By Monica M. Walk
A small Chicago non-profit organization has put hundreds of nurses to work in Illinois, providing health care beyond measure to thousands of patients both before and during the current coronavirus (COVID-19) pandemic.
Since 2002, the Chicago Bilingual Nurse Consortium, located at 2800 S. Western Ave. in the Arturo Velasquez Building of the City Colleges of Chicago, has made it possible for nurses who relocate to the United States from other countries to use their degrees and training to attain required licensing to work professionally as nurses in Illinois.
“We help the nurse candidate address barriers and challenges—like English proficiency—to the knowledge of the process which differs by state,” said consortium executive director Fran LaMonica. “It can be a struggle to understand what to do. Our mission is to increase the number of nurses through advocacy, education, and supportive services.”
The United States faces a deep need for nurses. By 2022, the U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses (RNs) for expansion, to replace retirees, and to avoid a true nursing shortage.
More than 840 international nurses from 70 countries have completed the Chicago Bilingual Nurse Consortium’s rigorous program, which requires evaluation of international school credentials and an English language proficiency exam targeted at a tenth/eleventh grade reading level. (The average reading level of United States citizens falls at the seventh/eighth grade level, and the American Medical Association recommends readability for patient materials should not exceed, or should meet, the sixth grade reading level.)
After completing these two steps, international nurses are ready to take the National Council Licensure Examination (NCLEX-RN). According to LaMonica, the consortium’s international nurses pass the NCLEX at a rate of 91%, higher than the pass rate for foreign nurses who take the test without the assistance of CNBC.
The consortium originally focused on helping provide care for large numbers of Hispanic and Chinese patients in the Chicago area. It became a 501c(3) non-profit in 2005, and its nursing candidates span a wide variety of languages and cultures. The current cohort consists of nurses from Tunisia, Lithuania, Great Britain, Puerto Rico, Mexico, and Poland.
“We realized there was a need for bilingual and culturally sensitive nurses,” LaMonica said. “And also realized many immigrants in Chicago were nurses in their home country and not able to work in the United States.”
“I can be amazing, speaking more than one language,” said Maricela Pineda, an ER nurse in Humboldt Park who soon will move to intensive care unit work in a South Side hospital. “I had a patient, and I translated to him all the instructions for medication. He said, ‘I am so comfortable to talk to you. Thank you.’ With COVID 19, there are people who have no access to insurance or healthcare, and people think they can’t go to the hospital. I tell them to go to the ER, make a payment plan, ask for a translator or come when I work and ask for me. It feels so necessary to speak another language.”
Pineda grew up in a small town near Veracruz, Mexico, watching her father work as a community nurse. “He was a first aid responder, the only one in town trained in CPR [cardio-pulmonary resuscitation], wound care, delivering babies,” Pineda said. “I was little, he would say, ‘Put on your shoes. Let’s go.’ One day a lady passed, and there was nothing we can do. I say, ‘Let’s go home,’ My father says, ‘No. We still do this. We hold her hand because she is leaving. Pray.’ I come from these good morals, values, heart. Nursing is a call; it’s not money. You have to do what you love to do.”
Pineda recalled that she was 15 or 16 when she took her first nursing class. By 18, she was doing wound care, disease prevention, and oral and prenatal care, often walking long distances to other small towns to give information. After completing her nursing degree, she worked as a community nurse in Mexico for five years. In 2005, she came to the United States at a cousin’s urging. She worked in factories, doing general labor. A supervisor learned she was a nurse in Mexico and told her the United States needed nurses, but Pineda could not speak English.
A friend helped her find the Chicago Bilingual Nursing Consortium, where a representative advised her to complete English language classes and then come back. Pineda sought free English classes at churches and worked on her own with a dictionary. She found Daley College and began taking adult English courses. She became a citizen, returned to the consortium, and learned how to become a Certified Nurse Assistant as she continued to refine her language skills.
Pineda also earned certification as a medical assistant but wanted to be a nurse again, so she pushed herself to repeat English language classes and enrolled in an associate degree program in nursing, essentially repeating her education in English. She did not need those academic credits but found the review beneficial. She took the English test for nurses and earned her license. She now is enrolled in a Public Health master’s degree program while working 12-hour days.
Consortium associate director Paula Schipiour, who works closely with students, noted, “Maricela is unique that she also graduated from an American school. She wanted to be a nurse. Whatever process, she would do it.”
Coronavirus front line
Pineda has worked as a nurse in Chicago for a year. “I am very proud to be a nurse here,” she said. “It is my heart. I feel like a soldier fighting COVID 19. I understand the worries. A patient with COVID said to me, ‘You stay with me. I will die.’ I said, ‘Let’s fight together.’ To be a nurse, you have to have the gift to feel empathy and compassion. I got that from my parents.”
