jobs. Let us know where are the latest jobs in the United States for you to apply for to work as a nurse. Today, we're focusing on RN retrogression heroes. These are nurses who have been through retrogression, have gone through that journey and are now on the other side, realizing their American Dreams here in the United States. This is a show of hope and inspiration. Finally, we will finish off last but not least with Holly's clinical corner for this week's clinical tips, remember, apply now go to AMNHealthcare.com/International, send us your application. Start your American dream working as a nurse here in the United States, our recruiters are on hand waiting to speak with you. Speaking of recruiters, let's bring out the most one of the most important, let's check in with Deirdre the dream jobs with Dee.

Good morning, good afternoon, good evening. Wherever you are watching from, thank you for joining us today, and welcome to dream jobs with Dee. So as Luciana had mentioned. You know, we have jobs all over the United States, so, but today we're going to focus on two locations, Mississippi and Virginia. So both of these locations are currently interviewing for nurses like yourself. So if you have not already, please make sure that you submit your application to AMNHealthcare.com/International, we are the only organization that offers both direct hire and staffing. Again, I'll say it again, the only organization that offers direct hire and staffing. So let's without further ado, let's start with Mississippi. So let's talk about the top three reasons my why you may want to consider moving to Mississippi. So one, it is the home of southern hospitality. And who doesn't love that you want to feel warm and welcome when you relocate to a new destination, affordable cost of living, very important if you are traveling with a family, always, always consider those locations that have an affordable cost of living, and Mississippi is just rich in history and culture. It is a beautiful state, and they are interviewing right now.

So get your application in today, and let's take a look at cost of living comparisons. So Jackson, Mississippi, when you compare it to Los Angeles, California, the cost of living is 70% higher in Los Angeles than it is in Mississippi. Look at that housing cost 215% higher in Los Angeles, California. So definitely, you want to consider these options as you are looking at opportunities across the US. Remember, be open, you will get a placement a lot faster if you are open to location. So let's take a look at cost of living compared to New York City. So the cost of living in New York City is 164% higher than in Jackson Mississipi so Wow. Huge numbers there and look at that. Housing cost 594% higher to live in New York City than it is in Mississippi. And you know what? The transportation is great, so you can always go visit. So here is where Mississippi is located in the United States. So if you have not already, please make sure that you get your application in and get an interview with this amazing facility. So let's move on to Virginia.

Why you may want to consider options in Virginia. So the top three reasons, and we could list a lot more, it is a top quality healthcare system that is interviewing right now, taxes are lower, so that's important. You know, we all pay taxes, and it has extremely low crime rates. So again, if you are bringing a family with you, these are all things that you may want to consider in choosing a location here in the US. Let's do a quick cost of living comparison. So Winchester, Virginia, the cost of living in Winchester is 32% lower than Los Angeles, California. So again, lower cost of living. You do want to consider these options as you are looking in finding your destination here in in the US. Let's compare it quickly to New York. So to live in Winchester Virginia, the cost of living is 56% lower in Winchester Virginia than it is in New York City. Cost of housing again, 81% lower. So almost 100% lower. So all of these things you do want to consider when you are making your decision in moving here to the US. So just like we had said, if you not applied yet, please get your application in today, our recruiters are on hand waiting to speak to you.

They are excited to get you started on your journey. And as we always say, dream big, dream smart and choose AMN International until the next time I love that, Dee, and especially today, we're talking about being in the south, Southern Living. That's where I am I'm in the beautiful state of Georgia. Love the South, nicest people in the country. It's really true. You know, Dee today we're talking about retrogression, and really focusing on retrogression here, heroes, you've been doing this for a very long time. What is your advice to nurses who are going through retrogression right now? So what I would say is, you know, control what you can control, right? To keep yourself motivated, to keep yourself well, really motivated to take the next step. So things that you can do if you have not passed English, work on passing your English while we are in retrogression.

If you have not gotten your I-140 filed, don't delay. Get your place in line today, you can still secure that all important priority date while in retrogression. And the luxury of time. You have the luxury of time to really do a lot of research and choose where you and your family want to be once you are visa eligible and ready to travel. So don't delay and take your English if you have not already and get your I-140 file immediately to secure that priority date. Those things are in your control. Thank you so much Dee, what words of wisdom control? What you can control, it can be applied to so many things absolutely. Thank you so much. And for everybody at home, please know that Deirdre will be working the chat throughout the show, answering all of your recruitment questions in the chat. She'll be on our Facebook chat. So please keep the questions coming. This is our Senior Director of Recruitment. Great person to give you wonderful information.

