It's not an easy process to get a bill passed. But determination and necessity fueled the Philippine Nurses Association of Michigan (PNAM) to do just that.
On June 14, 2007, Michigan Gov. Jennifer Granholm signed into law House Bill 4207/Senate Bill 197, which removes the CGFNS Qualifying Examination as a requirement for licensure of foreign-educated nurses in the state.
"The Commission on Graduates of Foreign Nursing Schools (CGFNS) Qualifying Examination of Nursing Knowledge became unnecessary, an extra burden on foreign-educated nurses seeking to work in the U.S.," says Ellen Dioso, RN, BSN, CCRN, president of PNAM.
The rules have changed
Changes in visa requirements precipitated the call for elimination of the Qualifying Examination. With the wave of immigration in the mid-1960s, nurses were permitted to enter the U.S. on tourist visas even without prearranged employment or as part of an exchange visitor-nursing program.
In the '70s, nurses seeking employment in the U.S. (applying for occupational visas) took the CGFNS Qualifying Examination. This is part of the CGFNS Certification Program created to more accurately forecast whether foreign-educated nurses were likely to meet the requirements for licensure of registered nurses in the U.S.
"Taking the qualifying examination meant nurses were taking two exams for the nursing license — the preparatory exam in their home country and the NCLEX-RN in the U.S.," says Remedios Alvarez Solarte, RN, NP, MSN, chair of PNAM's CGFNS Task Force.
Currently, foreign-educated nurses enter the U.S. with immigrant visas. They can take the NCLEX-RN examination at one of the 15 International Testing sites, such as in the Philippines, or in the U.S. state where they plan to work.
Challenging effort
The initiative for the removal of the qualifying examination in Michigan, spearheaded by PNAM, began in 2005 and spanned 21 months. Solarte credits the support of the Coalition of Michigan Organizations of Nursing, the Department of Community Health, and the Michigan Board of Nursing.
Long-range benefits
Jeanette Klemczak, RN, MSN, chief nurse executive of the Michigan Department of Community Health in Lansing, says the elimination of the qualifying exam fits within the larger strategic plan for addressing nursing needs in Michigan. "Any and all ways that we can improve the ability of nurses who want to come to Michigan to provide nursing care is part of our agenda," she says.
Filipinos are the second-largest group of foreign- educated nurses working in Michigan. Canadians, the largest group, need to undergo only a credential review to qualify for work.
According to the Michigan Department of Labor and Economic Growth, the state's demand for RNs by 2010 will exceed supply by 7,000 nurses, with a shortage of 18,000 by 2015. "Foreign-educated nurses fill a gap to help care for our patients," says Linda Taft, RN, chair of the Michigan Board of Nursing.
National trend
Of the 59 states and territorial boards of nursing that comprise the National Council of State Boards of Nursing, 29 do not require the Qualifying Exam. New Jersey removed the exam in 2006 as a requirement to take the NCLEX.
Michigan requires the CGFNS Credentials Evaluation Service Full Education Course-by-Course Report for internationally educated RNs who have not been licensed in another U.S. jurisdiction for at least five years. Applicants who graduated from a nursing program that was taught in a language other than English also must take an English-language proficiency exam.
