International Nurses' Journey to the USA

Good morning, good afternoon, good evening. Wherever you may be joining us from and welcome to AMN Healthcare International's live show Onwards and Upwards, where we. Discuss everything a global healthcare worker needs to know about living and working in the United States. Today is day four of Career Week we have made it. We've had some amazing shows. We've had the AMN Academy. We've have all about recruitment. We've highlighted one of our employers, Methodist Le Bonheur, out in Tennessee, and today, to round us out, we are going to be talking about the journey of two international nurses to the USA. I am personally very excited for today. I know we have some amazing stories to share. So I hope you all buckle up and we are going to get started. So let's bring out our nurse guests. 

Hi, good morning. How are how are you? Susmita, good. We are very excited to have you both here with us today. If you are joining along, please let us know where you are watching from in the comments, and please let us know if you have any questions for Lydia or Susmita. I'm going to be monitoring the chat. I see we have Arlene saying, Good morning. Good morning, Arlene. If you have any questions for our two lovely nurses, we are going to be taking them. So let's get started. Lydia, why don't we get started with you? Can you just tell us briefly about yourself when you came to the US where you currently live, and if you brought anybody else with you? Hi my name is Lydia I started my nursing 17 years ago in Ghana with a focus in medical, surgical nursing. 

Right now, I just completed my two years contract with the AMN at Rhode Island Hospital, now rebranded as Brown University Hospital. Okay? Well, very exciting. Well, congrats on completing your contract. I think we're all very excited to hear more about your journey and a little bit more about what it's like to live in Rhode Island. I've actually never been there, so I'm excited to learn, uh, Susmita. You want to go next. Yeah, first of all, Hi everyone I'm Susmita I'm from Nepal. I started my nursing career in Nepal. I started working there since 2015 and I came to us in 2023 so it's been like one and half years, almost done with my half of the contract. So I will be working here till 2026 June. I'm currently working in Sanford Health. It's in Bemidji, Minnesota so I'm working in women's and children department here. So far so good. It's going all fantastic. 

Okay, exciting. Well, I am excited to hear from both of you all about where you both live, how the journey was to come here. You now have both been here for quite some time. So I would say you are a little bit of veterans, and you can give our nurses some good advice. As I was introducing the show, I think I was so excited to get started and to meet you both, I forgot to introduce myself. So my name is Danielle Friedman. I am the host of onwards and upwards. I've been with AMN for about four years now, but I've been doing international recruitment for a little bit longer than that, and I'm actually an immigrant myself. I originally moved here from South Africa with my family in 2000 so I have been here for 25 years, pretty much the whole time in California. So I have not been to Minnesota and Rhode Island because the US is huge, and it would take forever to get everywhere, but I would love to go there, and I'm excited to learn more.  

So before we jump in and hear both of your stories, we've now spent a few days talking on career week about how to get to the US, about some of our employers, and some of you who may have been following along are going to be inspired to apply at our website. Am and healthcare.com, forward slash International. So we will also drop that link in the chat. I see we also have lots of people who have started Joining us now. I see Gladys is watching from the Philippines. Glacia is watching from Jamaica, Abdullah from Gambia. Mika is from Nepal so hello to everybody. Thank you for joining us. Please feel free to put in the chat your questions for Lydia and Susmita, and let's get started. So Lydia, let's start with you. Why did you decide to move to the US? 

Well, in as much as I love what I do as a nurse, you got to a point or a moment, I wanted to change. So I discovered America had the highest standard of medicine. And so how do I get there? I spoke to a friend, and then a friend referred me to AMN, and then I got on board with AMN passed my NCLEX and then that was how come I found myself in United State of America. Okay, that's great. And can you tell us a little bit more about your journey? Did you come with your family? Did you come alone? How was that process? Very well, actually, I came with my spouse. During the process I got pregnant, so I came in pregnant at the stage of six months, and then I started my orientation. However, I had to pause and then deliver my baby. That was, I think, three months. I came in at six months or three months, then I delivered, and then I continued with orientation. And then now I'm down with orientation, but I still have an offer with the hospital. 

Wow, that is amazing. Moving here at six months pregnant. I'm sure that must have been a little stressful, but your baby girl looks beautiful. What's her name Karen cute. She looks adorable. Well, I'm excited to hear a little bit more about that whole process. I'm sure a lot of viewers might be in a similar situation. So I'm very excited to hear a little bit more about that. Susmita, can you tell us a little bit about your journey to come to the US? So like I said, I came here in us in 2023, so I came with my husband and my son. He was 26 month old while we came here. So now he is already like almost four level before this March. So it's been, it's been wonderful journey. So whenever you come with your family, you will never be alone. So that's a plus point about my process. It was pretty smooth once, after I passed my NCLEX examination, I did my NCLEX from NCLEX Nepal, and then they connected me with AMN International.  

It was Connetics USA before. So I got chance to talk to Sarah, who used to work in this agency, and then she helped me with job interview, job placement. I used to work in pediatric and birthing, so it's I heard that it will be pretty hard to get a job in that maternity department like women's and children and pediatric but then, luckily, I got chance to attend job interview for women's and children department in Sanford, Bemidji. So I did my job interview. It went well, I got job offer from here. So I chose Bemidji because of hospital, because it's like kind of relevant related to my previous exposure. So I did not, I did not make a second option or second choice. So I just came here I passed my NCLEX in 2022 April, and then I did my visa interview in 2023, April. So it took me, like a year for the whole process after I passed my NCLEX examination. So it was pretty good amount of time. It was not a lot. And then I think after that April, we had this retrogradation issue. So luckily, I got chance to come before that.  