Thanks so much Dee, until the next time, and of course, follow us on Facebook and Instagram. Stay updated on our latest opportunities. AMN Healthcare International. Please follow us, like us. Share us with your friends. We have lots of friends watching right now from all over the world. Let's say hello we have Sivek from India. Rhonda is joining from Riyadh, Prince from Ghana. Pit was watching from Nigeria, Fernanda from Brazil, saying good morning. Bungia, just stars, Kenya, Gladys, Philippines, rosemary, Ghana, Emma UK. Oh my gosh, I think I just named half the countries in the world. Let's get started in I'm going to introduce retrogression heroes. First of all, let's find out what is retrogression from one of our immigration attorney partners, Mike. Retrogression occurs when demand exceeds the supply of the visa numbers and there is a great demand for International workers, whether it be health care or in any other space for the US, and we're still working with rules set 30 40, years ago. As far as the numbers that have not really changed. And so the demand is simply going to ultimately exceed the supply we had a short term over the last couple years benefit from covid Because unused family numbers got passed over to the employment side.

Exactly so there's a finite number of basically EB three green cards, and coming up next month actually? Yeah, we're about to start September. We are it's the end of the fiscal year for the United States, and so we're going to be hearing news about retrogression, seeing if the dates move up. It is a big day of the year. And as soon as it happens, we are going to go live the next morning right here with both of our attorney partners, Mike and Chris, to answer all of your questions about retro aggression. So that is coming up this and actually probably a couple weeks ago. We'll let you know when it's going to happen and give you the news you will hear it here first, we promise you. Let's. Say hello to our RN retrogressions heroes. We have two joining us today. But first, let's say hello to Sushma. Hi, how are you doing? Hello, I'm fine. Hi, please introduce yourself. How am I pronouncing your name correctly? Hi, yes, right. It's Sushma Singh, wonderful, Sushma, please introduce yourself to our audience. Oh, my name is Sushma Singh, I'm from Nepal, and I survived retrogradation, like for two years. I waited around two years to come here, so it's okay. Where are you originally from, and what was your nursing specialty there? Oh, I'm from Nepal, and I was working there as a medicine Wonderful.

Well, when you first decided to come to the United States. How did you come about that decision? When I completed my BSN degree, I was like, I need to do something that is good, you know, good for me as well as my economy, and I can just earn a more and also get a good career in a like in abroad country. So I decided to do the inflation examination. Then I got to do the IELTS session.  After that, I applied in AMN Healthcare. Thank you, all of you for that you are great. Thank you. Tell us more about that. How did you go about applying the AMN the recruitment process. What was that experience like for you? Tell us about it. I have been doing that from like I was sourcing for and good agency that would afford me as sponsor me in a USA. So I got to know from my friend and Rachel, my husband, sourced it for me, the AMN, and he told me that this one is the best for you, so try this. So I was like, Okay, let's do it. So he's the one wonderful. And so then once you applied, what happened next after I applied the AMN Healthcare has a great team, I must say that the you people are like, always with us whenever we need any help, you are like, within us, a mail or a message. You are there for us. Like, we don't have to wait for something or like, like, wait for like, days or months to get your reply.

But in other agencies, what I have heard from other my friends are like, they are not that responsive, but you people are so responsive, and you have, like, something in brain going on that you need to help us, and that made me so it made me to choose you, actually. And I waited two years. And with me, you also waited two years for me. And you, you were like, you need to do these things. You need to do these things. And they were the session, like every time, like educational session and about the retrograde, what is going on in our file. Everything was so updated. And that made me to wait two years. You are, you all are like so updated in everything, what where my file is, where I am, where I'm going to be in the next two months or three months. And that was arranged very precise manner, I guess. Thank you so much for sharing that with beautiful words. We have so many members of our team watching right now, and I know that they absolutely love to hear that from you.

Thank you so much. Of course, if you are a nurse living anywhere around the world, please come and apply now. AMNHealthcare.com/International, and let's start your journey. Tell me something. When did you find out that you were under retrogression? Did you even know what that meant at the time? Be no friends. And they were like, you know, Sushma we are facing a retrogression. I was like, What is retrogression? First, I denied it like a let it be it is something, because I was preparing for my IELTS session. So I was like, let it be something. Then I was not worrying about it. After I did my IELTS session, I then I attended your AMN International session of retrogression. Then I came to know that what is retrogression and I was like, I started your session, like, every time you know week. I guess there is a once in a week your session, yeah, and I just attended the session, and I came to know what is going on. So that helped me. And from there, I came to. Know, retrogression and I need to wait. What did you do during that time? So you found out what it was which means that you had to wait. You applied first get your place in line. That's the most important thing.

Start now don't wait. There's a line right for all of the nurses who are applying now. So what did you do while you were waiting in line? It was like normal day of living, going for your duty, okay, getting the things done in home talk, spending time with parents, grandparents, and all those things. I was loving the time because I knew in my mind that I'm going to fly one day. So let's enjoy the time that was going on Monday you saw the future and you said, the prize is there. And I was like, one day I'm gonna fly. So let's use this time for, like, spending time with your parents, your loved one, because you're gonna really miss them. Can only imagine long time to say goodbye and say, We'll miss you, and then when the time comes, is this your family here? Yeah, these are my family members who came to receive me at the airport. Looks good my did you arrive alone? Did you arrive with other people, your family? I arrived with my husband, the husband, yeah, and my mother in law. You came with the family, and obviously you weren't alone when you arrived. I have someone what, right? What did that moment feel like? How did you find out that you were complete with the retrogression that it was now your turn? How did you find out and what did that feel like when, when I saw the visa volatility, then there was, like, on my date of PD, so I was like, oh my god, now I'm gonna go, and I don't have really time. And it was only two months.

