The nursing/midwife saga update

My blogging efforts of late have been pathetic. But, to cut to the chase, I feel I need to update those curious on the details of my continued quest to work in Norway as a midwife. I apologize if this seems really disjointed (and not at all funny). I have written it several times over in the last few weeks as information evolves.

In mid-February (2014), I posted on Facebook that my final appeal for a nursing license had been denied. At that time, I thought that was true, and believed it was as black and white as “go start your education over again”. The actual decision, which we learned a few days later once it finally arrived in the mail, was that I must repeat 6 months of clinical training in geriatrics, home health care and psychiatric nursing. Then I can be authorized as a nurse. Then I must work for one year as a nurse in Norway. Then I can re-apply for the fourth time as a midwife. . . wait 6 months for a decision. . . perhaps need to appeal. . . .perhaps need to re-train 6-12 months, as was once originally recommended. . . and then 2-3 years down the road I might be able to work as a midwife. But, no guarantee. ‘Cause I’m not going to get that answer for another 1.5 years.

In May 2012, the appeals board had upheld the recommendationof SAK (the Norwegian authorization board) that I begin my entire nursing education from the beginning. They suggested I contact a nursing school and that perhaps I could get credit for a few of my American nursing courses.

That’s what we did. And what we found when contacting Norwegian nursing schools and nursing educators is that they were overwhelmingly supportive of my education and, after doing thorough reviews of my coursework and job experience, maintained that I did not need to repeat any nursing education. 

By September of 2013, with the help of an attorney, we finally managed to send in the following information to the appeals board, demanding that they do what is essentially an appeal of the original appeal (an omgjøringsbejæring), something that we didn’t know was an option until we actually spoke with an attorney.

*A four-page letter from a former dean of a local nursing program that explains how the number of credit hours I have earned as a nursing student in the United States actually exceeds the Norwegian hours. She points out that although I have fewer clinical hours than Norwegian, my 12 years of work experience can compensate for this.

*A letter from the fiery PhD-educated Norwegian nurse educator, stating the above as well.

*A letter from a third nursing college educator, stating that he agreed with the other two evaluations, and recommends that I become authorized as a nurse.

*A letter from a midwife who started the first and only master’s degree program for midwives in Norway, (of note: I have my master’s degree, nearly all midwifery programs in the US are master’s programs, and many are becoming doctoral programs), stating that my midwifery education and work experience is equal to a Norwegian, and she believes I should be authorized as a nurse and midwife.

*A letter from the regional office of the Norsk Sykepleierforbund (the Norwegian nurses union/professional organization) stating that they support my authorization as a nurse and midwife.

*A letter from the Norsk jordmorforbund (Norwegian midwife organization/union) supporting my authorization as a nurse and midwife.

*A letter from the Norsk jordmorforening (a second Norwegian midwife organization/union) supporting my authorization as a nurse and midwife.

In November, we heard that the appeals board would review my case in December, but they were first sending my paperwork to two new nurse educator/experts to review my application. They were not given any of the three letters from their fellow nurse educators to review, contradict, argue against, or agree with. We felt this was not a fair or complete evaluation, but there was nothing we could do, even with an attorney helping us out.

A day after the deadline for the new nurse experts to turn in their evaluations to the appeals board, one of them asked to see the “reading list” (essentially the syllabi) from my nursing classes at St. Olaf. This is despite the fact that she had detailed descriptions of every prerequisite class and every nursing class I took at St. Olaf. Needless to say, getting ahold of syllabi from 1995-97 was nearly impossible. The nursing department at St. Olaf bent over backwards trying to locate these, but were only able to find one

In mid-January we finally received the two reviews from appeals board’s experts. The first was completely in agreement with our four—that while Norwegian and American nursing education programs are different in their approach, if one looks at the entire content and the final result, combined with a decade of work experience—I should be granted authorization. The second evaluation—from the nurse educator who wanted the syllabi—focused on the number of hours that differed in our clinical training, and felt that if I did 24 weeks of supervised clinical training in geriatrics, home-health care and psychiatric nursing I could be authorized as a nurse.

