Understanding US Nursing Job Market

Transcript

Hey, everybody.

It's Earl Dalton. I'm the chief clinical officer here at HealthCare Cell. And today, I'm joined by my good friend, Ryan. You wanna just take a second, Ryan, and introduce yourself?

Hi. My name is Ryan Alex. I am an international deployment advocate here at HealthCare. So I've been here for two years, and I'm happy to join you today.

Well said, Ryan. And it's a treat for everybody to get a chance to talk to you. Ryan, has been doing this for quite some time and is, quite the subject matter expert. And, we're lucky, Ryan, to have you join the conversation today. So thank you for that.

And, and today, folks, our discussion will center around your immigration journey. We're gonna look at job placement, so what to expect and how to prepare, so that, so that you can maximize and get the most out of, your experience as you work with Health Carousel. So let's just talk for a minute about what's happening in health care, largely today. So within the US health care system, it's a it's a very unique time in that, there are a couple of things colliding that just make for a great, US job market for nursing.

So, first off, there is a massive nursing shortage. And in fact, the nursing shortage, isn't just affecting, the United States. It's affecting, folks around the world, but, but, certainly, the US is not immune to this. So, what we have happening here is that there is a retirement phenomenon where, nurses of tenure, nurses who've been, been nurses for a long, long time, are exiting, in, in really record numbers, around the United States.

So in the United States, when you turn sixty five, you you exit the marketplace and you move into your retirement years.

And we have, about ten thousand sixty five year olds getting created every single day.

And so lots of those folks are nurses. And so we see, we're seeing this mass exit out of the nursing profession, for those who are just at the age to where they can go and join retirement. So that makes for a great time for for nurses, to come to America.

It collides on, a period of time where hospitals are also, struggling to meet budgetary, concerns, and, and find a way to staff hospitals, with with rising costs on all sides, and in many cases, loss of reimbursement, less reimbursement from, from the government, payers. And so, hospitals have a very complex system to balance, but, but certainly from a nursing perspective, what we are seeing is a continued strong support and need for additional nurses, in nursing roles. And so let's just talk for a minute, for with Ryan here now that we've got, got his undivided attention around, you know, how does your placement work, why the timing matters, and what can you do nurses to make sure that when it's your time to get selected or to continue, to hold on to your placement, what those things, what those things look like. Because I think the the audience will find this incredibly helpful. But let me start with, when in our process do nurses get placed?

Let's let's enlighten the crew on on that.

For sure. For sure. So, placement normally happens, after you become what's called documentarily qualified. So that means your I one forty has been approved. You've submitted your DS two sixties.

The NVC has been able to look through all of your documents, and you're good to go.

Now, the timeline can look a little bit different. It used to happen a lot earlier once you were documentarily qualified, but due to retrogression, sometimes it can take a little bit longer.

So it's all the same steps as it used to be. It's just that the, selection process is happening closer to your arrival, once you've kind of made it through the process of retrogression and kinda navigated those challenges.

Gotcha. And, Ryan, so there's a lot of immigration terms inside of of, of the things that you just said there. If people are confused about that, because I'm often confused about that. Right? It's hard to keep For sure.

Is there someone they can reach out to? They they sort of get the clarity on what those terms mean and where they're at specifically?

For sure. So your current assignee is gonna be a great resource for you. We're happy to help you with any questions you have.

As an IDA, these are terms I use every single day. So, I am kind of the subject matter expert on what documentarily qualified means. I can give you a background on what that could look like for you and the processes on how that works for you. So if you ever have any questions about these, like, you know, terms, feel free to reach out. We're happy to help you out, because it is a little bit confusing.

Well, your street credibility being with with me is what I it's hard for me to sort of keep track of all those things, but I should. That's great answer. So, Riley, let's talk a little bit about placement. So how does a placement work in terms of a nurse connecting to a hospital?

Do do you have jobs that you're offering people or is it, you know, we're connecting people? Explain for the for the audience, how a connection to a placement works.

For sure. That's a really good question.

So there is just a couple of misconceptions I kind of wanna talk about. So one would be the idea that healthcare cell is a hospital and we have jobs for you, in that way. What we're doing is we're working with partner facilities and we're placing you on an assignment at a facility.