So that was my journey. And then if we, if you are coming with your family, you don't have to, you don't have to stress a lot about that. If you have your husband, if you have shared, it's like there is some issues. There will be some issues or challenges coming in, but you don't need to worry about that. It will everything will go well. The education system here is so good, like my son was 26 month old, like he was below five years so you can attend different like community program, early childhood program. You don't have to worry about education for baby. You don't have to worry about health care system for baby, because it's you have to pay for insurance, but you don't have to worry about like you have to pay money right away the time of treatment so if you're coming with your family. You don't have to make a like second thought about that. 

Okay. Thank you for sharing Susmita. You both said a lot of very interesting stuff that I want to dig into. But I did just want to say I have a two year old and a eight month old, and I am so impressed with you both traveling at six months and bringing your 26 month old. I know how difficult that must have been. So you know you're both Testaments that it can be done. But I am very impressed on a personal level, but I'm sure, clearly it was a good decision and a good move. So we're going to dig a little bit deeper into that you both said something that I just want to clarify for our audience. So Lydia came with OGP, which is the staffing of AMN healthcare International, and Susmita came with Connetics which is our direct hire with Connetics or with AMN International. So it's a little bit of a different process. 

And if you've watched our shows before, we go into a lot of detail about staffing and about direct hire, and we'll actually drop the link in the chat in one of our shows, comparing both. But if you're watching along and you're thinking what does that mean exactly? It just means that staffing, the employer will be the agency, so OGP will be the agency, and when you're doing direct hire, it means that the US healthcare facility will be the employer. So it's just a little bit different, but both ways will get you to the US, and if you have an offer from either at this point, we would highly recommend that you take that and you start your journey towards coming to America, but that's a different topic for a different show. Today, we are focusing on Lydia and Susmita, and we are here to hear all about their journey. So Lydia, you mentioned why you wanted to come to the US. You said something about the healthcare system being a different standard, a better standard. Were there any other reasons that you wanted to move to the US? 

Not really. It was just about a change, and then I wanted a better place. That makes sense, totally makes sense. You wanted a better place. I'm sure, when you were pregnant and you're thinking about your future like my parents, you wanted a better life for your child. So that definitely makes sense. What about you? Susmita, what made you want to move to the United States? 

So being a citizen of like third world country, I think there are so many people who always want to come to like America, like, I don't know, people always dream of living that American dream life. So I'm one of the people from there. So I started working, like, I started nursing since like, 20 50, and then I worked in like, government hospital and then one of the central hospital, but I always felt like there is some lack of job satisfaction regarding pay. I mean, I was earning good amount for my country, but after having me, what I felt is it's not everything, so I also have to think about my, like, son's future. And then even in like nursing career, there is not, like, broad scope of nursing in Nepal, but it's like, it's good here you can go to like, either like different sectors in nursing. There is opportunities in every field. Like, if you want to go to child, if you want to go to moms and babies, if you want to go to mentors or geriatric or you want to do nursing practitioner like there are so many scope of nursing here, so that is one thing, and then there is like better job opportunities here. The pay rate is high. 

There is like sense of freedom here. There are so many things which I think that influence most of the people in third world country so And recently, like, after last, maybe, like, 5 6 7, years, there are so many Nepalese nurses coming to us. And then I was kind of influenced by that too. So I decided, like, I decided to come to us after having my baby, and then EB3 visa is, like a kind of a visa process for NCLEX nursing. So that also provides you green card, and then you don't have to worry about, like, work permit and everything your family will, like your immediate family, husband, child, they will get green card too. So you don't, you don't have to worry about lot of things if you come here with NCLEX nursing like EB three visa. That's why I chose us, and I'm happy about that. 

Thank you for sharing Susmita. You know, I've been doing this for quite a few years now, and I hear from a lot of nurses the same thing. They're looking for a better life for themselves and their family. They're looking for better pay, more opportunity. So sounds like for both of you, that was those were big reasons why you came to America. Can you Lydia, I'm going to start with you. Can you talk about what your experience was like with AMN during the transition, and how AMN supported you while you were coming to the US. Good. Personally, I have my five observations that I've made. One technically their sense of organization, right from the orientation groupness into cohorts per month. And then the process. Went through the process, stage by stage, to pass your bank list, and then completing the immigration process, and then finally relocating to the United States with a job offer.  

Secondly, I will talk about employment, employee recognition, whereby periodically they call us on phone to access how we are doing, and then they are periodic visitations. One time we got the opportunity to talk to the hospital nursing director. I wasn't expecting it, the HR representatives, the chief nursing officers, I was very grateful about that. Moreover, I'm talk. I'm going to talk about employee empowerment. Why do I say that you come with your green card, you come with your family, you come with health insurance, you come with a job offer. You come with your accommodation ready for you. Thirdly, fourthly, I'll talk about flexibility in terms of our schedule, in terms of asking for vacation, doing over time, and then even the float pool going to the various departments. Me, for instance, I've worked in about 16 departments, and I'm very grateful for that exposure. And then lastly, about the teamwork. And then they are networking. 

They have so many reps within the AMN concerning clinical money, clinical experience, housing, whatever you want to think about. And then when it comes to the networking, there was one time I had an issue with my health insurance enrollments, I just reach out to Amy, and then Amy quickly linked me to the health insurance office, and then this issue that had been pending for a year, you took just one week for it to be resolved. Secondly, I would like to recommend or acknowledge Kelly Elwood, with all our clinical conflicts, she's just a good mediator, very good one. The issue will just be resolved nicely, amicably, and then everybody is satisfied. That is what I will say about AMN. 

