ONEONTA _ Pushpa Parasa traveled thousands of miles to join the staff of A.O. Fox Memorial Hospital in Oneonta, where she is a registered nurse working in the operating room.
"It's a big challenge working with the surgeons,'' said Parasa, who began in the OR about six months ago after learning about nursing and paperwork practices.
Parasa, 43, the first recruit from India in Fox's program to stem a nursing shortage, has earned an employee pin marking five years at the hospital. Her husband, Anand Anil Kadamandla, 44, who works as a stock clerk in the materials management department, also has his five-year pin.
Passing that mark, they said, has qualified them to apply for United States citizenship, which they did this month.
Two other registered nurses and a kitchen aide from India also are working at Fox. Though they are from the same city in India, they met through the recruiting program and have since become family friends who celebrate American and Indian holidays in Oneonta.
``It's a very good place,'' said Jessy Chovallur, 28, a registered nurse who works in the pediatrics department.
She and Amulya Pingali, 32, continue working toward their five-year pins as nurses. Pingali's husband, Laxmi N. Naraparaju, 35, is employed by Fox as a kitchen aide in the nutrition department.
They have two daughters, including Harshini, who was born at Fox six months ago. Their 9-year-old daughter, Meghana, is in fourth grade at Valleyview Elementary School. The girls have their father's last name.
On Thursday at Fox, the Indian nurses and relatives talked about experiences adjusting to life in Oneonta. Health care is more accessible in the United States than in India, where rich people have better access than poor people, they said.
Oneonta is a peaceful, quiet place, they said, but adjusting from their hot climate to one with snow was a major challenge. They live in apartments near each other and within walking distance to the hospital on Main Street.
This weekend, they will celebrate the Indian holiday of Diwali, a traditional festival of lights. The families said they have found places to practice their respective religions _ Christianity in Oneonta and Hinduism at a temple in Albany.
Preferred shopping sites for rice, lentils and other Indian vegetables are in Albany and New York City, they said, and they have traveled to major cities and other states.
Robbin Scobie, vice president of nursing at Fox, went to India to recruit the nurses. Of 17 job offers made, five nurses joined the hospital, and two left after fulfilling their three-year commitment, she said. All of the Fox workers from India have green cards, hospital officials said.
The nurses have impressed staff and patients with their work ethic and willingness to step in where asked, said Maggie Barnes, Fox spokeswoman. The hospital had more success because it focused on citizenship instead of temporary employment under green-card provisions, she said.
The five nurses already were trained before joining Fox, but they had to take the New York state licensing exams. They reached that goal by studying and through support from Fox, which paid for materials and fees.
The nurses said they were eager to come to the United States, learn advanced technology and science and practice in the medical field.
The Indians are from Hyderabad, a city in south India. Hyderabad, with a population of about 3.8 million, is the fifth-largest metropolitan city of India, according to its website, and the presence of Microsoft and IBM makes it a ``high-tech city.''
English was a second language they studied in school, the Fox employees said, but it was somewhat of a challenge after arriving in Oneonta, especially in learning American English and slang.
``We had culture shock in the beginning,'' Kadamandla said.
Parasa said she and her husband wanted their son, Peter, 19, a 2006 Oneonta High School graduate, to have access to education in America, and he is taking college classes online.
The Indians said they stay in touch with relatives by telephone and through the Internet. They also access Indian music and movies and other cultural resources online.
Naraparaju agreed the cultural adjustments were difficult. But he and others were reassured by help from Scobie.
``We are very thankful to her,'' he said.
The exchange has been a positive, life-changing experience, said Scobie, who has traveled to India to attend the wedding of an employee's relative and has met many family members there.
At the hospital, the nurses have been complimented for their positive approach, including smiles that make patients feel better, said Scobie, who this week also is being recognized for years of service.
``I'm celebrating my 20-year anniversary _ so it's even that much more special,'' Scobie said. `They've given more to myself and my family than I ever expected.''