They made only $5 a day in the Philippines, but here they earn a decent living and help with a nurse shortage.
By COLLEEN JENKINS
Published June 8, 2003
INVERNESS - The promise of a more prosperous life was the easy part for Leigh Mosqueda. As she boarded a plane in March, she knew moving to the United States meant a job in nursing with wages far exceeding what she could have earned in the profession in the Philippines.
But the journey required leaving behind her mother, her siblings and the only country she'd ever known. Family is important to Filipinos, so the break would be especially tough.
She never had set foot in the United States, much less Citrus County, her destination. She had relatives in Los Angeles, Chicago and Las Vegas but didn't know a soul in Florida.
Which made her just as shocked as anyone at Citrus Memorial Hospital, her new employer, when they learned Leigh's uncle lived in Beverly Hills. Mosqueda, 27, hadn't met him before, but within a week of her arrival, the family tie had forged a link between the familiar and the unknown.
The discovery was one of life's well-timed blessings, better than any comfort hospital officials could have offered to ease the transition into Mosqueda's new life.
Since mid March, three Filipino nurses, all with upbeat demeanors and ready smiles, have taken their places among the overnight staff in Citrus Memorial's progressive care unit.
Like Leigh, pronounced as "lay," Joy Echavez, 30, and Gwynne Leilah Rendon, 29, came to Citrus from Cebu, a large city in the central Philippines often compared to Manila. They, too, were looking to make a living in nursing.
The prospects at home were discouraging. Thousands too many nurses flood the Filipino work force. They make a meager $5 a day, or the equivalent to about $100 per month in the United States. Hardly enough to pay bills or feed a family, many trained nurses switch to banking or sales or hotel work to earn a decent salary.
Some volunteer without pay in hospitals just to maintain their nursing skills in case the chance comes to work abroad.
"All nurses there want to come to the United States," Mosqueda said. "You have a better opportunity here."
Gainesville-based Nurses to USA Inc. and hundreds of other recruitment agencies offer that chance. American hospitals suffer from a shortage of nurses. In Florida alone, there are as many as 30,000 to 50,000 nursing vacancies, according to Galileo Encabo, head of Nurses to USA's credentials department.
Some hospitals turn to South America, Africa, India and China to fill the work force gap. In late 2001, Citrus Memorial chose the Philippines, where Nurses to USA has about 600 nurses being processed for jobs at 18 hospitals throughout Florida, California and Illinois.
A former U.S. colony, the Philippines still bases its school curriculum on the American education system. Classes are taught in English. Nurses earn a four-year bachelor's degree, sometimes more than American nurses obtain. Thus, the learning curve for Philippines-trained nurses in the United States is minimal.
But the road still wasn't easy. The three women now at Citrus Memorial said they spent between one and two years studying for a battery of tests: the American nursing board exam, plus written and spoken English exams.
They also had to have a year of experience in a hospital in the Philippines before an American counterpart would consider hiring them. Mosqueda worked at a teaching hospital, and Rendon worked as a nurse for various companies. Echavez worked as a nurse in a private hospital in Cebu in the Philippines before spending five years in the hotel industry, where the pay was better.
And then, there was the waiting. It takes about 11/2 to two years for immigration papers to be processed. But the outcome is worthwhile. Through Nurses to USA, the women received immigrant visas, which will set them in motion for permanent U.S. residency.
They began arriving in the United States in January. None had seen the country before, or at least not with her own eyes.
"I was like, "wow I am in America'," Rendon said. "It felt great to be here finally after years of dreaming about it."
She visited an aunt in California before arriving in Citrus County with just one suitcase and a sports bag.
Echavez struggled to carry two bulging suitcases by the time she came to the apartment the two women would share in Inverness. She had purchased lots of winter clothes during a three-month stay with family in Chicago, she said sheepishly.
Both had come equipped with nursing scrubs from the Philippines, where they could be tailor-made for just $4 a set.
They each bought a queen-size bed and later a card table and four chairs. No furniture sits in their living room, except for a microwave resting on top of an empty box.
The college schoolmates quickly hooked up with Mosqueda, who began her new job at Citrus Memorial first. A newlywed, she and her husband, Armel, already were settled into their own Inverness apartment.
And, Mosqueda, whom Echavez had known in high school, already had a car. For a while, Mosqueda had been walking 30 minutes or biking for 15 to get to her 11 p.m. shift. But her uncle, the one she had just met, soon loaned her a '91 Dodge Caravan he wasn't using.
"Probably, God took pity on me," she said, recalling the sweaty trek to work.
She has shared her good fortune with the other women, picking them up for work or to grocery shop and run errands. Wal-Mart is a frequent destination.
In some ways, their new life in Citrus County is strikingly different. There are the big things, like the much improved working conditions they now enjoy at Citrus Memorial. In Cebu, they worked with outdated equipment, had fewer safety regulations with needles and even reused gloves after washing them.
"We only see this in nursing books," Rendon said of the equipment she now uses on a daily basis.
"We tend to improvise (in the Philippines)," Echavez added, noting they didn't always follow textbook procedure.
But at Citrus Memorial, Mosqueda said during another conversation, "Everything is safe, safe, safe. I appreciate that very much."
Citrus County definitely isn't Cebu, which was bigger, faster paced and more polluted, they said. And most families have house help there, so the women have had to adjust to doing their own cleaning, cooking and laundry.
They aren't complaining.
"We like the independence," Rendon said. "We're getting used to it."
The peacefulness of Citrus is "a good place to start for us," Echavez said.
The small differences also take some getting used to. Cebu offered public transportation, so owning a car was unnecessary. Echavez hopes to save enough money for a car by August, a goal solidified after she and Rendon got scared walking in the dark to a store one night.
Then there's the challenge of finding foods to their taste at American grocery stores. American rice is too wet and the soy sauce has too much vinegar, Mosqueda points out. Luckily, the JMJ Oriental Market in Inverness offers Asian versions more to her liking, plus Filipino shampoo and junk food.
Mostly, the adjustments have come smoothly, with just a few bumps in the road. They buy numerous phone cards to call their families, whom they miss the most out of anything from home.
Armel Mosqueda, Leigh's husband, can't find an engineering job, making his transition a bit tougher.
Last week, the couple and the other two women set out for an overnight trip to Busch Gardens in Tampa. The drive, which they began at 7 a.m. after getting off work, took three hours. A wrong turn landed them in Ocala first.
"That was an experience," Echavez said.
It's comforting, though, that they've had the least trouble adjusting in the place that brought them here. At Citrus Memorial, patients and staff have embraced them warmly, the women said.
Typically, patients think their Filipino ethnicity is intriguing, Rendon said. Having been taught all their lives in English, the nurses have only faint accents, if any at all, so language barriers aren't a problem.
Julia Doucette, the hospital's human relations director, said the hospital feels lucky to have them. The overseas experiment is working so well that the hospital has recruited 35 more nurses from the Philippines, she said. They'll come over the next two years, at a cost to the hospital of about $8,000 each in recruiting and immigration fees.
"Leigh, do you know what a guinea pig is?" Doucette recalled asking Mosqueda when she arrived at the Orlando airport in March.
"Yes," she answered.
"Well, you're it honey," Doucette told her.
That news sounded swell to Mosqueda, who sang a karaoke version of the B-52s' Love Shack with Doucette at an outing for nurses a couple of weeks ago.
"I'm part of history!" she exclaimed recently, just hours before her next night shift would begin.
