Behind the Scenes of International Nurses

An interview with Leah Ramos & Christy McEachern of Medical University of South Carolina (MUSC)

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Leah Ramos, Executive Director of Nursing for the Adult Hospital at Medical University of South Carolina or MUSC, and her teammate Christy McEachern, the clinical director there, each have a unique experience that brought them both to MUSC and to healthcare. Let’s dive into Christy’s story.


I've been in USC for 13 years. And I actually came here as a traveling nurse.

So I loved just started working in USA, decided to stay here permanently and loved working with everyone. And then as I moved up within the organization, I just have established great relationships with a lot of great leaders.

It's a challenge every single day, but I love challenges because you usually have a reward at the end of them and you have this achievement for getting through all the barriers and Gosh, we've had so many barriers over the past year.

I was a teacher and a former life, okay, kindergarten, first grade teacher and which is kind of what drew me to the pediatric piece of nursing in the beginning.

I love being in the service industry. I love taking care of patients and their families and providing, you know, great health care for them and, and knowing that we made their experience everything that I would want it to be for my family.

Probably every single one of us has had family members who've been in the hospital and it's not been the best experience all the time. So, I think just always keeping patients and families at the forefront of everything that we do every day...keeps me motivated in my work every day. And it was a reason why I chose nursing.


Now we’ll hear from Leah, and how she stumbled upon her passion for nursing.


I was born and raised in the Philippines, I went to school in the Philippines. So originally, I really want to become a math teacher. But growing up in the Philippines, I know that would probably not bring me anywhere. So I chose nursing.

And so it's really the opportunity for a better life, not just for me, but for my family. So I went to nursing school, and I actually loved it, even if I initially wanted to be a math teacher or mathematician. And during nursing school, also, my family had some health issues. So it just sort of made me realize that nursing is not a bad profession at all.

And I was also one of the lucky ones who had an opportunity to come here in the United States and work here.


International nurses have proven to be instrumental for a number of Health Carousel clients across the country. This is evident for Leah (LAY-AH) and Christy at MUSC. Between filling the staffing gaps, and adding invaluable talent to their staff long term — international nurses have made all the difference, especially this year.


I knew that international nurses will be hard workers. I knew that they will be hard workers. I know that they'll be able to adapt, because they really want to excel and they want to be perceived as an asset to whichever organization will hire them.

So, for me, my responsibility as a former international nurse is to make sure that they will be able to adapt quickly in their environment. That's why I work collaboratively with Christy’s team, because that's where we first onboarded the international nurses to make sure that, do we have the things? Do they know where to go for their grocery? Or do they know what are the Filipino restaurants here? Or do they know that there's a Filipino community center? So we partner with the Christy’s team to make sure that they have the things that they need once they land here.

I'm also part of the Filipino Nurses Association. So I knew that we can also use the organization to welcome them and make sure that they are treated very well. So, I made sure of that, and at the same time as well, meeting their needs, and be there for them if they need any help.

They're able to close the staffing gaps. And aside from that, too, it just really adds diversity in the mix. Not just with race, but ideas and other things.

For CBIC, we had two Passport nurses, our international nurses, and they were very welcomed by the team. One of the team members even brought one of the nurses and his family to their first to their first baseball game.


So the other option would have been a traveler, who we have to renew their contract every 13 weeks. And so there's a lot to be said for that knowing that we have these individuals here for sure, for three years, but hope they will want to continue to stay with us forever.

And so there's, you know, there's a lot to be said for that, or you don't have to keep going back and begging for positions that are very expensive to keep for every 13 weeks.

As we entered 2020 and then beyond, but then no one really accounted for having to deal with what was already going into a nursing shortage in a pandemic. And I think that forced a lot of like baby boomers out that would have probably hung on before they retired. And, you know, there's been a lot of people believe nursing that probably would have stayed in the field for a little bit longer because of the pandemic. It's hard to recruit a nurse Because of track all the demand for nurses everywhere,

It's hard to, you know, to fill the gaps with nursing, even offering incentives, it's hard to fill the gaps.


