US RN looking to work in UK -- ER

  1. Hey!

    I'm a BSN and BS prepared RN with 2 years emergency department experience looking into working in the UK in the ER (as is my preferred specialty), and I have a few questions. Any and all help and insight would be greatly appreciated!

    Does anyone know if the standard/scope of practice remains the same between US and UK? My biggest concern is being licensed to perform certain duties in the US (IV placement, foleys, wound care, advanced medication administration, running codes, etc.) and being legally disallowed from performing such duties in the UK, as these skills are just as valuable to me as the clinical knowledge/education that supports them.

    As a whole, how do emergency departments in the UK differ from the US? Are they run much the same? The ER I currently work in affords the nurse a significant amount of autonomy, and I'm fortunate enough to work with doctors who respect and support said autonomy. What type of supportive staff is available? We tend to work closest with the phlebotomists, respiratory therapists, patient-care technicians, and in-house pharmacists.

    From my research it seems UK nurses get paid less than equally prepared US nurses, but is there a pay increase for specialist areas like ED or ICU as compared to med-surg staff nursing in the UK? Is there a large need for ED nurses in the UK, or do those positions seem hard to come by?

    Thanks once again in advance,

    P.S. any further insight regarding RN practice in the ED would be greatly appreciated
  2. 2 Comments

  3. by   GrumpyRN
    You are asking a lot of questions that are difficult to answer. ED's or A&E's (NOT ER) differ in themselves. Some will give you more than others. Insertion of IV's and Foleys should be standard but it is extremely unlikely you would run a code unless you are in some small cottage hospital. You can still be ALS qualified and assist with this. Remember, you would be the junior nurse so would have staff above you.
    What do you mean by "advanced medication?" You give what is prescribed.

    How do A&E's differ from US? Don't know, never worked in the US. Someone on this site may hep you with that. I only have what I see on TV and that tends to get my blood pressure raised due to the usual 'physician as nurse' nonsense and the way that doctors talk to nurses on TV programmes.

    The autonomy you get will depend on the senior medical/nursing staff - I was an ENP and had complete autonomy but my colleagues had to go with what was prescribed by medical staff - ie, a doctor would say this patient is for wound dressing but it is usually the nurses decision what dressing is used. Wound suturing again depends on place. Nurses can suture but a lot of them don't.
    Just as a difference that springs to mind, you will not need a stethoscope in UK ED. Nurses do not sound chests unless they are advanced practitioners

    You won't have much to do with phlebotomist's - do your own bloods.
    Respiratory therapists don't exist - they are called physiotherapists. They tend to be utilised on the wards as you should not need them in ED. You look after your own ventilated patients until you hand them over at theatre or ICU.
    Patient-care technicians??? Whats that? Again you look after your own patients.
    Pharmacy will probably not have a great input into ED on a daily basis.

    Pay is what it is. As a staff nurse you are paid at Band 5. All staff nurses are paid at Band 5 no matter where they are. Working in ED, ICU are not seen as specialist unless you have a specialist qualification/role. Then you can move up the bands. Charge nurses tend to be band 6. There is no point whatsoever looking at US salaries and trying to do a direct comparison. Costs are different. Approximately 1 third of your salary goes to tax and national insurance but health care is free at the point of use.

    4 hour target in ED - 95% of patients discharged or admitted within 4 hours of attending ED. Very few ED's meet this. I was lucky enough to have worked in an ED that met the old 98% target.

    Finally, and most importantly, can you work in the UK? Do you have the qualifications, hours etc to get an NMC PIN number?
    This forum is full of foreign nurse who are trying to do that. It takes time and money and you have to pass an assessment.

    Good luck.
  4. by   Extra Pickles
    Grumpy I am personally not looking to be a nurse in the UK but I found this a very interesting and informative read! Thank you for posting it.