How to Work in the U.S. as a Foreign-Educated Nurse (With Nelson Hurtado)

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Welcome to Club Nurse. I'm Colton Lord, your host. By you being here today, it shows me that you are someone who wants to learn, Grow, laugh, connect, and just let your emotions flow. We are here to share real stories and hear real life experiences from real people. You are not alone in this, and Club Nurse is here to show you that. Don't forget to follow the show and share today's episode with someone you love. Now let's dive into today's conversation. Welcome back to Club Nurse, everybody. I have with me today Nelson Hurtado, who is the founder and CEO of ANP Health Services, which is a startup company that specializes in recruiting and placing foreign-educated nurses in various healthcare settings across the United States. Since 2018, Nelson has developed and executed strategic plans that align with the mission of supporting international nurses in realizing their dreams of pursuing a nursing career in the US. So without further ado, welcome Nelson to the Club Nurse Podcast.

Thank you. Thank you. It's a pleasure to be here, Colton. I appreciate it.

Yeah, of course. I'm so glad that you're here. So let's kind of start with, we'll jump into kind of what ANP Health is, but let's kind of just talk about your journey. I spoke a little bit at the health conference in Las Vegas, but kind of tell the audience how you got to the US, where you're from, and kind of like what sparked you into starting this company.

Yeah, so I, I'm originally from Venezuela. I came to the United States when I was around 18 years old. I came with a big dream of playing baseball. I was a pretty good baseball player back home. I was actually going to sign in the minor leagues, but you know, I The contract that they put on my table wasn't juicy enough for me to decide to go through the whole journey. So instead, I decided to come to the US and try to get drafted, go to college. So I played in college, and initially, Colton, I wanted to do marketing and public relations. But coming as an international, you're always thinking, how can I stay here in the United States? Like, what's the best way? And, you know, a lot of people take the marriage route, but when you are When you're an immigrant that is skinny and barely eating, don't have any money, and didn't speak the language, trust me, man, like, there was no girl that saw a potential husband in that little kid, right? So I had to figure out where do I go in order to get the green card. And I remember one of my directors of the international department was the one that told me about nursing. My dad is a thoracic surgeon, so I always thought I wanted to be a surgeon, and nursing Latin America, it's, it's really, it's really bad. So when they told me you should think about nursing, I'm like, oh heck no, thank you. Are you kidding me? No, I'm not going to become a nurse. I'm going to be in the worst of the worst, right? However, I started meeting people and then I met a friend of mine, you know, his mom was a nurse and, and I started realizing, oh crap, like nursing here, it's different. So I started doing a little bit of research and long story short, I ended up going into nursing. And in my first quarter, I actually fell in love with the profession and I I truly believe that God had a plan for me to become a nurse. And through nursing, it's when I got my green card, the permanent residency. There's a better ROI in nursing than getting married, you know, and through that—

A better option. Yeah.

A better option, you know, and I got my green card through nursing. And I've always had this entrepreneurial spirit since I was a kid. Trying to pay for college was hard because my parents couldn't send me money. So I had to buy and resell stuff. And I used to go to Latin America, bring, you know, technology, iPhones, computers. And actually, funny story though, for the record, I used to bring suitcases, like literally 2, 3 suitcases packed of Victoria's Secret underwear, dude. And I sold the crap out of it too. Like, I would, I would spend $300, I would make like $7,000 out of it. Wow.

So natural-born entrepreneur then.

I was always hustling, hustling, hustling. And when nursing came into my life and I got the green card, And I was able to provide my family, you know, a more stable situation and lifestyle. I started thinking, wait, I want more. I want more. Like this is not cutting it. I either need to go to NP school, become a CRNA. I need to make more money. But I learned early on, you know, it's not about the money. It's about the impact that you do on others. So I thought, what can I do that impact people's life positively? And then the money will follow. And that's a phrase that I heard in 2012 from, from a guy, one of the tech founders of Facebook. His name is, um, Chamath Palihapitiya, something like that. He said, you know, the, the future businesses are going to be successful based on, on the impact that they have in the world. If you impact people's life positively, the money will follow. And that just clicked in. So when I started thinking, what should I do? Then I thought all the experiences that I've had, all the benefits that nursing have given me, And all the international people that are struggling to try to get into the legal system, and they could do it through nursing. And besides, we have a huge need of nurses. And just like me, who thought, no, I don't want to be a nurse, but once I tried it and I fell in love with it, I figured many people could do the same. And indeed, nowadays, you know, there are, you know, handfuls of people that have told me, I started nursing after I heard your story, and they actually love it. I've heard a couple of them that are like, I actually hate it, but I got my green card, yoo-hoo. And then they go on and do something else.

