American Nurses in U.K

World UK

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Hello Everyone!

It has been a long time since I have been here, so I hope that I am in the right place. I am thinking about nursing in London. All of my kids are adults and I love visiting the U.K. Has anyone worked in the NHS? If so, how was the experience? Thanks, in advance

Specializes in Critical Care.

I am finding working for the NHS is very different than working in the US. I was an ICU nurse and my specialty was switched because they were short staffed in another ward. Staffing shortages are an everyday problem. The work process is outrageously inefficient - - logging into multiple systems to access meds/"observations"/"bloods"/etc. Paper charting is crazy as you're in one chart for drs notes, one for nurse care plans, one bedside clipboard with multiple record keeping forms that RNs and CSWs are supposed to complete, don't even get me started on drug trollies and paper charting for narcotics (our trust only allows administering one patient's CD at a time, lugging the trolley back and forth to the med room and back to each patient needing pain meds with another nurse to coverify the patient). The system needs to have a better, cohesive electronic system from which to perform the job. I had hoped that the NHS would be one national system where lack of money and a strong sense of using the best evidence to make policy decisions about available resources would have created a far more efficient process but I've been stunned at the utter lack of progress in this area.

The scope of practice for an RN is different - I'm not permitted to use my stethoscope to assess my patients, I'm not part of rounding on my patients, I'm not supposed to analyze their lab work, and now my assessment consists of taking vital signs in order to come up with a National Early Warning Score. It's demoralizing, really. I'm losing my nursing skills and feel less proud to be a nurse in the UK.

I would say the cost of living is definitely higher, too. I have my visa through my husband's job, so we don't have that expense but because he's a US government contractor we get a cost of living stipend each month to offset the increased expense of living costs. I do not know how nurses live comfortably on their salary.

Shifts at our trust are from 715-2015, too

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Specializes in Emergency Nursing in USA and UK.

@brin11299 Yes, you must have a BSN to qualify for a license with the NMC (England's regulatory board of nursing, the Nursing and Midwifery Council). I can't recommend any agencies to you if you don't have a BSN.

@Candy82 Yes, you have to take the CBT (Computer Based Test) and the OSCE (an on site clinical skills practical test).

@USnurseNowUK I feel this 100%. I'm dealing with my own feelings of frustration with the de-skilling of nurses and general loss of education and responsibility in the hospital. I've spoken to one of my band 7's about using my stethoscope and they said that if it's a skill I have, I should continue to use it. Obviously I would still report any information I get from a stethoscope assessment to the doctor anyway but I haven't been told off for using it and I include the information in my written assessments.

My hospital system doesn't use very much paper charting at all. There is more of it on the regular wards but much less where I work in the ED, and the EMR system we use is one that I trained on when I was in nursing school in America, so that's a bonus. It is still fairly new to this hospital system however so it is vastly underutilized. Controlled drugs are still on paper charting which drives me nuts and makes me nervous but we don't have to drag the cart around like you're saying.

I miss being able to do assessments and being a part of rounding. As it stands, the doctors mostly leave the nurses out and then tell you what they want, rarely consulting you, which is frustrating for both me and them when I have to inform them their treatment is not the best course given what I've been assessing over time. Nurses are vastly underutilized and truthfully I don't feel like the CSW (tech/support worker, unlicensed) and nursing positions are that different from each other, with the exception that nurses can pass meds. I equally feel less proud to be a nurse and wish that there was more I could do to use the skills I have. Further, it is not only American nurses who feel this way. Many of my coworkers are from Spain, Portugal, Italy, Philippines and they all feel the same as I do. It is indelibly frustrating.

Income is definitely less but tbh I wouldn't mind if I was about to use my skills and have the same scope of practice as in America. I don't mind a pay cut to support the NHS, a system I generally believe in as a concept, especially coming from the privatized healthcare system we have in America.

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Specializes in N/A.
7 minutes ago, kaitfinder said:

@kaitfinder I'm in the process of getting my BSN. I would still love some agencies in the London area if you have any to recommend! My fiance and I still aren't sure if I should apply for a spousal visa or a work visa, and the more information we have the better!

