Eighteen Mexican nurses are in the process of getting jobs in U.S. hospitals, thanks to a training and placement business backed by Louisville-based Blue Equity, LLC.

The Blue Equity division, Nurses Now International, trains nurses in English medical terminology and American culture, preparing them to work on a temporary basis in U.S. hospitals.

After a few years of working in the United States, they will return to their native country.

David Roth, vice chairman of Blue Equity, said that after years of honing the concept, the program is accelerating its pace. “It’s been refinement and re-refinement — constantly tweaking.”

How it got started

The idea for the company stemmed from a conversation that Roth had in late 2006 with a man in the staffing business.

“He just didn’t understand why there weren’t more Mexican nurses coming over under the provisions of the NAFTA treaty,” Roth said.

The North American Free Trade Agreement went into effect in 1994 with the intent of eliminating trade barriers between the United States, Mexico and Canada.

It allows Treaty NAFTA, or TN, visas to be issued to Mexican and Canadian citizens, allowing them to work in professional jobs in the United States on a temporary basis.

Roth presented the idea to Blue Equity chairman and managing director Jonathan Blue, and company officials looked into the possibility of developing a business to serve that niche.

Blue Equity officials found that Mexican nurses had good clinical training, Roth said, but they needed a higher level of competency in medical English and cultural training in order to work for American hospitals.

“So we established a program to address that, while at the same time trying to be ethical in terms of our migration and to not be a brain drain on Mexico,” Roth said.

Multi-tiered program

Nurses Now International was founded in 2007. It operates as a subsidiary of MexConex, a cluster of U.S. and Mexican companies organized by Blue Equity.

Also in 2007, Blue Equity hired Mauricio Gojman, who was pursuing an MBA at Harvard University. Gojman, now CEO of Nurses Now International and a vice president of Blue Equity, brought on others to help develop the company.

Nurses Now International starts with its Medical English as a Foreign Language, or MEFL, program, which takes place in Mexico.

The program teaches basic English to students with a nursing background.

Students pay for the MEFL training, which costs the equivalent of $37 per month.

Nurses Now officials expect to have more than 300 students enrolled in MEFL programs by the end of this year in 10 cities in Mexico.

Students that meet standards of the MEFL program can apply for the company’s Intensive Training Program, which lasts seven months. This program is paid for by MexConex and NNI.

Participants in the intensive program spend a week in Dallas, where they attend a language “boot camp,” and visit El Centro College, which has a simulation hospital.

Students then return to Mexico for five months of training, including a workshop that focuses on caring for patients from different cultures and accreditation training.

The intensive program wraps up with students returning to El Centro College for six weeks. During this time, participants complete more than 100 hours of hospital rotations in Dallas-area hospitals.

“By the time they get to Dallas for these six weeks, they’ve completed the testing elements of the nursing license and can focus exclusively on the practical aspects of the day-to-day work experience,” Gojman said.

NNI then arranges for them to obtain any necessary licensing. The nurses must get licensed in the state where they will practice, Roth said.

Portions of the training program have been developed through partnerships with such entities as the Vancouver Medical English Institute and New York-based Kaplan Inc.

500 nurses in five years

After completion of the intensive program, the nurses are placed in U.S. hospitals or in hospitals in Mexico with a focus on medical tourism.

Under the TN visa, workers can remain in the United States for as long as three years, although that period can be extended. Company officials expect the nurses they place generally will remain in the United States for three to five years before returning to Mexico, Roth said.

The company and hospitals determine the nurses’ pay, Roth said, including a premium that goes to NNI.

The 18 nurses being placed in U.S. hospitals were in the first group of 30 nurses to complete the intensive training program. The remainder have been placed in Mexican hospitals that cater to medical tourism.

The second intensive program started in January and has 25 nurses. A third intensive program is set to start in June and has 25 confirmed participants.

Within the next five years, Roth said, the company expects to place “several thousand” nurses in hospitals in the United States and Mexico. Of those, 500 likely will be placed in the United States, he said.

Gojman said that in 2008, more than 750,000 Americans left the United States for medical care. And although Mexico still is not a primary destination for medical travel, significant efforts are under way by the government and hospitals there to make it such a destination.

“I estimate that Mexico will, indeed, capture a more important share of the medical tourism market in the near term,” he said.

Changes in immigration laws

Recent changes in immigration laws might be a factor in increasing demand for nurses from Mexico and Canada, rather than countries abroad.

Chris Noronha, owner of Louisville-based IDG Management Services Inc., found success placing nurses from India and the Philippines in U.S. hospitals.

The company placed 50 to 60 nurses in hospitals in Chicago and 180 nurses with Norton Healthcare Inc., in Louisville from 2001 to 2006, Noronha said.

But in 2006, the number of green card visas that allowed international nurses into the country ran out. They have not been renewed since.

“We’ve got nearly 100 nurses in the pipeline, waiting to come here once the visa situation opens up,” Noronha said.

Noronha said he plans to resume nurse-staffing services once the green card visas are renewed. IDG Management’s efforts differ from Nurses Now International in that most of its nurses have become U.S. citizens.

Most also have bought homes and cars and put kids through college, Noronha said, creating a “huge (economic) multiplier effect.”

Not yet profitable

Nurses Now International has 25 full-time employees at its headquarters in Monterrey, Mexico, Gojman said. It also employs more than 20 instructors in Mexico, and another 15 or so American instructors work part time as trainers.

The company relies on Blue Equity for back-office and other services out of Louisville, Gojman said.

Roth declined to disclose the investment in the enterprise but said “it is very significant.”

He also declined to disclose revenue projections but said the company is not yet profitable. Officials expect to reach profitability within a couple of years, Roth said. “It just depends on how fast we develop it.”


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