M.D.-to-RN Program Offers Second Chance at Caring
By Debra Wood, RN, contributor
Rarely do you hear about physicians returning to school to become nurses, but 32 foreign-educated doctors recently graduated with a bachelor of science in nursing from a unique education program at Florida International University (FIU) in Miami.
"It allows us to go back to the medical field and the health-care system," said Hancy Brignol, GN, one of the students in the first class. "There will be a lot of opportunities for us."
Brignol came to the United States from Haiti, in 1991, and while raising two children as a single mother, could not make time to prepare for physician licensing exams or locate a residency program. She worked at a research facility and longed to return to an active healing role.
Adjusting to nursing practice proved a little difficult at first, but FIU professors prepared coursework explaining the scope of practice, nursing diagnosis and nursing process, which aided with the transition.
"I’m a very caring person and that helped me to change from one mentality [medicine] to benefit the other one," Brignol said.
Fellow students John Alvarez, GN, and Edwin Vides, GN, reported little trouble adapting to their new roles.
"The way we practiced medicine is more like the nursing model in the states," Vides said. "The approach of a doctor in our country is more holistic and [deals with] the whole complex entity. We take care of the family and [patient], and our office visit may be 60 minutes and 45 minutes for follow up. It is very different than how medicine is practiced here."
Vides practiced as chief of an emergency room in Columbia before arriving in the United States, in 2000, as a political refugee. He started in this country as a nursing assistant and has worked as a case manager at a hospital and for an insurance company.
Alvarez moved from the Dominican Republic, in 1990, and said in his country, doctors do a lot of nursing. He found the technological advances and monitors amazing and exciting.
"The critical thinking portion of nursing was a challenge, because we had to change our mode of thinking," said Alvarez, explaining that doctors do not coordinate and follow up on all aspects of care. "But the assessment is very similar and one of our strong points."
FIU nursing school director Divina Grossman, Ph.D., RN, ARNP, CS, FAAN, expects the students will stick with nursing and not use it as a stepping-stone back to medicine, because the model of nursing practice in the United States offers so many opportunities for professional satisfaction.
"We have a very professional nursing practice model," Grossman said. "Nurses are autonomous and responsible for the kind of assessment that maybe in their countries, nurses were not responsible for. My guess, going through this program will increase the likelihood of their staying in nursing, because they will have professional satisfaction."
A special sense of camaraderie developed between the students. Vides said it felt as if partnerships formed as they coached each other through the rigorous five-semesters.
With accelerated classes in a range of traditional nursing topics in the evening, clinicals on the weekend and most students working full time, Brignol said it sometimes felt as if 24 hours were not enough for one day.
FIU initially developed the program, in 1997, after a group of Cuban-trained physicians suggested it to Grossman. The school obtained board of nursing approval, but lacking funding, it never got off the ground.
The chief nursing officer at a local HCA hospital noted a number of foreign physicians worked at her facility as aides, technicians and phlebotomists. She arranged for a meeting between corporate officials and Grossman, which resulted in the hospital firm sponsoring the program.
HCA East Florida Division, HCA facilities Kendall Regional Medical Center and Cedars Medical Center, and Catholic Health East’s Mercy Hospital each contributed $150,000 to sponsor 40 students in the first class. In return, the students agreed to work in one of the facilities for two years.
Alvarez and Vides have lined up jobs in critical-care units. Brignol plans to complete her commitment and work on a master’s degree. Grossman called it a win-win for the hospital due to all the experience and knowledge these new nurses will bring to their positions. FIU said it is the only program of its kind in the country.
The hospitals funded another class with 60 students, who will graduate in 2004. The school has an additional 632 applicants on a waiting list. With additional funding, FIU could expand the program immediately.
The students came from countries all over the world, including Cuba, Colombia, Haiti, Romania, Mexico, the Caribbean and the Philippines. Eighty percent speak Spanish. Many could not afford to take medical board exams or complete residencies, which are required to practice as a physician. Some had tried and failed. Many were underemployed in minimum-wage positions.
Ensuring the students were fluent in English presented some challenges to the school of nursing. It worked with the university’s English Language Institute to screen applicants and offer courses for those not quite up to the level needed.
Men comprised half of the first class. Adding men and minority nurses to the workforce bodes well for the profession.
"That’s what we need in our community, what we need in nursing, because the patient population is diverse, yet the nursing population is not," Grossman said. "They will bring their professionalism to nursing, and it will be wonderful."
© 2004. AMN Healthcare, Inc. All Rights Reserved.
source: http://www.nursezone.com/printArticle.aspx?ID=12044&profile=Spotlight+on+nurses
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