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Specializes in Emergency Nursing in USA and UK.

@brin11299 I don't work in London and none of the agencies I looked at serviced London either, however many agencies work thru hospitals in London so I'd recommend googling and doing your research, that's how I found my agencies! Also, I have a friend who is going the marriage visa route. You have to already be married and I believe be married for some time and meet a variety of other criteria in order to qualify for a spousal visa. Also, I assume your spouse is English?

Work visa is a better choice and lasts for 3 years, costs the same, and is just as easy to get as long as you have a job offer. When it expires, you could then apply for a spousal visa to renew. But genuinely, my friend has had such a struggle trying to get through the spousal visa. Not sure how long until you'll have your BSN but it's worth considering.

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Specializes in N/A.

@kaitfinder Yes, he's an English citizen ? and I'm sorry to hear about that for your friend ? I've heard many people say that it's easier than a work visa, but also none of them were nurses. My fiance even said a few weeks ago that we were lucky I chose to pursue nursing since it's much easier for us to get work visas than most other professions.

I've definitely done some googling looking for an agency, I guess I'm just not sure what exactly I should be looking for? It's not as simple as just sending resumes to a hospital and calling ?

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Specializes in NICU.

Thanks for providing your perspective. I have a NMC license (although have never practiced in the UK) in case my husband and I ever moved there (he was born and raised there).

Really makes me sad to hear that nurses aren’t part of the rounding process- I have always viewed RNs as integral as they know the patient more intimately than the provider ever could. I also wonder what it would compare working as a NP in the USA vs UK but haven’t across anyone who has done both...

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Specializes in Medical and general practice now LTC.

Things must have really changed because the couple of hospitals I worked in nurses where always involved in the rounds with doctors

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Specializes in ER.

I was just thinking the same thing.

I had far more autonomy in the NHS than I do in the US.

We worked in partnership with the docs, not as their assistants, it was real teamwork. Here in the US I just look at my computer for the list of orders they are giving me, and work thru them. Very boring, and not what I trained to do.

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Specializes in Surgical, quality,management.
On 2/20/2020 at 5:35 AM, Silverdragon102 said:

Things must have really changed because the couple of hospitals I worked in nurses where always involved in the rounds with doctors

I strongly believe that is local culture rather than a system wide thing.

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Specializes in Emergency Department.
8 hours ago, K+MgSO4 said:

I strongly believe that is local culture rather than a system wide thing.

I agree, even back in the old Richard Gordon days (https://en.wikipedia.org/wiki/Richard_Gordon_(English_author)) nurses were on the ward round.

ETA. It is a very stupid doctor who does not listen to the nursing staff.

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Specializes in ICU.

Hello everyone! I’m a US nurse in the process of registering with the NMC. I’m seeking any advice as to how to make the process as smooth as possible. I have the visa thing covered as I will be joining my husband as his dependent on his work visa. But I am now at the stage where they have told me I will take the CBT and OSCE as well as upload several supporting documents about my health and character etc. Does anyone have any advice on how to study for the CBT and OSCE? Did anyone have a job before being fully registered? How did you prove the English language requirement? I’ve got so many questions LOL but any insight of any part of the process would be appreciated.

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Specializes in Nurse.
On 3/24/2020 at 4:35 PM, Apandriano said:

Hello everyone! I’m a US nurse in the process of registering with the NMC. I’m seeking any advice as to how to make the process as smooth as possible. I have the visa thing covered as I will be joining my husband as his dependent on his work visa. But I am now at the stage where they have told me I will take the CBT and OSCE as well as upload several supporting documents about my health and character etc. Does anyone have any advice on how to study for the CBT and OSCE? Did anyone have a job before being fully registered? How did you prove the English language requirement? I’ve got so many questions LOL but any insight of any part of the process would be appreciated.

I used some questions to study for cbt, but I already got a job before writing osce, the hospital did osce training for the new international nurses and it was really helpful. U can also practice on you own, the Youtube video by health education England osce training is also helpful.

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