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NURSES WHO TRAINED in the US and have years of professional experience are being denied access to work in Irish hospitals – despite a huge staffing shortage.
According to HSE annual report figures for 2016, nursing staffing levels have fallen by more than 3,000 since 2007 and the HSE has committed to increasing the nursing and midwifery workforce to deliver 1,208 additional permanent posts this year.
However, TheJournal.ie has heard from a number of nurses trained in the US who described being refused registration to work here because they were told they didn’t have the correct amount of clinical and theory hours from their studies – even though they have been working as professionals for years.
There are 65,000 nurses in Ireland: 51,000 are Irish, 4,600 are from India and 4,265 are from the Philippines, but only 270 are from the United States.
Rebecca Love, a professor at the School of Nursing Northeastern University and founder of American nurse recruitment website HireNurses.com, says she has been in touch with more than 5,000 American nurses who have shown an interest in working in Ireland since last year.
She says of those nurses actively seeking employment, many qualified in the US so are unable to register for work here despite Irish hospitals wanting to employ them.
TheJournal.ie has heard from more than a dozen nurses who say that the difference in their clinical and theory hours from their degree is the reason they have been refused or told to take an adaptation course. They also said that they were not told this information until after they applied – at a cost of €425 – even though it is a well-known issue.
Love said she has spent hours researching, calculating and reviewing the transcripts and documents of American nurses and she claims that nurses with a BSN (bachelor of science in nursing) from the US do have the correct theory and clinical hours needed.
I believe that there has been a severe misunderstanding and miscalculation of American credit hours to clock hours that may have wrongly denied American nurses access to a nursing license in Ireland.
Adaptation courses
The Nursing and Midwifery Board of Ireland (NMBI) is responsible for evaluating overseas applications from nurses and midwives who want to work in Ireland.
Some applicants will receive a flat refusal from the NNBI but others will be encouraged to take adaptation courses to ‘make up hours’.
The board told this website that “when overseas applicants do not have the required hours for registration, applications are refused or, if they fall slightly below, they may be offered adaptation/aptitude tests to support an application for registration”.
The only aptitude test available in Ireland is run by the Royal College of Surgeons at a cost of €2,800 per test.
According to NMBI standards, a minimum of 1,533 theoretical hours and 2,300 clinical hours are required for registration.
The NMBI provide nurses who have been told to do the adaptation course or aptitude test a list of NMBI-approved hospitals that can provide them, but they don’t give contact information or even tell nurses which hospitals are currently carrying out the courses.
The nurses we spoke to said they were unable to find any hospitals that were carrying out these adaptation courses.
The NMBI says it has no role in organising placements and it’s up to individual hospitals to run them at their discretion.
This website contacted the HSE to ask how many of its 21 hospitals – that are on the list the NMBI provides to nurses – are actually carrying out these courses. It said:
The HSE does not centrally monitor programmes provided by hospitals for their own new recruits.
The only other option for these nurses is a two-day aptitude test with the Royal College of Surgeons which costs €2,800. The expensive aptitude test only goes ahead if the college has at least 20 applications and US nurses who want to move here can’t pre-book a test.
The NMBI also imposes a deadline for overseas nurses told to find an adaptation course or pay for an aptitude test. It says:
“A decision letter recommending adaptation/aptitude test is valid for 12 months after the date of decision. If the process has not been completed and NMBI has not had any contact from the applicant for six months, the file is closed.”
George Russell, a director at Irish healthcare recruiting firm Epic World jobs, is currently dealing with a number of US nurses who are trying to get registered to work in Ireland.
Speaking to TheJournal.ie, he said:
Currently I’m working with more than 300 nurses and can get any amount of American nurses if the obstacles at NMBI were out of the way.
Ireland is very high on their radar and with over three million nurses registered in the US, Ireland’s nursing crisis would be eclipsed by the amount of American nurses that have a desire to work here.
“I think adaptation is a much better idea than taking the RCSI aptitude test. Many foreign nurses wanting to come here are unable to afford the test. It’s a deterrent.
I think the HSE should have its own centralised adaptation programme – it would make the process for candidates more fluid.
“Nurses are going to have to do orientation wherever they are hired and learn how things are done. I think that adaptation would help teach them how things are done here before they even start their new jobs. It would probably give them a leg up on adapting to their units.”
