kaitfinder

Hey! Actually I don't know really anything about HCA, so I can't speak for it, and it looks like they're primarily based in London, and I work in Oxford. In general, private healthcare is an acceptable alternative if you can afford it, and can at times cut down wait times for certain procedures including surgeries etc. I know patients prefer it because it is faster and several have reported feeling like they get that "personal touch", likely since the private hospitals will have significantly less patients and nurses will have a smaller patient load. I don't know any nurses who have worked or are planning on working in the private sector, but from what I can tell, they get paid more and likely have less stress as a result of lower patient loads. Unfortunately, my specialty is ED and there are no private EDs. It all comes down to your preferred specialty, and definitely be sure to ask them for the details of employment. How many shifts per week, nurse to patient ratios, base pay and possibility for overtime (no overtime in NHS, have to work extra shifts which pay more base rate per shift), how much time off (I currently get 7 weeks paid time off), etc. I know this is coming over a month after you posted, but maybe you'll have more information now. Also be aware that many hospitals will want to lock you into a contract, so you can't switch jobs part way through without incurring penalties. Also note that with the NHS, they paid for my visa, OSCE fees, flight, and 3 months housing on arrival, so see if they offer you the same at a private hospital. CBT is annoying, read the Royal Marsden Manual of Clinical Nursing Procedures (I used student version) which is mildly helpful for CBT and majorly helpful for OSCE. Brush up on med calculations and learn how to calculate drip rate which I never had to do in USA. Also learn how ot do calculations without a calculator. Questions are weighted based on your ability to prioritize patient dignity and safety, so make that a must. You will have an excess of time to take the test, so don't rush. Let me know if you have any other questions.

Hello, When you move to the UK and obtain a job as a nurse here, you have to have a UK license. You need to have a valid education as a nurse in the US obviously and therefore have a US nurse license in order to apply for a UK nurse license. NMC doesn't help with very much at all, and at times has actually given me incorrect or out of date information. I maintain my American license as a potential backup, plus it would be frustrating to try to obtain again after it has expired. I'm not sure what help, guidance, or advice you want? I'm happy to help but you haven't given me a question haha.

@invalidcharacters Oh boy it sounds like there's a bit of misinformation you've been given?? I moved to the UK from the US January 2019. When I moved, I had been a nurse for 2 years working in ED. I now currently work in an ED in the south of England. Currently, my monthly UK paycheck after tax is just over £1800. I am on the lower end of the Band 5 payscale. It goes up significantly more if I work nights, bank holidays, or weekends, but I hate nights and work at least one day out of every weekend. This equates to roughly $2400/month. My rent, living just outside Oxford (which is extremely high cost of living, almost as much as London, but we do not get a pay increase like London does) is £500/month. I have a car which I purchased on arrival and including insurance was £1400. I have not had an issue in the year and a half I've had it. I cannot take the bus as it doesn't service my village during my work hours, so gas costs about £45 to fill up, roughly once a month. Healthcare tax comes out of your paycheck and thus no further money is put towards health. Groceries between me and my partner (who eats so much more than I do) costs roughly £150/month, so about £70. I also shop at a nicer grocery store because of quality etc. but cheaper stores have higher food quality than cheap American grocery stores as a result of higher expectations and food practices in the UK. In America, I worked in a smaller A&E just outside the perimeter of Atlanta, GA and was paid roughly $1500 bi-monthly iirc (online banking is down at the moment so can't double check). When I calculated my potential pay back when I first moved, I currently make about $12000 less than I did in America. HOWEVER. As I was under 25 years old, I was under my parent's health insurance and thus didn't have to pay, as well as already owning a car that was paid off. My rent in an apartment in America was roughly $900/month including utilities. My commute was the same as it is in the UK, about 25 minutes, but I also had to drive far to do anything or go anywhere, whereas everything in the UK is nearby or can tkae a bus to. Gas was roughly $60 to fill up and almost bi-monthly. About the band system: I don't like it on principle, but roughly, at my trust, at the top of my band's payscale, I can make about £2100/monthly after tax, which is roughly $2700. More experienced nurses can apply to be a band 6 (read: charge nurse responsibilities) which can make anywhere from $2800 to $3800/month. This is for working DAY SHIFTS ONLY, no weekends or bank holidays. If you work all nights (3-4 shifts weekly) weekdays (no weekends or bank holidays) you stand to make roughly $6100/month at the upper limit of the band 6 payscale. If you work regular nights and weekends etc pay will increase accordingly. Further, if you work bank shifts (you pick up extra shifts that other wards or your own ward advertize) you are paid £20/hr ish as opposed to £12.74/hr (for the lowest end of band 5 payscale). If you work float pool shifts (you submit your availability and they call you and tell you night before or day of what unit you are to go to) you will get £28.62/hr (numbers for my trust only). You also get 7 weeks Paid Time Off (vacation days) which is markedly increased from the 2 weeks I had in America which was standard regardless of your experience level or otherwise. This number increases based on how much time you spend here. Pension is also fairly good (can't quote numbers for this at this time, apologies) and general social services (cost and quality of education for all ages/levels, public services like road repair, and general care about the population) are significantly better in the UK compared to America. If you plan on having children, you will save an infinite amount of money on education alone if they choose to go through higher education. For reference, before scholarships in America, my dual-degree 5 year bachelor's nursing program would have cost roughly $260,000 not including room/board, books, etc. There are also good savings programs for buying houses, and houses can be quite cheap depending on where you are looking (in the north you could buy a moderate sized house for as cheap as £100,000 give or take). You get less pay, at the exchange of more free time and vacation time, better worker's rights, better general civil protections, cheaper cost of education, etc. It has been such a relief to live in a country that expresses a sense of public and personal responsibility to maintain ethical treatment of others, if that makes sense. In America I was getting run over by managers, businesses, government, etc. Here, not so much. I was afraid that I would not have enough to save, but it is not as difficult as I expected to be able to do so. The culture is different, and this has affected my spending and saving practices. I cannot speak for the pay of NPs or doctors as I am not one. You will always get paid more privately than via public, however my preferred specialty (ED) is not offered in a private service.