I have a two months to fly over here. So I was asked to, I came to know everything from your this live session and AMN healthcare the case manager used to mail us every session is going on and there is a your tape, so I can help you all. I really feel when you when you found out, I was like, literally, I'm going, Oh, I should have got more time to spend with my family. That was in my brain. So soon the two year passes, like I'm flowing like a river. Everyone gonna survive retrograde. It's not that talk, because when you it's in your brain that you are going one day in a USA. So you have like that. Okay, I have a limited time, so I'm gonna enjoy these. I'm gonna do this, I'm gonna do this, make a plan and use that time I see this.

That's a really, really great piece of advice. So it seems that once you found out that you were that you were current, everything happened really quick. Yeah, it's very quick, like you have around two months, not two months. Also, like you need to do everything in two months. So be ready for that. When retrogression hits you, you're gonna do this things in a very quick I arrived here within two months. Wow. And you know, it is different depending on what country you're originating from. Where's your birth country that really can dictate how long you will be under retro aggression, how long it will take for your number to be called. And then it's different also between that period of time when you find out that you're current and you actually come to the United States before that time, don't go selling your house, because you don't know, right? I mean, are you just kind of waiting for life to happen and still living?

Is that sort of how it felt? Don't take any major decision, like selling the house, quitting the job, or if you have a children, don't just quit their school. Or if you have, if you have a spouse coming with, you don't let him or her to quit the job, because that is the major decision you you're going to survive retrogression. That is the fact that is 100% true. But before retrogression, taking any decision that is like life changing, you should not do that. You should be connected to the agency. They're gonna help you. They are the great I have. I have many issues going on my life, but the AMN was like so good to me. I'm very thankful to them. So follow the agency, follow your case manager instruction what they are gonna do, what they tell you to do, and they keep on mailing us like, don't do the major decision. Don't do this don't do that. So follow their instruction that gonna help you, and don't try to do this alone. It seems that that the support is so important. Don't try to go and file your I-140 on your own or anything like that. You're gonna mess up with your documents.

Don't do that. You. I will always tell you to follow the instruction that is given by your essence. That's the thing. And mom, because I have been marking your all words, and you were like, you're gonna fly. You have only you. You'll have only limited time when your priority date is here. That is the one thing that you need to keep in brain. So you people were telling me that, and it comes to, yeah, it does come true and you can apply now. AMN Healthcare.com/International, as Deirdre was saying earlier, we offer both staffing and direct hire immigration sponsorship for each of those are different. With direct hire the hospital system, they hire you, they sponsor your visa. And on the staffing side, it is AMN International that is sponsoring your visa. So there are two ways to go about it, either way, and actually the staffing side will get you through sooner.

It says just little tip right there, but we will support you throughout that we will give you all the resources that you need and the support and let you know when it's time, right? Yeah, yeah, you all sponsor only, not only the visa, you sponsored us for green card, and not only for us for our response to so and the green card is too quick here, like we waited only around 14 days, though there was a weekend and everything in most this takes us. We waited only like 14 to 15 days, I guess. So you all are very quick. They sponsor our airfare tickets so you don't have that economy boarding. And they also sponsor us for, like, signing among owners. So yes, you are in a right hand apply for it. And, yeah, I'm gonna tell this Well, and, and you guys came on an EB three green card, which, that is the category that is retrogressed right now. They're also H1b AMN International. We do have some spaces on that end for you as well. Whenever you came to your husband, also get the EB three green card as well with you.

Yeah, you got a green card. Where do you live now? Oh, I'm in Dallas. What's that like? Tell us about your life. We want to know the other side. I came here before two months, and I love this place. You're going to miss family. That is so obvious. You're going to miss them, but you don't have, you gonna miss your family, but not your community, and your community people here, because this is a, this is a nation of colors, okay, so you're gonna find, if you are into church, you're gonna find church. If you are gonna, if you are in a temple, you gonna find temples. There are lot of things your for your every kind of practice, the food, the religious practice, and everything is here. So you gonna miss your family, but not the culture and everything. So I am a typical vegetarian girl, so I'm not missing any food here, because everything is evacuating.

