Seven (7) New International Testing Sites For NCLEX-RN®

The Philippines is again bypassed by the NCSBN Board of Directors as an international testing site for the NCLEX-RN®. New international testing sites for the NCLEX-RN® inlcude: Australia, India, Japan, Mexico, Canada, Germany and Taiwan.

All seven (7) additional sites were chosen based on the same rigorous criteria that the three current sites (Hong Kong, Seoul, and London) were evaluated on. The evaluation included security and geographic representation outside of the current member board of nursing locations.

The Philippines via the Commission on Filipinos Overseas has been lobbying with the US National Council of State Boards of Nursing (NCSBN) to include the Philippines as a venue for the international licensure examinations for nurses who wish to work in US hospitals.

Currently, filipino nurses have no choice but to fly to Hong Kong, Seoul, and London to take the NCLEX-RN® exam.

The National Council of State Boards of Nursing (NCSBN), www.ncsbn.org, will expand the number of sites that offer the NCLEX® examinations abroad for domestic nurse licensure purposes. NCSBN’s Board of Directors affirmed the decision at its December 2005 meeting upon recommendations from the NCSBN Examination Committee.

The current international sites for NCLEX® examinations in London, England; Seoul, South Korea; and Hong Kong have been operational since January 2005. It is planned that the new sites will begin to offer the exam sometime in the next year. The new testing sites will be located in Australia, India, Japan, Mexico, Canada, Germany and Taiwan.

Source: NCSBN Jan 24, 2006 Press Release

Specific test center locations in the seven (7) new test sites have been announced by the NCSBN in their February 9, 2006 press release.

The National Council of State Boards of Nursing (NCSBN), www.ncsbn.org, will begin NCLEX® testing at the newly selected international Pearson Professional Centers on April 1, 2006. Appointments for testing on, or after April 1, will begin on February 15, 2006.

The new centers will be located in Sydney, Australia; Toronto, Montreal, and Vancouver, Canada; Frankfurt, Germany; Mumbai, New Delhi, Hyderabad, Bangalore, and Chennai, India; Mexico City, Mexico; and Taipei, Taiwan. Appointment availability for Pearson Professional Centers in Chiyoda-ku, and Yokohama, Japan will be announced at a later date. These new sites are in addition to centers in London, England; Seoul, South Korea; and Hong Kong, which have been operational since January 2005.

Source: NCSBN February 9, 2006 Press Release

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Understanding the NCLEX-RN® Test Plan

The NCLEX-RN® examination is a variable length Computer Adaptive Test (CAT). It can be a short as 75 questions and as long as 265 questions. Of these items, 15 items are not scored and is part of a pretest. The maximum alloted time is six (6) hours including optional break periods.

The scope and content of the NCLEX-RN® examination is described in the NCLEX-RN® Test Plan. The practice of nursing requires knowledge of client health needs and a thorough understanding of integrated process fundamental to the practice of nursing. Client Needs is the framework used in the development of NCLEX-RN® examination questions.

The health care needs of clients in a variety of settings across the life span are grouped in four (4) Categories. These are:

• Safe, Effective Care Environment
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity
  

The percentage of items taken from each category is broken down in the table below.

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Environment Health
Environment-Health
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Maintenance Psychosocial
Maintenance-Psychosocial
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Integrity Physiological
Integrity-Physiological
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US Nursing Exams: CGFNS vs NCLEX-RN®

Now that some states have removed the requirement of taking the CGFNS qualifying exam prior to being allowed to sit for the NCLEX-RN®, it has become easier and faster for foreign-educated nurses to get a VisaScreen™ and eventually migrate to the US to work as Registered Nurses.

What is a VisaScreen™?

U.S. Immigration law now requires that healthcare professionals, other than physicians, complete a screening program in order to qualify for certain occupational visas. VisaScreen™, a program offered by The International Commission on Healthcare Professions (ICHP), a division of CGFNS, enables healthcare professionals to meet this requirement by verifying and evaluating their credentials to ensure that they meet the government’s minimum eligibility standards. CGFNS is named in Federal law as a qualified provider of such a screening program.

If I am a registered nurse, do I need to complete the CGFNS Qualifying Exam and the NCLEX-RN® examination in order to complete my VisaScreen™ application?