The appeals board said they could not give any weight to the four evaluations that we had submitted, as they were “privately engaged” (even though they were supported by one of their own independent evaluations). And so they focused entirely on the evaluation that recommended I repeat 24 weeks of clinical training, and additionally took phrases out of context from the more favorable evaluation and used them to support the less favorable evaluation.  

The TV journalist who originally reported on my case back in November 2012 has been hot on this case. The nurses who wrote the independent positive evaluation have been interviewed, the midwives in charge of the midwife organizations and midwife education programs have been interviewed, as well as some of the members of the appeals board. Our house was full of four journalists a few days ago—TV journalist, print journalist for the online version, and two camera people—still and film, interviewing Erik and me, and capturing the darling American children speaking English and Norwegian. But I digress. . . The questions are, how can an appeals board of lawyers and judges, not one with an educational background, an only one nurse, feel that they are more qualified to evaluate a foreign nursing education than 6-10 nursing professionals? And how can they give so much weight to the most negative evaluation over the other 4-5 that are in agreement with one another?  

Erik and I don't know exactly where this is going. The report will likely air within the next few weeks, and it appears that it will be going national (writing that makes me sick to my stomach). Officially, we don't have any recourse in regards to the appeal aside from a lawsuit, which would cost us somewhere around $18,000 and another 9 months of waiting. That is not going to happen. But, there are enough very angry and powerful nursing professionals out there that, well, who knows what will happen. I am not alone in this fight--these nursing professionals are not fighting for my case alone--there have been dozens of other American-educated nurses turned away because of SAK's inability and unwillingness to recognize and understand the American credit system and acknowledge that there are other countries in the world that can adequately educated a nurse. What this case means for me, and for my fellow RNs. . . .? Only time will tell. 

And hopefully not too much time. To say that I am sick of waiting is the understatement of the century. I need a paycheck, like, yesterday. Those lawyer bills aren't going to pay themselves. 

Hope

Months have sped by, and my motivation to blog through the after-effects of my nursing course, Christmas preparations, two solid months of work, growing a baby and general day-to-day life busyness has been minimal. 

But I do owe you a few updates. . . 

The last real development in my quest for nursing/midwifery authorization was in late November, when a few members of Parliament spoke out in my behalf. But the buzz and momentum fizzled a bit after that, due to a combination of more pressing healthcare and other political events (hard to believe, I know) and Christmas break. 

I cannot be terribly specific in describing with whom we've been consulting, but after months and months of emails and phone calls and referrals from one person to another, we've eventually nailed down a few players in higher-up nursing/midwifery circles who are supportive, understanding, disgusted, and began working "undercover," so to speak. Many feel that they cannot officially come out and support me publicly, which has been a bit frustrating. It was also suggested that we form a Facebook "support group" where people can officially and publicly voice their support and let it be known to SAK (the artists formerly known as SAFH, the Norwegian authroization office for health professionals) that we ain't goin' away. Two who have supported the group include the local county/regional office of the Norsk Sykepleierforbund (the Norwegian nursing association/union) who is calling for SAK to reevaluate my application, based on the evaluation done by the local college research dean who judged that my bachelor's degree nursing education and work experience equaled (and exceeded) what her educational institution could offer me as a new nursing student. Also supporting the group is the member of Parliament who initially spoke out on my behalf. You can find the support group here: Støttegruppe for Emily Stange. 

Since then, Erik (and Greta) and I traveled to Oslo this past week, armed with binders of documents and correspondence, and met with the member of Parliament to discuss possible courses of action. We also met with two other powerful nursing figures who seem to have more connections than the Queen herself. For example, when we mentioned that we had been in contact with (names have been changed for the time being. . . ) Kari Nordmann, former head of a midwife organization, who cannot understand the reasoning behind SAK denying my midwife application, one of our two powerful nursing figures said, "Oh yes, she's my best friend. I'm having lunch with her next week. We'll contact this other Powerful Nursing Figure and get this straightened out." 