I know you couldn't see my face Lydia while you were talking, but I was like this the whole time. That makes me so happy to hear I'm so happy to hear that you felt so supported and empowered during your journey. That's really our goal for all of our nurses. And I'm so happy to hear that you felt really like you had AMN by your side. Because it can be a very, very scary process, especially if you're bringing your family, if you're bringing your children. So thank you for summing it up so beautifully. Lydia, what about you, Susmita, can you tell us a little bit about your experience working with AMN and how AMN supported you during the transition. I'm like 100% agree with what Lydia said, AMN nursing, am in international. It's been a wonderful throughout my NCLEX journey. After I passed my NCLEX, like I said, I taught, I talked to Sarah for my job placement and everything she helped me with, like, preparing resume, sending that to, like, different hospitals, and then she was so helpful with that process.  

I did have so many queries about the process. She was such a good case expert. And then after that process was done, like, after my visa. Interview. My on onboarding specialist was crystal, and then I was still in contact with crystal. And the good thing about crystal is any I'm I need to say that I heard that after I come here. I heard that one of the Nepalese nurses coming to our place, so I talked to her, because AMN also provides a community liaison who helps us to like from helps us in picking up from your board, helping with like housing, moving in, going to groceries like for the first few days. They help us with our transition. And then I did know that, like, there is no one community liaison in Bemidji. So I talked to her, like, if my husband can work as a community liaison. And then she said, Okay, yes. And she was so excited and happy, because there was no one, like, no community liaison for Bemidji. And then my husband got that offer. So he worked as community liaison for AMN International, for like, I think, since May or June, but then there is no nurse coming in for now.  

So he is a still Community Liaison for nurses who come to Bemidji. So that is another thing. And Joan, who came, who was my community liaison for that process, and he came from North Dakota, so there was, like, I don't have any complaint towards AMN International. It helped me and my family throughout my process, it was so smooth. I didn't have to worry about, like, anything. She used to tell me, okay, we need this, this, this. And then I had to, I just had to, like, prepare my part. Otherwise, I didn't have to worry about, like, what, what's going to happen next, what I need, what I need to do. Like, I didn't have to worry about that. So am in nursing has been, like, always there for me, and even I have not heard anything about AMN International like any like, let's say, like, bad reviews from my friends who are here in Bemidji.  

It helped us, like, throughout the process, and to be honest, once I got chance to talk to the person from AMN International. I didn't even, like, thought about, think about any other agencies, because after having a baby, your mom's brain does not work 100% so I didn't, I didn't want to, like, take a stress and talk to like other people and then, like, compare everything. So I don't regret about that too. So it was like wonderful journey that is amazing to hear. I definitely did a little chuckle when you said, Mom, brain is just single focused, as I think we all can agree. My friend from my friend from Nepal, like there are so many nurses were, like, doing the same processing from different agencies, and then they used to ask me, how is this agency? How is that agency? And I'm like, I just know about AMN works.  

Why break it right? Because I didn't know about any other agencies. And then I couldn't even, like, take that stress, like, talk to different people, and then, like, compare everything, and then decide so well, it sounds like you didn't even need to, because it all worked out. And now here you are a year and a half later, and you're living your life. So that's so good to hear. I'm so glad to hear that you 100% agree with Lydia, and you also felt supported, and like, AMN was there for you, and we were able to get you here. Thank you both for those kind words and for mentioning all of the people that you worked with. I know I'm personally going to go back after our show and make sure to go thank all of those people and make sure they know that they got a shout out. So that's very special. So I see that we have some questions in the chat before we deep dive into both of your lives in Rhode Island and in Minnesota, I want to take a couple of questions.  

So Elvis, I see that you're asking a question about the link to apply. So we're going to drop the link for that. The link in the chat, it's amnhealthcare.com/international, and that is for both direct hire and staffing. So if you are contacted by a recruiter for one arm or the other, you can discuss with your recruiter which might be a good fit for you. And I also see a question, or rather a comment about how frustrating retrogression is. Lydia and Sue Smith da I'm sure you've heard from a lot of people how frustrating retrogression is, and how they felt that you are very lucky because you had a much faster processing. I just want to give you both an opportunity to touch on you know, I think both of you probably got here and made. 

Be a year maybe two. But really, to touch on what you tell any friends or family or colleagues who come to you with frustration about retrogression, do you still think it's worth coming to the United States? Should they still persevere? Susmita, I'm going to start with you on this one. To be honest, I don't have much idea about, like, this retrogression, because I came here before that, but I do have my, like, very close friend who are, like, done with everything, and then they're waiting, they're just waiting for visa interview. So it's, it's obviously frustrating, even, like, if you have to wait for like, one month or two month, it's frustrating. But then if you have to wait for, like, I don't know how many months or years, if that is unknown, then it's definitely frustrating for them. So if somebody come and talk to me, I mean, I, I usually say, like, if you don't want to go to like, other country, or if you want to just come to us, then just, like, just keep on working. I usually suggest them to, like, learn driving during this time, try to learn swimming. Because, I mean, even I don't know swimming.  

And then in our in my country, like most of the people, they don't know swimming. So after coming here, I realized the importance of swimming like everyone knows swimming here. So you can learn swimming before coming here. You can work on your language, like accent and everything. You can work on that. So I try to, like, help them with some information, like, what we can do before coming here, if they don't want to, like, go to the other option. So I usually tell them those things, like, don't take stress, try to work on other different things that will eventually help you with the transition after coming here. I also suggest them to, like, watch TikTok videos of like us Aryan nurses, how they work. What is their experience regarding working in us? So I usually suggest them those basic things. 