Where are the courses?
When asked which hospitals currently have available placements, a spokesperson for the NMBI said:
It is at the discretion of the approved health care facilities as to how they manage adaptation placements and queries regarding the numbers currently on placement in each facility should be directed to those institutions. NMBI has no role in organising placements.
However, as was already stated, the HSE does not monitor the programmes being provided by the hospitals.
TheJournal.ie directly contacted 21 HSE hospitals which the NMBI lists and asked if they were currently carrying out adaptation courses. Of the 21 only two replied; the Department of Psychiatry in Drogheda and Tallaght Hospital.
A spokesperson for Tallaght Hospital pointed us to information supplied on its website which states: “You apply to a nursing home for a position as a registered nurse, informing them you have a decision letter from NMBI and need to be assessed for registration. If you are successful in gaining a contract with the nursing home, they then sponsor you to undertake adaptation and assessment.”
The spokesperson for Drogheda Department of Psychiatry said adaptation placements are facilitated “pending the availability of clinical placements and nurse practice development coordinator as the under graduate nursing programme is also facilitated”.
Speaking about her experience of the process, a nurse who trained and worked in the US for nine years but has recently moved back to Ireland told TheJournal.ie:
None of the hospitals actually offer the adaptation course though they are approved to run them. From what I have found out, the Dublin hospitals will run them for people they have recruited in but I (and other nurses I have talked to) have yet to find other hospitals running them.
“The only adaptation classes I have heard of are either through agencies or if you have contracted to a private nursing home. Both of these scenarios mean you contract to either the agency or nursing home for two years.
Every hospital I called, including the hospital who wanted to hire me, said they cannot do the adaptation.
The HSE told TheJournal.ie that, “Most sites provide the period of adaptation and assessment to candidates whom they have offered employment (subject to successful completion and registration).
The HSE also provides the adaptation and assessment programmes for candidates who have been offered employment within the private nursing home sector.
The HSE said that 25 candidates who were offered employment within the private nursing home sector undertook adaptation and assessment in four programmes last year.
So far this year 10 candidates who were offered employment within the private nursing home sector undertook adaptation in two programmes.
‘Lack of help’
The Department of Health also encourages these adaptation courses to nurses with years of professional experience but who are lacking in college hours.
Mary Taaffe left Ireland for the US in 1989 and has been working as a nurse with a BA Degree in nursing since 2000. She has been employed in a hospital ICU and ER since 2012. She applied to the NMBI in January 2016 but was denied because it said she didn’t have the correct theory and clinical hours.
Taffe said she spent €425 ($479) for her first application. She was then told time had run out after a year and then paid another €355 ($400) and a further €133 ($150) to appeal. She said:
Nurses from the US are sending money to an organisation that has no intention of registering them, and this has been going on for years.
After complaining to Minister for Health Simon Harris’s office, a department spokesperson sent a letter to Taaffe describing the benefits of adaptation courses.
It may be of interest to you to note that of the 283 US-trained nurses and the 152 nurses who trained in Australia and who are now registered with the NMBI, the vast majority had to undertake and successfully complete either an adaptation course or an aptitude test as a pre-requisite to registration.
TheJournal.ie contacted the Department of Health asking if it was aware that many nurses cannot find hospitals that are carrying out the adaptation courses and if there are any plans to improve the registration services for overseas nurses trying to get registered to work here.
In a statement it said: “Resourcing and recruitment issues in the clinical environment are outside the NMBI’s statutory remit and NMBI has no regulatory role in organising adaptation placements.”
Many nurses who trained in the US aren’t even offered the adaptation programme as their clinical and theory hours are deemed to be too low.
One American woman who worked as a nurse for seven years told TheJournal.ie that she was told by the NMBI to complete another nursing degree here in Ireland.
She added that her emails were nearly always returned by an out of office, saying that the individual she was mailing was on leave. She described the lack of help and guidance from the NMBI as “just unbelievable”.
This is an issue that was described to TheJournal.ie previously, with another nurse saying: “The delay in response from NMBI each time I submitted additional documents or communications was extensive — many weeks to months each time.”
When asked about this, a spokesperson for the Department of Health said: “If an applicant who has experienced an unanswered call or email provides details to the NMBI the matter will be investigated.”
