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Stephanie Johnson

From Zero to Launch: Building a Global Nursing Program in 8 Months

cross cultural leadership global project delivery Jun 16, 2025

Authored By Stephanie Johnson

The phone call came at 5:32 p.m. on a Tuesday. I was wrapping up a risk-review meeting for my division when the VP of a brand new business unit asked a deceptively simple question: “Would you be up for launching an international nursing program in the Philippines?”

On the surface, it sounded like an adventure. In reality, it was a race against an eight-month clock. We needed a temporary education facility, government entity registrations and licenses, immigration-compliant staffing partners, a high-fidelity clinical simulation center, and an entirely new operations stack that could ideally integrate with our existing systems.

The payoff was clear. If we meet the deadline, the company would gain a foothold in Southeast Asia, diversify its talent pipeline, and demonstrate that our Canadian, U.S., and U.K. brands can travel globally. If we missed, we would burn millions and damage the reputation we had spent decades building.

Saying yes felt equal parts bold and reckless, which is precisely why it mattered. The global nursing shortage was worsening, and the Philippines was already training some of the most sought-after clinicians, helping them upskill locally while building a sustainable talent bridge that aligned perfectly with our mission of providing safe, high-quality care everywhere.

Purpose plus pressure is an irresistible combination. I accepted within forty-eight hours, and a four-page pro and con list. Before I jumped, I pulled my boss aside, locked eyes, and got a guarantee: if this overseas experiment crashed and burned, he would save me a seat back home in his org. Safety net secured, I leapt.

Scoping the Unknown

My inbox had no real requirements, so I started with a whiteboard divided into five columns: Licensing, Facility, People, Brand, Ops. Under each header, I listed every unanswered question:

  • How do we register an educational entity in the Philippines?
  • What simulation equipment meets local voltage standards and will be used again in the U.S.?
  • Do nurses prefer WhatsApp, Viber, or email for recruitment outreach?

The list grew to seventy-nine items in the first hour.

Building a Relay Race Team

Time zone math: Manila is twelve hours ahead of New York. That reality shaped our staffing model. I maintained a small core team in the U.S. to handle delivery escalations, legal matters, and curriculum design. In Manila, I hired a managing director and ops manager who became the nerve center—field visits by day, WhatsApp voice notes to us by night.

We met at 6 a.m. Eastern three to five times a week so decisions landed in their inbox before their workday began. The rhythm preserved momentum without wrecking everyone’s sleep.

The Temporary Campus

Regulators require an audited facility before they will even review a license application. Permanent construction could not finish in eight months, so we scouted short-term options.

After three property tours and one dramatic IT and networking adventure, we secured a vacant space. The landlord agreed to a short-term lease with rolling extensions and allowed us to retrofit three spaces for educational and simulation setups. Getting that letter of intent signed unlocked the first of many approvals.

Government Green Lights

In the Philippines, staffing is not a side hustle. Agencies must be at least 75 percent Filipino-owned, provide ₱5 million in paid-up capital, and park enough escrow to cover worker claims.

Miss a quarterly compliance report or botch a contract verification, and the government can freeze your license. Sneak in extra charges, and you might see a license revocation headline before breakfast.

We adapted our contracting process to include each recruiter’s POEA and DMW license number and verified escrow status. It added nine weeks of due diligence but earned instant credibility with regulators and nurses alike.

Designing a High Fidelity Simulation Center

Sim labs cannot run on converted office furniture. We needed adult and pediatric manikins with physiologic responses, piped-in oxygen, and AV setups for debriefs.

Import permits took up to 90 days, so we dual-tracked the procurement process. Items not yet registered could take 180 to 365 days. We placed orders early and worked with our vendor to get a Pyxis machine registered. It cost an extra 10 percent but ensured our first cohort would practice on day one instead of staring at empty beds.

Construction of the Permanent Space

Next came the forever home. We evaluated industrial units and shell spaces and met with multiple business offices.

The winner: a 20th-floor space attached to Manila’s largest mall, featuring the coolest twisted design I had ever seen. Local code mandates the use of a Filipino general contractor for educational builds, so we issued a design-build RFP only to firms with proven experience in healthcare. Frequent site videos kept our U.S. execs engaged and the contractor honest.