I have not allowed my hopes to get raised at all in the past few months, as they have tended to get dashed shortly thereafter. But even I will admit that these were very positive meetings with tremendous potential and--dare I say it outloud--I do have some hope for the first time in a very, very long time. 

Erik says I owe you this one

When you last saw our heroes, they were crumpled in the middle of the living room floor, weeping over the idiocy of Norwegian bureaucrats. Rest assured, gentle readers, your heroes have risen to battle once again. Because it's either that or. . . well, yeah. Not many other options.

Erik told me I owe you all an update, so you don't think we have been completely beaten down by The Man. We have made some promising connections, and are allowing ourselves to be the slightest bit hopeful. Turns out Erik's boss is a rather well-connected guy. Turns out he kind of values Erik's work and wants to keep him around. Turns out Erik won't be staying around much longer if his wife has to work as an underemployed, underpaid nursing assistant. A few emails were exchanged, and a few days later a nursing researcher and former head of the nursing department from a local college came walking through our front door. Literally. (The door was wide open, because it was such a beautiful evening). Turns out she lives about 200m away.

We gave her a large two-ring binder (yes, they only have 2 rings in Norway, not 3) that chronologically  detailed the application, judgement, appeal, request for information, information supplied, judgement, appeal, summary of appeal, special appeal and final judgement of the past 20 months. She has apparently butted heads with SAFH in the past, and has dealt with other foreign-educated nurses seeking approval of their nursing education. As we sat around our dining room table, giving her a few details of my education and work experience, as well as the final judgment from the appeal board, she kept repeating "Unbelievable. . . Horrifying."

As the final appeal verdict stated, I essentially need to enroll in a nursing school again. But the nursing schools have the flexibility to approve courses from other educational institutions (something that SAFH claims they can do, but never actually do).

So, that's where we stand. A glimmer of hope.

Numb in Paradise

This past week Norway burst its way into summer. Our apple trees are in full bloom, the lawn demanding attention and the lilacs are timing their arrival perfectly with my parents arrival on Friday. We hung a swing from the apple tree for Greta, who has been soaking in lots of Vitamin D. 


I posted this picture on Facebook, and a friend commented "you live in a fairy land". Looking out from our kitchen window, seeing my daughter scamper about in our generous-by-Norwegian-standards-yard with our neighbor's kids, enjoying our first dinner of the season outdoor under the apple tree, I'd have to agree. I responded, "I know. I see this and think, "I have to do everything in my power to make this work out here. How can I leave this???"


The answer to our appeal on my nursing and midwife license application came in the mail today, and it was not the answer to our prayers. Their final judgment--one we cannot appeal--is that I should enroll myself in nursing school, and try to get credit for some of the classes I took 15 years ago. 


We are stunned. Dumbfounded. I was numb. Erik was devastated and perhaps the angriest I've ever seen him before. I was worried he might punch a hole in a wall that he had framed, sheet-rocked, mudded, primed and painted with his own two hands. And then we crumpled in the middle of our living room floor together, and wept. 

Appeals board tomorrow

Tomorrow Erik and I will travel to Oslo to meet with the Helsepersonnelnemda (the Health Personnel independent appeals board) who will review both my nursing and midwife license applications for the last time.

It is a long awaited day. This process began in October 2010, when I sent in pages and pages of documentation of my transcripts from my bachelor’s and master’s degrees, along with long letters from my advisors and department chairs, explaining what topics were covered in each course, and how many hours and weeks were spent in each course and in every area of clinical practice.

This process was repeated again in February 2011, after SAFH (the folk who review these applications) concluded (after 4 months of contemplating their belly button) that I had a two year degree in nursing and not a four year degree. More papers, more letters, more documents.

And we repeated this process a third time in August 2011, when they decided a second time that my nursing degree was not thorough enough, and I needed more training in psychiatry and medical/surgical nursing. (Yes folks. . . I want to work as a midwife. This does not matter to them).