Healthcare itself is not a hospital, but we are partnering with you to get you placed in a facility that fits your needs, and also the hospital's needs as well.

The other misconception is that it's an automatic assignment.

We get to work with you and the hospital to kind of match your needs.

So we're taking into an account, what the hospital's needs are at that specific time.

And then we also use your own preferences. So those could be things like unit. You know, what experience do you have and what units have you worked in? Maybe location preferences.

You maybe you have family in a specific area and you wanna be there. Or maybe you really, really like warm weather, so you wanna be in an area that matches that. And so there are a lot of different variables. And so we're taking all of those variables, matching you with a facility that that can fit those, and then putting your resume up with the facility.

And they're going to decide who they would like to interview. They're going to interview to make sure you're gonna be a good match with the facility, and that's how you're placed on assignment. So there are a lot of different variables that can go in there.

And, you know, you also have some control on those variables, like your preferences.

And then that's how we're gonna match you with the facility to make sure that, you know, you and the facility are both happy at the end of the day, with your placement.

That's great. Right? That is great. So so let's just dive a little deeper on this question, Ryan.

In terms of hospitals, do they have an endless supply of jobs, or how does the job market go? How do how do we connect people to those hospitals and those jobs?

Right. So every hospital has specific needs.

So at at one point in time, they may need a ton of med surg nurses, and at another point in time, maybe they need a little bit less. And so, each hospital has their own specific needs.

And like I said, different units have different needs. So, for example, if you're a NICU nurse, there might not be as many options for you because that's not as high a demand as say ICU or med surg. So, those are some things that can come into play when, working with the facilities and interviewing with facilities because they may not need a bunch of NICU nurses. They really need med surg nurses at that point. And so, matching that experience with the facility's needs is gonna kind of determine, you know, where you're gonna be able to place be able to be placed and what the facility needs from us at that time.

Love it. Love it. That's a great answer, Ryan. So so I'm connecting here in my mind.

I want you to connect this for the audience. So depending on the on the setting of nursing that you're doing, there are more or less needs based on the size of the setting that you're applying to. For example, in your example here, the, the NICU nurses are they're they just require less of them. Right?

Tell me how that factors into someone's preference choice and how that might limit them even further if they have, you know, really narrow selections. Right? I think that's good for the group to do.

Yeah. For sure. So, like I said, we're taking that experience and then also what your preferences are.

So one thing that can really help with selection is flexibility. How flexible are you? How flexible are you on location? How flexible are you on units, based on your own experience?

And so the more flexible you are, obviously the more options you're gonna have.

For example, if you only wanna be, a PACU nurse and you only wanna be in a specific area of Nebraska, I don't know.

Those are very specific preferences that you have, and it's gonna make it a lot harder because maybe this specific area of Nebraska doesn't have a need for a PACU nurse at that time. Right?

So the more narrowed down your preferences are, the harder it can be to find an assignment. And it can also take a little bit longer if you're really, on a specific area or a specific unit.

So, you know, one thing that can happen because we really do wanna get you matched is if we don't have a specific match for everything you're looking for, we might go with a second best option. And that's gonna be something that your current assignee is going to discuss with you and see if that could be, something you'd be open to as well.

So there are a lot of things that go into a selection, but flexibility is gonna be a really big one, on all different aspects, location, unit, you know, anything like that, is gonna be really important to kinda look into and and decide, you know, what's going to be, the most important to you, and maybe what can you give a little bit so that you can have the most options, to find something that's gonna work for you?

Yeah. Great great answer, Ryan. Yeah. I think, the big piece that people would feel, I think, would be the the timing piece.

Right? If if you're holding out for very specific set of, circumstances to play out, then that's fine, but it would affect timing. Right? It it could take For sure.

For sure. It can take a lot longer, if if you have those specific ones.

So Yeah.

Absolutely. Great advice. Great advice for the for the team here. So, so Ryan, tell me about selection. Right? And you've already pointed out, like, health care cell is not a hospital. We have like, in terms of health care cell being a provider to patients, we don't provide care to patients.

Hospital we're in. We help connect people, to those jobs. But what influences a nurse getting selected, by a hospital?

So, again, there's so much there's so many things that can come into play.

So one thing that could, like I said, the hospital needs, can come into play with that.

