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Hello friends!
I am vigorously searching for my first job as an RN in global health, yet am meeting some resistance. Most organizations (for example: fema, mercy corps, smile train etc.) want experienced nurses..... I will take any job with pretty much any pay(need to start paying loans some how), yet would rather not work a hospital. Any suggestions on places to start my nursing career?

thanks for all your help! you are all wonderful!

 
Kelly Smith
Replied at 5:14 PM, 20 Jul 2014

Hi Melissa,

I've been a nurse for the past five years and am just about to finish my Masters in Global Health. If I'm understanding correctly, you have just graduated? I would strongly encourage you to get hospital experience first before you try to find a job in global health. First, there is a reason all of those organizations require experience. Working as a nurse in a resource limited setting is hard. It's much harder than working as a nurse in a US hospital and new graduates function at a very low level when starting out. The amount you learn in the first year, even two years as a nurse is huge. When you work in a resource limited setting you rely heavily on your assessment skills, your ability to improvise and adapt. All of these come with experience and you will be able to be an asset to those organizations instead of them using resources to train you. The second reason is if you do chose to come back and work as a nurse in the US at some point in your life, no one will hire a nurse who graduated and then didn't work in US hospital for X many years. From experience, they don't count the hospital you worked at in sub-Saharan Africa or anywhere else for that matter. They will just look at it as a big gap in employment. I understand wanting to start working in global health right away, but a couple of years experience will make a huge difference in your skills and abilities and isn't that much time in the scheme of things.

dian marandola
Replied at 6:19 PM, 20 Jul 2014

Dear Melissa,

I'm not so sure I agree with the fact that you need to be experienced in one area of health care when you aspire to work in another as skill sets differ greatly and need to be cultivated for various practice sites. That being said, I think you have identified some stellar organizations that are telling you they have a requirement that you need to achieve....whether we agree or not!

So, consider the kind of work you wish to do. What is the profile of the setting you wish to be in: OR, hospital, community based, public health, primary care, children, acute or chronic care, underserved, underinsured, people suffering from broad disparitiy?...which country?

Once you define your goal, I can imagine that there are settings in the US that can match the profile of patients you wish to serve on a global level.

Did you know...the Bronx, NY is one of the most impoverished areas in US where children die of asthma and suffer obesity at alarming rates. Detroit has some tremendous health needs and professionals working collaboratively to address these problems, also. Main Street and Roosevelt Ave in Queens NY holds the distinction of having the most diverse convergence of populations in the US.

And if you have to work in a US hospital to pay your dues,why not make it an exemplar nursing setting that has achieved ANCC's Magnet designation. In such an organization, you will see shared governance in full swing and nursing defining its practice environment.

Being a Visiting Nurse places in you in patient's homes where you may help some of the most complex patients live in their home community.

As you find your practice setting (If you want to work in the OR with SMILES, you need to work in an OR or PACU) why not volunteer with an organization you hope to work for someday....get to know them and give them a chance to know you....while fueling your aspirations to be a global health nurse.

All my best, Dian

Celestina Nkiruka Onuoha
Replied at 3:52 AM, 21 Jul 2014

Dear One,
Getting a good job is hard this days due to number of unemployment nurses
in the country. So, I encourage you to enroll into any hospital to acquire
more experience in nursing which will enable you get a job of your choice
inglobal health.
thank you.

HANAN SACA-HAZBOUN
Replied at 6:52 AM, 21 Jul 2014

Hi all
as mentioned above, getting jobs these days is very competitive. I am seasoned nurse who worked in California for long.time as a travel nurse. when I moved to Philadelphia, I was only able to work part time in home care and when I had to go back to California, I was not able to work in acute care because I had been out of acute care for two years.
Try to get a job in acute care with pediatric or maternal focus and get a master in community health or global health.
When the time is appropriate, you have a experience and the graduate degree.

Elizabeth Glaser
Replied at 2:25 AM, 22 Jul 2014

Melissa ,

As a new grad, it may be helpful to develop knowledge and expertise in the country where you received your initial education/training before expanding your practice to include other countries. There are many opportunities to practice in lower resources setting right here in the US. I choose not to get the traditional 1-2 years of med-surg work on a hospital unit in favor of working at a medical respite facility for homeless men and women. While there, I was able to work beside experienced nurses, docs, and mid level providers who were great teachers. I received a strong clinical foundation and developed organizational skills that have served me well over the past two decades and across a number of domestic and international settings.


Elizabeth

Michele Sare
Replied at 10:42 AM, 22 Jul 2014

Dear Melissa,

There is another set of factors to be considered that have yet to be
discussed here. While working across borders, you are taking-up valuable
resources of money, living, drivers, and perhaps even security - but more
than anything - you are being hosted by people -in their country & culture
- welcomed into their lives - So the most important considerations are not
about what you can experience and gain, but what do you have to offer - are
you the right person who can do the right thing in the right way?

