As a Canadian RN who just moved to the US, I can name the following differences:
1. Patient load. Heavier in the US than in Canada. I came from an ICU where we had to have our single patient (mostly fresh post-ops) within our sight at all times, so I still get nervous when I'm stuck in one of my patient's rooms for a while and can't visualize my other patient.
2. Lack of breaks. RNs on staff don't seem to have a problem with not taking a break during their 12 hour shifts. Some of them think that eating at the nurses station for 15 minutes is sufficient. There is no clear system of break relief like there was at my Canadian hospital. No one is willing to give me a clear answer on who will be responsible for my patient if I decide to take my union mandated break time. Most of them don't even know how much of a break they are legally allowed to take during their shift. I've had nurses give me snarky "I don't take breaks." when I offer to look after their patients so they can go on break. There seems to be a mentality here that if you take breaks, you aren't a good nurse. Or that you're lazy and don't want to work hard. In Canada, at least on the unit I worked on, we HAD to take a break. It was a scheduled part of our shift.
3. Emphasis on customer service is huge in the US. Almost to the point where RNs will not report being verbally abused or bullied by patients and their families.
4. Larger disconnect between physicians and nurses. To the point where members of the physician team enter orders in the computer without informing you when you're standing a foot away from them. This seems very odd to me since as a nurse, I'm with my patient for 12 hours, and can give important information that might influence their plan of care. RNs presented the patients (head-to-toe assessment) during rounds at my Canadian hospital (teaching hospital as well).
5. Fancy surroundings. It seems like hospitals here are more concerned with aesthetics (I guess it brings in those "customers"). There are new gadgets everywhere and everything looks hotel fancy. I can't help but wonder if that money could be better used to hire more nurses and decrease patient loads. Might benefit the patients more than flat screen TVs in their huge rooms.
6. Last but not least, TEAM WORK: During my entire nursing career in Canada, there is not way people would be sitting and laughing at the nurses station while another RN ran their butt off for 12 hours. You didn't have to ask for help, it was just assumed that we would help everyone until every patient on the unit was settled. I find that no one wants to go above and beyond for a patient that they're not assigned to. There seems to be a larger focus on the individual, as opposed to the general wellbeing of the entire group.
1. Taxes. I was quite surprised that I get almost the same amount of taxes and deductions taken off my US paychecks that were deducted from my Canadian paycheck. Maybe it's just my state, but it seems like Canadians get more bang for their taxes than Americans do.
2. I get paid $1 more an hour in the US (although I've been told that this state has higher wages than average for nurses than the rest of the country) than I did in Canada, however overtime was double time at my hospital in Canada, so made more money yearly.
The things I do admire about my US hospital is their commitment to evidence based practice and how a lot of the RNs seem to be pursuing research and advanced degrees. I think this has more to do with there being a larger market for mid-level providers in the US.
This post wasn't intended to be critical, just stating the differences. Overall, I think Canadians nurses definitely have better working conditions (pay, benefits, workload).
Thank you for reading.