But that's a good, that's a good point to kind of like jump off of there is that you don't have to like, and I even say this about myself, you don't have— nursing doesn't have to be your like love and passion in the world, but it is a great vessel or conduit for people, especially international people, to kind of, you know, make a better life for themselves. And even people who, you know, like me, who's like born here in America, it's always there. And you can be a really great nurse, a really caring and compassionate nurse, and not be your you know, life's goal and ambition to do this forever. So I think that's, that's a great point to make.

100%. And I, and I think the whole vocational and you have to be a nurse because it's the vocational aspect and the passion of it, that has changed. That doesn't apply anymore. You can love it, but trust me, I don't love working in med-surg, but I love working in CVICU. And nursing has so many subspecialties, like you working remotely doing something and then You can work on an airplane, you can work on a freaking cruise ship. Like, there's so much that you can do as a nurse that yes, you can fall in love in certain aspects of it. And if not, like you just said, it's always a great plan B. It's a secure job. It's not horrible. You're going to make decent money. But in my case, I wanted more, and there's nothing wrong with that. So I decided to found AMP by helping, trying to impact people's lives positively, trying to impact the system. And why not make money out of it?

So, yeah. Yeah, absolutely. I, something that I've kind of, kind of go to go back on what you were talking about, my experience working with really anybody who's international coming into the US, there's a different level of like grit and just gratitude for what you're doing versus people, like I said, like me who were born here in America who were just like, oh my God, I have to do this job. It's like, there's, there's just a different level of understanding coming from somewhere that you're trying to get, you know, whatever your reason is for wanting to come to America or to a different country from where you're originally from, there's just that extra level of, like I said, just like determination and gratitude for the work, which I think makes a huge difference. So you went to nursing school in America after you got here, or did you do that back where you're from in Venezuela and then come here?

I actually did in America. I went to nursing school in Washington State. Okay. In a little town called Yakima. It's a desert, and I don't know if you've ever been there, but, you know, there's nothing much more than apples and, and great people. You know, I, I love I got my associate's degree from there. Then I went back home in 2013 after I graduated, because interesting enough, after I graduated, I called about 8 lawyers in Washington State, Yakima, that, you know, they were not used to international nursing and the EB-3 and the visa type. They were used to more, you know, illegal immigrants and how to transition, or farmers, how to transition. And I always say, you know, a lawyer, an immigration lawyer, is like a cardiologist. You give a cardiologist an EKG and he might interpret it one way, the other one may interpret the other way.

Mm-hmm.

Immigration lawyers are the same. So funny was that this immigration lawyers are like, ah, no, you need to get married. I'm like, you're— I, I went to nursing school to get my green card. And they're like, no, we don't know anything about it. So I had to leave the country before I became an overstay status, which was an illegal status. I didn't want to go through that. Went back home, stayed there for 2 years, um, started my own business there, a medical import business, um, supply After 2 years, Venezuela went to crap, as everybody's known, and then decided to come back. And I went to Minnesota, and that's where I finished my bachelor's degree in nursing. And during the bachelor's is when I found an agency that actually sponsored me to get the green card.

Okay, so explain to the audience, to anybody listening, what is the— and I'm sure that there's a bunch of nuances to this, and maybe it's different for everybody, I'm not sure, but What is, what is the process? So if there is, if there is a nurse who has graduated in another country, they've got their nursing degree, do they kind of give us the process of how they get here? And then what is your role in that of helping them along that path?

Awesome. So the process in a general broad aspect is 4 steps, you know, in each step there are many, many micro, micro steps. But initially, we have to make sure that the education that that international nurse got, it's equivalent to the education in the United States. So if somebody claims to have a bachelor's degree in nursing in Mexico or Venezuela, Argentina, we have to make sure through the credentialing agencies that it is equivalent, you know, credit hours, theory, clinicals, that at least they receive the same amount of knowledge that we do here in the United States. The second step is the proficiency of English. We have to make sure that they speak the language. And for that, it's not based on my company, it's based on third parties. There are tests, like TOEFL test or IELTS or OET. Those are tests that are accepted by the Board of Nursing or accepted by each state in order to say, once you pass this, you have demonstrated that you have proficiency in the language of English. Then the third step is the NCLEX. Every single international nurse has to take the NCLEX.