It was only after an article appeared in the local paper in November 2011, featuring my case and the long process, that SAFH quickly responded—with two decisions this time—the first time they even bothered to consider my midwife application. They denied both applications, stating again that I needed more training for a nursing license, and claiming that I since I didn’t document any of the patients I had seen as a midwife student, I could not be licensed as a midwife.

In January 2011 I sent in 45 pages documenting the over 800 patients I saw as a student midwife, clearly labeling how each patient fell into each category—prenatal, postpartum, high risk, birth, newborn. SAFH’s response, in February 2011, was essentially “there’s no way to prove these are real, as they don’t look official”. No letter from them stating “this looks like a lot of patients—could you somehow verify them.” No contacting my advisor or the chair of the midwifery department, despite offers from them both in the numerous documents they prepared on my behalf. It was almost as if they said “Shit. This is a lot of paperwork that we don’t want to deal with. Let’s just send it on to the appeals board. That’s what they are there for.”

So, on to the appeals board we go.  An independent appeals board, or so they say, and so we hope. More documents, more paperwork, more verification, more last minute panicky emails to my advisors, and several sob sessions on our living room couch, wondering what the fuck I was thinking getting myself into in this kind of situation.

I am not going to be so arrogant or so naive as to think that everything I learned in American nursing/medical training translates directly and smoothly to nursing and midwifery care in Norway. I acknowledge that some training time would be both valuable and justifiably required. But to go back and enroll myself in a university again for both degrees, and ask for credit on classes I’ve taken? I just might be so arrogant as to say “I’m not going there.”

Tomorrow is a big day. The appeals board decision will likely make those final hurdles clear—just how high they are, how many more, and how far away the finish line is. And then the toughest decision of them all: is it all worth it at the finish line? Do I even bother finishing this race? Or will I decide, “you know. . . I was prepared for a 100m hurdle race, I could suffer through a 400m hurdle race, but I will never do the steeplechase. I’ve got better things to do in life than run around this track a dozen times, jump over barriers and land in water on the other side, and end up soaking wet and exhausted at the end”.

On the (job) hunt

My interview at Maihaugen back in February apparently went pretty well, as I received a phone call on Thursday from a Norwegian-named woman speaking Norwegian who apparently works at Maihaugen, offering me a summer job! It is not terribly exciting; in fact, it starts out pretty grungy--"spring cleaning" for one to two weeks in April. I don't know what this involves--pulling up bushes, washing windows, cleaning fireplaces, all of the above? But come summer, I've been offered a position in the museum shops. One of the shops is a pretty typical museum shop, filled with tempting and expensive Scandinavian-designed houseware items, books, clothing, jewelry and the requisite trolls. The other shop is located in the byen, a representation of main street Lillehammer from around the 1900s. In that shop, I would be wearing a costume of some sort. As some of you may know, growing up in Minnesota I was a little obsessed with Laura Ingalls Wilder, and wore pretty much nothing but long calico dresses and bonnets from the age of 7-11, so wearing a costume from the 1900s. . . well, that actually sounds like it could be kind of fun.

I have not completely made up my mind if I will be working in the shops or not. I have applied for a few other positions through the city--namely nurses' aide positions at the nursing homes and home health aide positions. And, if I can work up the nerve and get my rumpa i gir, I'll visit the local nursing homes personally and drop off my CV. I have been told over and over again, from people not in the know (and where has that gotten me in the past? In Norway, based on uninformed opinions that Norway needs nurses, and it will be easy to get a job!), that the nursing homes always need help. Does that sound appealing? No. Does that sound like they are short-staffed and over-worked? Yes. Reassuring, when it comes to actually getting a job? Maybe.

In the end I think it will come down to money and guaranteed hours. Where can I earn the most. The nursing-aide type positions would probably be much more helpful in terms of language development that  would be most relevant to my field. But, one way or another, I will be working this summer.

