Any Canucks "Disappointed" after moving to the US to practice?

  1. Please don't flame me! I am just very interested in other nurses experiences - positive and negative. I've lived in Texas for a few months now, and maybe it is the hospital I am at, but I have found the standards of care so much lower. I was not expecting that. The technology is great, but other things just blow my mind...

    For example, rarely do they hang IVPB meds with a line of NS - they will just plain old hang an antibiotic and let it run.... why? I'm told it is because NS bags are too expensive. Now, I was taught to always have a primary line of something "just in case....." Oh, and another thing: I'm in the ER where we of course give many IV push meds. Oh my gosh - the majority of nurses that push morphine (or whatever) straight up into the saline lock! I at least make sure I have a 250 ml NS hanging to dilute the push.....
    These are just some examples, but there are many others. I find just find the whole attitude so much more "unprofessional"

    I did work back in Canada as an RN, so I am able to compare my experiences. So far, I can honestly say I'm worried about my nursing skills and am considering moving home. The techs and LVNs have such a broad scope of practice here that I am always asking myself (this is NOT a bad thing... it is very helpful)- "what do RNs actually do?" When I get chewed out by a tech for starting my OWN IV (yes), or for taking someone to CAT Scan, I have to give my head a shake.

    Please, this isn't a post to "bash" US healthcare. I am sincerely interested in other nurses' experiences. Like I said, maybe it is the hospital.... but I am really curious.
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  2. 20 Comments

  3. by   live4today
    Welcome to the "disintegration of nursing" in the good ol' U.S.A. :redlight: It truly is an eye opening experience for one to learn that not everything is greener on the otherside of the fence. Healthcare in the U.S.A. has been going downhill for years now, and I see no improvement in sight. No rest for those who are weary of the downside of being in healthcare.

    Many foreign healthcare workers long to come to the U.S.A. for wages higher than they may be making in their own country. They may come for a better opportunity than they had in their own country. Unfortunately, what the rest of the world imagines America to be isn't always what it is.

    Reality is a bear, isn't it? Many many changes "for the better" are seriously needed in the healthcare structure of this country. I don't blame you for wanting to go home. I'd say stay and try to make a difference, but Americans who do try aren't being heard....hence, the trouble we are experiencing in the healthcare system today in this country.

  4. by   fergus51
    I have in some ways been dissapointed. The financial considerations down here impact care in a way I didn't experience in Canada. I don't like having to go to the pyxis to charge my patient for a cotton ball. It wastes a lot of my time. I don't like seeing nurses' jobs being given to lower paying personell to save a buck either, but fortunately that doesn't happen much in my area (NICU). I also find the threat of litigation impacts care a lot more here and my hospital is very resistant to updating things which can be frustrating.

    That said, I also love so many things about working here. Self scheduling, only working 3 12s a week, good opportunities for furthering my education, lots of jobs available, lots of places willing to train you in a specialty area, lots of full time positions, nice managers, etc. Plus, the weather in California just can't be beat! There are always pros and cons. Some things I really dislike at work, but if I can't change them I just had to decide to accept them and not let it get to me. It's the serenity prayer for nurses At the very least, seeing what I don't like is very educational and will provide me with a different perspective when I go back.
  5. by   schroeders_piano
    Quote from Camelhappy1
    Oh, and another thing: I'm in the ER where we of course give many IV push meds. Oh my gosh - the majority of nurses that push morphine (or whatever) straight up into the saline lock! I at least make sure I have a 250 ml NS hanging to dilute the push.....
    As far as your experiences go, it does really depend on the hospital you are working in and even the state that you are in. Nursing in the US is in crisis and reform is needed.

    As far as doing IV push meds straight into a saline lock, that is how we are taught to do it in nursing school. We are taught to do the SAS(H) method.

    Saline flush
    Antibiotic or morphine or whatever IV push med
    Saline flush
    (Heparin flush-if your hospital uses heparin locks)

    Hang in there. Maybe you could be an agent for change in your facility.