Even if they've— even if they've taken their exam in wherever they're from?

Correct.

Is it the same? Is it the NCLEX just there, or is it a different licensing exam?

So it's the same NCLEX because the NCLEX is held by Pearson VUE. You know, when we took the NCLEX, we didn't submit the documents at the Board of Nursing because most universities here do it for us. But then we have to schedule once we have the ATT, our, you know, our board, and then we go and sit. And where we sit, it's a Pearson VUE center. So Pearson VUE has different centers all across the globe. They have one in Brazil, they have one in Mexico, they have many in Canada and the United States, all over the states. Um, so these nurses would have to go to one of those centers. So if we have a nurse from Argentina, they have to fly into Brazil and take it. Some countries in Latin America, they have their own national test, but, but that's not equivalent to the NCLEX. Everyone have to take the NCLEX. And then the final piece is if they're not already a US citizen or US permanent resident, they have to find a sponsor, which is an employer. And then the employer have to say, I want that nurse. We have a shortage. That nurse meets the credentialing validation process. It's the same. It's equivalent. They speak the language and they pass the NCLEX. And then immigration will request all of those documentations. plus a job offer. And then after that, it takes about 2 years before they can arrive. And it all depends on the visa, the different types of visa. So our job, it's literally, we have, so the company has grown and we have now several divisions and it's a holding company with 3 companies underneath. But all those 4 different steps, we support it between the credentialing of the credit, of the evaluation of the credentials, because we're an authorized agent you know, before all these credentialing agencies. Um, we also launched the very first bilingual app, um, for NCLEX. I don't know if I showed it to you at Health, did I?

I don't think so.

Yeah, so kind of like Kaplan and UWorld and all these apps that are out there, there's not a— there was not an app that, you know, was catered to the international environment. So we developed the very first bilingual app. So it's an app that you study for the NCLEX And if you don't understand what you're reading, you just hit a button and then it translates into Spanish so you understand it. And then you go back into English and then you reply. And it has a bunch of AI. And we just launched it in May. We already have 1,500 students using it.

So what's it called?

It's called LearnClex. LearnClex. Yeah. And, and it— we have, we have great momentum. Um, a couple universities are wanting to use it because, you know, it just helps you improve your English and at the end helps you understand the context better. So you're going to have more, more chances of success in the test. So we help from the credentialing process to the training for the NCLEX, and then eventually also for the connection with the hospital. We have contracts with, I don't know, maybe over 150 hospitals today in the United States.

Wow.

So once the nurse meets all the requirements, we introduce it to the hospital and say, hey, this is a candidate you're looking for. And then we staff the hospital under a direct hire model. It's not like We bill per hour. This is a flat fee that we say, this is the nurse that you're looking for. Do you like him? Interview him. Yes. Issue the letter. Then we handle all the immigration process for the hospital and the nurse. And then once the nurse is delivered, we support the nurse for, you know, 3, 4, 6 months. And then they stay with the hospital as long as the hospital and the nurse want. Nurse.org and major league sports teams are honoring nurses with discounted game tickets and once-in-a-lifetime experiences. From throwing the first pitch to riding the Zamboni to on-court recognition, join the fun. Visit nurse.org/nursenight to find a nurse appreciation event near you and grab your discounted tickets today.

Wow. It sounds like you're really changing lives. I mean, that's, that's really huge. Um, and something that's obviously so special to you and, um, so close to your heart. I mean, with just kind of, you know, the process that you've had to go through as well. Um, so how does, how exactly does a sponsorship work? Is that who, who is sponsoring, uh, international people coming from other countries? Is this someone in the hospital system? Is it really— can anybody sponsor? How does that work?

