Enough nurses or not?

skylark, BSN, RN · Sep 10, 2010

The NMC website is the ONLY place to find factual and accurate answers, and you should be looking there rather than a chat forum.

I'm not at all sure about your comments that "obviously" English nurses should be favorite in selection. UK hospitals have recruited from abroad for many years, and choose to do so for a variety of reasons.

Often it is because the foreign nurses are cheaper, they choose not to take out pension schemes for example, if they plan on returning home at some point.

But mostly it is because UK nurse training is painfully basic compared to the rest of the world, and they can get a higher caliber of nurses elsewhere.

The Philippines are the preferred choice, their nurse training is based on the US system, hence it is far better, but their national economy is weaker than the Uk so they are happy to work for wages that Uk nurses would not consider as it is still far higher than they can earn at home.

Silverdragon102, BSN · Sep 10, 2010

The NMC website is the ONLY place to find factual and accurate answers, and you should be looking there rather than a chat forum.
I'm not at all sure about your comments that "obviously" English nurses should be favorite in selection. UK hospitals have recruited from abroad for many years, and choose to do so for a variety of reasons.
Often it is because the foreign nurses are cheaper, they choose not to take out pension schemes for example, if they plan on returning home at some point.
But mostly it is because UK nurse training is painfully basic compared to the rest of the world, and they can get a higher caliber of nurses elsewhere.
The Philippines are the preferred choice, their nurse training is based on the US system, hence it is far better, but their national economy is weaker than the Uk so they are happy to work for wages that Uk nurses would not consider as it is still far higher than they can earn at home.

Where do you get the idea that employing foriegn nurses are cheaper? they have to be paid the same pay as a UK nurse if employed in the NHS and I believe the same is for private as well. UK training is not basic compared to the rest of the world but is now more specialised and I have seen the same variety of good and bad students as you can find elsewhere in the world.

I actually find this an insulting piece towards UK nurses

skylark, BSN, RN · Sep 10, 2010

My understanding is that foreign nurses are generally seen as cheaper if they are on fixed term contracts. No pensions, no maternity leave, just workers!

As regards insulting UK nurses, I originally trained in the UK and have worked many years there. (Iam there at the moment.)

But in order to do a foreign exam (NCLEX) I had to study a further 2 years, as my Uk training was not sufficiently medical/clinically based. Pharmacology and biochemistry are taught at a basic level in the UK, hence the high failure rate of Uk nurses when attempting foreign exams.

Sure UK students can write reflective essays til the cows come home, but I also have 3rd year students who had never heard of quinolones, GCS scales, or how to test urine for a ?UTI. What use is a nurse without clinical knowledge?

These students will be qualified in a couple of months and their lack of clinical knowledge is quite frankly scary.

Silverdragon102, BSN · Sep 10, 2010

As far as I am aware foreign workers still get maternity leave and can opt for pension in the same way a UK nurse can opt into the pension. I know the Philippine nurses I used to speak to when I was in the UK said they could.

UK training is more specialised now and personally I think this happened to make it harder to move abraod, but this is my opinion. I trained in the UK way back in 86 and have seen many changes, not all for the good but there is some good. Even back then I would see students coming out that knew little and yes it is scarey but I also blame a lot on the universities not making sure that adequate training is provided.

It isn't just UK nurses that have a high fail rate for the NCLEX as I have seen many other nurses from Philippines, Australia and Canada fail the NCLEX so you can't just blame it on the UK system

skylark, BSN, RN · Sep 10, 2010

This might be out of date, but the last article i read said that the pass rate for Filipino nurses in NCLEX was 75% and UK nurses 4%.

Even though I had been qualified and working as a SSN for 15 years, I had to study hard for 2 years to pass the NCLEX. Not revise, but study.

Learn new stuff that I had never learned in the UK.

As regards foreign nurses, it seems that many are on fixed term contacts that relinquish rights to Mat leave and pensions, etc, though i imagine that varies between trusts.

I was not blaming the students themselves, i was blaming the institutions that 'train' them. I knew more as a N/Aux, (now a HCA) in the 1980s than some of the 3rd years that come through here now.

Basic care knowledge is lacking, doesn't anyone learn wound care anymore?

If I see one more grade 4 ulcer with a Mepore slapped on it i will scream . . .

ceridwyn · Sep 11, 2010

Mepore on highly excudating wounds he he he, I see this often from hospitals, this is not from lack of training or education, this is from lack of care. An older friend of mine was released from hospital after a bypass surgery, I found out had several wounds including a massive pressure sore to a heel all covered with mepore. that was falling off, of course within the hour. (I volunteered to care for (one small wound) I know she was nursed by New Zealand, Somalian, Fillipino and an Australian nurse on day of release. :uhoh3:

allnurses Guide · Sep 13, 2010

The NMC website is the ONLY place to find factual and accurate answers, and you should be looking there rather than a chat forum.

I respectfully disagree, the OP was asking about job prospects not how to register with the NMC as a EU national and qualified nurse he will already fill the requirements to work as a nurse in the UK.