International nurses weren’t the only solution for the MUSC team. They implemented a few innovative solutions including team and step-up nursing.


I think it really forced us to think outside the box. So we have to come up with some innovative staffing ideas. So we implemented team nursing in some of our areas here. And we learned a lot of lessons.

Team nursing is.. we have to use some of the registered nurses that are not regularly in the inpatient setting and train them to help out. So not necessarily as a primary nurse, but they can be in a different role wherein they can do some med passes, or they can do some turning...anything that they can do in order for us to help the primary nurse. So with that team nursing model, the usual nurse patient ratio is going to be higher than what it normally is.

We also did step up nursing, because with the COVID, the need really is for the ICU. So, what we did is we trained some of the med surg nursing to be able to care for that. So sort of like a lower ICU acuity patients. So we had 20 of them. And the good thing about it, too, is with everything that's happening, the AACA, or the American Association of critical care nurses, they basically provided like a four hour module for free. That will cover the basics of critical care. So we took advantage of that and trained 20 of the med surg nurses to help in the ICU.

The other team nursing model that we did is like we had CRNAs helping in the ICU, or in the other areas, because at that time the ORs were on hold or we didn't have any OR cases.

It forced us to communicate and less silos or spread out. And so previously, you know, inpatient would kind of communicate their thing, … But we were really having, we had and we still do, because of all the rapid change with growth, while we're trying to grow as we're recovering from COVID. It's forced us to realize the importance of working together, and that it truly takes collaboration from every piece of the organization to make something work effectively.

And I think we still have to think outside the box for everything we do to recover from everything that's happened and continues to happen. And you know, things still aren't back to normal.


And while the world transitions back to more conventional ways of life, it’s important to consider the effects that this experience has had on all of us, but especially those within the healthcare industry.

Maintaining physical and mental health has been as much of a challenge as any of the day-to-day operations. Leah and Christy share how their tactics for fighting fatigue and burn out.


We're actually celebrating today, the one year for all of our Governor's declaring the state of emergency because of COVID. So today is the one year anniversary of that declaration. So we've been doing this for a year now. And it really tests your resiliency.

And not just your resiliency, but your compassion as well. So you really need to be compassionate, not just towards your team members. But you also need to do that for yourself. And it's really challenging that just -- I'm sure it isn't just for me and Christy as leaders, but especially for the care team members, because outside of work, you still have your family to take care of. I am in school as well. So there's just a lot of factors that will really test you and will push you to your limit.

I'm glad that I like running. So I do, right. But I also discovered that my friend keeps on telling me about k dramas or Korean drama. And so I was like, Oh, let me check that. I actually had some time. So I tested one of the shows that you recommended. And it really helped me because it forces me to read the subtitles. So I really don't have a choice but to focus my energies in reading subtitles in order for me to understand what I'm watching. So that has been a great distraction for me.

As a leader and as a care team member, especially in the healthcare field, you need to find something outside of work that will distract you in order for you to keep on going. You really need to take care of yourself. That's really the bottom line.


We started, the organization has a resiliency program for the care team members, where they come and talk to them about what they need to do to to deal with resiliency,

For me, I know when I reached my limit, I know when I need to like say, OK, it's time for me to sto. Even if it's 24 hours just to recharge, but I know when I hit that point where I'm no longer productive or good for the environment.

Last year, I guess about this time, we purchased a Peloton bike, and I love that piece of machine. You find your favorite riders and there's one on there that she is almost like a therapist, and so I'll lose it.

She will say things and it'll just make you want to cry. And so I'll when I've had a bad bad day, I'll be like, OK, I'm getting on my bike to cry now. So don't bother me for an hour. But other than that you have fun when I do the fun rides.


This episode of The Workforce Solution has been an interview with  Leah Ramos, Executive Director of Nursing for the Adult Hospital at Medical University of South Carolina or MUSC, and her teammate Christy McEachern, the clinical director there.

The Workforce Solution is a storytelling series brought to you by Health Carousel,  a world-class healthcare staffing and workforce solutions company designed to improve lives and make healthcare work better.