Difference between nursing in the UK vs nursing in the US? - page 5

Seems everyone's legging it from the UK to the US. What's the deal?... Read More

  1. by   dino-nurseUK
    Hello
    This is the first time I've posted on this messageboard, although I've been reading comments for a while now. I trained in the UK during the 1980s when the system was very different- much more like an apprenticeship. Students were salaried (although very poorly paid) and learnt most of their skills on the wards rather than in college, over 3 years (RN) or 2 years (EN, like the LPNs). We spent around 8 weeks a year actually in college, had 8 weeks paid leave and the rest was on the wards. Most of our studying had to be fitted around our job. Most assignments would be tailored to the area you were working in, so for instance you might have to do an assignment about caring for a patient with cardiac problems whilst working on a medical ward. Hands on care was seen as the "gold standard". Although we worked in teams, the actual staff to patient ratios were quite high due to the different skill mixes. Third year students were able to do nearly everything a qualified nurse could do, bar giving out controlled drugs, IV meds and a few more specialist things. Typical shift would have 2 students, 2 ENs, 2 RNs and a few support workers (HCAs). If no sister/charge nurse was on then one of the RNs would be in charge for the shift. Wards typically had around 32 patients.
    Having worked in the US as well as the UK, I feel that both systems have their own merits. As I worked mainly in ICU and A&E (ER) I noticed less differences between the two. Yes, in the US I had more "protocols" to follow but as was previoulsy posted, that is mainly to do with the legal situation. In the UK I had more autonomy most of the time as I became more senior. I originally went to the US with a group of friends in the 1990s and stayed for 5 years. I worked in a variety of hospitals, including County hospitals (think this is what they are still called? Patients can get certain care for free if they have no/basic insurance). I also used to volunteer at a free clinic. Although I enjoyed living in the US, I came back to the Uk because I was finding the insurance-orientated care in the US more and more difficult to cope with. More and more of the patients I saw in the ER were being denied treatment becuase they couldn't afford the meds etc for a variety of reasons. Now I am back in the UK working for the NHS. I am appalled at the state the NHS has been allowed to get into. Staff ratios on the ward are a joke most of the time. The lack of enrolled nurses (similar but not exactly same as LPNs) has had a big impact. Now the good ship NHS seems to be trying to turn support workers into ENs. Joy. Less experience, no accountability....they also seem to be trying to replace junior doctors with RNs. Much as I would love to have the time to give patients basic care, I find myself being buried under more paperwork than I ever thought possible. Think its time to leave the trauma ward and return to ICU.
    At least in the UK I can get a decent cup of tea, if nothing else :smilecoffeecup:
  2. by   blue_red23
    As an ICU nurse here in the UK for 5 years, I guess we are more independent in terms of patient wholistic care. We do everything from ventilators to CVVH.We are very important part of multidisciplinary team.We need to act/think quickly to every changes the patients manifest.We get more annual leaves here.
  3. by   telc
    hi to everyone! just a bit curious..betweeen US and UK, which has a better compensation to nurses..(i mean financially)..ive been asking this to my friends but they dont have any idea how much euro is paid to an entry-level nurse in UK..i know that an entry level nurse in US is paid about 30 to 4o dollars depending on his experience etc.. and a friend told me that in UK, there's a high standard of living..thats why most nurses want to go to US..
    i hope UK nurses out there can clear up my querries... thank you for any reply you can impart..:smilecoffeecup:
  4. by   oreo75
    Starting pay for nurses in the UK is 19,166 which is staring band 5 money for a registered nurse, before you get your registeration you get paid at band 3 which is 14,037.

    Hope this helps.
    Last edit by oreo75 on Nov 22, '06
  5. by   telc
    hi oreo..are you a filipino? 19,166?? how much will that be in peso? 1=?
    i think thats way too high compared to US nurse's salary..i didnt understand the band 5 and band 3 that you were telling me..
    how about the lifestyle in UK?they said its haigh standard..is this true?
  6. by   blue_red23
    standard of living in the UK is high compared to US.However, quality of life in the UK is better compared to US. Less stressful, more annual leaves(it means for time for yourself and family if u got kids).
  7. by   Silverdragon102
    Banding is how the UK health sector is paided. Pay is dependant on job and experience. Here is a link which shows pay scales RCN: Agenda for Change - Pay and Conditions - Pay 2006 I know I am on band 6 and ear approx 21,000 a year but when I move to the US I will be paid double. You do get more holidays in the UK than the US but standards of lining varies greatly depending where you live ie big cities (London) the cost is higher than living somewhere a lot smaller and quieter
  8. by   RGN1
    Quote from telc
    hi oreo..are you a filipino? 19,166?? how much will that be in peso? 1=?
    i think thats way too high compared to US nurse's salary..i didnt understand the band 5 and band 3 that you were telling me..
    how about the lifestyle in UK?they said its haigh standard..is this true?
    You have your currency conversions wrong here - it is way too low compared to US nurses!

    Lifestyle is expensive - especially here in the capital. Taxes are really high & there's all sorts of "hidden" taxes too. Add to that TV license fee, parking charges, congestion charges, petrol (gas) prices & you're in for a huge dent to your already poor wage packet!

    UK nurses are officially the lowest paid of all public sector workers & it's a disgrace! Especially considering the stress of the job, the responsibilities we have & the training we undergo.
  9. by   twotrees2
    Quote from RGN1
    I'm a UK nurse who is also "legging it" across the pond. I'm leaving for many of the reasons that Janelola mantioned along with the congestion, draconian parking measures, stealth taxes etc.