Okay, thank you. Sue Smith, I think that's really good advice for our nurses who might be frustrated, do something that's going to help you while you're waiting, you're going to get to America eventually. Retrogression doesn't mean that you're not going to get here. It just means it's going to take a little bit longer. And like Susmita said, better yourself in all of the areas that you can. Learn a new skill. Get more experience in your nursing. Make sure that you are bedside. Pass your NCLEX, past your aisles. There are lots of things that you can do with this time while you're in this waiting period. Lydia, what about you? Any words of advice, yeah, honestly, I also buy into the idea of learning a skill before something like driving, swimming, working on your accent, something I didn't do before coming so I'm so struggling with that, uh, however, with the retrogression, AMN is very clean in that, because it's about the embassy or immigration, it's not an issue with AMN. 

I was lucky to come before the era of the immigration so I don't really have much to say, but I know a lot of people were really frustrated. People finished their exams before I did, but they were affected by the retrogression. What I would like to say is that what matters is the end result. Because when you come in here, things are very good. The opportunities are here. I mean, the standard of practice is there, you're going to like it. It's something I'm really enjoying. And I don't know how to express my joy to the world about airmen and their job offers or working in America's us area. So what I'll say is that for retrogression is just an issue with the immigration not Amn, so you cannot really blame AMN or OGP for that. 

Well, thank you, Lydia. I think that's a really good way to put it, because I know everybody feels very frustrated, including myself. I wish that I just had a magic wand so that I could go, bam, and the floodgates were open, and it was easy, and everybody could just come but unfortunately, I don't control the government, although that would be fun if I did, and it's not something that, unfortunately, we can control. The only thing that we can do, like you said, Lydia, is to be transparent and be honest with our nurses and make sure that you're getting all of the information that you need. And that's really, I know it's my personal goal, and that's really our goal at Amn, is to make sure that our nurses have the information they need. So you can also check out once a month we do an immigration update, where we spend an hour with expert attorneys taking your questions. 

It's free advice we discuss the visa bulletin, so make sure to check that out if you're watching along and you are curious about retrogression and the visa bulletin. So let's go back to both of you and talk about where you live. Can you tell us a little bit about your city, where the nearest big city is the closest airport, Susmita. Let's start with you. So I live in Bemidji. It is one, one like small town in Minnesota. It it's in Minnesota. It's in the northern side, like northern part of us, and our northern border is connected with Canada, and then the other side, North Dakota, South Dakota. So it's like more over snowy part. So we do have pretty bad snow after I signed my job offer. So I talked to one of my friend who used to live in North Dakota, and I asked her, like, I got job offer from Minnesota. So I say yes or no, and she said, The only bad thing about Minnesota is snow.  

Otherwise, there is, like, good nursing unit and like Nursing Association, so you can the pay was good. So she said, like, yeah, you can go for it. Otherwise, the half of the Yes, like you, you will find snow anywhere you go, and the like Northern side. So I said yes for this, but then the first winter, it was kind of okay. It was not very good for us, but it was okay for this place. But then this year, the winter is like it's, it's, it feels like it's never ending. Started from November and it's still snowing. So I'm hoping the summer will come soon. So working in Minnesota, in my part, there is, like, there is not much population here. It's like a small town which has, like, pretty good number of lakes around. 

It's not much crowded. So driving itself is easy here because of, like, not overcrowded population. Everything is like, you know, walking distance, even like, where I'm staying right now, it's like, just seven minutes of walking distance  All the shopping centers are, like, around our housing, like, Walmart is pretty close target. Like, everything is pretty close. There is, like, driving, what is a driving license center? It's, it's also pretty close here. It's, I didn't have driving license while I came here, so I did my knowledge taste and then I had to wait for three months to give to do my road test. So if somebody comes here, like from a different country, somebody comes here with driving license, their own driving license from their own country, I think they can drive with their own license for 60 or 90 days. So the plus point of plus point of your own driving license. If you come here with a driving license, that is the plus point. 

What is the other thing? And my hospital, it's like Sanford Health, northern Minnesota. The main office is, and then it's, it does have like different hospital in different places, mostly on the northern side. It has few hospitals in North Dakota, in South Dakota, and then in Minnesota. It's, I think it has like somewhere between 100 to 200 bed. I try to find it is like 118 bed here. So it's not like very big hospital, but it's a good sized hospital, and it also like provide services to, like, mostly the rural area here. So I got chance to meet like patient from, like, especially Native American patients. So I'm like exploring different culture here, it was pretty hard for the first few months. I mean, I'm still struggling with exploring those things, trying to learn different like new things regarding culture, like even culture food, food cultures, different, percepts, percept, percept, what is that like, the way of thinking of people here? So it's, it's pretty different here.  

So far, it's going good anywhere you go in us. It's not always the big cities or like, tall buildings. So don't expect that whenever you're like when, when you are planning to come to us. USS. It has big cities, and mostly it also has, like small towns, residential areas, lots of lakes. Some places has, like mountains, state parks, a lot. So that's all well, there you go. So I think you touched on a lot of really important topics there. Susmita, you talked about diversity and driving and culture shock and a lot of stuff that I really want to get into as we talk a little bit deeper. But thank you for sharing your experience. Lydia, can you tell us a little bit about where you live? You know what? What's there to do? What's the closest airport, closest city? Anything you could share with our viewers? 

Well, I am in New England, one of the New England state called Rhode Island. Rhode Island in the north eastern region of America. Well before I came here, I decided I wanted the smallest state in America, because I didn't want a crowded or city life. I wanted some kind of peace, and truly, that's what I go so I spoke to couple of family friends in America already, and then three out of five recommended Rhode Island. That is how come I found myself here. Rhode Island is also a historical region or state for America. I learned that was, this is where Christopher Columbus first entered America. However, where I live also has a lot of lakes water bodies around the weather here is not as bad as where my other colleague is coming from. They have the usual winter, which is cold, with snow. They have their spring, they have their falls, the summer falls and the and then I realized, for the rain, it's cut across the whole year.  