That's a great question, you know, and it is kind of like a, like an old but new topic, you know, like now every hospital is being reactive and they want to sponsor a nurse. Certain companies have been doing it for the last 20 years, but primarily hospitals are the ones that are sponsoring. But literally almost anybody could sponsor a nurse if they, if they qualify. The hospitals, they have They have to meet certain criteria. Certain home health agencies meet certain criteria, rehab centers meet criteria. But typically, the contracts that we have are 98% with hospitals, and then 2% with like long-term care, you know, nursing homes. And not everybody understands the long-term play. Not every company can also afford an investment of, I'm going to wait 2 to 3 years before they show up. But then they go and fall into, I'm gonna pay agencies, and they're gonna end up paying hundreds and hundreds of millions of dollars. Yeah, hospitals, they're very reactive, you know, and they say, okay, uh, I need 200 nurses for tomorrow. It's like, okay, but what's your plan for 2028, 2029? You're still gonna need nurses and you're not acting. It's not that international is a true solution, but it's one of the many solutions.

It helps.

It helps, and, and it helps units. Like, you could literally staff a unit with 20 international nurses and it's gonna be better than 20 travelers. It's gonna be better for patient care. It's gonna be better for retention of staff. It's gonna be better for, for everything, results and money. I mean, there are multiple levels of, of why it's beneficial. And, and there's some misunderstanding of, oh, the international doesn't meet the criteria. They have to pass all the same standard tests that we here have to pass and they have to pass the immigration process. So it's, it's very complex. If you see an international nurse who've made it, it's kind of like, oh man, you know, Feel a little empathy because they, they went through the wring.

That's a lot. There's a lot of, there's a lot of hoops to jump through and it's a long journey to get, to get there. And I think too, what these hospitals maybe don't think about or understand is once, you know, once that nurse finally does get here and gets that job, like I guarantee you their retention rates are higher. I mean, I don't know the numbers. This is me just kind of guessing. I guarantee the retention rates are higher with international nurses versus, you know, Somebody that just went to school here, that's from here.

And like, just like you said it, you know, I, I went to Fargo, North Dakota, and in cold— I mean, granted, you know, there are some nurses that are stinky, you know, and it depends on where they come from. Some of them know the system better than others. However, the nurses we work with, Latin America and Europe primarily, these nurses are extremely thankful. I went to Fargo, North Dakota. Who wants to go to Fargo?

Nobody.

Nobody does. Why? Because they said, Nelson, that's where your green card is. I'm like, let's go. I stayed with my employer for 2 years.

Yeah.

And granted, it wasn't the best. And back then, I didn't know as much as I do now. I wasn't getting paid weekend differentials, not because of the nursing home. The agency that represented me was taking that money from me.

Wow.

I didn't sue. I just said, listen, I'm thankful for the green card. Thank you very much. When can I get out? And they charged me a fee and I paid them.

I was like, yeah, $8,000.

I paid him and then I was able to leave. Now today, that's part of my passion too.

But don't take advantage of people.

Yeah, I'm— we don't allow— like, there are only 16 companies in the US that are considered ethical recruiters under CGFNS, which is one of the biggest— it's called TrueMerit today— one of the biggest credentialing agencies for international nurses. There are hundreds of agencies out there. We're one of the 16 companies that said our practices are ethical. Why? We're in the middle ground. What's best for the nurse is going to end up impacting positively to the hospital. Whichever system that understands that is going to have a way more successful international program. We don't allow the nurses to take advantage of the hospital in whatever we can control and vice versa.

Mm-hmm.

Because I went through it. They didn't pay me weekend differentials. Like, I could have made a huge lawsuit, dude, make millions. But it wasn't in me because, you know, I was so appreciative. I said, thank you very much for That is correct. We don't allow that now, but— and that's why we, we are picky with who we work with. But, um, but yeah, I mean, the turnover rate is gonna— it's decreased just simply, you know, you, you help them so much. And when you're new in Fargo, North Dakota, you don't know anybody. You're not planning on moving because it was so hectic that you're not thinking about, I'm gonna go to California and start from zero. It's like, no. Barely learning the system right now. I better stay here in my 3, 4 years.

Right. Yeah.

Yeah.

Like, that's what I'm saying. It's just, it's the gratitude and the appreciation to just be here. Give us an example of, so if somebody, if somebody, uh, how do they, first of all, if you want, if you could give advice to somebody, a nurse who's in another country, who's able to use your services, first of all, how do they find you? And second of all, what is like the first thing that you tell them that they need to do? Um, if they've already graduated a nursing school, like, can you kind of just like tell us like, what's the first thing that somebody needs to do?