All too often I hear about what an international experience gives to those
working in another culture - Arguably - there is benefit to a 'cultural
exchange' - as long as it is a positive synergistic one. But with the ethic
and morality and the immense privilege of working in another's community,
the most important set of considerations are not about you...the return on
investment must be aligned in every regard...If it will cost you $10,000
for a couple months in a developing country - is that the best use of the
money, time & effort - not just for you, but for those you will have the
sacred pleasure & privilege to work along-side?

I completely understand the drive & desire to work globally, but in today's
healthcare arena and w/ the plethora of international aid organizations -
most working on what they believe is needed - and not always with
communities - we must stop and ask better questions. The question isn't
'where can I get global work experience', it is 'what do I have to offer,
where is the best fit, and am I the right person to do the right job?' What
do you know about the complexities of global health and do you know
anything about development, are you a student of the MDG, SDH, the
Strategic Directions for Strengthening Nurisng & Midwifery..., and what do
you know of the challenges facing the nurses/healthcare workforce of the
country you'd like to visit?...So many more questions that just 'where and
how can I get there?'

Best wsihes to you in you juorney in care...it isn't an easy one and the
roles & responsibilities of nurses in global health & development are
poorly defined....some of us are working on it, but none of us have all the
answers...So whatever you choose to do at this juncture of your career -
grab-a-hold-of the paradigm that we have a lot yet to learn and the way
foward is riddled with more questions than answers. What I do know w/
absolute certainty is that we have to work together...nurses at every
level...Blessings to you on your path and don't let any of us deter you
from what you feel in your heart is your way forward...Michele

Rachel Breman
Replied at 2:02 PM, 22 Jul 2014

Dear Melissa,
There are a few suggestions that I have, the first being you should look at the kinds of jobs you want in the future and network with the people who currently hold those jobs and then figure out how they got there. There are many nurses working in international development as program managers and other roles.

One of the best and most fulfilling (not to mention economical) ways to get out into the field is through Peace Corps. Nursing is one of the majors they highly value, however, you will most likely not be able to practice clinically. If you want to gain clinical experience, and provide direct patient care, then you will most likely need to start your job in the US. That said, you should also investigate opportunities in the Middle East, as often nurses are in high demand and sometimes they offer new graduates positions.
Good luck!

Maggie Sullivan
Replied at 11:12 AM, 23 Jul 2014

Melissa - a timely event for you tomorrow, Thursday 7/24: An Online Career Conversation with Global Health Professionals (ow.ly/z3L2d). "Join the Global Health Fellows Program II for an audience-driven webinar. We’ve gathered together a group of former GHFP fellows and interns who are excited to spend 60 minutes answering your questions about career paths, sharing stories, and sharing advice about how to move your career forward. What is it like to be a technical advisor at USAID? How can I start my global health career? Do I have what it takes to work in international development? Take a minute to think about the questions you would ask, now that you have this perfect chance!"

**Space Is Limited, RSVP today!**
Thursday July 24th, 2013 | 2 - 3 pm EDT | 11 am - 12 pm PDT
ow.ly/z3L2d

**Who’ll Be There?**
Hundreds of you with all backgrounds and experience levels will join us to interact with a gifted group of professionals with a diverse range of paths and areas of expertise, including: Antoinette ‘Toni’ Craig, HIV/AIDS Care and Treatment Intern; Cecilia Vu, Health Research Analyst Intern in the Office of Maternal and Child Health; Dr. Fred Fuentes, Public Health Integration & Development Advisor in Guatemala; and Jennifer Mason, Health Advisor in the Bureau for Asia and the Middle East. See their profiles here [http://dialogue4health.org/web-forums/detail/an-online-career-conversation-wi...], find out what their work is like, and what they are doing now!

Important: Submit your questions in advance to help shape the discussion. You can also submit questions during the event.

Closed captioning will be available for this webinar.

Attached resource:

Pat Daoust
Replied at 11:34 AM, 23 Jul 2014

Hello Melissa,

I want to echo Rachel's suggestion regarding the Peace Corps and the high
value they place on nursing. She is correct that as a traditional PC
volunteer you would not be able to practice direct care but would most
likely focus on community health and education. It can be an amazing
experience and provide you with a true feel for global health.

As the CNO for Seed Global Health and our Global Health Service
Partnership program with the Peace Corps, I am always very interested in
working with nurses who are Returned Peace Corps volunteers and would
then like to serve as adjunct faculty in nursing schools and universities
at our sites in Africa. Their previous experience is invaluable.

We do recommend that our applicants have an advanced degree in nursing or a
related field (MPH) and some strong clinical experience so I
would also advise that you weigh what others have have suggested regarding
continuing your education and practice.