They don't have specific season for rain in where I come from. And then the hospital that I work with, the medical surgical unit or department, is very big. They have about 750 beds for medical surgical and it's also a trauma C center for Rhode Island, and is one of the best in the New England state. The closest city I have here is Massachusetts. I've only been there once just to visit a family friend, but I didn't actually go for a tour or for any recreational purposes. Back to where I live. I live in a small city called Port Harcourt. I have almost everything within proximity, terms of shopping, school, church, recreational centers, Park. My workplace is just eight to 10 minutes drive, and it's a very serene place, fresh air, nice people. So that's the little thing I'll talk about. I have to say about Rhode Island. 

Okay, thank you for sharing. Lydia. I loved that picture spanning the whole of Rhode Island. I've heard that the color changing the leaves in New England is very beautiful. Have you experienced that yet? Yes, very beautiful. Yeah, that's one of my bucket list items in life, is to get over to Rhode Island and see the leaves changing color. So if you are just joining us now, we have nurse Lydia, who is in Rhode Island, and nurse Susmita, who is in Minnesota. And if you've seen this, the map of the United States, the United States is a huge place. You get many different cultures, climates, states. I'm over in California, so me and Lydia are on complete opposite sides, and Sumita is somewhere in the middle, and it would take a long time. You couldn't drive, you would have to fly to both. And that that's just the beauty of the United States. There is so much to do, so much to see, a lot going on. So let's dig a little bit deeper, deeper. Sumita, what made you decide to go to Minnesota. 

For Minnesota, I like I said, I did not have much idea about like Minnesota, because being on like non Americans, we usually like here, California, Texas, New York, Baltimore, like those kind of places from there. So I didn't have much idea that Minnesota is also the state in us. And then after I while I was preparing for my job interview, I got to know about Minnesota. And then I searched in Google. I talked to my friend. So what I got to know about Minnesota is, like, about the Nursing Association and the pay rate here. And then one good thing about Minnesota is, like, it says, Minnesota Nice. So people here, I found people here are pretty nice. Like, they are good. Like, they people here, like, talk to us, like, in a very good way, they're pretty helpful. I have noticed that, like, I have even experienced that in my workplace, they are always like, ready to help. So that's a good thing about Minnesota.  

So I heard, I searched and I got information regarding those things. So that's why I came here in Minnesota. I didn't have, like, any pre plan, like, I just wanted to go. I wanted to come to Minnesota. But after I got my job, I started searching about this place. So, but the only hardest part for me now is the snow, the weather. Because I'm, I'm from the place I hadn't seen a snow before coming here. So it's, it's getting hard for me, but I'm getting used to it. But probably, like, after this three years, I will probably move to, like, different state. So and in my case, in Bemidji, there is not like much multicultural community, so it's hard to find our community people. We do have like we have now we have like few Nepalese people here, four nurses, they we came here like Nepalese nurse came through AMN International, and then there are two Nepalese doctor now.  

So we do have like, pretty decent amount of population right now, but since I have kid, I need like, other parents, like Nepalese parents, so that I can make like, good connection with them. So that is the only problem for now. Otherwise, it's going all good. Okay, that totally makes sense. Sounds like you were a little bit flexible when you were deciding on where to come to the US, and maybe you just decided I want to come to the US, and I'll see what positions are open for me, which I think is a pretty good way to actually get going, because, like we've said, the US is a huge place. There's lots of opportunity all over. So there's a question from travel with Nelson, who's asking about the cost of living. Susmita, can you tell us about the cost of living in Minnesota? I'm not sure if you've traveled around the US, but have you found it to be a reasonable or low cost of living? 

I don't have much idea about like overall Minnesota, since this is the small city and the cost of living, the first thing the period is good in Minnesota, like in comparison to like different other state, the housing it you can find like a one bedroom apartment from like 700 around. And it even like towns, you can get good townhouse within like 1300 around so it's the cost of housing is not like the apartment and rental, rental housing, it's not that high. Otherwise, groceries. I don't have much idea if this is expensive or if this is okay, but if you're earning like, a good amount, I think it's okay. I don't know. I didn't. I can't say if this is expensive or if this is, like, okay, but I heard that people's people saying that the cost of groceries is, like, increasing every day, so maybe it's expensive, but overall, the cost of living in Bemidji is it's normal, is affordable.  

I don't want to say normal, but it's affordable because I have heard from my friend that they are paying even the double amount of money just for two bedroom like above, 2020 503,000 something. So comparison, in comparison to those states, is pretty affordable. I'm not sure about, like, other places in Minnesota, but if you're living in a, like, small town, it should be all okay, like, it should be all affordable. But I'm not sure about the, like, big towns and cities. Well, I did a little bit of research right before I came on, and I actually saw that. I did a little cost of living analysis between Saint Paul, which is not where you live, but it is the capital of Minnesota, versus Manhattan, New York. And I found that it's 145% higher to live in Manhattan, New York housing costs are. 

Are much higher food costs, entertainment costs, health care, transportation, all much higher to live in a major metropolitan city. So I think very interesting to hear that the cost of living, as I would have expected, is much more affordable. And I'm sure being in a more rural part of Minnesota even more affordable than being in a major city. What about you, Lydia, I know you've mentioned reasons why you wanted to come to Rhode Island. You mentioned that it was a smaller state. You were looking for a little bit of a more tight knit community. Are there any other reasons that you decided to go to Rhode Island? And how is the did the cost of living play into your decision at all. 