    Schroeder
  6. by   spots
    I absolutely agree Schroeder, hospital standards in the US vary from facility to facility, just like the pay. I have worked at some excellent hospitals like Vanderbilt and one particulary poor facility at a US Army post.
  7. by   Camelhappy1
    This past week I have been reflecting long and hard about this whole topic... yes, I think it is the low standard of THIS hospital (and I can't believe they're trying desperately to obtain magnet status!)... A few RNs I spoke to this week seem to shake their heads in disgust when talking about how things are done at this facility. That's the most frustrating part when you take a chance on a place and move 4000km from home - you never know what you're truly in for! Even though I did my research and spoke to many people.... too bad. I'm too mentally exhausted to move for another few months! Whew. :angryfire
  8. by   KatieBell
    It definitely is partly the hosptial. I have worked with some Canadian nurses who were happy (those usually started as New Grads in the US) and several who were disappointed in many different ways...some due to immigration laws, some due to the hospitals, and some because they felt that they had been duped by promises of greener pastures...

    I've worked at 5 different hosptials in the US and seen 5 different standards of care...

    Its difficult to adjust to a new environment, especially when the care standards seem inappropriate.
  9. by   fergus51
    My first US hospital was an absolute nightmare. I wouldn't let my dog go there for medical care. But, I was lucky enough to find a nicer place nearby and commute. Is this a possibility for you? I agree with KatieBell, many Canadians are sort of set up for a let down when they think they are coming here for greener pastures.
  10. by   Camelhappy1
    There's only one other show in town... and things don't look good from that perspective (I'm NOT in a decent part of the state to begin with). Actually I've just transferred units - I hear the area I will be going into is probably the best place to be right now... we'll see. At least I can say with confidence that I tried! I hate to be defeated after such a short period of time. Next stop - hmmmmmm... I hear Alaska is gorgeous
  11. by   MzKittenRN
    from one canuck to another, i commend you in exploring your options in this great land called america....

    i am working at a hospital here in new york which recently achieved magnet status....and ironically right before winning this status, i saw a few canuck nurses leave to go back to canada....but for many reasons- some miss home alot, some came for the great hiring bonuses, some were not happy,difficult immigration issues, etc, etc...

    but i do believe there are pros and cons to every workplace....i have to say that generally, i am quite content with my hospital and work experiences here in the usofa.....the self-scheduling which offers more freedom, great nursing support, benefits, work experiences, great coworkers, and of course, sad to say, the pay is greater.

    i know if i was working in ontario (where some of my friends are working back home,) i would not be making as much as i am here and be stuck dealing with at least 8-10 patients....the max. amount of patient-nurse ratio is 4 to 1, here. every hospital is different though.

    i don't think i'm going home yet....it won't be for awhile.

    mzkitten
  12. by   gchelak
    Quote from schroeders_piano
    As far as doing IV push meds straight into a saline lock, that is how we are taught to do it in nursing school. We are taught to do the SAS(H) method.

    Saline flush
    Antibiotic or morphine or whatever IV push med
    Saline flush
    (Heparin flush-if your hospital uses heparin locks)

    Hang in there. Maybe you could be an agent for change in your facility.





    Schroeder
    I am still in school (35 days left!) in TX and we are taught to dilute as the IV meds book tells us. For morphine it does say you can give it undiluted or with 5ml SW or NS (which is they way most of our nurses tell us to give it through an IV push)
    SASH is for a central line not a regular peripheral IV, but of course saline, meds (diluted or not), saline as you said for a saline lock.

    gail
  13. by   twigloo
    Quote from mzkittenrn
    from one canuck to another, i commend you in exploring your options in this great land called america....

    i am working at a hospital here in new york which recently achieved magnet status....and ironically right before winning this status, i saw a few canuck nurses leave to go back to canada....but for many reasons- some miss home alot, some came for the great hiring bonuses, some were not happy,difficult immigration issues, etc, etc...

    but i do believe there are pros and cons to every workplace....i have to say that generally, i am quite content with my hospital and work experiences here in the usofa.....the self-scheduling which offers more freedom, great nursing support, benefits, work experiences, great coworkers, and of course, sad to say, the pay is greater.


    i know if i was working in ontario (where some of my friends are working back home,) i would not be making as much as i am here and be stuck dealing with at least 8-10 patients....the max. amount of patient-nurse ratio is 4 to 1, here. every hospital is different though.

    i don't think i'm going home yet....it won't be for awhile.

    mzkitten

    i am too wondering about moving to the states...mzkitten..what hospital do you work for in new york and how is the pay? and bonuses?
  14. by   twigloo
    I am also looking at moving to the States..does anyone know a good hospital to work for?...and in what state?

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