As a nurse who loves global health I am excited to hear and read about your
interest and commitment! Welcome.

Pat

Brittney Sullivan
Replied at 12:41 PM, 23 Jul 2014

Hi Melissa,
It seems like you're getting a lot of advise, so I hope you're finding it helpful. I just returned from the Peace Corps/SEED Global Health Service Partnership Pat Daoust just mentioned and served for a year in Malawi teaching pediatric nursing which was great!
I think everyone has had great advice above. Like you, I knew while an undergrad that I wanted to focus my career on global health, so volunteered in Honduras (5x) and Nicaragua while in nursing school. I also spent a month in Guatemala learning medical Spanish and volunteering in a clinic (there are quite a few programs to learn medical Spanish where you can also volunteer - I did it through AmeriSpan). After graduating with a MSN (I'm a PNP) I worked in an under served population - an adolescent jail near Worcester, MA. While working there I also volunteered in Haiti with Partners In Development (PID) on week-long medical service trips (short-term "Band Aid" trips can be controversial for sure, but I felt I was filling a gap with a program that has volunteers year round and working alongside Haitian staff).
So, like others have mentioned, you can definitely gain global health skills/experience locally that are valued abroad. I would also caution that you should have solid skills (health assessment, comfort teaching, foundation of common "global" medications, etc) prior to taking on global responsibilities as you want to be adding value/capacity rather than taking away in forms of lengthy orientations, constant supervision, etc.
Best of luck - I am quite young/new (I'm 27) to the global health field and feel my ongoing short- and long-term experiences have really provided me with a solid foundation. Being involved with an organization where you can continuously return is definitely helpful as you don't require as much of an orientation and can "hit the ground running" once you arrive in country for the 2nd, 3rd, or 4th time and help mentor both foreign and local staff.
Good luck!
Brittney

Robyn Churchill
Replied at 12:54 PM, 23 Jul 2014

I want to weigh in as someone who spent time internationally before becoming a nurse and then a nurse-midwife. My clinical experience was primarily in the US--with migrant workers, immigrant women, inner city teens, and other local women in "access poor' communities (Wisconsin and then Boston area). 20 years later (when my children left home), I had clinical expertise, as well as experience in leadership/management, grant-writing, systems-development, capacity-buildling, quality improvement. In that interim, I believe I had an impact on the health care of some very vulnerable populations, albeit local ones.
Once I pivoted into global health, I brought with me some very high-level experience, which meant I could enter the field as an expert, with the caveat that I had (and still have) a lot to learn about the global health context, and each country's unique situation. (That learning need will always exist).

I know that as a new nurse, my perspective won't be popular, but I put it out there just to point out that time spent in your own country is not time "lost", nor is it just "doing time". You can make it a real opportunity to grow your skills, and increase the value of what you have to offer internationally.

I agree with what has been offered here so far, and would build on Rachel's suggestion that you think about where you want to be in global health, talk with folks, and then figure out what you need to build expertise in. Then find ways of building that expertise where you are for a bit, keep your goals clear, and remind yourself of the progress you are making as you do great work in your own community.

That said, if you get the right position internationally, I will be the last to tell you to turn it down! ;)

Jeanne Leffers
Replied at 1:18 PM, 23 Jul 2014

Hello Brittany, I think you offer a great deal of solid advice in this short summary! Key areas you mention that I believe are essential are: 1) learning the language--particularly medical vocabulary where possible 2) returning to the same location to really learn about the local culture, health practices and forge partnerships with the people, 3) that nurses must gain the essential skills--(you mention health assessment, comfort teaching, foundation of common "global" medications, etc) and I would add that the visitor should learn about the location, people, culture and common health problems as much as possible and 4) that short term trips can be beneficial if you choose well. I have worked with Partners In Development (PID) in Haiti for the past several years (5 trips) and when we volunteer as "extra hands" to accomplish what the Haitian National staff does on a daily basis it can serve as more than a "band-aid". Short term volunteer experiences with organizations where there are strong partnerships can be beneficial to not only the nurse but the partner organization as well. Thanks for sharing from your experiences! Best, Jeanne

Annie Mead
Replied at 3:19 PM, 23 Jul 2014

Dear Melissa,

I completely understand, and share, your desire to apply your RN degree in an international health organization, but I have to say that I strongly agree with the advice given by some here about getting experience as an RN before moving to an organization or programmatic setting. I am also a recent grad of an RN program, and previously worked in different NGO settings with an MPH in global health. While I absolutely share your desire to go straight to work in international health organizations, the advice I have been given and my experience so far has taught me that I can add so much more to the conversation with other nurses and, as Michele mentioned above, provide so much more to the organization, country or setting in which I will find myself if I have solid assessment and bedside nursing skills and have experience as a nurse trying to address the challenges that diversity of culture, language, environment and health systems will present to you and to your patients when trying to achieve health.