First of all, I'll say the rates that I got also was very good. I had multiple interviews anyway, but then the road, the rate in Rhode Island was much better. However, when I got here, I realized the cost of living was high, but thankfully, the pay and the cost of living is being balanced, or is balancing for me. Not much not that bad. Sorry, my rent for now, I used to be in one bedroom apartment, which was going for like a 1615 to 1600 and then right now, I moved to a two bedroom apartment, which is now 1800 for me, which is not that crazy. Okay, thank you for sharing Lydia. I also did a cost comparison between Rhode Island and New York, because I was curious, and I found that New York was a much higher cost of living. It was 103% higher to live in New York than it is in Providence Rhode Island. So of course, a little bit more cost of more affordable to live in the Midwest, where Susmita is living but still much more affordable than maybe a major metropolitan city to live in Providence Rhode Island.  

So I thought that was very interesting. So I see we have a lot of new faces who are joining us and saying hello. So I wanted to say hi to Jino who's watching from the UK. We have Chicana who's watching from Botswana. We have Silva who's watching from Kenya. Hello to everybody destined for good joining from Ghana. We have a lot of faces who are watching from all around the world. So thank you all for joining us. Oh, you got a neighbor, Lydia, someone in New England. So thank you all for joining us today. If you have any questions for Lydia and Susmita, please feel free to put them in the chat. We will take as many questions as we can. So Sue Smitha, you've been in the US for now about a year and a half. Have you done any fun traveling, or any fun traveling in your state? What's been your favorite place that you've been to? 

Yeah, I got chance to travel to different places, like last summer, because it's hard to travel in winter. So last summer, I went to Duluth, like, multiple times. It's a beautiful place. It's like one of the tourist destination, maybe for us, like, like, from different other states, it's, it's pretty good. There is like, Lake Superior, one of the greatest lake in the world. So you can visit there if you come to Minnesota, I went to Fargo, Fargo is our like neighbor neighbors, neighbor state. Like North Dakota is our neighbor state. And then Fargo is one of the closest city from another state. So you can go to Fargo, it's like two and a half hours of driving. So I went there, and there is like, Nepalese restaurant and Nepalese grocery store in Fargo. So we don't have any Nepalese store here. So we usually go to Fargo for grocery shopping if we have to buy something specific. 

And I also went to St Louis, Missouri. My friend from Nepal sleeps there. So I went to different places there. Got chance to go to that gateway arc, which was so amazing. It was so tall and amazing, so and then I also went to Kansas. I went to Kansas State University premises. I didn't go to like other places in Kansas. My relatives sleeps there. Da studying in Kansas State University. I love that place too. So apart from that, yeah, I went to those places last summer. So that was pretty good experience. I we did a long drive to Missouri. That was our first long drive, and unfortunately, well, coming back. 

To be mid da we got into a car accident. Luckily, nothing happened to us, but we have to do like total for our car, and then we had to buy another car again. So that was funny, but oh no. Well, I guess maybe it sounds like one of those things that you can laugh about after, but I'm sure it wasn't so fun in the moment. Well, I'm glad that you're all okay. And sounds like you got to explore a lot of different places last summer. So that's pretty amazing that you had so many places accessible to you. And I loved those pictures. I love that picture right by the Arch in St Louis. I've been there as well, and it is amazing to see. Thank you for sharing. What about you, Lydia? Have you got to do any travels around your state or around the US? What's been your favorite? Not very much. But then I've been to the Newport ferry in Rhode Island which is having a beautiful ocean. 

They also have a museum for the ferry historical places over there. Unfortunately, the day we were going, there was lot of traffic. We didn't plan very well. We didn't check about that, so we couldn't spend much time over there. But at least we enjoy the summer heat at the beach. We met a lot of people. We had some food from their restaurants, seafood, which was very nice. And then secondly, we went to the US capital. And not much to say about my tourism, or maybe expeditions. I would say in United States, I'm planning more in the future. Well, you do also have a young child, so I think that is very fair as somebody who has a young child and doesn't want to leave home because it's just harder. Yeah, so that makes sense, but I'm sure you will have plenty of time to explore. And sounds very beautiful, even just where you are, I'm sure is, I'm sure is beautiful just to see the four seasons and the leaves change and all of that.  

So thank you for sharing. Lenia, so I see we have a question from faith. Faith is asking, what are the challenges the two nurses faced as new immigrants. So I know you both mentioned diversity. You're both in small places. Susmita, maybe we could start with you. How did you handle, you know, being in a small town, maybe not as much diversity and any other challenges that you faced during your process of coming to the United States? Yeah, that's a good question. Actually, like coming to us as US Aryn, it's an opportunity itself, but it always comes with lots of challenges and limitations. The first thing as soon as you come here is like a culture differences that is a barrier for us language even, even if we know English, we have studied English little bit there, the accent is different. So language barrier is there for sure. 

The other thing is, while working in a hospital, documentation, it's a different personally, I used to do, like, paper and pen documentation. Like, we just used to use our write down all our documentation, but you it's like computerized, so you have to learn whole different thing. So that's the other thing of food culture is different here. Like, for me, I'm I do have, like, I'm from Hinduism, so I don't eat beef. It's, it's from my cultural, cultural part. But then people here eat beef a lot. It's, it's so common here. So while I share this thing to my colleague, they were, like, so surprised, like, why can't you eat beef? So there is that food culture, different differences. 

So since I'm in a very small, small town here, so you we don't have, like, access to our, like, Nepalese groceries market or Asian market here, so you can find everything here. So that is one other challenges. If you are coming with your family, like if you are coming with your spouse, you have to find job for your spouse. And then if your spouse does not have, like, any technical academic background, it's hard to get the similar kind of job. If you're coming with your baby, you have to work on finding preschool or school for them, because it can like, it's good here, but it's totally different from other countries, so you have to do lots of research before starting your school. So I think those are some of. Of the major challenges, and there are still like challenges coming in on my way.  