Yeah, you're gonna miss something, but not the things. Okay? You can make a new community, and you'll always see your family, right? Then you'll go and go back and forth. And how wonderful video calls, right? You can do that. What is your final piece of advice for all the nurses and their families who are currently in their home countries going through this anxiety, waiting? What's your advice? Have patience. Wait till your priority date comes once it is the way you have literally a very limited time to come here. So use that time for like, for your families, for your loved ones, and do the recreation things if you are into your. Job, do the job and that's it, or you can make the friends from us, okay, so that you cannot see your the lifestyle and what is going on us. What is Nepal or Philippians or some other countries? So you're gonna do that. That will help you and talk to your family that your priority date is not it arrived okay, because I have been asking by my parents, Nina, you going to go, even you going to go? You, you passed your NCLEX two years ago, and you are waiting. And I was like, my priority date is not near. So you can just convince your parents that priority date is this. We going to get this date, then only going to apply for visa so you can make them clear that will help you. I guess that helped me. Thank you so much for joining us, for sharing your story, for giving our nurses hope and inspiration. You are a true hero, especially also working as a nurse, helping save lives.

Thank you so much for joining us. Thank you for inviting me. We do have a another nurse who's going to be joining us and sharing her retrogression story. If you want to learn more about EB three green cards about retrogression, check out our website. We actually have a wonderful blog that we wrote that has all the information about it. We have our last immigration q and a bookmark this page. We update it with the visa bulletin. We have guidebooks for you to download. They give you all the information. What is an EB three green card, what is an adjustment of status, a TN Visa. Learn about that on our website, and we'll put the link in the chat there so that you can easily go check it out. Like I said, bookmark it. So we do have a couple questions coming in here in the chat, we have ask about just covid in order to apply to AMN, do we have to have NCLEX right now we are prioritizing nurses who have passed their NCLEX. That's who we're prioritizing right now, if you haven't passed your NCLEX, do some studying. Join our AMN Academy show every Monday.

We do NCLEX classes, and we also do free IELTS classes live. So please make sure to join us every Monday for a new course on a new topic. Now we have Tanisha saying here now was affected by retrogression as well. Well. We hope that you are absolutely enjoying your time at home like session said, take that time with your family and get ready to come here. Please keep saying hello in the chat. How about this? Share your inspirational quote with us. What is the inspirational quote that keeps you moving through this time? We really want to hear about it. Here's one that we have, if you have ever seen the movie A League of Their own, you have it's during World War Two, there's a women's baseball team, and they are just very, very they're struggling on how to become these baseball players. And the main character, she just said she wants to quit because it just got too hard. And Tom Hanks his quote, it's supposed to be hard. If it wasn't hard, everyone would do it. The hard is what makes it great. It's supposed to be hard. Otherwise everyone would do it. Keep that in mind, you are doing something special right now.

You are doing something that's going to change your life forever in a wonderful way. Supposed to be hard, otherwise everyone would do it. Let's bring in our next RN, retrogression. Hello Marynor how are you doing? Hello good morning, good evening. I'm Marynor Pablo. I' not from the AMN, but I experienced retrogression, like, really for a long time, eight years. Tell us about your background. Where are you from? What were you doing there before you came? I'm from the Philippines, so I'm a nurse back in the Philippines, way back in the Philippines, like I passed the NCLEX back then we have like CGFNS first before you take the NCLEX, that's the foreign commission of foreign graduates. You have to pass the CGFNS first before you take the NCLEX, and back in the Philippines, we don't have the NCLEX, you have to either go to Hong Kong or Saipan or Guam to take the NCLEX. So I passed the NCLEX 2000 late 2005 actually, December, 2005. The IELTS and had retrogression hits eight years.

We have to wait eight years. When did you find out that you were under, under retrogression? Did you even know what that meant at the time? Yes, because I do always, I do research. We always like, because you have we can't depend on our agency, because they do help. But back then, you have to do your own research. You have to be proactive. You have to be assertive. Like, what retrogression is. We were short. We were supposed to be having, like early interview, like we were two months short when the hate, when the retrogression hits, and then we have to wait for a long time. But I, I made sure that we were making updates back then. We don't have the Google to look for. What the updates for the retrogression, what's the current dates. So we have to buy newspapers and see what's the current update for every month, we have to look at the dates of the current visa that's been given. But still, you have to be proactive. Still continue working as a nurse. I work as I work in the dialysis, I work in the or and I work in the medical surgical floor or unit.

So that's it, like I was like giving up, like I told my husband, I don't want to go anymore. It's been a long time, but suddenly, when you least expect it, the US Embassy called, oh, I mean, email us and telling us that actually, it's not the US Embassy, it's the USCIS. It's been a long time, it's the USCIS telling us that we have to set a schedule in a Philippine Embassy because our were, were they're ready for an interview, to set a schedule for an interview. So we did that, and after setting the schedule, but back then, even the agency, if I have the agency, the AMN, right now, I'm not going to think twice of applying AMN or Connetics, because you guys, I can see you guys really helping. You're making every it's a passion for you. You're helping, your nurses. You're updating your nurses. We don't have that back then to our agency. You either swim or sink back then because you have to do your own research. You have to follow up with your agencies. They never call because they almost like practical giving up on or under applicants because of the long retrogressions that we have. That seems so stressful that you don't have anyone there giving you updates. Thank goodness. It's different now.

