British nurse made it to the USA wow is it different!!!

[meeky71]

I have recently made the journey from UK to USA I am about to start my second and final week of orientation on the ER floor. I have been working in ER for almost 20 years and in the same department, however after my first week I feel like I am drowning. The whole way of working is completely different and I am begining to doubt my decision. I know I shouldn't as it has only been 1 week, but I am worried that once I start being allocated my own patient's they are going to think I am too slow, I am asking too many questions etc.

I would love to hear from any international nurses who may have found themselves in my position and whether is gets any easier.

Thankyou in advance

Meeky

[loriangel14, RN]

Hang in there. I'm sure it will get better. What are the differences between there and home?

[llg, PhD, RN]

I, too, am curious about what is so different and hope you will share a little. Also, I am a little concerned that you are only getting 2 weeks of orientation to your new job. My hospital would be giving you a lot more orientation than that -- even if you are experienced -- given that your experience has been in another country. It might just be that you are working for a bad hospital: keep that in mind.

As for advice ... have you found anyone in your new work environment that you can trust so that you could talk to them about some of your struggles? Having a mentor or friend to go to for advice can be a big help to someone making a big transition.

[gen88]

So curious to know what the differences are! Especially seeing as you have so much experience. I'm in Australia so our practice is very similar to UK- but whenever I work with North American nurses down here , they are always a treat because they are so knowledgeable and well-trained!

[jangirl]

Congrats Meeky71. Don't be discouraged. Be open minded.

[US RN in Oz]

Hi Meeky,

I've gone through the international change, other direction though... US to Oz.

Yes. Some aspects should get easier. I agree with llg that 2 weeks orientation is not enough. That's unusual for the US. If I remember correctly, most of my orientations were about 6 weeks in America. In which city are you working?

I'll also second llg's sound advice. Of course, this was all like 6 months ago.

I see that a few folks were interested to know about the differences. I also here about UK nursing being similar to Oz nursing. The context of the differences I've notice are between US and Oz acute care med-surg.

As far as small differences, there are heaps. Like, thousands. There are more differences in the words used than one could anticipate. So, instead of 'taking vitals before placing a chuck under the urinal for the man who feels funny; it would be, 'getting obs before placing a bluey under the bottle/jug for the bloke who's crook'.

Bung vs cath, jab vs injection, it goes on and on. Of course, brand name meds are frequently different but, sometimes the genarics are, too. Paracetamol vs Acetaminophen. Could you imaging being patient while a nurse straight of the boat doesn't know what Tylenol is? Lol... true sorry.

As for the broader difference...

Oz: More task oriented

US: More assessment, decision making, patient advocacy, and interdisciplinary collaboration

Oz: Subordinate

US: Member of a team

Oz: Inefficient paper-based system

US: Up to the minute eMR, eMAR, BCMA, DICOM, PACS, etc.

Oz: Errors galore

US: Never Events

Oz: Some nurses can't give meds, place IVs, insert caths, or drop NG tubes

US: Some nurses can't properly make a bed or wipe a butt

Oz: Tea breaks, seemingly every 2 hours

US: Beast mode

Oz: Shift report is getting a tiny bit of info on each of 56 patients on the ward

US: Extremely detailed handover report on each of your patients

Oz: Busy because your tracking down the one existing physical chart, waiting for results, sorting through disheveled papers, clarifying orders, toileting patients

US: Busy trying to appease big whingy babies for good patient satisfaction scores... and kicking so much ass whilst doing so =D

[Britnursecalibound]

Did it get easier?

[US RN in Oz]

Hi Meeky,

Got a bit easier. I started teaching university nursing students this past year. This helped me, myself, in my own management of the different system when I'm in the wards. Got much better at the paper-based system. I also got mire selective with where I accept shifts via agency. I won't go to sites that I know are a mess.... i.e. frequent lost charts, obscene infection rates, etc. Still terribly inefficient.

Just applied to do nurse-led bedside PICC line insertions. Something I've always wanted to do. Fingers crossed =).