What problem specifically are you having? From start to finish, obtaining my license as a non-UK citizen took roughly 9 months. There is a lot of misinformation out there and the NMC isn't always the best resource, unfortunately. I moved recently (Jan 2019).

@hypnotizer90 Yes that's accurate pay for a starting nurse Band 5 and yes you can easily make enough to pay rent/bills and save. You won't make as much (as you can see) as USA or Canada however you don't have to pay for health insurance (this comes out of your pay as tax) and I've found various other little things don't cost as much either (if you use public transportation or walk, you'll save a lot by not having a car). One of my Australian coworkers came over with the intent of not saving very much so she could use the proximity to Europe to travel, so if that's your plan (stay for only 3 years and then go back to Canada/America), it's definitely feasible, especially if you have a roommate.

@emilyecrowe Like Silverdragon said, starting with the NMC website for overseas nurses is a good place to start. It will help you know if your qualifications and degree are transferable and applicable. https://www.nmc.org.uk/registration/joining-the-register/register-nurse-midwife/trained-outside-the-eueea/new-application/ There are many other steps involved in moving to and working in the UK as a nurse but this would be one of the first ones, along with determining reasons for why you'd want to work here and whether you're really committed to it, because it is an involved and not inexpensive series of events, as well as a dedication of at least 2-3 years of your time.