And I'm telling my family, because most of my friends like, if you want to apply, apply AMN it's direct hire. We for us because of the hospital paid for our visa screen and everything. But because for a long period of time, it's been retrogressed so it passes, they ask us to pay for everything, for our visa screen, again, for our medical we practically spend like almost 20 grand back then. That was 2006 2008 and we don't have signing bonus everything. Then for after we did our interview in the embassy. I met the one who hold, who held our papers the console, she was new. She was asking, she was questioning our job offer, because our job offer was back in 2006 and we had the interview at two 2014 and she was questioning our offer, why it was increased because, and I told her in the interview that because it was the offer was back in 2006 of course, it's 2014 the offer was higher than it was before, and she didn't give us our visa. So in the in the eight years of retrogression, I took three IELTS.

I passed the first IELTS, it expires. I took a second IELTS, it expires, and I took another IELTS, it expires. It's all out of the pocket, my goodness, because you have to keep, keep. And keep going. And when you were going, I never, never stopped. And my husband will. My husband, you really have to have a partner who supports you. My husband is the I tend to be negativistic, but my husband will like, no this is, this is our American dream. This is we have to go through with this one I almost gave up, but we with him. He's like, 110% support. Tell you what, I know you're mark. Yep, absolutely. And actually, Mark is one of our onboarding specialists at AMN International, and this is what he's devoted his life to, supporting nurses. Now he experienced the retrogressions. He knows how it is. That's why, when he's when he when he talks to his to the nurses, he always tells his experience.

Because when we arrive here, the agency pick us up from the airport, we don't have anywhere to stay. We will we're willing to pay for the hotel. We don't have apartment. We don't know about Zillow before, where how to rent an apartment. We go house to house to look for an apartment that has like for rent. That's how we did it back then they just left us. We got our Social Security, left us, then we have to look for our own apartment, and my son doesn't want to my husband wants to be with us. So like, come on, let's go together, because we feel stronger when we're together. We we're like, we're really close. So they're my they're my strength, so we got everything. And my son is only wish to go to the US is to ride the yellow box, the yellow bus, because he wants to exactly. He calls me the yellow bus because he watched movies like that's his only dream is to and when Mark, that's the one thing that the agency didn't tell us, is the main they did tell us, like your visa will come out in two or three weeks, so ask your husband to resign now, because you will be living like in a month's time or in a two months time after the visa.

He did resign, but our visa didn't come out. It took like nine months, so he was out of work for nine months. Thank you for sharing this story. In terms of warning nurses who are thinking about applying and doing this, you have to do your research on who you're applying to, because what you're saying here is this could happen if you do not select the right recruitment agency to work with you, to support you, you develop relationships with our licensing team, with our onboarding Team. It seems like, especially in your situation how stressful it was that you went with an agency that wasn't able to support you. We know at AMN, that's our number one priority. I don't know when AMN started or Connetics. Sorry, but if we have AMN before, everybody will go to am because I see how your you care for your nurses. I see how passionate you I see Mark how he calls, even if it's not office hours anymore, he still answers their emails like he's you're very passionate in taking care of your nurses. That's why most of my friends like if, if one of my friends, like my niece or my daughter will be, will be taking up and clicks, can they apply? I said, Go ahead apply.

So can I text Mark about what website we're going I said, Go ahead, because you support your nurses so good that I haven't seen I've seen a lot of agencies here it's not how they take care of their nurses. Thank you so much for that. We do have some inspirational quotes coming in.  Now it's just at the tip of your fingers, Google it up, see what hospital you're going if you're going to the to a certain hospital, see what system they're using, if it's an epic, do your research. Because when you get to the US with everything, you're facing, cultural shock, cultural adjustment. And you have to adjust to the health care system, the US, the system they're using, because it's really different from other countries. You'll be like, you'll be shocked. You'll be you'll you will be like, cramming to learn everything in so it's hard. Sometimes you'll feel like down and depressed, that you'll sometimes ask yourself, like, did I make the right decision? Can I can I really do this, but do your research? Because nursing is a dynamic thing.

It learning never ends. It's a constant learning every day. Even if you're even if you're an experienced nurse with an ex with a vast experience, there's always something new to learn every day. What did you do during those eight years while you were waiting nursing. I do nursing, and then I did the dialysis, I did or and I did the medical surgical. And also I went to before nursing. I also went to become a medical representative. I work for a pharmaceutical company. Very well rounded. So eight years go by, you find out, hey, I'm current. Now, everything's good. How did that feel? And what did you do next? I researched the place we're going. I look at the place, I see what. I was even looking for, a car back then I was, I was so my husband said, like, don't you want to sleep? Because I was awake even at last three in the morning. I was looking like, when we get there, this is the car I want. This is the place we want to stay.

