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CGFNS head discusses support of foreign nurses
After 40 years, the organization continues global nursing outreach
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By Janice Petrella Lynch, MSN, RN
EDITOR'S NOTE: Janice Petrella Lynch, MSN, RN, is a nurse consultant for Nurse.com and a former nurse editor/nurse executive for OnCourse Learning. She is the director of the Help and Resource Center for the Marfan Foundation.
Through a variety of services, CGFNS supports the global community of nurses and healthcare professionals in their desire to work in and migrate to a different country.

Shaffer shared his thoughts with Nurse.com about the organization’s history, development and organizational goals, how the CGFNS has influenced the profession and the professional lives of nurses, and how it impacted cultural diversity within the organization and throughout the world.
Our story began in 1977, when the U.S. was experiencing a severe nursing shortage, creating a reliance on recruiting nurses educated beyond U.S. borders. Many of these nurses were unsuccessful in passing the U.S. nurse licensure exam, which led to the federal government, employers and professional associations becoming increasingly concerned and challenged as to what to do. This scenario led to the creation of the Commission on Graduates of Foreign Nursing Schools, which later changed its name to CGFNS International when it became independent of American Nurses Association and National League for Nursing.

The original intent of the commission was to create the qualifying exam, which is a predictor exam of how nurses will fare on the NCLEX prior to migrating to the U.S. It is important to note that CGFNS International is immigration-neutral, meaning that we do not recruit or staff U.S. hospitals with foreign-educated nurses. Rather, we assist these nurses with their desire to migrate to and practice in the U.S. and in Canada.
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What is the organization’s history in bringing foreign nurses to the U.S.?
How has your organization’s global outreach to nurses in other countries influenced their professional lives?
Nurses see CGFNS as the organization that provides them with the opportunity to migrate, and we consider migration to be a global right for all. We have been called a lifeline because we enable nurses to make broader career choices whether it be to migrate to the U.S. and Canada or to other countries around the world. CGFNS is an organization that has 40 years of experience with evaluating the credentials of nurses wishing to migrate to countries around the world. Our goal is to become their career partner through the lifetime of their career, from the moment they use their first services to the moment they no longer need them. We accomplish this by offering an e-portfolio or an online record that is available throughout their careers. We also play an advocacy role for nurses around the globe. Through our Alliance Ethical International Recruitment Practices, we advocate for the migrating nurse, educating them of their rights as well as their responsibilities before they sign a contract. While we are not able to recruit nurses, we ensure through the alliance that foreign-educated nurses are ethically protected against abuse, trafficking and unscrupulous recruiters. Through our partnership with the International Council of Nurses, we contribute scholar research and data analysis through the International Centre on Nurse Migration. ICNM serves as an international database of the most recent and relevant research regarding nurse migration. This work is ultimately used to develop positive policies and institute organizational directives that will positively impact the lives of foreign-educated nurses and healthcare professionals that use our services.
Franklin A. Shaffer, EdD, RN, FAAN, FFNMRCSI, is president and CEO of CGFNS International Inc., formerly known as the Commission on Graduates of Foreign Nursing Schools, non-profit organization based in Philadelphia.
Yes, hospitals and staffing firms are still sponsoring foreign nurses. I think that there is not one answer to how is it working out. I think it varies, depending upon the nurse and the hospital or staffing firm, and how the nurses are on-boarded and supported throughout the different institutions. Finally, some large hospitals and the long-term care sector continue to do this, but to a lesser degree than during the heights of nursing shortage.
We do hear of an occasional situation where the acculturation process isn’t running smoothly as desired or planned. I believe that before a hospital becomes involved in the recruitment or sponsoring of foreign nurses, it must perform a cultural self-assessment to gain insights into how the culture of the organization supports or doesn’t support the diversity of language and culture.
As an organization, we have grown and developed to help meet some of the leading issues pertaining to the global nursing workforce. We know that there are over 20 million nurses in the world and we also know that there is a present shortage, both in numbers and in skill sets.

Based on the WHO Report “Global Strategy on Human Resources for Health: Workforce 2030,” and also the UN High-Level Commission on Health Employment and Economic Growth, we have learned the importance of a healthy, sustainable nursing workforce in obtaining economic development and social progress throughout the globe. Nurses must take the lead in advocating for sustainable development, global health and equitable societies, and we believe that our work at CGFNS directly impacts this. We hold consultative status in the United Nations, which grants us a strategic seat at the table regarding key global decisions pertaining to nurse migration, policy and global health. We also have various relationships and collaborations with international organizations such as the International Organization for Migration, the International Labour Organization, the World Health Organization and the World Bank. Through continuing our globally renowned credentials evaluations, we ensure that nurses and healthcare professionals are able to practice their right to migrate. Through the CGFNS Alliance, we ensure this migration is done ethically to protect both the migrant’s life and the lives of patients.

Through our research and analysis through ICNM and other avenues, we can predict future nursing trends and strategize ways to obtain sustainable health workforces. Through events such as our International Distinguished Leadership Symposium, we offer nursing leaders a space to come together and collaborate. Through our partnerships with international organizations, we have a seat at the table to ensure we are up to date with the most pressing issues of the day.
How has the CGFNS developed over the years?
Are hospitals still sponsoring foreign nurses? If so, how is that working out for the nurse and for the facilities?
How has CGFNS’s global outreach affected cultural diversity within the organization?
Tell us about the recent Ninth International Distinguished Leadership Symposium recently held in Philadelphia.
We held our 9th International Distinguished Leadership Symposium in tandem with our 40th Anniversary Celebrations and the awarding of our 2017 International Distinguished Leadership Award to Barbara Nichols, DNSc (hon), MS, RN, FAAN, former president and CEO of CGFNS International, Inc. This award recognizes global nursing leaders for their contribution to advancing the nursing profession worldwide. The theme of this year’s symposium was “Beyond Borders: Connecting Tomorrow’s Workforce.” Leading experts from around the globe convened in Philadelphia to address the crucial issues concerning international nursing and global health. Rear Admiral Sylvia Trent-Adams, former Acting U.S. Surgeon General, gave the keynote address, discussing the strategic role of the nursing profession in solving some of the world’s most challenging health issues. Some of the major topics covered throughout the day were the 10 recommendations of the U.N. High-Level Commission on Health Employment and Economic Growth; the fulfillment of the U.N. sustainable development goals; ethical international recruitment practice of foreign healthcare professionals, and global nurse migration trends. We also held a panel discussion titled “Voices Across Borders: The Untold Stories” which gave former CGFNS applicants and nurse migrants an opportunity to share their experience migrating to the U.S.
Our global reach has been an outward and an inward realization. While we have expanded our reach throughout the globe, we have also striven to bring this mentality within the organization. Currently, our staff is composed of individuals from around the world and, together, we speak a total of 39 different languages and represent 26 different countries. Diversity is something I cherish, and it was something very important to me when beginning my role here as president and CEO. By diversifying ourselves inwardly, we are becoming more equipped to serve our applicants who come from a diverse array of backgrounds and experiences. And by assisting foreign-educated nurses in their migration to different countries, we have helped to increase diversity in the U.S. and throughout the world.
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