What would be useful is to check out the NHS jobs site which can be found at NHS Jobs or do a job centre search for jobs in nursing homes or the private sector.

I'm not at all sure about your comments that "obviously" English nurses should be favorite in selection. UK hospitals have recruited from abroad for many years, and choose to do so for a variety of reasons.
Often it is because the foreign nurses are cheaper, they choose not to take out pension schemes for example, if they plan on returning home at some point.

Really, I have to be honest if you look at the unemployment rates in the UK I again have to respectfully disagree with you, although UK nurses will pay into the pension scheme if you look at the cost of paying unemployment benefit and couple that with the cost of training and UK nurse of course UK nurse should be considered first and as a person who recruits within the NHS I certainly give preference to UK trained nurses. Foreign nurses are not cheaper, they get paid on an equal pay band to any other nurse who is doing the same job as them.

But mostly it is because UK nurse training is painfully basic compared to the rest of the world, and they can get a higher caliber of nurses elsewhere.

Again I have to strongly disagree with you here as find your comments insulting. Our training is different but that does not make it more basic, and as far as passing foreign exams nurses in the UK are trained to work in the UK they are not trained to take things like the NCLEX so of course it is going to be very different to what they are currently doing. I work with extremely competent and highly skilled nurses and am very proud to be trained as a UK nurse. We work very differently and to even begin to compare is like comparing apples to oranges.

I was not blaming the students themselves, i was blaming the institutions that 'train' them. I knew more as a N/Aux, (now a HCA) in the 1980s than some of the 3rd years that come through here now.
Basic care knowledge is lacking, doesn't anyone learn wound care anymore?
If I see one more grade 4 ulcer with a Mepore slapped on it i will scream . . .

That's just poor care, I am not sure where you work but that certainly doesn't happen in any of the hospitals that I have worked in (and I've worked in a few in the 20 + years I've been nursing in the UK)

Of course you get poor nursing, but you also get some excellent nursing care as well in the UK. I look around at the knowledge and skills of the staff I work with at the moment and get extremely frustrated at the broad generalisations that categorise all UK nurses as "basic"

allnurses Guide · Sep 13, 2010

Hi everybody, I'm new to this group. I live in italy but I'm interested to relocate in UK (scotland mainly) with my family, my wife is a nurse too with 13 years of experience. I started my project being sure that in Uk (like in many other countries) nurses haven't any problem to find a job in NHS or private sector. I read hundred of job serch in every site about nursing in UK but You say something different in your discussions so...where is the truth?
It's obvious that uk nurses should be favourite in selection but, are there enough english nurses now to cover uk requests? What about future prospectives? Is it possible to have recognized years of experience in italian nhs to start from a superior pay band?
Thank you everybody for your answers.
Danilo

Danilo, jobs within the UK are not brilliant at the moment but that doesn't mean that there aren't any. It depends on which area of the country you want to work.

Yes sometimes UK nurse would get preference over someone not from the UK however because your within the EU you are eligible to apply for the jobs that are advertised. As far as recognising prior experience in Italy, I am sure it would be taken into consideration but initially I think your wife would need to apply for jobs at a band 5 to gain the experience within the UK NHS before she would be considered for a higher band. However were as a newly qualified UK nurse may not apply for a band 6 for a few years because of the experience your wife already has it wouldn't necessarily need to be too long before she looked for a higher grade

english_nurse · Sep 14, 2010

This might be out of date, but the last article i read said that the pass rate for Filipino nurses in NCLEX was 75% and UK nurses 4%.
Even though I had been qualified and working as a SSN for 15 years, I had to study hard for 2 years to pass the NCLEX. Not revise, but study.
Learn new stuff that I had never learned in the UK.
As regards foreign nurses, it seems that many are on fixed term contacts that relinquish rights to Mat leave and pensions, etc, though i imagine that varies between trusts.
I was not blaming the students themselves, i was blaming the institutions that 'train' them. I knew more as a N/Aux, (now a HCA) in the 1980s than some of the 3rd years that come through here now.
Basic care knowledge is lacking, doesn't anyone learn wound care anymore?
If I see one more grade 4 ulcer with a Mepore slapped on it i will scream . . .

as a UK trained nurse it took me around 6 months to study for the NCLEX and pass with the minimum questions and in the minimum time.....

skylark, BSN, RN · Sep 17, 2010

as a UK trained nurse it took me around 6 months to study for the NCLEX and pass with the minimum questions and in the minimum time.....

Wow thats great. Guess you aren't a single mom working a 60 hour week in two jobs!

Don't get me started on what I think of the CSA . . .

But you have kinda missed the point. The issue was that studying for NCLEX involved learning NEW stuff, my UK training did not even come close to preparing me for it. Biochemistry and pharmacology are not taught in any depth in the UK and consequently UK nurses are not equipped to undertake patient assessment or practice in their own right.