Brand Localization Without Dilution

North American quality standards heavily influence our brand. Filipino audiences, however, tend to respond more to messages that emphasize warmth and community service.

We hired a Manila agency to adapt visuals and copy while keeping our logo and safety promises intact. From social media to hiring events and our ribbon-cutting ceremony, the marketing team crushed it. The brand resonated without feeling imported. By year-end, over 400 nurses were in various stages of education and immigration.

Curriculum and Equipment Arrive in Parallel

While electricians ran conduit onsite, U.S.-based instructional designers finalized lesson plans aligned to North American competencies and client needs.

Two Boeing-sized pallets of consumables and IT systems began arriving. Customs delayed the release due to a missing commodity code; however, our in-country and U.S. legal teams successfully resolved the issue. Relationships trumped process again.

Standing Up Operations

We rolled out our HRIS, single sign-on, and help desk in sandbox mode. Philippine data privacy law required a securities certificate, so we did a rapid legal gap assessment.

The fix: Register all digital products containing PII or PHI and appoint a local Data Protection Officer. Security audits passed on the first try.

The 24/7 Reality

Overlap windows were gold. At 6 a.m., fresh WhatsApp photos pinged—drywall up, simulators delivered—and I dropped them into dashboards before my kettle whistled.

Noon was the magic hour: Manila’s afternoon met New York’s midnight, and decisions ricocheted across Teams. By 11 p.m., I was still crunching punch lists, construction tweaks, and visa counts—eyes gritty, mind steady.

Somewhere in that marathon, we formed a micro tribe. Anyone could type “Yellow flag, tapping out for four hours” and get instant thumbs up. That honesty killed fatigue-driven mistakes and made trust our default operating system.

Launch Day and the First Cohort

On a steamy Monday, exactly eight months after that VP call, the first cohort of ten nurses walked through our temporary campus doors.

AC units hummed. Manikins blinked. Educators stretched across the lobby, ready to welcome them.

I was on the edge of my bed with my laptop and phone in hand, frantically trying to find a Grab driver to deliver rice, because I wasn't culturally prepared for them to reject muffins and bagels. (Big rookie mistake. Never again.)

Takeaways I Still Carry

Big projects do not come with perfect blueprints. You build your playbook while the clock is ticking and the stakes are rising.

  • Map questions before answers. A blank whiteboard exposes hidden assumptions.

  • Hire a local connector early. The right person removes more blockers than a project plan ever will.

  • Licensing drives everything. Get provisional approval first. Everything else falls more easily into place.

  • Dual-track critical imports. Local rentals and vendors gave us scheduled insurance at a modest cost.

  • Local contractors, global standards. Match your home-country architect with a local builder.

  • Respect cultural cues in branding and food. Adapt tone and visuals. Keep core promises. Never forget the rice.

  • Protect human bandwidth. Yellow flag fatigue days reduced errors and boosted morale.

  • Document the playbook in real time. We captured 43 lessons in two weeks. Now, future launches start on page one, not page zero.

If I were to do this again, I would embed an in-country manager six months earlier and budget for two extra site visits to focus on curriculum, delivery, and operations.

But the biggest lesson remains: distance is just a math problem. Shared purpose, disciplined communication, and respect for local expertise turn time zone lag into the least interesting part of the story.

Conclusion

Looking back, this project was never just about timelines, logistics, or regulatory checklists. It was about trust, adaptability, and honoring the people at the heart of the work. Every decision, from simulation specs to breakfast menus, was a reflection of deeper values—respect, collaboration, and doing right by our teams and students. We did not just launch a program; we built a bridge that connects potential with purpose. And in doing so, we proved that even the most ambitious global projects can succeed when grounded in shared humanity and bold leadership.


Contributor Bio

Stephanie is an Army veteran and global Chief of Staff and PMO operations strategist with over 20 years of experience turning blank canvases into revenue engines, most recently leading cross-continent launches that generated $66 million in new business in just one year. Armed with an MBA, MPH, Lean Six Sigma Master Black Belt, and PMP, she specializes in translating chaos into streamlined processes that become policy, keeping boards smiling and frontline teams sane. Off the clock, she reverse engineers espresso shots and sneakily applies Lean principles to SCUBA education and trip planning.

Connect on LinkedInStephanie Johnson

 

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