On a related noted, we were recently notified that my nursing and midwife cases will likely be reviewed by the license appeals board in late May. (A 3-month turn around. Not bad). On an even more positive note, Erik has been in contact with the head of the Norwegian midwife organization, and she is shocked at the handling that my case has received and has asked him for all the paperwork that we have submitted to and received from SAFH. She could be a really good ally to have.

As much as it's hard to believe. . . life is looking up. And with it brings change, and along with that uncertainty. So although these new developments are good, I'm still feeling a little uneasy about it. As unhappy as I may have been with the state of the world as I knew it in Lillehammer, at least it was familiar.

The A4 Envelope

I received another A4 envelope in the mail last Friday.

A4 is the European "standard" size paper, the Euro 8.5"x11". As my Norwegian class read about the "typisk Norsk" who goes skiing, eats brown cheese and lefse, and only dresses in wool, my teacher referred to the "A4 Norwegians"--the standard family with 2 kids, a Volvo station wagon, a labrador retriever and a "rekkehus" (row house). I was secretly pleased to have caught the cultural reference to the standard "A4" Norwegian, but then also rather struck by the similarities between the American Dream and the A4 Norwegian dream. (Although the typical American would probably consider the average Norwegian row house to be a little small.)

So, I received my A4 envelope. From SAFH. Informing me that, again, I do not meet Norwegian standards for nursing or midwife education, and that both applications would be sent on to the independent appeals board for review. I was not surprised by this response, at least not for the nursing application. Erik and I felt I had submitted a very thorough response to the deficiencies SAFH stated I hadn't addressed on my midwife application, but apparently not so. Their complete refusal to acknowledge that any of my points had any validity at all was rather stunning. Enough to get my thoughts swimming back across the Atlantic, back to where the grass is greener.

But the roller-coaster ride continued. . . In tears after reading through the double refusal letter from SAFH, I  "got my shit together", so to speak, and went to my first job interview that afternoon. Maihaugen is hiring summer employees: ticket sales, museum store employees, tour guides, "actors" in the exhibitions. If I understood the interviewers correctly, they had over 250 applicants, and our group of 7 interviewees were the "cream of the crop". I did it all in Norwegian, and apparently well enough that one of the interviewers said, "you are speaking Norwegian very well for only having lived here 18 months". Her comment, combined with my nervous adrenaline, elevated my mood for the rest of the evening.

I rode that high through Saturday, a beautiful sunny spring day, which also happened to be my birthday. Home with my family the whole day in our nearly completed living room, Skype calls with loved ones, out for a sunny walk to a cafe for lunch, and home again for homemade chocolate cake, were more high points on the roller-coaster.

On Sunday, my mood came crashing down again. Still sunny and warm, but the reality of more waiting--the appeals board says the average waiting time is 3-4 months--combined with the realities of a job search in Norway and the slightly depressing reality of another birthday, made for a difficult day.

I long for the days when I knew what the day would hold, what my life would hold, or at least felt like I had the emotional capacity to handle what was thrown my way. That A4 envelope sat on my dining room table, and I thought "do I dare open it, and have it ruin my weekend?" But then again, could I really let it sit there all weekend long, taunting me with its contents? The roller-coaster was inevitable.

We escape!

A foggy view up the Tower

 Still no internet access at the new house, so I try to squeeze in an hour or so at the library cafe, with a cappuccino to keep me company. 


Many friends have remarked how fun it must have been to spend Christmas in our new house, but the truth is we celebrated a very different Christmas this year. . . by escaping to Paris!


My in-laws wanted to spend Christmas with us, and luckily we came to our senses early enough in the remodeling process to realize that our home would not be very welcoming to guests by Christmas, even though we ourselves would be living there. Instead we opted to meet in Paris, joined by Erik's sister and her friends. It was perhaps my first Christmas ever without snow, aside from my first year of life in sunny Santa Barbara, California. But I must say, 45-50 degrees and sunny was a welcome breath of fresh air. 