@heyred823 Hey! No problem. I looked into another one or two agencies but ultimately I went with this agency because it seemed competent and also worked with the hospital I wanted to work at specifically, and they were the only agency I found that did so. Definitely be thorough in your research of agencies, though. Jordannecc makes a good point, that you will be under contract if you go through an agency. My contract is for 3 years at my current hospital. But that's alright for me because I'm not interested in working for another hospital and I need to stay in this area to be with my partner (which is a big reason why I moved haha). It's up to you, though! I'd definitely recommend not moving hospitals sooner than 2 years though because you need to get adjusted to things, and the time goes fast. You can always change departments if you get frustrated. I don't know what a "standard" UK resume looks like; I had my updated "american" resume that I modified at their request. They asked me to list out ALL of my skills and ALL of my work sites and a few other really very detailed bits that made my resume almost 11 pages long (they sent me a sample "good" resume from another applicant as example). But I would not say this is the norm or something you should do unless it is asked for specifically. I think this was their way of determining how qualified international applicants are, because schools/programs/international hospitals may not have the same standards. Make your resume updated to the usual standard for any job position and then update as they request. The CBT was not hard but was fairly stressful just because I didn't know exactly how to prepare for it (there is little information and almost no prep books like there are for NCLEX) and I was on a timetable. There are also 10 (I think?) KEY questions and if you get any of those wrong, you fail the exam. They don't tell you which ones they are, but it's safe to say they involve patient safety and critical things that I suspect would be difficult to miss if you are a competent american nurse. I used the Royal Marsden Manual of Clinical Nursing Procedures (for Students) to help study for both CBT and OSCE. Brush up on your med calculation questions (also you will NOT be allowed to use a calculator) and make sure you know how to calculate drip rate. I studied for about a month because I had a lot to lose if I failed. But I'd say a month of leisurely (but regular) studying would be sufficient. If you did well on the NCLEX, you'll likely do well on the CBT. @yamilet Hey! I'm glad to help, there wasn't much information (or anything that wasn't 10 years old) for me when I was applying so I'm happy to provide what I went through. Oxford is good actually! The weather has been nice and we're holding our own with COVID 19, so not to worry. Feel free to ask any other questions you may have!

@app22 don't stress! It's an interview but there will be many opportunities if it doesn't go well. Best of luck! @heyred823 It's no problem! When I was going through this there was no recent information, all of it was several years old at best or from non-American nurses. If you have any questions, feel free to ask! I see you're going to apply straight to the NHS, but if you decide to go the agency route, let me know! I'm happy to provide tips on agencies, visas, and NMC registration.

Absolutely go for the FBI one. You lose nothing by being extra prepared.

@Apandriano Hello! Yes, I did have a Skype interview. You probably won't even need to ask for one, they'll likely just offer it to you. The interview itself went very well and standard to any other interview I've had as a nurse in the US. It was formal but relaxed, I met with the nurse head of international nurses and I think one of the nurses in charge of a few departments in the hospital including A&E. Who you meet with will likely vary, though you can be certain they'll be a higher-up. They ask all of the basic questions you might expect in an interview for a nursing position. Patient centered care is very big and heavily emphasized in the UK so make sure you prep responses to questions such as, "talk about a time when you showed patient centered care," etc. as well as all of the usual questions like strengths/weaknesses, disagreements, problems, etc. etc. It's a standard interview. You don't have to ask questions in an interview however I think it is valuable insight for the interviewers because it expresses your enthusiasm and interest in the position. I asked questions like size of the department (how many beds), level of acuity seen there, common health problems of the population the hospital serviced, etc. but ask whatever questions you'd think would help you make a decision if you were offered the position between this place and another A&E. What would make or break working at this department for you? Yadda yadda.

@Apandriano For the CBT, I recommend using The Royal Marsden Manual of Clinical Nursing Procedures (Student Edition) to prep. It gives some insight into the expectations and nuanced differences between, as well as help with some drug calculations which are mostly the same as you might find in America with the exception that you may be asked to calculate drip rate which is not something I had ever learned it do in America as it was not needed. It is also useful for prep for the OSCE, however as Temi1234 said almost every (if not all) hospitals will provide training for the OSCE with classes and practice sessions etc. If they don't, it might be worth looking into employment somewhere else because it is very important that you receive training for this highly nit-picky and overly-particular test. As for the CBT, general nursing knowledge and making sure you're always choosing the response that promotes patient dignity and safety is the key to help you with that test. Also they don't let you use a calculator for the CBT drug calculations tests so make sure you're comfortable with doing those calculations by hand (some may require multiplying or dividing decimals). When it comes to police clearance, I highly recommend applying for the full FBI screen. I had both my state's background check and my FBI screen because I was initially told the state was acceptable, but the NMC later got back to me and said an FBI screen was necessary. I had even called the NMC to ask and was told state only was acceptable only to have them ask for it later. I luckily had it to hand because I needed it for my work visa (separate application) but it's better to have more than less. You can opt to have your FBI clearance emailed digitally to you and then you can print it yourself; it does not need to be mailed to you (which can take many more days to weeks, especially with COVID slowing everything down). Definitely opt for the digital version and then print it yourself. Also save multiple copies on your computer.

