Nurses wanting to work in the United States often hit a brick wall of stringent standards but it is possible for Australian and New Zealand nurses to secure work in the land of opportunity.

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Experts are forecasting a major nurse shortage amid estimates an extra 1.2 million nurses will be needed in the U.S. before 2020, but foreign nurses are finding it increasingly difficult to gain entry into the States.

Nursing education in Australia does not meet standards equivalent to the U.S., particularly in the areas of maternity, paediatrics and psychiatry.

U.S.-based international recruitment agency Avant Healthcare Professionals operations senior vice president Lesley Hamilton said international nurses must go through

a credentialing process, such as with international authority CGFNS, to ensure their education meets U.S. standards.

Ms Hamilton said Australian nurses are generally deficient in the areas of maternity, paediatrics and psychiatry based on U.S. standards but it can ultimately come down to the specific tertiary institution where nurses have studied.

“The reasons for the shortfalls are not clear and have not been confirmed but it likely is tied to a lack of clinical placements and faculty in universities and training facilities,” she said.

“Nurses applying to work in the U.S. usually need to take additional courses to make these up and meet our country’s standards, and must also show that they have both theory and clinical experience at an undergraduate level in each of the deficient areas.”

Ms Hamilton said nurses needing to take extra courses could take supplementary courses at either Deakin University in Melbourne or Otago University in New Zealand.

“Registered nurses who have completed additional training, such as a midwifery program, or were enrolled nurses prior to applying for employment in the U.S. should provide these transcripts, as they may assist in proving adequacy for employment in the U.S. system,” she added.

Ms Hamilton said it can be more difficult to gain entry into some U.S. states, such as California, than others.

“The California Board of Nursing requires a social security number to even apply for a licence, and this number cannot be applied for until an applicant is already in the U.S. on a work-related visa,” she said.

“California also has stricter policies on accepting the overseas make-up courses that typically help a nurse gain entry into the U.S., so the individual must complete these courses through U.S.-based programs in order to meet the state’s requirements.”

While Australian nurses’ clinical skills are well-accepted in the U.S., the biggest hurdle for foreign nurses is often in meeting initial licensure requirements, Ms Hamilton said.

She advised nurses wanting to gain employment in the U.S. to work with an agency.

“We can guide the nurse through the steps from beginning to end, ensuring that he or she saves time and money,” she said.

“We also advise that nurses take the initiative to check their training hours before spending money to apply for credentialing or a nursing board – if an individual needs clarification on or has trouble obtaining his or her hours, Avant can assist with locating and completing the necessary documentation.

“Avant also offers an excellent NCLEX review program that has an 85 to 90 per cent first-time pass rate.”

Despite the stumbling blocks, Ms Hamilton said there are major advantages for nurses wanting to work in the States, with Australian citizens able to apply for non-immigrant visas that provide spouses with working status in the States.

“A job confirmation letter is required to obtain it, as well as a few additional requirements. Avant can provide this type of visa sponsorship to qualified applicants,” she said.

Ms Hamilton said the U.S. is poised for a severe nurse shortage between now and 2020.

“Currently, this shortage is veiled by the recession forcing nurses back into clinical settings, delaying retirement and deterring career changes,” she said.

“However, as this begins to change, we will need foreign nurses more than ever to compensate for the shortage.”