No. You only need to successfully complete either one of the exams.

Source: CGFNS VisaScreen™ FAQ

A noted US immigration lawyer also pointed out that employers now prefer NCLEX-RN® passers over CGFNS passers.

As a practical matter, the NCLEX exam is the far more desirable of the two exams to take. The NCLEX exam is usually the final step in the licensing process. Healthcare employers prefer to petition those RNs who are already licensed in the state where they will be working so that they can be put to work immediately. With an unlicensed RN, employers run the risk that the RN may not pass the NCLEX exam and the employer is stuck with an employee that they cannot use in the RN capacity.

Source: Manila Bulletin Article by Robert Reeves

It musted be noted, however, that while several states have decided to forego with the CGFNS qualifying exam, some non-CGFNS states like Illinois and New York still require a Credentials Evaluation Service (CES) report and Credentials Verification Service (CVS) respectively which are issued by the CGFNS.

The CGFNS Credentials Evaluation Service (CES) is a report prepared by CGFNS for a Board of Registration/Licensure, university, immigration office, employer, etc. This report analyzes the education and licensure earned outside of the United States in terms of how it compares with U.S. standards and expectations. There is no examination included in this program; once all required documentation, fees and a completed application are received, a report will be prepared and submitted to the recipient (i.e., Board of Nursing [if applying for U.S. licensure], U.S. college/university [if applying for academic admission], an employer, etc.) as well as a copy to the applicant.

Source: CGFNS CES Fact Sheet

CGFNS created the Credentials Verification Service (CVS) for New York State to independently verify credentials of foreign-educated healthcare professionals who are seeking licensure in New York State.

Source: CGFNS CVS Page

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Tips on Preparing for the NCLEX-RN® Exam

Taking the NCLEX-RN® exam is no walk in the park. The mere financial cost of applying for it is enough reason to cringe at the idea of failing it. Moreover, it's the ultimate test for the US-bound nurse.

The stories of both successful and unsuccessful examinees on how difficult the NCLEX-RN® exam is, give us a sense of foreboding and ultimately lead us to doubting our capabilities. What little confidence we have left is easily shattered by sob stories of friends and acquaintances who were less than lucky with the exam. Ironically, luck is not actually a factor in passing the NCLEX-RN® exam.

Successful examinees point out that the key to conquering the NCLEX-RN® is preparation, preparation, and more preparation. So, how does one prepare for the NCLEX-RN® exam?

Listed are some of the practical preparation tips culled from reputable review guides for the NCLEX-RN® exam.

• Know the Test Plan. Be familiar about the exam content, topics, question format, and most importantly, the manner of how the exam is administered.
• Identify Strengths and Weaknesses. Make an honest assessment of your knowledge in nursing content by taking as many diagnostic exams as possible. Identify strengths and weaknesses in test-taking strategies as well.
• Decide on the Need to Take Review Classes. In enrolling for a review program, find out if the course includes test-taking techniques and strategies as well as opportunities for practice tests on application-level questions.
• Prepare Physically, Emotionally, and Mentally. Maintain a nutritionally-balanced diet, get enough rest and sleep, and engage in a moderate but stimulating exercise. Confidence can also be boosted by a constant visualization of passing the NCLEX-RN® exam.
• Establish a Study Plan. Having a study schedule is a must. Maintaining a calendar or a planner is a good way of keeping track of your progress and with how much time is left before the scheduled exam. Study schedules must be realistic and goals set must be those that can be met.
• Find a Suitable Study Space. The study area must be conducive for learning, meaning, it is located in a quiet space away from the bed, radio, telephone, and television. It must also be well-lit and well-ventilated with a chair that encourages good posture.
• Concentrate. The key to maintaining concentration is to approach studying with commitment and to study continuously without interruptions but with periodic short breaks. It is best to study difficult topics when one is most alert.
• Maximize Study Time. Studying can be maximized by having a to-do list. For example, 2-3 months before the NCLEX-RN® exam, begin studying notes and review materials, answer as many practice exams as possible to diagnose strong and weak areas. 4-6 weeks prior to the exam date, focus on the identified areas of weakness. A week into the exam, answer as many computer adaptive test-type practice questions to evaluate progress.
• Jazz Up. Having a study partner and joining a study group are excellent ways to energize studying as solitary studying can be grueling in the long haul. Using audio-visual review materials are good tools for supplementing the review.
• Practice, Practice and More Practice. Take as many practice questions as possible to become test-wise and develop critical thinking skills. Strategies include:

