Hey @yamilet ! No problem, I don't mind the questions!
Some things I have learned about working for the NHS from a USA-prepared nurse perspective:
The NHS is short staffed. Likely more short staffed than the USA. However, nursing is short staffed pretty much the world over, indicated by the fact that many countries include nursing on a short list of occupations that will easily earn you a work visa since they're needed so badly (https://www.gov.uk/guidance/immigration-rules/immigration-rules-appendix-k-shortage-occupation-list here's the list for the UK, in case you're curious, just scroll to table 1). Pretty much every area of nursing in the UK is short staffed, but some are worse than others. Truthfully, it doesn't feel that much worse off than my experience in the US. I work in a major hospital in Emergency care.
The NHS does pay its nurses less than most countries; you can get paid significantly more if you work in a nursing home that is privatized or private hospital, but any sort of acute hospital nursing is not really available in private facilities and those patients will often get transferred to NHS run hospitals for acute management, so it depends on your personal interest. There are public health/community nurses in the UK and they do an extensive amount of work, but as I work in the hospital I have minimal knowledge/understanding for how that type of nursing is and how it compares to my (limited) understanding of community nursing in America. Many hospitals have a bank/pool system where you can pick up "short" shifts that the hospital releases and will pay an increased hourly rate to fill need for, so there is some opportunity to make more money if you need to.
The short staffing is at times frustrating, but I find myself in situations where we are short staffed to the point where it causes a detriment to my ability to function as a nurse minimal, and roughly at the same amount as I did in America.
What I do find frustrating is the scope of practice for nurses in the UK is below that of most other countries (many countries in the EU base their nursing programs and guidelines on American guidelines and nursing standards of practice, whereas the UK writes their own). Nurses in the UK are more social care than they are clinical; bear in mind that I work in Emergency and thus am used to a higher degree of clinical scope and management than a general ward/unit nurse. From what I have seen, ward nursing appears to be roughly the same in the UK as in America, with the exception that nurses in the UK are ubiquitously not trained or expected to use a stethoscope and generally are expected to be less clinically prepared/knowledgeable. I find this very frustrating but other USA nurses do not always feel the same.
Personally, however, I do find it easier to work for the NHS/UK in general as the healthcare system is public and thus accessible to all patients regardless of income or ability to pay, something I have much respect for. Social care and community care is far more advanced and managed better than in the USA, as the NHS has a vested interest in spending as little money as possible. They accomplish this in part by focusing on primary care and care at home, in an attempt to prevent patients from having to come to the hospital in the first place, and thus GPs, social workers, home health care, nursing homes, etc. have significant support systems in place to help manage their load. Perhaps this is just the area I work in (Oxford) but I get the impression this is a nationwide motivation. CT scans cost more than regular GP visits and packages of care.
My timeline for coming to the UK is roughly thus:
May-June-ish 2018: research/looking for job opportunities and travel agencies
June-July 2018: applying to nursing agencies and interviewing/sending resume and rough credentials (I knew I wanted to work at a specific hospital in Oxford so this made my search easier since I knew where to look). July, after pre-screening and interviews with the agency they passed my information on to the hospital recruiting team where I interviewed via Skype with the hospital I currently work at. I was offered a position a few days later and signed a preliminary contract of employment. Then, I took the CBT (if I had failed the CBT more than a few times or was unable to pass, my contract would be void).
August 2018: gathering documents to send to UK Visas & Immigration to apply for my visa, as well as receiving Certificate of Sponsorship from the hospital I work for. My hospital also paid for my visa application ($780 I believe?) and the Immigration Health Surcharge fee (£200 per year of the visa, work visas are 3 years so £600). From what I understand most hospitals will pay these fees but will not pay for CBT ($120? I forget).
September 2018: visa applied for, documents sent, etc.
December 2018: I had an issue with my visa where they forgot/lost some documents and took about 2 months longer than the maximum wait time to get me my visa; it was originaly planned to arrive October 2018. Visa arrived sometime December and I flew out at the end of December to start work January 6th. My hospital also paid for my one way ticket over.
January 2019: work start, hospital mandated training for OSCE, very minimal attendance in a clinical area until the end of training.
February 17 2019: pass OSCE, PIN received some days later, precepting for a few more days and then independent from there.
The agency I went through was very good so I don't mind recommending them. I worked with NEU Professionals. From what I can tell, they service a variety of different areas, mostly in the south of England, but you can see where on their website under the "existing and historic trusts" tab. There are any number of agencies out there and it will make it easier to find them if you narrow down where in the country you'd like to work (a specific city, or area of the country like, southern, northern, etc.). I highly recommend going through an agency as they were very helpful with securing an interview with the hospital (and the hospital is likely more amenable to hiring through a trusted agency rather than someone who approaches them blind) and imperative to me filling out my visa paperwork and liasing with the hospital recruitment team. I wouldn't really advise not using an agency, but that's up to you. None of the agencies expect anything from you compensation-wise and they shouldn't require a commitment time either. The hospital will understandably require a commitment of time to them but that makes sense. If an agency is requesting you pay for their services or dedicate a certain amount of time to working through htem, I would recommend you find another agency as most agencies likely make money by getting paid a finder's fee by the hospitals they refer to.
Overall I would say it's a good experience to work in another country, but it is different. I wouldn't recommend putting off regular nursing as your skills get rusty with time. Feel free to ask any other questions you have!
-Kaitlyn