What, what, what the hospital needs, if they need med searches, if they need ICU nurses. And then there's also a lot of things on the candidate side. So what is your experience?

Where where have you worked? Are you currently working?

That's gonna be something that's also gonna come into play too. Hospitals are looking for nurses with recent experience.

And then also, like I said, kind of along the same the same lines, candidate readiness.

You know, is your resume up to date?

You know, are is your clinical experience up to date? And, again, flexibility is gonna be a big thing there.

How flexible are you, and and how ready are you for, this assignment? And then also just kind of retrogression timelines as well.

You know, we wanna have a better idea of a time that you could be arriving before a facility is gonna select you because what facilities are looking at is their real time needs in that moment.

And so, you know, the further out from your priority date and you are, and, you know, the longer retrogression period there is, you know, facilities, you know, might not want to select you at that time because you're not gonna be able to fill a real time need they have. You know?

Yeah. Yeah. No. That makes a lot of sense. Ryan, you mentioned, resume, and and, you know, I always my term for this is always, like, you need to be a very active participant in your career, and making sure that your skills are up to date and that sort of thing. Tell me about in in terms of US tradition, and and sort of the customs of US, how how important is the resume, as a vehicle to discuss just all of your talents and those sorts of things and why we should help have nurses keep that up?

For sure. Yeah. Your resume is extremely important. So that is going to be the first thing a hospital is gonna see when they hear your name.

Right? The The resume is going to be in front of them and they're going to be seeing your experience. So, it's going to be really important that any, you know, if you were to change positions, that's going to be updated. So, real time experience is on that resume.

Also highlight as much as you can. Show the things that you have worked hard.

Obviously, we're super excited to get you here to the US and and continue your career here. But you've worked so hard in your career now.

What can you show in your resume that can set you apart from everybody else, so that you can get that good selection? And so it's extremely important that it's up to date, that you're highlighting all of the great things that you have worked so hard for. Because, again, that's the first thing this hospital is going to see, when they hear about you, and you wanna make a really good first impression.

Yeah. Great great answer, Ryan. You're absolutely right. What, what becomes who you are, in terms of the initial steps with a hospital is what you are in your resume. And so as you read it in the specialty you're in, do do you put the most attractive, version of yourself forward on the paper? Because that is the piece of paper that the hospital is going to look up when they're deciding on whether or not you might be for them.

And so that's great advice, Ryan. I think that is incredibly well said.

Do they as people think about their resume and, you know, advice on, you know, even interviewing, those sorts of things, but sort of keeping up their career, but do they have to handle that on their own, or or, do do we offer any help in those sorts of things? Because I don't even know I'd know where to start. Right? I can't remember what time. Totally.

Totally. It can definitely feel overwhelming. You know? What do I put down? How do I make myself look as great as I can and and showcase the amazing things I have done?

So, you know, you have your current assignee. So if you have an IDA, you can reach out to them and ask questions.

We're always happy to help you out. We wanna make sure you look as great as you can, because we wanna make sure that you're getting a great assignment and that you're, you know, showing up the best possible way you can. Right.

And we also have a clinical team here that we can reach out to and talk with our Quinn team.

And and they're going to be able to give us great advice on how to showcase specifically nursing experience.

Right?

And which is a great a great thing that we offer. And so if that was something you wanted to get connected with, we can always help with that. And we can always reach out on your behalf to make sure that we're showcasing you the best possible. So you're getting from a nurse, exactly what they wanna see in the setting. So those are just two really, really good resources that we have. And we're always happy to get you connected with those resources along your journey.

Well said, Ryan. Very very well said. Yes. So, so, you know, nurses, if you take nothing else, somebody right now, you're not in this alone.

And, you know, resume building and that sort of thing is not something necessarily nurses do every single day, but we've got a team of experts here. Right? Ryan on out. Right?

That could connect you to people that can, certainly, I think, help in that sort of place.

Ryan, let's let's get into I'm gonna come back to flexibility in a minute, but we we've talked lots about that, and You've done a really nice job of talking about the importance of being flexible in your choices and preferences as it applies to where you'd like to work in the United States. But let's move over and have a discussion around. Okay. So, you know, I've locked a placement and, right, and I I think I know where I'm going, but then that that deployment is going to change. Right, for for one reason or another, the hospital is has, has changed, their mind, and then you're not coming anymore.