Let's try an example -

I worked for a good while in an acute assessment area, a short stay area that allowed further assessment and treatment once the A&E 4 hour period had elapsed.

Sometimes a patient would unexpectedly spike a high temperature. Here's what would happen.

Traditional/older UK nurses - writes the reading on the obs chart, and bleeps the doctor. Write copious noted in the kardex about how they notifiied which doctor and when. No further action taken by the nurse.

Newly qualified UK nurse - does not have sufficieint clinical knowledge to recognise an abnormal temp, therefore just tells the charge nurse that the obs are done and then goes to lunch. I can't begin to recall how many times I have seen this happen, and then I as the nurse in charge cops it next time the doc shows up.

Filipino nurse - rechecks the temp with a second thermometer and documents findings. Obtains blood cultures while at the same time siting an IV access device, in anticipation of receiving orders for IV fluids and anti-pyretics. Explains to the patients the need to also obtain sputum, stool, and urine specimens. Considers isolating the patients if symptoms justify this. Contacts the doctor to inform and also request prescriptions. Commences a fluid balance chart, and documents all actions.

This example is not just three individual nurses, its what I saw, time and time again. A difference in training, clinical knowledge base, and perception of the nurses' role.

English nurses talk a lot above moving away from being a doctor's handmaiden, but until they take a proactive role as practitioners in their right, it is unlikely to happen.

allnurses Guide · Sep 17, 2010

Wow thats great. Guess you aren't a single mom working a 60 hour week in two jobs!
Don't get me started on what I think of the CSA . . .
But you have kinda missed the point. The issue was that studying for NCLEX involved learning NEW stuff, my UK training did not even come close to preparing me for it. Biochemistry and pharmacology are not taught in any depth in the UK and consequently UK nurses are not equipped to undertake patient assessment or practice in their own right.

We practice a very different nursing to those in the US it doesn't make ours worse just different. Again comparing apples to oranges is never going to give a fair assessment is it

Let's try an example -
I worked for a good while in an acute assessment area, a short stay area that allowed further assessment and treatment once the A&E 4 hour period had elapsed.
Sometimes a patient would unexpectedly spike a high temperature. Here's what would happen.
Traditional/older UK nurses - writes the reading on the obs chart, and bleeps the doctor. Write copious noted in the kardex about how they notifiied which doctor and when. No further action taken by the nurse.
Newly qualified UK nurse - does not have sufficieint clinical knowledge to recognise an abnormal temp, therefore just tells the charge nurse that the obs are done and then goes to lunch. I can't begin to recall how many times I have seen this happen, and then I as the nurse in charge cops it next time the doc shows up.
Filipino nurse - rechecks the temp with a second thermometer and documents findings. Obtains blood cultures while at the same time siting an IV access device, in anticipation of receiving orders for IV fluids and anti-pyretics. Explains to the patients the need to also obtain sputum, stool, and urine specimens. Considers isolating the patients if symptoms justify this. Contacts the doctor to inform and also request prescriptions. Commences a fluid balance chart, and documents all actions.
This example is not just three individual nurses, its what I saw, time and time again. A difference in training, clinical knowledge base, and perception of the nurses' role.
English nurses talk a lot above moving away from being a doctor's handmaiden, but until they take a proactive role as practitioners in their right, it is unlikely to happen.

We can all find examples of poor practice, I am now in a position that I respond to the calls that require assessment of sick patients, and to be honest generalisations are never wise. I can give examples of sick patients which demonstrate that traditionally trained nurses are not good, university trained nurses are not good and overseas nurses are not good.

Today I received a call from a nurse who had been qualified for 2 years, to review a patient with resolving bowel obstruction who was experiencing chest pain.

I arrived to find the patient sat up, with an ECG and recent blood results ready for me to assess, O2 in situ and on high flow. She had given morphine, had GTN ready and wanted to know what else I wanted her to do.

She had assessed, treated as much as she could clinically and got everything else I would need ready. She is a brilliant, capable nurse and trained in the UK.

I am not going to pass comment or judgement on our traditionally trained or overseas nurses, some are brilliant and a pleasure to work with some are appalling and I wouldn't let them look after my cat.

What I would say and would like to point out is this part of your post:

"I can't begin to recall how many times I have seen this happen, and then I as the nurse in charge cops it next time the doc shows up."

From your comments I can assume that you are a reasonably experienced and senior nurse, therefore if this is something that is happening regularly why aren't you dealing with the capability issues that you are describing rather than using them to generalise about the standard of nursing in the UK. If senior and experienced staff don't take action to support and educate our junior newer nurses then who will. It's also worth bearing in mind that the NMC states that

Share information with your colleagues
Work effectively as part of a team
You must work cooperatively within teams and respect the skills, expertise and contributions of your colleagues
You must be willing to share your skills and experience for the benefit of your colleagues
You must consult and take advice from colleagues when appropriate
You must treat your colleagues fairly and without discrimination
You must make a referral to another practitioner when it is in the best interests of someone in your care

I have bolded the bits that are relevant to your comments