This, and several posts on this discussion group, always bring me back to the question of what the definition of 'global health nursing' really is or what it means to be a 'global health nurse'. When a finished my MPH I too wanted to leave the U.S. immediately and go straight to work in an international organization. While actual experience in other countries has absolutely been important, my path over the last several years has taught me that global health really just means a having an understanding that different settings, cultures and environments affect health attainment and delivery of care that experience in any country can add to the conversation of how to address these differences. I believe you will be a global health nurse and have a rich 'global health' experience no matter where you are as long as you understand and have the desire to learn from and address the differences in culture, country, context, etc that affect health care.

Like others who have commented above, I have gained invaluable global health experience in a few short months working as a nurse in a Washington, DC hospital that receives patients from a wide range of countries, ethnicites, income levels, educational backgrounds. Bedside nursing is SO rough and exhausting and there is so much frustration involved in the challenges that the U.S. (like any other) health care system presents to nursing care, but without this experience, I don't know if I could truly feel as though I am a colleague of other nurses with years of experience, or that I can fully understand what it means to be a nurse.
Similarly, I have gained invaluable experience working in U.S.-based NGO's with a goal to not let diversity of culture in U.S. communities become a barrier to health for all community members. Seeing what it means for someone to attempt to achieve health in a setting that is unfamiliar is a very important part of global health and the U.S. is the perfect place to experience this. The rich experience and years of challenges that are expressed in the posts on this forum by nurses all over the world confirm for me every day that I need to know what it is like to be an RN and face health are challenges in my own country, as well as others, if I want to have a meaningful impact or truly be part of a larger nursing community.

All of this is definitely not to discourage anyone's interest in international health organizations, rather, just to note that if you have to, there is immense, if not essential value for any new RN to put in hours at the bedside. While you should absolutely continue to pursue your goals to work in an international organization, the resistance you are facing may be telling you something. And if you have to spend some time in a hospital in the U.S., you can feel good about the fact that you can gain very rich 'global health' experience right here at home.

Best to all,
Ann

Susan Wood, PNP-BC, MPH, IBCLC
Replied at 4:17 PM, 23 Jul 2014

I am reading this discussion with great interest. However, I'm not sure there's a single "right" way to pursue one's dreams - be they in Global Health or anything else. Sometimes opportunities just unfold and you follow your instincts and see what happens next.
My first job after graduation from nursing school in 1981 was on the Thai / Cambodian border, where I worked as part of a medical team running an ER in a large refugee camp. International health ( now known as "Global Health") was not really my intention at the time - although continued learning & the opportunity to do so as a member of this medical team was. I was totally green, but kept my eyes open and learned a huge amount about infectious disease / acute care / Cambodian refugees / the Vietnam War / collaborative care / clinical work in a low resource setting and so much more. Found unforeseen opportunities to contribute ( like running a nursing course for our Cambodian translators, and doing a massive research project on Cambodian child rearing beliefs & practices in order facilitate the Cambodian family's resettlement.) I initially went to SE Asia for 3m and stayed a year. And this first experience as a nurse has been one of the most formative ones in my > 30 years as a PNP - shaping so much of where I've been & what I've done ever since. Who knew?
Much of this discussion makes total sense: being intentional about a career in Global Health, looking for opportunities domestically to work with diverse & underserved cultures, getting bedside nursing experience, learning a foreign language, finding mentors, etc. ( Your head must be spinning by now, Melissa!) I would only add keeping your eyes open to unforeseen possibilities, recognizing that it may not be perfect but you never know what door may open to you because of it.

melissa godfrey
Replied at 4:23 PM, 11 Aug 2014

Thank you all for your words of wisdom! I truly appreciate you spending the time to share your thoughts with me, it means more than you could ever know. I can feel all of your commitment and devotion to the global health community, it is so empowering and invigorating to hear from all of you who have served our world with such pure intentions. I agree 100% with your ideas that you for bringing so many points to the forefront of my sight. Although we all have our own paths to fulfill our life mission, I will be taking your advise to work in a hospital setting (probably med surg) for a few years to fully develop my holistic nursing foundation. I plan to also attain a public health policy degree, with a more broad array of assets I plan to then submerge myself into a global health organization. Seeing as my sole purpose of wanting to get involved in the global health field is to aide my brothers and sisters around the world to attain sustainability (so that this playing field of life is more even), I will only consider my future to include organizations that work with communities using culturally competent methods to attain what the community is in most need of.

I appreciate all of your love and support- thank you for all you are.
melissa

Mohd Ali Kamal Batcha
Replied at 9:55 PM, 11 Aug 2014

Globally required, but can try applying for a position in Singapore....Stable career and a learning culture with evidence based medical treatment and nursing care outcomes.

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