Another nurse who trained in the US, has a Masters Degree in Nursing and 30 years experience in critical care and primarily cardiothoracic ICU told this website that she has been “led on a merry dance with NMBI since 2014″.
Nobody believes me when I tell them I cannot get registration as they are so many ‘foreign-trained’ nurses in our local hospitals.
Of the 247 US applications received since 2013, less than 10% (24) were registered and 77 were refused.
Just nine US nurses were registered last year, despite the NMBI dealing with 101 applications from the US. The NMBI also noted that some of the registrations may be from applications from the previous year.
TheJournal.ie asked the NMBI what the number one reason for US applications being refused registration is, but none was given.
This comes at a time when the HSE says it’s implementing a “a broad range of retention measures” to get nurses to stay in Ireland and hospitals are spending thousands on overseas recruitment drives.
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Time to protest like the Irish Water scandal. We have to let our voices be heard.
@Seeking Truth: totally agree…
He’s worried about our third world health care system, would be more accurate.
@Darren Lambe: its only 3rd world because of the vested interests, as we are paying over and above what 1st world countries are putting into it..
Why are they so afraid to go against NPHET advice to implement widespread antigen testing, along with vaccines and PCR? It’s not understandable, Is Holohan more educated than other countries CMOs?
@David Lee: No.
@Franny Ando: correct, however he is more educated than our government
@Kim Steen Hansen: Well I wouldn’t go that far. Neither realised AZ & Janssen vaccinez were included in the equations!!
@Franny Ando: vaccines
@Kim Steen Hansen: Well I wouldn’t go that far. Neither realised AZ and Janssen vaccines weren’t included in the modelling.
@David Lee: no. They went against at Christmas and it was catastrophic with numbers and admissions rates to hospitals and ICUs being full.
@Brendan Harlowe: Incorrect.
@Brendan Harlowe: I will go to my grave believing that NPHET throwing us into level 5 for October & November caused the December increase.
Did you know that December’s wave started while we were still in level 5 in November?
@Brendan Harlowe: That’s because of the unnecessary lockdown in October and November. People just went bananas at Christmas.
@David Lee: 100%
I’m surprised it took this long for someone to say they have “no confidence” in Martin and Donnelly add Tony to the mix and you have the magic number. They all need to be put out to pasture.
Anyone ask him why he said that new the advice on vaccinations from NIAC was included in NPHET modelling on the Delta variant, when Tony revealed under opposition questioning today that it was not.
Serious questions need to be asked as to how the Gov was supposedly ‘blindsided’ by NPHET, coupled with the fact that Donnelly works in same building and on the same floor.
Is there actually any real-time communications between NPHET, Tony & the Gov, or is is all through official letters ?
A major contradiction has emerged between the Government and its public health officials over the basis upon which the delayed indoor dining was introduced.
The Chief Medical Officer Dr Tony Holohan told opposition TDs this afternoon that the new advice on vaccinations, from the National Immunisation Advisory Committee (Niac) was not included in the National Public Health Emergency Team’s (Nphet) modelling on the Delta variant.
However, at Cabinet on Tuesday, ministers were clearly told that the modelling did take account of the new vaccine schedule as outlined by Niac.
@Da Dell: The utter incompetence of Martin, Donnely and NPHET is mindblowing. Serious questions need to be asked immediately about this modelling. There needs to be a second independent opinion preferably from a group that actually understands the science.
@Franny Ando: also, I think what is the loudest, is the complete lack of the NPHET, Tony/government fanclub on here trying to defend the utter shambles this has been.
@Alan Wright: Seriously how could anyone with a modicum of intelligence try to defend it. As you say an utter shambles.
@Franny Ando: I know, but I’m sure we’ll hear from: Ally, Munster, Grumpy etc. at some stage.
@Alan Wright: seem to be a Mary and an Elaine now too …
They went quite earlier when the bombshell was dropped that Tony did not include the new NIAC advice in the modeling ..
Every time Fianna Fail are in power. Someone else ends up calling the shots. Plastic party
It’s like the scene in Titanic where the Captain has just ordered full power when his crew are not so sure. There will be an iceberg moment very soon. #disbandNphet
Well he might be on the defensive. His utter incompetence is embarrassing. He has to be the most ineffectual leader this country and F.F have ever had. Time for the party to make some serious decisions before the party is completely decimated as well as the country.