So the first thing that I always recommend is, is get educated about the process. You know, right now it's so easy to find information. You know, we had Google make things simpler, YouTube even simpler. Now we got ChatGPT and all AI. It's, it's really easy to find the information. But that's the very first step. If you're an international nurse, try to get familiar with the process. Try to get familiar with the agencies that are out there, you know, their, their reputation. Are they good? Are they bad? And then start seeking for all those opportunities and Learning the process is going to help them a lot to make an informed-based decision versus FOMO, and out of like, oh, okay, the first contract that hits your table, just make a decision. It's like, do, do a thorough evaluation of who's gonna actually help you genuinely to fulfill that dream for you and your family. That's always the first step that I, that I recommend to people. It all depends on when you first graduated. You got 2 options, Colton. They have the option of doing the the initial process themselves or hiring a company to do it because it's a simple process. But if you're not familiar with the American system, just as simple as sending some documents to these validation agencies or evaluation companies could put you on a backlog if you do it wrong. So, you know, for example, when, when I was going to take my test at Pearson VUE, You know, Latinos, we have like ten names. You know, we have a first and middle name, then the last name, and then a maiden name. But it's all like one name.

Yeah, I grew up in Arizona, so I okay.

So you have Martinez Rodriguez and all about that. So I never used my maiden last name here in the United States. I was Nelson Hurtado the entire time. But when I go to register my ID, my governmental ID had all my full name. So when I register Pearson VUE, I just said. Nelson Hurtado. So I graduated in 2013. I go to take the test. They rejected me, dude. They said, you cannot take it. It's not the same person. And then back then I had to wait 90 days before I could take the next one. And my flight to Venezuela was leaving like in 2 days. I had to leave in 2013 and I couldn't take my NCLEX until 2014, a year later.

Wow.

Because I didn't have the money to come back. So I forgot everything. I had to study all over again. And then I came back. So it's just those little details that if you don't know how the system works, then it's gonna push you back time, it's gonna make you spend more money. So basically just get educated about the process, you know, go and find videos of us or whoever companies out there giving information for free and try to learn and then engage with the company for the services that you need. It's my biggest advice.

Yeah, well, that's great. And I think that that's super helpful for people. And yeah, I feel like the return on investment by just having some assistance upfront in the long run, just saves you so much headache. I mean, that's anything that you do that has anything to do with government paperwork or anything. It's just, it's a headache. And there's so many hoops you have to jump through and you just don't— and especially if English is not your first language too, just trying to navigate that is probably like so hard. I can't even imagine, which is why I have so much respect for anybody who is leaving the country that they know, that they live in, where their family and their friends are. And again, for whatever reason that they're wanting to come here, it's hard. I don't know. I don't even know how else to put that into words. Like, that's just such a hard thing to do.

It is. It is. It takes, it takes bravery. You know, the, the, this, these nurses are brave. And a lot of people are like, why would they want to come to America? It's just, I always ask the same question as, have you ever been outside of America?

Yeah. People don't understand.

Have you ever gone to Brazil or Venezuela or Colombia? Because once you do and you go to a hospital and you realize that colleagues because they're nurses as well. The situations that they have over there, dude, we got it so dandy here in the US. It's such a breeze.

Right.

And, and you said it at the beginning, it's, it's perspective. The perspective that when you come from worse to better, you see things, you're more appreciative. Doesn't mean that you have to accept and normalize the things that are done wrong in the United States, which is not perfect. Nursing here is not perfect. But it's by far so much better than the majority of the places in the world.

Yeah, there's a reason. There's a reason people want to come here. And yes, like you're saying, it's not, it's not to ignore the things that are happening here because it's far from perfect and it could be much better. But yes, when you see the conditions that are elsewhere, just being educated on that is so important and it does kind of shift your perspective and give you a little bit more gratitude for, you know, the level of healthcare that we, that we do have. here as well. So what was your— kind of to go back, what was your specialty before you got into this business?

So I started in a nursing home. They were the ones that were going to give me the green card. And then as soon as I left, I went to cath lab. And I loved cath lab, but I was like, okay, this is more like a retiring environment than actually learning. I always thought I wanted to do CRA school. So I quickly transitioned after like 8 months to trauma ICU. And then that was in Fargo. They had a huge medical center and they had all these specialties. And then from trauma, I went to neurotrauma, which I loved it. It's like the grayest area ever.