Why why does that happen, to to nurses, that are locked on assignments?

Yeah. So, things can change.

Hospitals have, hospitals can change, you know, their budgets. They can change that they're filling needs internally.

There's a lot of different things that can happen with a hospital.

And, you know, it's really important to remember it doesn't mean you're not coming to the US. That is not what that that's not what that means. What that means is that, you know, we might have to look at alternate placements for you. And a lot of times what that can come down to is, there's a couple of different things.

Like I said, it could be the hospital side. It could also be that, we have like changes in retrogression, and it's not moving forward the way we thought it was. And the hospital, you know, the timeline doesn't match what the hospital is. Also, sometimes candidates decide that that's not where they want to go.

And so they decide that they want to be unselected from a facility and, and reselected elsewhere. You know, whether that's because family moved or they have, you know, different needs or changes that happen in their life. Things happen. We understand.

And that's where flexibility comes into play. Okay. So the great thing is that we have a large network of facilities that we work with.

So while, you know, maybe you decide that you don't wanna be in Nebraska because your family moved, and you have to go somewhere on the East Coast. We have a wide variety and a great network of facilities, and we also have a great internal team who's gonna work with you and also update those preferences, help you update those resumes to make sure that we are placing you on a on an assignment that you're happy with and that matches your facility needs.

So if any sort of changes, first of all, we're gonna be here to support you in whatever way that looks like for you. And then also, the more flexible you are, you know, the better chances you are to get selected another great facility.

Yeah. Yeah. That's that's great, Ryan. And I I think you would agree, and maybe I'll get you to give just a couple of words on this.

People shouldn't shouldn't internalize this about them. Right? These are sort of right. It's a disassociated thing from who you are as a person where this is a business decision often for the side of the hump.

Definitely. And it's important to remember that they chose you. You know, they they wanted you to come. But, unfortunately, certain things can happen like retrogression.

It's totally out of our control. It's not something anybody, you know, enjoys happening, but things can happen. And so it's important to remember that, we've got your back, and we will make sure that we find a good facility for you regardless of what happens.

Great answer. Great answer.

Ryan, so for, for nurses that are, that are ready for selection or are selected, how do they how do they stay ready? What what are some, sustaining behaviors that they should do to make sure that they continue to be ready, either for a placement or that they continue to be, ready for the placement that they already have secured?

Totally. Totally. So one of the biggest things is keeping your resume updated.

Again, if you ever have any, you know, unit changes, maybe you're a charge nurse now and, you know, that's an exciting thing you get to share with us. We want you to update that and make sure your resume looks as best as it can, at any time. And so again, you're feel free to reach out to any of us or your current assignee to make sure that we have that updated for you. We're we're always happy to help you out and we'll be excited for you for you with any career change, you know, when you're progressing in your career along the same lines, continue to keep progressing in your career.

You know, if, if you, you know, you're able to move up to that charged nurse role, we want you to do that. That's great experience. It's going to help create an even better transition here, gaining more experience, you know, wherever you are, to again, have a, have a better chance of securing a great assignment here. Again, we'll update that on your resume and continue to keep learning and whatever way that works possible. You know, we are gonna provide you, you know, modules and and and we'll help you out with that along the process.

But find different ways to, again, advance your career and continue learning in your career. It's gonna create, like I said, a great transition. The more you learn, the more, you know, the more experience you have. So, continue to keep doing all of those things. If you do all of those things, you're gonna be set to find a great assignment.

Yeah. Well well said, Ryan. I always say be an active participant in your career. Right? And, and once you know this well, if you didn't document it, you didn't do it. Right? So document your right right in, in your resume.

Right? So are just so that we overstate it, and you've done a nice job of explaining it through. But a nurse applying for a job in the health care cell program, are they singularly the nurse that's up for that job and no one else is competing? Or are there other people competing for the same job for the hospital at the resume review portion?

There's gonna be other people who are going to be, you know, you know, competing for that position. There's gonna be other people who are gonna be interviewing as well.