• Correctly identify what the question is asking by rewording or paraphrasing the question.
• Focus on the information needed to answer the question.
• Eliminate choices that do not answer the reworded question.
• Never predict or guess answers.
• Read answer choices for clues to the topic being asked.
• When prioritizing, remember Maslow's Heirarchy of Needs, ABC (Airway, Breathing, Circulation), the Nursing Process, and Safety.
• In answering questions on therapeutic communication, eliminate responses with "Don't Worry","Why","Let's Explore". Nurse-focused answers and authoritarian responses should also be eliminated. Choose responses that reflect the patient's feelings and those that provide information to the client.
• Remember the rules of nursing management. Only the care of stable patients with expected outcomes and standard, unchanging procedures can be delegated. Assessment, Health teachings, and Evaluation cannot be delegated.
• Be sure to avoid common pitfalls in answering test questions such as: Relying on recall and recognition. Most, if not all, NCLEX-RN® questions deal with analysis in the clinical application of nursing theories and principles; Basing answers on personal clinical experience rather than on established nursing theories and principles; NCLEX-RN® questions are based on standardized clinical principles and not on institutional protocols. Choosing the longest or lengthy response or option; and Answering on impulse to familiar questions. Take time to analyze each option.

• Positive Outlook, Positive Results. Surround yourself with individuals with positive outlook. Accomplishing all the aforementioned things will boost one's confidence on the day of the exam so it is imperative that one remain committed to the plan of action. On the examination day, be at the exam site early, rested, nourished, focused yet relaxed with only one thing in mind, "I will pass the NCLEX-RN® exam!"

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Note: Article written with contributions from my study partner who prefer to remain anonymous.

Choosing Nursing Review Centers

Selecting the best review center is like choosing the best answer in a board exam question. Almost all choices appear to be correct but only one is the best answer. So how exactly does one arrive at the best decision? Use the nursing process!

Step 1 - ASSESSMENT

• Listen to the presentation of each review center. Your school will normally schedule a date where review centers are given equal opportunities to make a sales pitch. Take down notes. Make a list of the good points of each review center. This will help you narrow down your choices.
• Ask questions. Find out the track record of review centers as shown by their passing rate in past board examinations. Inquire as to the number of review hours and the kind of materials they use in their review. Scrutinize their roster of lecturers.
  
• Visit the actual review site. The environment should be conducive for learning. Classroom size is important as well as the number of reviewees per class. The relationship of reviewees should be inversely proportional to the classroom size. This means bigger classrooms with fewer reviewees is better. Facilities such as library, audio-video equipment, and computers are major considerations too.
  
• Examine the packages being offered by each review center and its corresponding costs.
  
• Ask people you know about their experience with each review center.
  

Step 2 - ANALYSIS / DIAGNOSIS

• Make a decision based on the information you have gathered. Your decision should be based on YOUR own review needs as assessed by you and NOT by the choice of your friends or anyone else.
  

Step 3 - PLANNING / GOAL SETTING

• Planning is key. Set review goals. Most review centers conduct diagnostic exams on the first few days of formal review to assess your areas of weakness. Use this as your gauge for evaluating the effectiveness of the review program you enrolled with.
• Most review centers' review program are divided in phases. Find out if you can enlist for the first phase of review only. This is to avoid being tied up with the review center should you feel that the review program and approach is not effective for you.
  

Step 4 - IMPLEMENTATION / INTERVENTION

• This is mostly on you. Make sure you adhere to your review program and do your part. Learning is not one way. No review center will be good enough and a good review program will be ineffective and futile if you don't study.

Step 5 - EVALUATION

• When the first phase of the review is complete, most often than not, the review center will conduct post-test assessment. This will be a good indicator if the review program is effective. If you feel that you have done your part and yet the review program is insufficient, then try to venture into other review centers.