She said she does not fear her work in the pandemic. “My profession is risk every second; this is nothing new,” she said. “I can say, as an ER nurse, we can do everything. It’s a broad profession, and we prepare nurses capable to do everything about the health system. This is my call and where I belong.”
Pineda also volunteers in the community at Mercy Hospital, St. Anthony Hospital, and Catholic Charities. “I love this country and say thank you to this country,” she said. “Public health is amazing. My heart is in the community. COVID is public health: I have to be part of this process to be part of planning to improve.”
Marlene Santos also is working in the thick of the coronavirus crisis. She is a collegiate (student) nurse at Mercy Hospital, where she works on the ER floor with mentors while studying for her U.S. license. “I love that I can work in nursing prior to certification,” she said. “I help nurses, and they teach me.”
Santos earned her nursing license in Puerto Rico in 2014 and worked in hospital labor and delivery in a clinic for cardiologists and then as a school nurse. She moved to Chicago after Hurricane Maria’s 2017 devastation, which destroyed her home, She recalled the hardship of no running water for three months—which meant collecting and using rainwater—and no electricity for six months.
While Puerto Ricans are United States citizens, Puerto Rico uses a different exam to license nurses. Santos is following the consortium procedures to prepare for NCLEX-RN. Her aunt, a retired nurse, helped her find the consortium. Santos was ready to take the NCLEX in March, but the National Council canceled testing dates due to the coronavirus.
Santos’s typical day as a collegiate nurse involves all general ER nursing duties except administering medication. She is proud to use her longstanding ability to draw blood from patients with even the most difficult veins, a skill valued by her colleagues in triage. She felt a pull to wound care and blood draws as a teen and realized she wanted to be a nurse.
“We can’t show patients we are afraid,” she said. “It’s a job you have to love. I love to save lives. I’m not afraid.”
Because of her bilingual abilities, “Doctors look for me,” she said. “My culture and Spanish is different from Mexico; there is some confusion. But, at the end of the day, we understand, feel comfortable that someone is understanding. I translate to the doctor. I try to calm patients down, give them life experience. They come back and ask for me. A man came back and remembered me. His wife said he said, ‘Here comes the superhero.’ The wife is comforted because I am here.”
Schipiour commented, “There’s a saying: If you save one life, you’re a hero. If you save thousands, you’re a nurse.”
Many types of nurses needed
The consortium works to help all international nurses reach their nursing goals.
Saulena Antanaviciene, LCPC, NCC, was a nurse in Lithuania. She moved to the Southwest Side of Chicago with her husband and toddler in 2004 but discovered the consortium only last year. She is preparing for the NCLEX exam and hopes to take it within the year, then pursue an advanced degree. Her goal is to be a mental health nurse practitioner, with the ability to prescribe medications. She currently works as a licensed mental health counselor in her own practice, S.A. Integrative Health LLC, in Orland Park, IL, with a focus on anxiety disorders.
“My mom is a nurse,” Antanaviciene said. “It’s a helping profession, and I like to be around people, especially the mind and mental health part. It took some time to know the system here. It is hard work.”
She began her American nursing work as a certified nursing assistant (CNA) in home health while working on her English, which helped her complete her mental health counseling course work. English is Antanaviciene’s fourth language. She then worked in hospital emergency room mental health assessment.
Work in a psychiatrist’s office several years ago solidified her return to nursing. She found inspiration in a colleague whose counseling ability enabled her to make extremely fitting medical prescriptions for patients. That combination of skills launched Antanaviciene’s renewed ambition for her own nursing work.
“The nurse license was not known to me,” she said of the U.S. requirement. “I found out I was eligible for the license exam.”
Antanaviciene currently works via online consultation with a range of clients coping with anxiety disorders, including obsessive-compulsive disorder. She noted the current pandemic will create trauma for many people in the future.
“It’s an honor to be allowed inside someone else’s world,” she said. Her cultural bridging helps her practice. “Being from a different culture, you know the marginalization and stages of adjustment,” Antanaviciene said. “That helps with any immigrant.”
Not all international nurses who contact the consortium can earn their American license. For some, the language barrier is too steep to pass the challenging English test, although some find work as CNAs.
The approval process for degrees and coursework from other countries also can be frustrating. The consortium has made recommendations to the State of Illinois to drop the requirement for the GED for nurses who were educated in schools that begin nursing training in high school, particularly for those who have passed the licensure exam in other states.
“This is a very challenging process,” LaMonica said. “The internationally educated nurses are fine intellectually and really care for patients—or they wouldn’t go through this process.”
The World Health Organization has designated 2020 as the International Year of the Nurse and Midwife; May 12 is International Nurses Day.
The consortium is funded entirely through grants and donations. To donate, contact LaMonica at CBNC247@gmail.com. For other information, log on to chicagobilingualnurse.org or call (773) 838-1870.