    Also I do actually know where the OP was coming from with the original comment where he talked about RN's being like CNA's. What I think was meant was the fact that here the RN is expected to take full care of the patient. For example, When I get my allocated 5 patients (I'm lucky enough to be in the private sector where my maximum caseload is usulaly 5) I have to do everything for them that shift be it washing them, making their bed, helping them with their meals etc etc as well as meds, careplanning etc etc. This is where I think the idea of the UK RN being like a CNA comes from because we have to do the whole lot. When I was in the NHS my role also included washing the bed area & locker too, cleaning up with the mop if anything was spilled etc etc!

    However, I don't have a problem with orders because if a patient goes into retention I can just OK it with the RMO (resident medical officer) to put a cath in etc. Only occasionaly do I have to call their consultant for orders. I am certified to cannulate & take bloods but in the UK we are not taught to listen for heart or lung sounds (although I do listen to the latter if I'm concerned about fluid retention etc) however, bowel sounds are definitely part of my remit because we have plenty of gynae surgery on the unit.
    so then in the uk you are really not giving meds on your own free will at your discretion as you are calling in a resident to9 make that decision rather than the actual doc - that is similair to us where we have to call but we mayget the on call vs the actual doc -

    i had originally read it to say somehwere here ( dont recall actual post ) that you could give meds, foleys, ivs etc without consulting ANY doctor.

    so which is the right answer -
  10. by   Tanvi Tusti
    Quote from twotrees2
    so then in the uk you are really not giving meds on your own free will at your discretion as you are calling in a resident to9 make that decision rather than the actual doc - that is similair to us where we have to call but we mayget the on call vs the actual doc -

    i had originally read it to say somehwere here ( dont recall actual post ) that you could give meds, foleys, ivs etc without consulting ANY doctor.

    so which is the right answer -
    You can only prescribe meds if like me you are a nurse prescriber. Non nurse prescribers work with PGDs which allow them to give certain meds, treatments without the authority of a doctor. Foleys can be used without the authority of a doctor, if the nurse thinks its needed. As a midwife I can start an IV without the authority of a doctor under a PGD. As a nurse presciber I can prescibe any drug out of the BNF without a doctors authorisation.
  11. by   RGN1
    It very much depends on which level of nursing you are at & in some cases which hospital you practice in. Only nurse practitioners, who have done extra training, can prescribe etc without some form of medical consent be it written or verbal. As a staff nurse I cannot prescribe any drugs or give them without a written order. I would also seek verbal consent to insert a foley on a female patient (except in a real emergency). I am not allowed to insert a male catheter! I can give IV's with a written order, I can cannulate - don't necessarily have to have an order (eg if a cannula tissues I can go ahead & resite without further orders). I can take bloods either with a verbal/written order or because I know it's part of the consultants protocol (eg all hips have FBC/U&E post op day 1).

    I can go ahead & take an ECG without an order, in cases where I was concerned about rhythm it would be the first thing the doc would ask me to do anyway.
  12. by   twotrees2
    Quote from RGN1
    It very much depends on which level of nursing you are at & in some cases which hospital you practice in. Only nurse practitioners, who have done extra training, can prescribe etc without some form of medical consent be it written or verbal. As a staff nurse I cannot prescribe any drugs or give them without a written order. I would also seek verbal consent to insert a foley on a female patient (except in a real emergency). I am not allowed to insert a male catheter! I can give IV's with a written order, I can cannulate - don't necessarily have to have an order (eg if a cannula tissues I can go ahead & resite without further orders). I can take bloods either with a verbal/written order or because I know it's part of the consultants protocol (eg all hips have FBC/U&E post op day 1).

    I can go ahead & take an ECG without an order, in cases where I was concerned about rhythm it would be the first thing the doc would ask me to do anyway.
    doesnt sound different then here - we do the same - we get verbal or written unless ( we call it nurse practitioner here) we also reset IVs if they infiltrate without orders cause the original order is there so that is a given wed do that - we dont so ekgs - did in hospital without order ( but would get one after) but at the nursing home we dont even have a machine for it so we need the order to get the machine there lol. a lot of our docs have protocols in hospitals to follow hence no calling for an order we call them hmm been so long i worked hospital i forget oh standing orders - at the nursing home we just write doc when they come in we want this and that for standing orders and usually get it. we often will even cath someone in emergency ( haven't voided 2 shifts and get an order after without any trouble ( then we have further info - distended residual is etc,) one thing i do not get - why can yo not do male foleys?
  13. by   RGN1
    Quote from twotrees2
    one thing i do not get - why can yo not do male foleys?
    I have no idea! It's just an old traditional thing that I think has gone on into modern nursing for no good reason. I believe that if you work on a urology ward you are allowed to train to do so, I would also expect that goes for A&E/ICU too. However, if you are on a standard med/surg ward in most places you can't catheterise male patients - so they just have to put up with the discomfort until the doc is free!

    Of course I expect things are changing, slowly, I'm sure there are hospitals now that do allow nurses to cath males but not in my area, at least not yet anyway. the biggest reason things might change though is the new cut backs on junior doc hours, I think they'll have to allow nurses to cath males in general wards or some poor blokes bladder's gonna burst!

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