And so that's why it's really important to put your best foot forward in those scenarios. So again, updating that resume and then also, we're here to help you out with interview prep too. That's a very daunting thing. And so reaching out to your current assignee, we're happy to provide you with resources and and help you along the way so you know exactly what to expect in that interview, and and how to show up the best way you can.

It is a competitive process, but we're here to make sure that you show up, the best version of you to make sure that you get the assignment. Right?

Yeah. Yeah. Well said. Yeah. And so, you know, again, I think the audience right. To overstate it, right, we've got tons of hospital partners, in all all corners of, of the United States right from, from one coast to the other and from north to south. So we've got tons of partners.

Right. I want I want you to just go back to a minute about the impact of being flexible and open as opposed to having really specific, pieces. Let's let's just sort of close out on that, and any final words that you might have, for for the audience as we close out today. But I think those are really important parts that, you know, if you're not in it, you don't really I you know, may not, draw those conclusions, and I think those are important. So so why don't you just sort of infer us on a couple of pieces of advice. But if but if you could mention again the importance of the flexibility, I think that'd be helpful.

Definitely.

Definitely. So, like I I've I've said it, flexibility is so important. Like, we have facilities located all across the US. And again, certain facilities are going to have higher demands in certain units than others. And depending on your experience, that's going to kind of depend on how you match with those specific facilities.

And so creating a wider, you know, casting a larger net of possibilities is always important. It's also important to keep in mind that the US is big and there's so much opportunity here. There's places you've never heard of that are great places to live. Right?

And so it's really important to do your research, to kind of learn how you can expand what you're looking for because there's probably way more opportunities and way more places that could fit what you're looking for than maybe you even understand.

And again, we're here to help you out with that. I always love talking, with my nurses about the geography of the US and how that works and, the different things, the different, opportunities and things different areas offer and maybe places you've never even heard of that could be a great fit.

And so again, having a wider net is always going to give you more opportunity.

Maybe it'll help you discover something that you didn't even know of. And it's just gonna make sure that you have a wider, just a larger range of, of opportunities, that you can draw from to find the right opportunity for you. You know?

Yeah. No. That's great, Ryan. I think that that is great advice.

And and close to the end here. And and I will say this a little tongue in cheek. But, Ryan, so they shouldn't reach out to your team. You you really don't wanna talk to them. You really don't have any advice for them to have. When when is it appropriate to reach out to the team, and, right, if people are curious about questions around any of this. When when is it good, or is it is it never good?

You never wanna hear from him because that's I know that's not that's certainly not how, how you We I love to hear from I love to hear from my nurses, and I love talking with them.

We wanna make sure that everything makes sense and that all questions are cleared up.

This process can be overwhelming and it can feel scary because there are a lot of things that you might not know. And so always feel free to ask.

You know, we're never gonna be upset with you if you ask questions. We're always gonna wanna help you and point you in the right direction and provide you with the right resource to make sure that you feel good about the process. That's one of my biggest things. I want to make sure that you feel good about the process. So any questions whether it's about facilities, about location, you know, about the process, about immigration, because immigration is so confusing.

Feel free yeah.

Feel free to email us.

You know, you always have your check-in calls with your current assignee. You know, if you wanna write down a bunch of notes, and and ask away on those calls, feel free to do so. We wanna make sure that everything is cleared up and that you feel good about the process. So we're always here to help you any any stage of the journey, even through retrogression. It's tough. But we're here to help you, navigate all of those challenges that may be coming towards you, and make sure everything, everything goes smooth and that you have the smoothest transition here to the US as possible.

Well said. And and, of course, I I knew that was gonna be your answer. Your team, is incredibly passionate about helping, nurses that are on the journey, and so I always appreciate that. And, folks, we'll we'll end on this. I hope you got a lot out of your, your immigration journey and, and the process around job placement.

As you can tell, you know, I think it's been a real treat today to get a chance to talk to Ryan who, is one of our subject matter experts on this and, lives and breathes this stuff every single day. Ryan, you did a great job, I think, of walking through a lot of the questions there. And I'm sure if there if folks have other questions, they should reach out to their, to their deployment advocate and, and, and get the answers that they need. So, folks, thanks for joining today. It's been a complete pleasure for me, to to join with Ryan here and have the discussion. And, please do reach out if you have any questions, but, but we'll end it there.

‍

‍