@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.

@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.

@skylark I think what it may come down to is what facility you work in? Where I worked in America, they really promoted nursing skills, and doctors did few skills aside from central line insertions, suturing/draining, etc. but many of the other skills (foley insertion, port access, IV insertion, etc.) were managed by nurses. Where I work in the UK, I feel like a gopher, mainly passing meds, barely even inserting IVs or drawing blood, rarely inserting foleys, etc. I'M the one that's bored, here! They do genuinely skip triage as I have brought this up a few times with senior staff who refer to it as "streaming", do not apply any sort of triage classification such as what's used in the Manchester Triage. Instead, they have a form that assesses pain on a 0-3 scale and a small box with approx 250 character limit. Vitals are optionally taken at the discretion of the nurse. It does seem to be an accelerated assessment, but it makes me nervous because often nurses in the back are so busy they don't do a more in depth nursing assessment and will wait until they've been seen by a doctor. Momentum is definitely key here, I agree, but the hospital I worked at in America did achieve a roughly 4-5 hour door-to-discharge time, although there was less push to do so since there wasn't the government mandated push as there is in the UK. I do know that many american EDs will have excessive wait times upwards of 6 hours, though. Where I work in the UK, our ED does hit the door to discharge 4 hour time approximately 80% of the time. Where I worked in America, it was a smaller hospital and I felt roles were clearer in codes and run very efficiently. Here, I find that it feels like since they don't run codes as often here, people are stepping on each other's toes and there are often too many people present, and sometimes since there are many doctors (ICU doctors show up for codes because ED doctors and nurses apparently don't manage their own ventilators or codes), there can be stepping on toes between doctors. There is rarely, if ever, a scribe responsible for time-keeping and note-taking, unless it's trauma related. It feels much more disorganized to me.

@Becky C Sorry for the delay, the holidays were busy for me! I've learned a lot, probably too much to be able to put into one post, though I have made several different posts on this topic through various different threads on this forum. I work for a large, major hospital system in Oxford! A few adjustments: nurses have less autonomy and can do less skills here than in America. Some have told me this may just be the trust that I work for, however it is still widespread the U.K. over. For example, I was training at my old job in America to do ultrasound guided IV insertion. Nurses in the UK don't even touch ultrasounds except to use the bladder scanner. Doctors seem to do much more IV insertion here than nurses, and will regularly draw blood. This may just be because I am also at a teaching hospital. There is less emphasis on nursing assessments, and nurses seem to do more "technician" type roles. There is room to expand your skillset but you need to get further training/approval to do so, unlike in America where you are expected to know many skills off the bat. Nurses here, however, are allowed to stitch/staple wounds, which is not a thing in America as far as I'm aware. There isn't too much advice I wish I would have known before moving, mostly because either I did my research and knew it beforehand, or it's just information that wouldn't have helped to have known! There are certainly lifestyle changes you'd have to make, but that's expected and knowing about them won't make a difference; you are living in another country after all. All of the really useful and necessary information that you would need before moving can be found online, so do your research! If you have any specific questions, let me know! I'm just not sure where to start with that one exactly. England is different, but it's still a first world, english speaking western country. Emergency is both similar and different, and I think especially so in the hospital where I work. From what I can tell, most other emergency departments in the UK do not operate in some of the peculiar ways they do here; a lot of the changes they have made, however, appear to be to mitigate some of the issues they were having. For example, they do not do triage, but instead use a process called "streaming" which is a very short, limited assessment with the expectation that they will be seen faster initially and receive a more thorough nursing assessment in the back. Various other peculiarities like that. Additionally, (and I think this may be true for most of the UK) cardiac arrests are run in the community on site by paramedics and are only brought to the hospital if they were stabilized; therefore, you will see few cardiac arrests in ED, as most will only present in cardiac arrest if they arrest en route. Let me know if you have any other specific questions, though! Best, Kaitlyn