At the end of the day, it is NOT the review centers that will ensure your success in the board examination. It is your OWN perseverance, discipline, and hardwork that will determine your success in your quest to become a professional nurse endowed with knowledge, skills, and the right attitude.

In the meantime, happy holidays!


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Nursing Shortage in the Philippines: The Real Score

I was listening to the radio the other night. The radio anchor was interviewing this young nurse who has just learned that she placed 4th in the recently concluded Nurse Licensure Examination. Apparently, this young nurse is set to leave for the United States of America on an immigrant visa.

The radio anchor felt that it was rather unfortunate that a young and brilliant nurse would rather choose to use her knowledge and skills in a foreign land giving care to foreigners while a great majority of her countrymen are deprived of even the most basic of health services.

This sentiment is not isolated. In fact, several articles have been written on the exodus of our professional health workers. Some were well-placed and had valid points while others were plain ignorant and unfair. I once read an article, where nurses were labeled as "mukhang pera" because they leave the country to literally wipe a foreigner's ass while leaving their aging parents who have no one to look after them so they can earn green bucks.

I think the practice of blaming migrating nurses for the shortage or lack of decent and competent care in Philippine hospitals is utterly unfair and ignorant.

Point #1
True, hospitals close shop because they have no nurses and doctors left to man their wards. However, this cannot be fully attributed to the mass exodus of nurses to 1st world countries. Every year, thousands enrol to nursing schools, thousands more graduate from these schools, and a great number of this, pass the licensure examinations and become nurses. There is a constant supply of nurses. The shortage is in the job vacancies. Some hospitals simply refuse to hire more people as a way to cut operational costs. This is a fact.

Point #2
Nurses in government hospitals are underpaid yet overworked. In some cases, the nurse to patient ratio is as bad as 1:50. That's one underpaid and overworked nurse tasked to care for fifty patients with varying needs. As if this is not enough, they are constantly at great risk of losing their hard-earned license and means of livelihood should they commit grave oversights.

Point #3
Nurses undergo a 4-year rigorous academic and clinical training before they even get to sit for a licensure examination and this entails huge financial costs. While other courses get allowances from corporations when they undergo On-the-Job practicums, it is the opposite for student nurses. Student nurses pay training institutions varying amounts of affiliation fee for every day of duty. Add to that the cost of the supplies that will be used for every day of duty. The point that I'm trying to get at is that obtaining a nursing education involves tremendous financial costs that is unheard of in other professions/fields (I should know, nursing is my 2nd degree) and yet, a professional nurse's average pay is comparable or near to minimum wage. Nurses also have mouths to feed and bodies to keep warm (Read: families).

Point #4
In the early years of nurse migration, critics claim that the continuous migration of nurses to 1st world countries would result to a problem they call, "Brain Drain." This is the phenomenon where the best skilled and trained nurses leave and the less than stellar ones (Read: incompetent) remain to care for the filipino. In recent years, a rather exaggerated term has been created to describe the phenomenon. They now call it, "Brain Hemorrhage." While there may be some ounce of truth to the claim, I see it as self-defeating. It's "damn if you do, damn if you don't" If nurses migrate, they contribute to the health care decay that is the "Brain Drain" However, if they choose to be "patriotic" and remain in the service of the filipino, they are generally described as "incompetent" if we are to follow the logic of the "Brain Drain" phenomenon.

Point #5
Filipino nurses working abroad earn more than your average Overseas Filipino Worker. Thus, by simple math, it can be safely assumed that they are able to make more dollar remittance to their families in the Philippines. This means stronger peso for the the economy, lesser cost for social services for the government, families left behind get access to quality education, healthcare, and a generally better life. It is a well established fact that OFWs are the lifeblood of our country's economy. This is why OFWs are called "modern day heroes." Then why discriminate against the nurse OFW?

Nurses are human beings too like any other Tom, Dick, or Harry. They have dreams, aspirations, wants, and needs. If they choose to leave the country to find a greener pasture elsewhere, it should not be taken against them as it is just human nature to satisfy one's need. Each one of us has a right to pursue our goals and dreams. Engineers work in the middle east so they can earn their keep and realize their dreams; Seamen go on long and arduous voyages so thay can give their families a glimpse of the goodlife. Why can't nurses do the same?

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