ER/ICU Belgium ≠ ER/ICU Canada, a few questions :)

Pediatric Critical Care Columnist · Jun 1, 2012

Hello and welcome! allnurses.com is the BEST place to come for advice and information and we're glad you found us.

I can't speak for adult ICU/ERs in Canada since I work peds, but there are some commonalities. Most of our resources come from outside our borders, such as the books you mention. For the most part we try to use generic drug names like norepinephrine rather than Levophed, midazolam instead of Versed, omeprazole instead of Losec. We use SI units like the Netherlands for lab results. When it comes to treatments and technology, we're using what everybody else is using. (My unit uses Drager ventilation almost exclusively.) Nursing law is fairly uniform across the country. Each province has its own health professions act that governs nurses. Ontario's can be viewed here:

Legislation Governing Nursing - CNO

Canada has a single-payer health care system. Tax revenues are used to pay for most health care costs, with the exclusion of prescription drugs, physiotherapy, vision and dental care and a few other things. Anything provided within a hospital setting is covered.

Patient care in ICUs is typically the responsibility of the nurse. I have never had an ancillary health care worker such as a nursing assistant give my patient their bath, do dressing changes or transport them throughout the facility. We do not utilize patient care techs in Canada like they do in the US.

Patient care assignments are generally 1-2 patients per nurse. They are typically genuinely ICU patients but the availability of ward beds on any given day may result in some med-surg level patients remaining in the ICU.

Teaching hospitals, where the majority of ICUs are, have intensivists, fellows and residents on site. Community hospitals with ICUs will rely on hosptialists or the patient's attending for care decisions.

Some ERs have transport teams, but they're usually specialized teams. Most patient transport from out-of-hospital is provided by the EMS service.

12 hour shifts can be exhausting, no lie. But they also give you more days off in a row so you can recover and have time to do things you'd otherwise be too tired to do.

There's a significant number of aboriginal patients in any Canadian region. They have specific health care needs that may relate to lifestyle factors. Google "aboriginal health care needs in Canada" and you might be reading for days.

Ottawa right now is a very difficult place to find employment. If you're not fluent in French you'll have even more difficulty. Two of my coworkers are moving to Ottawa this summer due to their spouses' transfers; both are highly educated and experienced but both are having trouble finding a job. Keep that in mind.

Best of wishes to you.

Roben · Jun 2, 2012

Wow, thanks for answering so quick and thorough! It seems like there aren't really huge difference in the ICU.

I didn't know there where so many nurses looking for a job. In Netherlands, Belgium and Germany (the rest I do not know) we have the luxury we can choose our hospital. There is a big shortage. For eg. I did job applications in seven different hospitals, all seven said yes. What city would you suggest instead of Ottawa? Peterborough?

Pediatric Critical Care Columnist · Jun 2, 2012

Really, all of Ontario is struggling right now. The economy is depressed and the province's cash flow is severely curtailed. Because most nurses in Canada are actually employees of the province (although their pay cheques don't state that, the money does come from the provincial budget) and human resources costs are the easiest to trim, vacancies aren't being filled. New graduates are begging for work and many of them leave Ontario for another province in search of a job.

I'm not sure how much you know about Ontario. Belgium would fit into the province 35 times and still have loads of room to spare. Peterborough is 272 km from Ottawa, about a 4 hour drive if you do the speed limit. Much of the province is uninhabited due to terrain; most of the population of over 12 million lives to the south within a couple of hundred km of the US border. My father's family is from Ontario and I was born there, but haven't lived there since I left Ottawa in 1979. Most of my adult life has been spent in Manitoba and Alberta.

