By Sylvia Smith
Copyright 2007 Pinoy RN
Rule One - There is no perfect contract - all contracts will require some trade-offs - but you should always, always, always read and understand any contract before you sign.
Rule Two – If it sounds too good to be true – you can bet your bottom dollar that it is. If someone is offering too much money, grandiose benefits etc. ask yourself, “Why?” Is the facility located in a scary part of town or are the conditions so bad they can’t keep it staffed? Is there “fine print” in the contract that negates the promises? Look with a cautious eye. Hospitals, agencies and attorneys have to pay the bills. What’s the catch?
Rule Three - (This goes back to rule one) Don’t toss out a good offer/contract because it’s not “perfect.” Decide what is most important to you. Do you have family/friends in a certain state/city? If location is most important to you, to get it you will probably have to make accommodations in other things, for example – nursing home instead of a hospital, agency nursing instead of direct hire, lower wages, maybe even pay more of the expenses yourself. But if when you arrive you have the support of family and friends it may be well worth the trade-off.
If you are an experienced nurse and working in a hospital to build your skills is most important you, you may find the best thing for you is to take job at a larger hospital but in some smaller city not on the “popular” list. If salary is most important to you be sure to cross check on a “cost of living calculator” to be sure you are getting the bargain you think you are getting. Life would be rough on $25 an hr in California but in many other areas you can easily buy a home and live just fine on it. Again, decide what’s most important to you and then be willing to be flexible in other areas.
Rule Four - Don’t ever, ever, ever sign a contract planning from the start that you’ll just get out of it on arrival. It hurts the reputation of all International nurses when this happens, it’s dishonest and may result in immigration problems that will haunt a nurse for years to come. Instead, hold out for a contract you can live with (see Rule Three again) and then make it work when you arrive. Any contract is for a limited time – usually 2-3 years. Once it’s done you’ve got a green card and can go anywhere you want. You can stick it out. 2 to 3 years is a small price to pay for a “golden ticket”. NOTE: Yes, there are times where nurses are taken advantage off, promises are broken – and even laws are broken. In these cases of course a nurse should seek help to get out – but they are the rare exception and more often than not, related to not following Rule Two.
Where will you be working? - What state/city? At full hospital? At a nursing home? One set location or will you be moved about? NOTE: If you do not have hospital experience you will limit your options in this area and may not be able to get a hospital position. I know US schooled new grads who are having a hard time finding hospital positions – hospitals want experienced nurses, always have, always will (see Rule Two if someone is offering inexperienced nurses hospital positions – I’m not saying it’s impossible, but it's very unlikely that there is not a “catch” of some kind). However, if you have experience – You don’t have to settle for anything less than a full hospital position - there are plenty of them out there – but you may have to be flexible on what state you go to.
Who pays for what? – What expenses is the nurse responsible for? Are some items paid up front by the agency/hospital/attorney but the nurse needs to pay them back later? Are there expenses the nurse pays up front but that can be later reimbursed? Is there any kind of sign-on/arrival bonus? What about airfare and initial housing? NOTE: No one will pay for everything for you – see Rule Two. Find a balance you can live with. If you don’t have money for up front expenses you may need to take a contract where money is advanced that you have to pay back. (though I personally think these are terrible) If you get a sign–on bonus and a good salary who cares if they don’t provide initial housing or some other item another nurse is bragging about?
The most important thing is that you understand the financial side of the contract and it’s an arrangement you can live with.
“Buy-Outs” - Almost every contract now has a buy-out written in and it will be high – generally a lot more than the actual “visible” cash put out on the nurse. This is because to bring a nurse to the US it costs a lot more than that actual fees paid out. Time is the biggest cost – time searching out applicants, time vetting files, time interviewing, time gathering and sorting docs for immigration, time awaiting arrival, time for orientation. And after investing 12, 18, 24 months or even more waiting for a nurse to arrive if the nurse walks…it’s extremely expensive to the agency/facility. The fact of the matter is they don’t want your money from a buy-out – they want you. Don’t be afraid to sign a contract just because it has a high buy-out. If you have checked the sponsor out, followed the rules above and feel good with the rest of the contract, don’t worry about it.
NOTE: You can always ask if they will let you contact a nurse that they have already placed at the facility for the inside scoop as to what it’s like. Then you can feel better that you will be fine and not need to buy-out anyway.
This should give you a good start as you look at contract/job offers!
About the Author. Sylvia Smith is from Colorado, USA. She has been working with international nurses for more than 5 years. Having lived a few years in several countries, she helps nurses reach their dreams of coming to the US. Currently, she is doing contract work specifically with the H-1C work visa for nurses in the east coast.