@Franny Ando: This is a fact. The FF party need to make a decision quickly and deal with the leadership question or they will be decimated at the next election. Jim O Callaghan or Michael McGrath need to step up to the mark to save this party.
@Curragh Critic: They will be decimated at the next election anyway. Sure there only in government by the skin of their teeth anyway. And that was before this covid scenario.
@Curragh Critic: 100% agree.
@Franny Ando: And why would it be a problem if the disastrous Fianna Fáil party were decimated and hopefully consigned to history ?
@Curragh Critic: this party are not worthy of saving.
@Eddie Feeney: I didn’t say it was a problem. I just stated what, in my opinion, will happen if Micheal Martin is allowed to continue. Feel free to give me your opinion on the matter.
@Franny Ando: Give him as much rope as possible, he’ll bring the house of cards down with him, which would be nice.
But they’ll all toddle back into the Dáil and pass a bill that makes these measures the law..
@Daryl Walsh: they won’t have the support to get it through, that much is clear
@Daryl Walsh: Not to sure about that now. The backlash against this decision is growing. Not only among the general public but within F.F, F.G .
@Daryl Walsh: That would be political suicide.
As the photo above suggests I’ll be glad to see the back of him again very soon.
The thing is that FF TD’s know that their seats are in big trouble if they head down this path…… MM is in big trouble. If he doesn’t listen to them their will be a shove to get rid of him as leader…. FF are gonna get hammered in the next election
Tony Holohan needs to be fired immediately.
He has massively overstepped his boundaries and is no longer fit for purpose as CMO.
How can he claim no incompetence when it’s 17 months into the pandemic and they are just starting to plan a vaccine cert now. There are going to be many more variants like with any virus so kicking the inevitable down the line isn’t helping. We have to open up and live with the virus and it’s many inevitable mutations unfortunately.
@David Kelly: Plus Delta has been around for quite a while and they have no plans at all to deal with it for various scenarios, there was no plans for reopening really either, just kite-flying and grand announcements. Over a year as you say and not a proper track & trace system in place either. I’m sure the systems required for certs of whatever kind will be implemented post haste, once the meeting to plan the meeting for the meetings to plan how to do it are all over.
It has always been their aspiration to have a National ID card. This is their ticket to realise that dream.
Open the pubs and restaurants etc for every body.
Just ban over 65s for a few weeks until we reach the tipping point of vaccinations + herd immunity decreasing trend.
Most vulnerable >65 protected – no serious illness, no deaths, everybody happy.
People can live again and get back to work .
Virtually all over 65′s would accept this. Do it.
@Neuville-Kepler62F: Feck off I’m fully vaccinated:)
@Neuville-Kepler62F: since when did you speak for virtually all over 65’s?
@Neuville-Kepler62F: All they have to do is to advise people not fully vaccinated to drink or dine outside. Most people will comply.
@Tony Curtin: 70 FOR to your 29 AGAINST !
@Franny Ando: Me Feiner. Always one.
@Neuville-Kepler62F: Oh for crying out loud ever hear of humour!!!!
@Neuville-Kepler62F: Virtually all over 65′s would accept this?. That assumption is just what Martin and Varadkar would come up with. That’s why they are inept.
@Franny Ando: Apollo …!
Next up we follow uk again and drop requisite to have covid vaccine proof.wait for next kite flying with nphet warning that irish people should not be allowed go on sun holidays this summer yet visitors from Eu are welcomed with open arms.
@Martin Smith: Its an E.U directive thats why they announced yesterday travel would commence July 19th.
Usual dropped from the team unhappy gringes, both sides, cowan “novice” driver, o dea master of “gun picture that went wrong for him” & ring ( god help us in the west) all ex cabinet members..when thrown off the gravy train..tune has changed..knives are out..greater good my a ..e
@Matdrum Murdtam: Ah now say what you like about Willie but the man is a legend
In 2020, we had indoor dining and drinking when no vaccination process existed.
In 2021, with 4 million vaccine doses delivered, we cannot open pubs and restaurants and Nphet saying they are opposed to it in any form until end of Sept unless people can say they are vaccinated with an experimental jab?
