Many American hospitals encourage patients to fill out a comment card about the service they received. Iryna Zhgya gets a lot of these comments. She keeps them in a binder at her home and enjoys looking through it, reminiscing.

She pulls out a comment card from one especially difficult patient and reads, "Iryna is an excellent RN, and she knows how to be firm but yet gentle."

Zhgya learned those skills back in Ukraine.

"I knew how to take care of patients," she says matter-of-factly. "I was a nurse. I knew how to turn people every two hours and how to watch for the sores on their body."

And nursing in the United States, it turns out, isn't all that different from being a nurse anywhere else. The ideas are the same: You're making sure a patient's needs are met.

Politics, economics bring foreign-trained nurses to U.S.

But Zhyga's career as a nurse took a detour 17 years ago, when the Soviet Union collapsed and instability washed over the republics. She remembers being very afraid.

"I put my children on the floor one of the nights. I was afraid to go to another room? I sit on my knees, and I say, 'Dear Lord, take me to the place where you want me to be.'"

Zhyga talks a lot about her faith. She says it's what gave her and her children the courage to leave Ukraine as refugees and eventually resettle in Oregon. 

Zhyga came here barely able to speak English. She had twin daughters to support, and she couldn't even drive a car.  She was struggling as a single mom to make ends meet when she found out about the WIIN program. That stands for Workforce Improvement with Immigrant Nurses

Program brings diversity and experience to workforce

WIIN Director Judy Anderson explains, "The idea had started a long time ago with many of us in health care in getting more diversity into the workplace, particularly into the RN workforce."

The walls of Anderson's office at Clackamas Community College are decorated with ethnic dresses given to her by former students. And sitting on one of her shelves are tiny flags, representing the 27 nationalities of nurses who have come through this program from "all over, everything from Siberia to Micronesia!"

Only 12 to 14 students are selected each year for the one-year WIIN program. They learn communication and time-management skills and take refresher courses on nursing. Anderson says they love nursing.

"They want to help take care of patients. They are very hard workers. They have very complicated lives, and in spite of everything, they overcome the obstacles."

She notes that most of them work full time, go to school and raise children.

"And almost all of them that we admit to the program actually end up with their nursing licenses," she adds proudly. 

Iryna Zhyga admits, "We didn't know if we would become nurses here. We didn't know if our English was good enough for the patients. But the faith that Judy had in us, it was a lot."

She graduated from the WIIN program more than three years ago. Now she has a well-paying job at a nursing home in Portland.

Foreign-trained nurses help fill gap left by retiring health care workers
Lisa Snodderly, the nursing recruitment director at Providence Health Care in Portland, Oregon, has hired a number of WIIN graduates. She notes that as nurses who entered the workforce in the 1960s and '70s begin to retire, the nation faces a shortage of caregivers. There are plenty of new nursing school graduates, but there's a growing need for experienced nurses.

Snodderly says that's where the WIIN program comes in.

"What I see this group offering us, besides the fact that they can offer us diversity, is they have experience as a nurse, although in a very different setting in most cases, but they still have those skills where they learned how to prioritize? all the stuff you have to learn as a new nurse, they bring that to the work environment."

When Iryna Zhyga arrived in the United States, she says, she never dreamed of this life. But her 16-year-old twin daughters have just graduated from high school. And a year ago, she bought her first home.

"When we bought it," she says, "I walked around and I looked at the walls and I thought? I came with two suitcases and two children to this country and had nothing and I was able to grow here and have a place that I can call home."

It's a home that few immigrants and refugees ever experience. According to experts at the Migration Policy Institute, who study global migration trends, more than a million college-educated immigrants living in the United States are unemployed or working in minimum-wage jobs, like housekeeping, or driving a cab. That kind of work keeps them living in poverty. The bad economy makes that struggle even harder.

WIIN director Judy Anderson says programs like the Workforce Improvement with Immigrant Nurses can help change those statistics by giving immigrants like Iryna Zhyga a chance to leave poverty behind and return to a career path they thought was lost forever.