Like neuro ICU?

Yeah. Neuro ICU, neurotrauma ICU. It's like, you don't know what's gonna happen tomorrow. And I enjoyed that. It was just like everything was different. And then eventually I went into CVICU, which is like black and white. It's like, it's like, like, you know what's happening at all times. You have control and, and, you know, you can be predictive. You're like, okay, this is gonna happen. We're gonna do this completely different from the rest. So I stayed in, in CVSU for a while. It was a, an ECMO unit and I loved it during COVID And, but still, you know, I, I thought I wanted CRNA and I made a deal with my wife. I said, listen, I'm gonna apply to CRNA school and If I get accepted, great. If I don't get accepted— so in the process of applying, I founded AMP, and I kind of like stopped the application process. And then I made a promise and said, if I don't make more money in a year than what I would be making as a CRNA, then I'm going back to school.

And thank God, here you are.

Thank God I'm not going back to school.

Yeah, that's awesome. That's actually funny. I, I hated the neuro ICU, first of all. I, I worked there for 6 months, and I was like, I'm not And I'm glad that there are people that will because I do not want to do this.

It's insane. It's insane. All the EDDs and all that. Yeah, I mean, we're far in North Dakota, so the traumas that you see there is like a guy got stomped by a cow, by a buffalo, a semi-truck hit the crap out of somebody. And yeah, a lot of accidents happened that had to be airlifted. But the hospital was cool because the helipad landed right on top of the ICU. They didn't go through the ER or anything, and they had an elevator straight to the ICU.

And it was just It was amazing.

It was like an ER rush feeling with the ICU OCD behavior. So yeah.

Yeah, I like, I like the ER for the sense of— and this was really before. I mean, now it's like you, you get patients, you treat them, and you're holding them in the ER for so long, which is why I'm like, I got really overworking in the ER. I like to just treat them, do whatever they need done acutely, and move them on, ship them upstairs. That's what I like to do. Again, now it's more like you treat them and then you keep them for your shift.

I couldn't keep up in the ER. I— not, not that I hated it, but I just couldn't keep up with it. Like, I was— oh, every time they floated me to the ER, they would make fun of me because I would mess up all the numbers. Like, I would be so behind. I'll be extremely— like, somebody came complaining of something and I'll be like, okay, no, but how about— and then I'll just start digging into unnecessary things.

Yeah.

And it was just like everybody would make fun of me and I'm like, I, I just— I'm not a good ER nurse.

I think you learn, you learn to stop focusing on that. Like, when you start Like if you were up in the triage booth or wherever for a while, you would start to just learn to like focus on what's there. But yeah, you know, that's the beauty of nursing is it takes— there's— it takes all of us to do different jobs to make, you know, the wheels go round, as they say. I started my career inpatient on like med surg, went to the ER, knew I didn't want to do inpatient nursing again. That's when I went to the ICU and I just— I think I set myself up for failure because I also was like on this path of CRNA school. It's like what I wanted to do. And once I got there, I just was like, I can't even make this for a year. to try to get this experience under my belt. Like I've— so then I took a travel assignment back to the ER. Um, but whatever. Again, it's what makes the world of nursing go round, that we all do different things, that our brains all function kind of differently. Back to A&P health though, is there, is there anything that we didn't talk about that you think is important for the audience to know? If there's somebody who's listening internationally, somebody here in America who knows a nurse that's, uh, in another country that's trying to get here, anything that, that you want to leave for the audience that we didn't talk about?

Yeah, I mean, the— if you know a nurse who's an international nurse and they, and they need help understanding, they can always route them to our social media or website. Um, and on Instagram, we're AMP Health US. The AMP Health Services, it's all in Spanish because that's our primary market, but AMP Health US, um, they can contact us through there, or the website is AMP Health Solutions. Um, and then, you know, my, my social media is primarily in Spanish too. The whole name is in Spanish. You can tag it or put it on the podcast, but it's Enfermería en USA, Enusa. And, you know, refer them to us. We'll be more than happy to educate them and see how we can help them. The app, it's something great that it can also be shared because, you know, you can use it as a free app with limitations and it helps them. Uh, and, you know, there are some free functionalities there, but I, I guess it's be aware that it exists, um, an opportunity for international nurses. We need them. We need as many nurses as we can get. We have plenty of nurses, just not many nurses willing to work in the hospital setting.