So I'm just trying to figure out and deal with that that makes sense. So I'm sure Lydia was sitting there going like this the whole time, because I think those are challenges that a lot of international nurses and even just immigrants in general, face. It's difficult when you're coming to a new place, and especially if you're coming with your family, it's like a double edged sword. You know that you're coming with your family, so you have that built in support system, but you're also worrying about them as well. Susmita, how did AMN help you with any of those challenges? And how did you go about finding a support network when you moved here. 

While I come here, I So, before I come here, I already knew like to Nepalese friend from Nepal. So I used to talk to them. They also did their processing from AMN International and then so onboarding specialist crystal, she helped a lot with, like, preparing us for transition, like we have to do this and that, she used to give us, like, a whole list of things that we have to prepare and about housing the even like the hospital HR department, they helped us with, like the information, like how to find apartment before coming here, like there, there was like, whole information about, like, how to find school for kids, how to find job for a spa. Like, they used to give us websites like you, how you can go there and find the job and people there was Joan from North Dakota, who was my community liaison.  

I mentioned that before, so he helped us with most of the things here, even like when you come here with your kid, the first thing you need to think about is car seat. It's like very small thing, but car seat is very necessary for a smaller kid. So I talked to John, and he was so sweet. He bought, like a car seat for us and then made that ready before we come here. So that is one of the like kind gesture from his side. And after, after he landed here, we like crystal. She was in in like she was in contact with us. And I mentioned that before that she helped my husband to get up that community liaison job, which is part time. But anyway, he got, like job for AMN International, and then at our department they were so nice towards like all of us, like international nurses, they helped us with the necessary things. 

And also in my hospital, there is education center. They were pretty, like, nice. They were accepting and understanding towards like, regarding our indifferences.  

So it was, it was nice from AMN International side. They helped us a lot throughout the journey. Thank you for all of the examples. Sumita, I'm glad to hear that you felt supported. You know, I think with culture shock, sometimes it comes at different times. You know, my grandma moved to America five years ago, and I think she's experiencing culture shock right now. It's, it's like this goes up and down and up and down. So it can be very difficult when you move to a new place, and can I add something? So you said, like, cultural sub can come anytime. So it's been, like one and a half year, and my son started going preschool, like last year, so and so in preschool, they used to, like, do different activities, like, sometimes they do Christmas activities and Valentines. And I'm like, What should I do now? 

Well, you're learning all the new things. And then once my son told me, like, can you teach me Christmas song dance? And I'm like, I don't know. He's so cute. Well, I'm sure he's loving the snow. He is loving the snow. He says, like, I told him that winter is going away now I think Summer is coming back. And he said, like, I don't like hot, I like cold. Oh, that's so sweet. Well, there you go. You've got a fan of a white Christmas over there. So you never know how your family is going to react to moving, and how everybody's going to feel and how it's going to change. Because, as I think we all know, you go through waves Lydia, I want to, I know we're almost at time, and I want to give you an opportunity also to just share. If there's been any specific challenges that you've faced since moving to the US and how you've kind of overcome them. 

Actually, at the beginning, I didn't experience any shock, you know, before you come, they give you the auto loans for you to make your choices informed decision about that. So I had my plans when I go here. Within the first week, I got my car, my apartment was superb, so very comfortable. The laser officer was helping us around town. My first two weeks was in the classroom orientation, which was good. The teachers were good. And then when I got to the ward or the flaw, that is where the shock started. You know, one the ascent alone were putting some workers of, I don't know, their reactions were so bad, and I felt so intimidated, because it was like they were doubting our integrity or credibility in terms of the work, because if you are not able to express yourself or when you talk, and they don't really get you, it's an issue.  

So the only motivation I had that time was my nursing managers, because for them, when I talk, they don't do like, can you repeat yourself? What did you say? They don't do that. And then secondly, my clinical manager from Amn, that is Kelly Elwood, anytime we go for an assessment. And then I mentioned to them that, oh, okay, so these are my areas of weakness. She usually sent me materials, videos or links for me to make a revision of that, to just help me with the adjustment. And so one other thing was the floating system. I have no idea what it is. Today you go to work, they say you're going to this floor. You're going to this floor. And, my goodness, the shock keeps coming and coming and coming until they started following us. You know, coming to visit us, calling, checking on us. And then 

I also got to know American system is not like, back home, we're being spoon fed or like, oh, okay, this is how we do it over here it is do with yourself. You need to learn at a very fast space. You need speed to catch up with the policies, the protocols, the standard for you to get adjusted or used to the system. Otherwise, everyday you wake up with the post traumatic syndrome before you go to work, it's not easy, and I love my patients. No, none of my patient ever complain about my accent. So grateful about that. The patients are so, so respectful. So that is one area of my fulfillment when I go to work well. Thank you for sharing that, Lydia, I think you touched on a lot of stuff that can be difficult for international nurses when they're coming to the US. And also some good advice on how to, you know, keep up, how to keep pace, how to better yourself. Also some good ideas for nurses who might be watching at home right now and thinking, I want to come to the US, but it's going to be a long road. You had some good advice on what they could be doing right now, working on how they're speaking and getting more prepared with the US clinical practices, like you said, it's very different.  

So I think those are all really, really good pieces of advice. So, yeah, go ahead, yeah. In terms of the culture, like, cultural diversity here, I didn't have much problem, because I realized they have a lot of multicultural flavors in terms of, in terms of the shades of complexion. You have da black, black to white. I have no issue with that. I was familiar with almost all the food or cuisines they sell at the restaurant. And then I'm able to get every kind of African food in Rhode Island. So I don't think I'm able to, I'm going to move out of Rhode Island. 