Emigrating is a huge step to take and deserves due consideration. Continue to learn as much as you can about where you plan to live so that your decisions are sound. It'll be worth it in the long run.

stanv · Jun 10, 2013

Hello to you all,
I'm glad I found a way to find like minded people for over 7000 km's away. Isn't it the best job of the world ?
Before asking my question I will introduce myself. I'm a 24 year old male living, working and studying in Belgium (Antwerp). I did my bachelor nursing study in the Netherlands (comparable with RN) and I am currently working on an ICU in Belgium. To become better at my job I am doing an ER / ICU specialization in Belgium. Before I became a nurse I worked as a elderly care-taker and later as an EMT. I did a few small time jobs and ofc. my internships as a nurse :).
I am trying to realize working in Canada for a while now. My application for citizenship (mother is Canadian) has been send out last year december. Today I contacted the College of Nursing in Ontario and spoke with a very nice lady. I will fill out my application for RN soon. With other words, my plans are becoming more solid every moment. And I must say, I'm getting more excited every day.
Excuse me for my long introduction. I have already worked in two country's and I know it can be difficult to adjust (medication, law, you name it!). So to be as prepared as possible it would be great if someone could hand me some information about working on the ICU or ER in Canada.
Is there any typical Canadian book about the ICU/ER regarding:
- medication and dosages.
For eg. we work a lot with the vasopressin/inotropic levophed(noradrenaline) and we use gamma's for patients.
- normal values. We work with the metric system
For eg. in Netherlands they use 4-8 mmol/l for glucose (blood sugar test?) and in belgium they use 90-120 mg/dl
- standard procedures, we also have PiCCo, Swan Ganz, ventilation (dräger) etc etc. But I would like to read about it in English. Using the correct names, I still find that out every day
- nursing law?
- etc.
Besides that I would like to know how working on a ICU is: do you wash patients or does someone else do that? How many patients do you have? Are they all critical or do you also have MC patient's on your ward. Is there a permanent anesthetic or intensive care doctor?
For the ER: do you always stay on the ER or do you also ride out? I read somewhere you got shifts of 12 hrs, isn't it killing? I know it is region dependent but what's the general population you threat?
Any more information and story's are welcome. I'm going through the forums already to sniff up bright ideas !
Excuse my grammar and maybe the inappropriate / strange way I use my words.
Thanks!!
ps. I am focusing on Ontario, especially Ottawa city.

Hi Roben!

I was very happy to read about your post because I have been looking for someone from the Netherlands or Belgium who went to work in Canada. I have great difficulties finding out wich procedure you have to follow to work in Canada.

I am a 25 year old male nurse in Belgium. I have my Bachelor degree in Nursing and the as well the specialization for ER and ICU that you mentioned. In one month I will go to Guatemala to work for a year but after that I still have to decide if I go to Brasil or to Canada to work as a nurse. I started giving up on Canada because it seems so difficult to work as a foreign nurse in Canada.

Can you explain me what I have to do to work as a nurse in Canada, how long it would take and if there are a lot of fees?.

And if you succeeded at working there, how is working in the ICU in Canada?

Thank you very much,

stan

Silverdragon102, BSN · Jun 10, 2013

Hi Roben!
I was very happy to read about your post because I have been looking for someone from the Netherlands or Belgium who went to work in Canada. I have great difficulties finding out wich procedure you have to follow to work in Canada.
I am a 25 year old male nurse in Belgium. I have my Bachelor degree in Nursing and the as well the specialization for ER and ICU that you mentioned. In one month I will go to Guatemala to work for a year but after that I still have to decide if I go to Brasil or to Canada to work as a nurse. I started giving up on Canada because it seems so difficult to work as a foreign nurse in Canada.
Can you explain me what I have to do to work as a nurse in Canada, how long it would take and if there are a lot of fees?.
And if you succeeded at working there, how is working in the ICU in Canada?
Thank you very much,
stan

You will first have to meet provincial requirements and sit CRNE to work as a nurse in Canada and that isn't cheap. Fees will be on the provincial college of RN website. Then you have to find a employer willing to go the Temp Work Permit route as nurses are not on the federal skilled list this year, so there will then be costs for immigration in regards working in Canada