We had a 9 hour layover in Copenhagen, which we took full advantage of, taking a 10 minute train ride into the center of town to take in the pre-Christmas atmosphere of a bustling Scandinavian city. We spent six days in Paris, and while it wasn't exactly relaxing in the poolside-vacation sense of the word, it was a welcomed break from the chaos of remodeling and moving that we've been immersed in for the past 7 months. 


I found it incredibly difficult to even utter simple French words like "merci" or "au revoir" or even "non". As I opened my mouth to respond, Norwegian words came out--not English--Norwegian! If I bumped into a person in a store, I wouldn't say "excusez-moi", I'd say "Unnskyld!" A waiter in a restaurant asked us (in English) what "other" language we spoke, after I responded "nei" to one of his English questions. It was quite amusing, actually, and even rather reassuring. I am so deeply immersed in Norwegian it is, in many cases, the first language that comes to my brain. I would read French signs, or rather see signs in French, and realize that had they been in Norwegian--I could understand them. My confidence in my language skills was boosted, and all it took was a trip to France to do so. 


We spent our New Year's Eve with the same friends that we celebrated with a year ago. It was very comforting to feel that we have established such good friendships in just 16 months that we have now spent two consecutive holidays with one another. And after spending the entire evening speaking--and understanding--Norwegian with each other, I realized once again how far I have come in the last year. 

A Norwegian tradition: Kristoffer smashes the
gingerbread house on New Year's Eve,
while Greta and Sebastian duck!

A year ago I was just beginning my formal Norwegian classes; classes that would prove to be both challenging and disappointing in their level and quality of instruction. On Thursday I will resume my classes again, meeting two days a week as we did throughout the fall. I was incredibly distracted and busy this fall, and felt like I neglected my studies like I have never done before in my life. I'm hoping that I can recommit myself to mastering this language this semester. The trip to France, in some ways, gave me extra motivation and encouragement to do so. 


I am also assembling material and letters to bring to SAFH (nursing license organization) in regards to both my midwife and nursing licenses. After the newspaper article, SAFH kicked their efforts into full gear, and responded to my midwife application within 3 weeks. Their judgement/assessment was not entirely satisfactory (in my humble opinion), but after some clarification about my experiences and qualification from my student midwife education, I am hopeful the application will be viewed more favorably. Ever hopeful, I am. 

"The Emily-Case"

"Sorry, Emily"

On Wednesday, the day following my front page news headline and the immediate email response from SAFH (telling me, essentially, "we've only slightly changed our opinion on your mediocre education and work experience. You need more basic nursing student experiences), I was in the paper again. Twice. 


The first mention was a mini-editorial on page 2. It read:
GD brought yesterday the story of American Emily Stange struggling to obtain approval for her education from home. Years of work as a nurse and midwife is clearly not sufficient to resume training and practice in Norwegian working life. This is not a training example of how modern Norwegian society should take care of new citizens.

The Government has announced a parliamentary statement about integration. The notified measures for rapid recognition of immigrants' skills. Until the new decision is made it must nevertheless be allowed to use reason. The Emily-case is a good example of this.


So, that was nice. I've got the editors of the paper on my side. The "Emily-case". Makes me sound like a Law and Order episode.  Also got a few words of encouragement from the lady behind the counter at the new coffee shop, who recognized me from the paper! 


The second mention was a follow up article, written by the same journalist as the first. There are a few quotes from the communication director at SAFH, which I found interesting to learn that there was more than one person weighing in on this "case". I wasn't, however, entirely satisfied with the conclusion. Several people who read it were left to believe that everything was approved and all is A-OK. Not so.


Here's the article, again, according to the Gospel of Google Translate (with a few of my own editorialized comments for good measure):


We're sorry, Emily! (that makes it sound more apologetic than I think they really are)

The responsibility lies flat and regret that it has taken an unreasonably long time for Emily Stange to approve their education. Yesterday, she got an answer. (although not the one I was hoping for)

GD wrote Tuesday about the nurse and midwife Emily Stange from the United States. She has been waiting over a year to obtain approval for their education so that she can work in Norway.