That's one of the things that everything here that's amazing. That's so wonderful to hear very lucky. In my place, we don't have like Nepalese restaurant or even Indian restaurant. We have to go to Fargo or Minneapolis for that, so you're lucky. Yeah, I love to cook. So anytime I go to work and it's like they want to comment about the food, I'll say, How did you get this that I have time? I get time to shop for food? Well, I guess every place that you go. So there's the good parts and the parts that you have to adjust to, right? So I want to make sure that we're ending on a positive note. And I know we got lots of viewers. I see people joining us still. Ellen from New York, from New Ireland, Northern Ireland, oh my gosh, praises from Nigeria. And praises is actually asking a good question. Do you guys offer H, 1b, visas, praises? I'm going to get back to you in about one minute.  

I just want to give Lydia and Susmita one final minute to share some words of encouragement for nurses who might be watching around the world. What's one final piece of advice that you want to leave our nurses who are watching with Susmita we'll start with you. I mean, there are so many things. Even if you're processing for NCLEX or NCLEX journey, you will be experience. You will experience those things. The good thing about coming here, like regarding work, you will get enough orientation. You will get you to have enough resources to be reached out. There are lots of like resources you can refer to, you to have educator here, you will get enough trainings that you need, that you need while you are working, you do? We do have associations like Nursing Association, so if you have any issue, you can voice your concern.  

And then I think USA is like land of opportunities. That's true. You just need to learn skills and upgrade yourself. You will get good opportunities here, work, life, balances, I think it's better than what I did have before. So there are lots of good thing here. So if you are planning, if you are thinking about coming to us, you can proceed for that. Amn International is always there for you. It's always like it will help you with every steps in this and click journey. If you have any questions or concerns, you can always contact AMN International so if you have dream, we did it so you will also do that. If you really want to come here. It's difficult, but it's possible. So that's all I want to say. 

Thank you for that. Susmita, you know you reminded me of a quote from one of my favorite movies from Tom Hanks. I think we have a graphic with the quotes. Otherwise, I'm probably going to butcher it so we're going to pull it up. It says, if it wasn't hard, everyone would do it. It's the hard that makes it great. I think that moment that you touch down on the US soil and you realize, Wow, I did it, that's a pretty amazing moment. I was eight when I came and I will never forget that moment. So I think you hit the nail on the head. It's something that's so worth the journey. Um, not always easy, but it's worth, worth the hard. And then, before I go, I just want to add another thing. So as I said, it's land of opportunity. If you come to any of the state, any of the hospital, and if you think it's not working good, you do have other opportunities to you can move to different state.  

If nothing worked, you do have, like, work. You do have green card here. If you don't want to leave, you can always go back to your country. It's like a complete legal process. Everything is good. So you do have lots of opportunities. So you don't have to, like, make yourself feel down. You can. You can just try for other opportunities here. If you come here, you don't have to worry about just a single thing. So that makes sense. Thank you for sharing Susmita and Lydia over to you. What's one final piece of advice you have for global nurses who are watching us? I strongly side with both of you. However, I would like to start with the spirit of America. One thing I noticed is America trusting God, they have strong policies. You need to be hard working to enjoy. 

Moreover, recently, I came across this data that says nursing profession has been the highest or most trusted profession in America for 23 consecutive years. That tells you America or AMN or USRNs, the system, is not anywhere near to compromise with their professional ethics. So my fellow prospective us areas, don't forget about the Code of Ethics your nursing process, and then you need to be open minded for any professor. National Development. And then, above all, I'll say, thank you AMN thank you OGP, for making my dream come true. 

Thank you Lydia, that warms my heart. Thank you for sharing that I really love seeing the pictures of both of your children. I think they are so cute and so beautiful, and it really is just a testament to, you know, this American dream and what you have both been working for, what my parents worked for to give our children more opportunity, a better life, and, you know, a safe place to grow up. So thank you both so much for taking the time today to be with us and to answer some questions. You were both very inspiring, and we loved hearing about your journey. So thank you both so much for being on today. 

If you are joining us and you are curious about opportunities to come to the United States with AMN Healthcare, we're going to drop the link in the chat where you can apply amnhealthcare.co/international. And if you are looking for an opportunity that might be a faster opportunity and a unique opportunity, I saw we had a question from praises about the h1b visa. We are doing a big hiring event for h1B's for RNs, for direct hire only for an employer in Tennessee. The specialties needed are  Critical Care and Medsurg, the requirements you need to have a BSN, you need to have an NCLEX pass, English pass. PTE is not accepted, and a minimum of two years of current experience. Important to note you must not be committed to another employer and you must not have filed for an EB three. This is an amazing, very unique opportunity. H1B's are not available widely across the United States, but this is a unique opportunity that our employer, Methodist Le Bonheur in Tennessee, has. And if you're interested in learning more about Methodist, you can check out our show from yesterday. We'll drop the link in the chat, and you can learn all about Methodists.  

They are very, very impressive. It's an amazing opportunity for a nurse who meets all of those requirements. So once again, we're going to drop the link in the chat. It's amnhealthcare.com/international. Apply today our recruiters are on hand, ready and waiting, and we would love to help you take advantage of this amazing opportunity. So let's bring up our schedule for our future shows. In upcoming weeks, our shows are seven to eight Pacific Standard Time. On March 14, we have an immigration Q&A with legal experts. So bring your questions. It's free advice. March 18, we have our la fora talk show. And March 28 we're going to be talking to some DAISY Award winners who are extraordinary nurses. We're going to hear all about their journeys and why they were awarded Daisy awards. So thank you all for being here with us. Today we are going to play a short clip of some of our new arrivals. Hopefully you've been inspired by our show, and we hope to help you reach your American new dream as well. Onwards and Upwards everybody.