Im what they like to call nowadays "modern matron" (I never chose the name lol), and independent nurse prescriber so had to work a few years to get to this point in my career. Im on the top of pay scale 8 with 2 discressionary points so my annual salary is actually £46,900, which at current US exchange rates works out to about $91,924. If we decide to go back to the US (which is looking unlikely at this point), my salary in the Bay area will be $52,416, hence the reluctance. I am very lucky in that I really enjoy my job here in the UK. Im primarily based in primary care, although some of my work does involve the odd few hours in hospitals. That is where the problems lie. There are severe staff shortages which leads to poor moral etc, etc. I dont see that in my job. I work with a happy bunch of people, sure we have the odd grumble, who doesn't but generally things are pretty good. Ive worked in Australia where things are pretty similar to here in the UK, they have staff shortages too as do the US. Ive seen some pretty horrendous tales of woe from American nurses about their working conditions etc, especially ICU, so I certainly dont see the US as all milk and honey like some people do. Yes I love the country and the people (my husband is one of them), Im just not sure that working there is for me. I almost see it as a step backwards. My nurse prescribing is not recognised. I have two degress and a masters, my midwifery degree is not recognised, I would have to jump through hoops to get my MSc. recognised, whereas in Australia, its just a matter of getting a few certificates notorised and filling in an online application for a visa, all of which can be completed in less than 4 months. No exam, no burocrasy, and I get virtually the same pay and can use all my skills.