"SAFH acknowledges that the appeal proceedings have beenunreasonably prolonged. This is not how it should be, and we regret this," says communications director, Magnus Karlsrud Dahlen.

DEMANDING
He says that the authorization of health professionals trained outside the EU is a challenging task, more complicated than for applicants educated in European countries. (Here's an idea: TELL THE PEOPLE FROM OUTSIDE THE EU THAT IT TAKES MORE TIME FOR THEM).

"Documents must be verified and training be reviewed to ensurethat the applicant has an equivalent education with an similar Norwegian education," he says. (does equivalent mean identical?)

They pointed out that the procedure for Stange in the first halfwas completed within the specified three to four months. (yes, but taking 4 months to not even read the application correctly the first time, when it clearly was documented in multiple places that I had a 4-year degree, and not a 2-year degree as you stated, doesn't seem like a good use of your 4 months). It is for the processing of the complaint office lie flat and acknowledges that the waiting time has been unreasonably long. (it should also be noted that my second application was not actually sent to the "complaint" office, or so we were told, since they had f*#@ed it up so much the first time).

BECOMING BETTER
AFH has initiated a review of procedures and organization.(No idea what AFH is). The goal is that all matters, including complaints, should be treatedmore efficiently and with better quality.

"We want to offer health care personnel who are seeking authorization and license in Norway, a thorough and predictable procedure," said Karlsrud Dahlen.

For Emily Stange some extra practice is required before her education can be approved. (and before they will even consider her application to be a midwife, which is really what she wants to do for employment).


What's next?
Stay tuned. . . I'm trying not to think too much about this right now, and am actually doing a good job at it--until I sit down and blog. 


(Although those of you from Norway who are reading this blog and not commenting. . . if you have any opinions, thoughts, have heard of similar situations, know of someone who dealt with something like this:  Please let me know! I'd really appreciate it).

Newspaper, day two

So, what happened after my appearance on the front page of our local paper, criticizing a Norwegian governmental agency?


By 12:48pm that same afternoon I had an email in my inbox from the section leader of the nursing-license agency. It was a brief email, and basically said: "I regret that the processing of your complaint has taken a long time. SAFH has considered your complaint and added your comments and new information as a basis for review of your application for certification as a nurse. Our original decision to reject is now changed. I refer to an unsigned copy of the new decision that is attached."


Our original decision to reject is now changed! I wasn't floating on clouds, but I must admit--I was feeling pretty smug. It wasn't until about 5 minutes later than I realized there was an attached PDF and I opened the 4-page document, written in Norwegian. of course Having seen one of these letters before, I flipped to the final page, where they summarize their requirements. And there it was:


"In order to document that you have the necessary skills as a nurse in the Norwegian health care system, you must go through and pass the following courses and practice."


1. 3-week class in national subject for nurses (this was not a surprise, this is required for all foreign-educated nurses)
2. Minimum 6 weeks supervised clinicals in psychiatric healthcare (Still....???)
3. Minimum 5 weeks supervised clinical in medicine or surgery nursing  (Whaaa . . .???)


How is this different from their decision, after wrongly interpreting my four-year bachelor + master's degrees in nursing to be a two year degree, that they made in January 2011? What did they require me to do then?


4. 8 weeks of eldery care nursing (this is now removed)
5. National licensing exam for new nurses (thank God. . . this was a huge one).


BUT. . . 
After providing them with 12 weeks of full-time student employment on a med-surg floor, plus the documentation about my master's degree training, (not to mention our referring them to a Norwegian woman with a St. Olaf nursing degree just 3 years younger than I, who was approved for a license without all the bullshit extra clinicals). . . they did not change their requirements on psych clinicals at all, and they only reduced their requirements for med/surg clinicals from 8 weeks to 5 weeks! 


Don't read any further Mom, 'cause I'm about to use some profanity. . . 


WTF???