I look for good which, which county has a good education system, those things. And I even, I even bought a book, a living books for my son about American history, because that's the only thing that he's he, he doesn't really know much. It's the American history, because we don't take that in back in the Philippines, math. I don't have problems with math and science, because he always enters into a competition, but for Americans. So I asked him to read so that he will be advanced. So when he rich, he when we came to the US, he was even he graduated. I mean, he moved up to, I think, to eighth grade right away. So it took only, it took only one month for him to move up. So I asked him to study a lot and I tried to look at the hospital we're going so those are the things I tried to do to make to make our transition to the US easier. That bonded family. How old was your son when he when you all arrived? Just turned 11 he just turned 11, was he able to adjust? What was that like? Yes, he was able to adjust. Because when what back in the Philippines, he doesn't even know how to speak our own language. He just knew how to speak straight English, so he didn't have any difficulty adjusting in the US. And he loved it. He loved the school he went to and then the friends he made. So it was it's easier for him to adjust than the parents we It took time for us to adjust. But for my son, it's like three months. He is there he doesn't even have any difficulty. You know, you are not the first nurse that I have heard that from. They always say, hey, my children, so fast adjustment.

But myself, my spouse, or spouses, are half the piece of the puzzle, right? You do that adjustment, yeah, but for Mark, it's, it's more on my side that I'd have to adjust, because you get, you get a lot of stress from work, from the cultural adjustment. So I was crying the first three months, I was crying. I told Mark, like, can we just go home? And Mark said, Nope, it's just an adjustment now. And I wanted to go home because I miss my family. That's one thing, because you. Really, because we have a close family ties. I miss my family. I miss my sisters every Sunday that we have to go out and do our bonding. So I miss that one, but my sister's like, you know, that's your American dreams. You know how much people will pay to be able to get the green card? And I was like, then, after a year, I was like, okay, I'm good. Now, if you ask me to go back to the films, I go back two weeks. And I was like, can I go back to the US again? I miss the US. It's like, can I just ask my family to come here and for me not to go back to the Philippines? That's how.

And they were even asking me my other friends, like, don't you want to retire in the Philippines? Later on, I said, Now I'll retire here. I'll probably visit Philippines, but I retire here, I'll I love, oh, it's not perfect, but I love the healthcare system here, so especially if you're growing old. I'd rather have it here than in the Philippines. Unfortunately, others might say,  that's Filipino, but no, but when you come here, you know how the difference between the health care system, they say it's expensive. But of course, you're earning dollars. You spend dollars. You cannot earn dollars and pay in Philippine peso, so it's and one thing I can tell them is, like, when they are here, stop comparing, like this is how much I pay in the Philippines. How this is how much I pay. You always do the exchange and stop doing that, or you're gonna turn crazy. You're gonna go crazy about it.

Stop comparing. Stop comparing because you're earning dollars to spend dollars you can earn dollars and paid in peso, yeah, we're getting a lot of comments here in the chat. It's really, really beautiful. Yolanda is saying, Wow, this is getting me emotional. Jorly, oh, my God. Marynor you are an inspiration. Watching from Qatar. Muhammad is saying, what, asking, what was the cause for retrogression for eight years? Does that mean we will wait for eight years? This was long time ago that, yes, there was a very long retrogression. Now the retrogression, I think it's only been retrogressed. Maybe it began, what year and a half ago? I'm not 100% sure. Go to our website has that information on there. But every month we look at the visa bulletin and the dates change, they may move up, they may move back, but that big, big news, the big visa bulletin for the year that we can see, the greatest shift is the October visa bulletin. It comes out in September, usually somewhere between the 10th and the 15th. Watch our website, watch our social media. We will give you those updates, and we will be live the very next day with Mike and Chris, our immigration attorney partners, to take your questions, that they can answer your questions. Because there will be a change, hopefully a good change, right? But there will probably be a change, one way or another, and we will be there to help you and support you.

And Deirdre will be right there as well to answer your questions. Marynor, two more questions for you. One, where do you live now? And what's it like living there? We came here in Florida, in the Tampa Bay area. So we've been here for almost 10 years now. This is my first date, and I love it. So we bought house here, and I work in one of the hospitals I used to work in in the private sector for eight years. And one thing I have to say to the nurses, finish your contract. Never burn bridges. One thing you should learn is, never burn bridges. Finish your contract. Then once you finish your contract, that's like, so I stay with my since we have, like, an open contract, I stayed there for almost two years. We only have one year contract because we paid for everything. So they didn't keep us for two years or anything, because we paid for everything. So one year is enough, but we I stayed more than more than a year, almost two years, and then I went to another hospital, and I stayed there for seven years, and now I work for a different hospital. What a wonderful story.