Yep.

And we have to get creative about it, you know. And if there, if there are hospitals or, or hospitals struggling— hospitals are closing left and right— but those that are projecting for 2027, '28, '29, and international nursing. It's one of the solutions that the big boys are playing. You know, the biggest companies that, you know, we have contracts with, they're the ones that are saying, you know, I'm going to prepare for 2028, 2029, 2030 because the nursing shortage is not going anywhere. Like, we're still going to be nurses.

Yeah, yeah, yeah, for sure. Is there— last kind of last question to kind of wrap this up that I meant to ask you earlier. Do— I know you said you kind of got placed in North Dakota. It's kind of where you were sent to work. Is there— if nurses come through you, do they— are they telling you like, I want to go to California, or I want to go to like wherever, or are you kind of just like, okay, we'll help you, but these are, you know, this is where we're contracted through, this is where we can help you get to?

Yeah, exactly. That's a great question. And it's more of an option B because it all depends on the need of the hospital at the moment, right? And how many clients we could have. And there has to be certain level of flexibility. I had 2 options, whether it was North Dakota or Texas. Of course I would have chosen Texas, but they said North Dakota, you have the contract on the table. Texas, we're waiting for 2 months to see if they send the contract. I said, you know what, listen, I'm out. Take what I can get. So what we do is we analyze the profile of the nurse and then we say, listen, based on your profile, your experience, this is what we have available for you today. And then they can choose based on that. And then that fluctuates. You know, we had 250 job orders in one state, and we filled that up in like 3 months, and then that's it, that's done. Like, that hospital, that system doesn't need any more. So then we go to the, you know, next state. So currently, I, I think we have about 10 different states that are active looking, uh, for certain profiles, and that's what we would offer. And then if it doesn't, if it doesn't meet their need or want, then, you know, there are other companies out there that they can work with. However, I always advise a little degree of flexibility, a little big degree of flexibility will get you farther. I figure I go to Fargo, North Dakota, 2, 3 years, I'm out. It's time is money. And that's what people don't understand. Oh, I'm gonna wait for my opportunity.

Yeah.

Now you sit on your hands for a year and a half until it landed. That's what I wanted. Well, that's a year and a half that you could have been making money, right? Way more advanced in the system. Granted, you have you had to go to a different state, but you've been in different states nursing. I have seen from being in 4 or 5 different states, slightly changes, not much. I mean, it's, it's, it's more of the facility itself.

Yeah.

Than anything else. And the money, you know, sure, you make great money in New York and California, but you spend great money in New York and California. So that's how you're right. It's very balanced. What I think—

You're so right about that. Because just when I, just when I had lived in Boston, I worked for a number of different hospitals in Boston. It's not that big of a city. And I worked with several hospitals within the city and all were different. So it's not even like what you're saying, city or state dependent, it's facility dependent on kind of the experience that you're gonna have. And even further down from that, it's like unit dependent and specialty. Like it really, so people can have like a fabulous experience at a certain hospital in a certain specialty. And somebody in the next unit over is like, this is the worst job I've ever had. And it really just, perspective is just everything kind of going back to perspective.

Yeah.

Well, thank you, Nelson. I really appreciate this. I think the work that you're doing is really great. You know, I'm sure that there's a lot of motivation and inspiration behind just your own personal story. And that's probably why the work that you do is so impactful and why you're so successful in what you're doing. So thank you. And if anybody's listening is, you know, knows anybody in America who knows nurses that are international that are trying to get here, share this with them. If you know a nurse that's, or an aspiring nurse in another country who's wanting to come to America, share this with them because Knowledge and information really is power, and these kinds of things are really important for them to know. So thank you so much, Nelson.

Thank you, Colton. Take care. God bless.

From the bottom of my heart, I wanted to thank you for being here at Club Nurse. I hope you gained something valuable from today's episode, and if you did, remember to share this episode with someone that you love. Follow me on socials @NurseDaddies or @ColtonLord17, and be sure to follow nurse.org. To stay informed with all of the hottest healthcare topics. Until next time, take care of yourself the way you take care of everyone else. Love ya. Bye.