Me. . . in the news

This past spring, the Norwegian Parliament passed a recommendation on integration of foreigners/immigrants into the Norwegian workplace. Among other things, they strongly encouraged "improving measures for rapidly recognizing immigrants' education and skills". A reporter at our local Lillehammer newspaper, "Gudbrandsdølen Dagningen", known as "GD" (and pronounced: Gay-Day, because that's how you say "G" and "D" in Norwegian), anyway. . . the reporter was writing a series of stories about foreigners and their challenges of finding work in Norway. Last week she wrote a nice article about a local boutique that hired an Afghani woman to work, and what a great situation it's been for employee and employer. My former landlady, fellow barnehage mother, and now friend, is an editor of the paper, and told her colleague that she should talk to me, as I am a rather qualified nurse and midwife who can't get permission to work in this fine country.


I met the reporter on Monday morning. I told her my story, 95% in Norwegian. The latest update on my nursing license application is that in September I turned in paperwork clarifying student work experiences I had in 1996. We were told at the time that my application was at the top of the pile. Then two months passed. We called and called, never getting ahold of anyone. Finally, 3 weeks ago they say we should have a letter in 10 days. I was interviewed for this article on Day 19.


Here's the front page from Tuesday: front page!!!

Yes, that's ME, upper left corner!
The title reads: Over one year has gone
without approval. Nurse and midwife
education and over 12 years experience
in the USA is maybe not good enough
in Norway? It has been over one year
since Emily Stange sought approval from
Statens autorisajonskontor for helsepersonell.

And then, here's the article, translated with much help from GoogleTranslate:

Yes, this picture is about 8x10 inches tall. 

Intro:
Emily Stange is educated as a nurse and midwife from the USA and has more than 12 years of experience. But to get approved competence in Norway has proved to be a tough process.

Lillehammer: All immigrants should get credit for their competence, according to NOU 2011-14. The study is part of the basis for this spring's Parliament Paper on better integration of foreigners.

Emily Stange could not agree more. She longs to use her midwife education in this country, but has so far waited for over one year for approval.

DRAWN OUT

In August last year Emily came to Lillehammer together with her husband and daughter. Her husband who is also American, is long in the job as a research scientist at NINA.

Emily also believed it would be a cinch to get the paperwork in order.

"On the website of SAFH we were promised a waiting period of three to four months. Now it's been one year, and neither the midwife nor the nursing license has been approved. We have called and asked many times about how long I have to wait and have received various answers. It's almost an all-day job just to get in touch with the right person", says Emily.

Last she and her husband contacted SAFH,  they were told that she should receive a reply within ten days.  Now, three weeks have passed. . . 


WAS NAIVE?

The treatment of Emily's application was lopsided from the start. In January, she received a letter that she only had two years of nursing education and that her education, therefore, was not approved.

"They obviously had not read the application, where it is clear that my nursing education is four years. The whole process was set back five months at that point", says the 36-year-old.


She has a bachelor's degree as a nurse from St. Olaf College and a master's degree as a midwife from the University of Utah. For six years she has worked as a midwife at a large hospital in New Hampshire. Before that, she worked over six years as a nurse in a newborn intensive unit with a children's hospital in Salt Lake City. 


"I think I had a good education and great work experience from a pretty large and well-known country. Therefore I thought it should be totally fine to be able to use my education in Norway. Perhaps this was a bit naive?" asked Emily.


FRUSTRATED
She has experienced the waiting time as frustrating; an emotional roller-coaster. She has passed the time by learning better Norwegian and doing home improvements on a house in Søre Ål. 


"I've spoken with the midwives at the hospital in Lillehammer. They have been very encouraging. I think the Norwegian system seems square and not very flexible. It is as if the people at SAFH are sitting with a microscope to find anything that doesn't pass exactly, instead of focusing on the whole picture. In the first place, I have to wait for my nursing education to be approved. They haven't even begun on my midwifery application. This should be possible to coordinate", according to the health care worker, who is just waiting to get to work. "My husband has a good job in Lillehammer and we intend to stay here. But it can only happen if I, too, may use my education."




So, in the end. . . what happened? 
Stay tuned til tomorrow. I can only translate so much in one day. . .