Thank you so much for sharing it with us. You have one piece of advice to nurses all over the world, waiting, hoping, praying. What's your advice to that? Yeah, number one is pray, because you always need a divine intervention. Second is Be assertive. Try to learn everything. Don't be complacent as like, oh, it's retrogression. I'm not. Do your research, do your what ever the build your skills. Because once you're in, once you're here, it's a different ball game. It's a really different ball game, especially if you're in the ER or ICU, learn and never be afraid to speak up your mind, because you're gonna need it here. Don't be shy not to speak up your mind, because you hear when you don't speak up your mind, it means you don't have any, you don't have any, any, any you don't complain or tell something to your to your manager or to your to your church nurse, they will accept it as you know about it. So speak up your mind. Be assertive. Learn try to learn a lot of things. Try to learn, if you're going for a post surgical floor, medical surgical floor, try to learn all about medical, surgical so you won't be you won't be left behind in terms of skills, because they expect you if you say you have an experience, they expect you to have an experience and culture, you will be able to blend in.

It's try to be open minded us is it's a melting pot of different cultures. So you'll, you'll one way or the other. You have Filipinos, you have Chinese you have other cultures within the community. You can, you can be friends with be just be proactive and assertive in all sorts of things, like the cultures. Don't be afraid. Don't be afraid to follow your dreams. Because when it's not about the ideas, it's about making your ideas happen. Now I'm getting emotional. How beautiful, and what was some wonderful advice. And, yeah, the United States, you said it right. It's a melting pot. That's one thing that my husband said when he came to the United States. He's from Austria, his physical therapist. And he said, everyone is from everywhere. There's everything here. I'm not the only one with an accent. Don't be shy about your accent. I'm like, it's, it's one way or the other. They're gonna, they're gonna understand what you're saying. But what I do too is, is I google the pronunciation. When I go to like this is how you pronounce it, because you did. We pronounce different like medical terms in the Philippines, we were so before I go to a patient's room, I google the pronunciation. If there's something that I don't know, I Google it so that at least you can have an open conversation that you do both understand, because you will be meeting people of different walks of life. So not everybody understands everybody.

So Google everything. So that's how I learned, yep, and in 2024 all kinds of resources online now. Thank you so different from when you had to go through it before. We don't have but like, if I have am and I always even my sister, who is like, 50 years old, she's going back to nursing because she's a nurse. She's going back to nursing because she wants to go to finally do her American dream. She came from another country, but she wants to go to America, but she's still, she's now practicing back her nursing, and she wants to, and she was like, I'll be applying and if you at home want to apply now and start your American dream AMNHealthcare.com/International. Get your application, and now get your place in line for immigration. Just focus on the now control which you can control, like Deirdre said earlier, and I tell you what, Marynor, we are so grateful that you joined us today, that you shared your story with all of our nurses around the world. We really, really appreciate your words of inspiration. They're so meaningful.

Thank you. Thank you for having me absolutely and of course, for you at home, if you want to learn more about immigration, if you want to learn more about retrogression, please visit our website. You can go to https://conneticsusa.com/rn-international. We'll put the link here in the chat bookmark the page. Our latest immigration Q and A's are on there, and the visa bulletin, we are always updating it. So make sure you go to our website and also right here on our social media. We will be giving you all the details when the new visa bulletin comes out. Thank you again for joining us, and we actually now are going to be going through to clinical corner for those clinical tips you Holly. Hi everyone My name is Holly Musslewhite I'm the senior clinical manager for AMN International. Hope everybody's having a good friday and looking forward to the weekend here in the States, it's a holiday coming up on Monday, I think Labor Day.

Alrighty. So today's clinical corner topic is rapid response. What is it? So the cool thing about rapid response, or what we sometimes call RRT, rapid response teams, means that when you're at the bedside, often in like medical surgical units or a little bit lower acute units, that you're not alone. So if a patient has a changing condition, that's significant, and you're worried about what you are going to have to do and all the things that you're going to have to figure out, and you want to respond timely and urgently, that is something that you can respond to with a team around you. So let me tell you a little bit about how it works. First of all, the rapid response team, and that system is a safety process. It's meant to help us get a multidisciplinary approach to and response to a change in condition that could lead to an adverse clinical outcome. So instead of saying, well, we've had a change in vitals, and I'm going to make a phone call to the doctor, and I'm going to get some orders and I'm going to start those or, oh my goodness, what do I do? What do I do? What I do. It is a way of being proactive. When we see those changes, it's different from when a patient has a cardiopulmonary arrest.

So once that happens, of course, everybody gets called in, and that response is often called a code blue here, and the response is now to resuscitate the patient. Well, we want to get to them before they have to be resuscitated. So how it works is the team, usually, ICU, physicians and nurses, comes to the bedside of that patient when the response system is activated, and it's activated often by any staff member. So they will tell you, any staff member can do this. That means that, you know, sometimes a nurse tech might be the one to activate the system. The patient hasn't actually arrested, but they've seen enough of a change in that patient that they want to get that response to be initiated. So what are some typical things that we might call one for well, many facilities will define the changes, so they will say a really fast or a really slow heart rate, like more than 140 beats a minute, or less than 40 beats per minute. That's significant, and we should have a timely response to try and prevent that from becoming a more significant problem, or the patient arresting rapid respiratory rates, like more than 28 rest per minute, systolic blood pressure, more than 100 and 8002.

