Keep in mind that my comments are restricted to "in my experience" of the past 3 years.
I find the RN role very similar in general. In my hospital at least, there is a lot more electronic charting, electronic methods to access meds, scanning people's wristbands to assign meds. A *LOT* more (electronic) "paperwork" and clicking in boxes to document what you did on the shift.
Honestly the main difference I notice is in the work culture. You work sick, you don't take time off. You "yes sir, no sir" to many of the attendings, not calling them by first names as I was used to at home. Of course that varies by person, but in general there is more of a hierarchy with nurse as "worker" and doc as "money maker" in the hospital systems over here. There is a very "dibber dobber" mentality, and if you make a mistake and your coworkers find it, they generally "write you up" (eg. write a report) rather than just letting you know directly and helping each other out. People seem a lot more selfish professionally, rather than team oriented.
I don't want to give the impression it's all bad; I actually love my job. Not all of the above have actually happened to me - just aspects I have observed. The good side is the innovation in nursing care. There is a real expectation that nurses will seek advanced education over here - it's much more the norm to pursue a masters or even doctorate level education than it is back home. There are professional ladders that provide the incentive and opportunity to participate in professional development activities. There are advanced practice nursing models to pursue which give a much broader spectrum of nursing-based careers.
Hope that helps.