This Delta variant is so deadly, Delhi virtually wiped it out with Ivermectin with cases falling by 95% in a matter of weeks but its an unsafe drug despite been around for decades? It all makes perfect sense.
Your time is up Holohan. End this nonsense!
So based on NPHET’s worst case scenario, we will have 682,000 cases and 2,170 deaths over the next 3 months if we open up hospitality. That 2.5 times more cases and roughly 40% of the total numbers of deaths we have had in the previous 16 months (including last winter where no one was vaccinated and which, according to the way people describe it, almost wiped us all out ).
Evidence seems to indicate that the Delta is more transmissable but does not increase hospitalisation.
We have administered over 4 million vaccines.
Surely we are entering Walter Mitty country now?
@Verners Tess: I think they should be sending a major warning to the uk and the rest of the EU about this modelling and warning them about reopening hospitality………….oh wait
McSherry’s rant as usual. He loves listening to himself as usual. What does he not understand about straight facts of reality. He should cop on and get a grip of himself about the real dangers of Covid and it’s danger to our society.
@Irish big fellow: Yes Tony
@Irish big fellow: Hi boss seemed to have the same lack of facts, when he said that new the advice on vaccinations from NIAC was included in NPHET modelling on the Delta variant, when Tony revealed under opposition questioning today that it was not.
@Irish big fellow: the only danger is FF/FG
@Irish big fellow: And maybe NPHET should actually do the same. Get an expert who knows what they are doing. Who actually knows how to input all the information into their modelling.
A backlash probably followed by them all going back on the lash afterwards…
So much incompetence – the Taoiseach the CMO and the health minister couldn’t seemingly bring themselves to meet a week ago and trash out how and what was going to be communicated about reopening indoor dining – WHY ? – why can they not do their job ? How come we had indoor dining last summer ? How come the NPHETS of every other EU country and governments are able to reopen local hospitality economy but Ireland is not ? How on earth are we suppose to believe the clearly exaggerated death figures when there isn’t a country in the world that is seeing death rates creep back up after vaccinations – the anger from the people needs to stay directed with you local representatives to start insisting that we stop managing the country like it is Craggy Island in the 1970s and start behaving like we are a modern progressive society in the EU – the omnishambles of yesterday is just not good enough and shouldn’t be acceptable to the people – we pay for these people to manage our country
@Verners Tess: The writing was on the wall for pubs when he took 1000 delegates into this country at the end of March last year. All from countries who were already impacted by covid for a similar conference on alcohol. While we were told we couldn’t travel more than 2 km. Its time Government realise his anti alcohol bias is seriously impinging his decisions. Its time for him to be removed and someone more experienced to replace him. It’s the only way NPHET’S decisions can be taken seriously.
Pure spineless these professional politicians who would discriminate against the youth of this country.
We live in a Republic allegedly!
What a cluster f
So, that’s another multi million pound court case they’ll be losing then
60% vaccinated once; 40% fully… get it open – number even proven wrong (or out of date already if ur being kind) tonight… incompetency all over
By the next election FG will hold the top seat. FF will appear the junior partner. Who would ever have thought the gentlemen farmers of FG would outwit and outplay what was once THE party of government.
@John Kelly: F.G are not exactly covering themselves in glory. They are no better supporting this debacle. It will be interesting to see if they have the gumption over the next few days to change their stance especially in light of the modelling errors. If they don’t the writing will be on the wall for them as well. Then the proverbial will hit the fan!!
Keep the restaurants closed or thousands will die! Or not. Anyway, what day is it today?
Martin should resign, his communication skills are deplorable, he is not a leader
Tell you this much if they put up donkeys as candidates they will get elected before the FF candidates. Martin is driving his party into the ground.
Could everyone in the media especially those paid to unite and guide us in times of trouble eg government ministers please stop lashing out at Nphet and the Taoiseach and in giving so many different opinions on basically how to stop a pandemic with no qualification to do so . Just opinions or populism . Let Nphet do the job they are doing well and controlling a virus is bread and butter to them but a pandemic is as much about controlling people’s behaviour which is the reason it is proving so difficult . So please just stop, listen open windows snd door , sit out in the sun and play ball . I’m so tired of this stream of self proposed experts on infection transmission . Awful fir hospitality but this decision is to save countless lives but so many don’t get altruistic behaviour .
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