Sats that are less than 90, and you're giving the patient oxygen and they're not improving. So again, changes in mental status might be a rapid change in their mental status, not you know, they're slowly becoming more and more confused. That's not typically a rapid response, but a very quick change in their mental status could be a sign that something bad is getting ready to happen. Let's manage it now as a team. So again, you're not alone. It's pretty cool, but some people are a little reluctant when they first learn about this, and they're at a facility to get involved and actually activate the system. So there's some other things, like maybe a really low urine output over a period of time, or the team member just says there's a really significant change. And I can't, you know, explain all of it right this second, but I know we need to have more boots on the ground in this room responding to this emergency. So sometimes your charge nurse will have to respond first to the bedside. They may tell you before you call rapid response, call the charge nurse and see what he or she recommends. But I wanted to ask the audience if any staff member can do this.

If it's your first week on your unit with a preceptor, and you have one patient that's assigned to you, and that patient has a rapid heart rate like 182 beats per minute. Their respiratory rate is 30 a minute. Would you call? Or would you think it would be best if your preceptor calls for that rapid response? So go ahead and put your comments in the chat really quickly. I'm going to see if anybody responds. And again, those criteria could be different by facility, so you want to make sure that you're checking that. And I don't see any comments. Maybe no one wants to be very brave, but I'm going to tell you it can be. Who activates the Rapid Response System in week one with patient one, you have to know what those criteria are in the facility so you correctly act. Yes, you can inform your preceptor, but remember, this is about timely intervention. So if you had to go and find your preceptor to tell them that something significant had happened, they may educate you that I'm glad you told me, but you're a nurse. So you guys, you pass the NCLEX, you got your license in the US, you're a nurse, and that type of knowledge is something that is baseline for you. So you recognize what an abnormal heart rate, respiratory rate is, and you make sure that you act according to what you've been educated to do in your new facility. All right guide sets it for today's clinical corner. Thank you so much for watching. We've had some great guests today. I've enjoyed listening to some of the advice and stories. It's amazing. So I hope you've been inspired as well. Take care Holly wonderful advice.

One more piece of advice we have been talking about retrogression heroes, as you said, some amazing stories were shared today. What is your one piece of advice for nurses who are currently undergoing retrogression, don't give up. Keep getting that clinical experience, but don't give up. Don't get discouraged. There are so many people I've worked with over the years, because I've been doing International stuff for about 23 of my 24 years in nursing, and the biggest, most important thing is don't give up. It will come. It may be longer than you planned or hoped for, but during those years, you keep building your skills and your knowledge, you keep advancing your clinical practice to the degree that you can, and it will be. It will come, gain the experience past the NCLEX, pass the IELTS, and never give up. Don't stop going thank you so much, Holly. Enjoy Labor Day weekend.

Really, really excited about that too. As Holly said, it is a holiday weekend here in the United States. Everyone has Monday off. It's kind of, how would you say it, Holly, like the last holiday of the summer, something like that. Isn't that what it's yeah, the weather starts to change in a lot of places. So this is kind of the last time that we've got a holiday that is really, really sunny and bright out usually, and everybody just kind of takes time to spend with family if they can, and have enjoyed the outdoors before we start to see some of those significant weather changes and eat some delicious barbecue, Something else to look forward to in the United States. Please, nurses at home, share with us your photos of Labor Day. We would love to see them. It's such a wonderful holiday. Thank you so much again, Holly we appreciate you.

Take care Luci. Thank you all for joining us today, for joining our show. Let's take a look at our upcoming shows. We were talking about things that you can do during retrogression control. What you can control we have our AMN Academy. I'll get to that in a minute. But our onwards and upward show. So we have our immigration Q&A right now it's for September 13, but that's actually very, very flexible there, as we said, before the moment that the October visa bulletin drops, as soon as it comes out, we will be here live the very next morning to answer your questions. We'll also have our next onwards and upwards show September the 27th one month from now. So make sure you tune in and check our Facebook and our Instagram and our YouTube for all of the information and where to join us. We'll be right here on our social channels. The Lefora Talk Show is coming up on September the 17th, for out all of our Leforans, we really look forward to seeing you there and then Academy, as we said earlier in the show, it's every Monday, and it goes back and forth. So one week we'll have NCLEX with iPass, the next week we'll have Niners. So be giving us IELTS courses. Then we go back to the NCLEX with the Aspire RN, and we top off every month with another Niners course on for your English exams these are free. These are live, they are interactive, just like this.

Show you, put your questions, your answers in the chat. The instructor is there, helping you, guiding you, control what you can control. Get more experience. Pass these exams, but most importantly, apply now and get your place in line. Go to AMNHealthcare/International. Thank you so much for joining us. Thank you also to our crew, to our director Melanes and all the nurses that joined us today, as well as Deirdre and Holly and as we always say, onwards and upwards. Take care everyone.