HandmadeRN

Hi, I'm considering a move to Canada, i'm a British trained registered nurse. So, I know my training is not up to scratch (for Canadian/US standards). Before I shell out $650 on the NNAS report - does anyone have any advice as to which provinces I should apply to? (i'm single, no dependents, my background is health visitor/adult trained nurse currently working in EPR configuration but have a lot of experience working in the community) I know i'd need to do a bridging program but I don't want to be forced to do a programme for a whole year. If possible I'd like to just be able to make up the modules that I'm missing i.e. mat/child health and psych. From my internet research (and I'm very happy to be corrected on this) I'm wondering if some provinces like Ontario/BC are more likely to push you to do a full year's bridging programme and others like NS are happy for you to make up individual modules. What is everyone's experiences? I'm keen to be able to work in the US as well as I had originally applied there but got to a dead end with trying to make up hours. There doesn't seem to be a way to make up hours there without being a resident whereas in Canada it seems you can get a temporary student visa for healthcare students?

Hi osis, Honestly, I don't think it's a case of which is the easiest state to apply. If you don't have the evidence that a BON requires then most likely all BON's will assess you the same. I'm a UK registered nurse that has not been able to get licensure as our training is not comparable. From doing a bit of research, I think California is probably the best state to apply to because at least they offer make up courses there. I applied to North Carolina BON and I already knew that I would need to make up clinical and academic however NCBON could not/would not then help me to find somewhere to make up those hours in the state.

As a fellow acne sufferer, I feel your pain. Whilst it has never affected my ability as a nurse, it has greatly affected my self confidence. If you want to sort out the acne scarring, see a dermatologist. I've had skin peels and they were a wonder for my skin. I once worked three night shifts in a row after i'd just had a peel. Hardly anyone noticed my weirdly peeling face lol. And invest in some good skin serums. I've spent a fortune trying to get clear skin and I can't recommend The Ordinary enough (it's a Canadian brand but sold worldwide). It's cosmeceutical grade serums and skin products at a fraction of the prices your dermatologists will be trying to sell you. Do your research and use your scientific analytical skills to work out what's best for you.

Am I right in thinking that he was a previous band 3 and applying for a registered nurse job? I don't think enrolled nurses were ever equivalent to a band 3. I'm pretty sure we stopped referring to enrolled nurses when we changed to AfC bands so that doesn't even make sense. (But please do correct me if i'm wrong about this!) Found an interesting link about it here: http://www.ihrdni.org/303-004.pdf - Which specifically says band 2&3 were unqualified support staff.

There's little that can put off a nurse. We're pretty comfortable talking about anything related to bodily functions. And well, let's be honest, most of us have a slightly twisted sense of humour honed by years of nursing. Like drinking your tea or coffee out of this mug for example... What is everyone else's best (worst) mug in the staff room?

Sorry to hear you're not enjoying your job. It's difficult to tell what it is exactly that is making you not enjoy your job. Is it a) Newly Qualified Nerves - Trust me on this, everyone feels like this in their first job. There's an almighty leap between being a nursing student and suddenly being a staff nurse on a ward. Also, totally depends on where you get your first job. My first job was a cardiothoracic ward - mostly all pre-op or post op by a few days with a 1 to 6 ratio. Super supportive practice educators, proper preceptorship programme etc... And even though it was pretty stressful at times it wasn't as bad as my housemate at the time who would regularly have 1 to 11 ratio on a surgical orthopaedics/trauma ward (Even as a student I was so thankful I didn't get picked to do a placement on that ward!). b) Disillusioned with Nursing in general - Yep. I get that too (in fact, I think a lot of people do! And I often think if i was starting out again ten years ago I would not pick this profession) Pay freeze for 7 years. Tick. Doing more and more junior doctor's work without the money. Tick. etc... But if I can impart any useful advice it's this: 1. You are not a failure. You were awarded an academic prize. You have a degree. This is an accomplishment. You can do anything you want with that degree. If nursing is not for you, you did not waste your time doing that. You will not disappoint your parents. You need to dwell on the positives in your situation - you finished something that you knew you didn't want to do. It is a hard degree (work/life balance is completely different to other degrees). Also 2. You have options! - You can stick out your current job (if it's just newly qualified nerves) - You can apply to do a non clinical job that's still utilises your experience and health knowledge (Good option if you are keen to stop being a nurse but still want to do something health related. This is what I did after i got disillusioned with my career.) - Change direction and do a master's in something that does interest you more - Quit nursing completely and do something else. Just because you have a nursing degree does not mean you have to do a nursing job.

Whilst it's over ten years ago that I qualified, when I started as nurse we had a preceptorship programme at our hospital. We would have regular study days and had competencies that we needed to achieve. It was a bit like being a student nurse again but being paid and having more responsibility! And it's no different today. At the hospital where I work, the newly qualified nurses are really spoilt with the amount of training opportunities that are thrown at them! Makes my preceptorship look paltry in comparison :-) Every unit will differ on how long you are supernumerary for but I think I worked 2 weeks supernumerary to begin with and I had Cardiac HDU experience previously. It might be longer for you as you'll likely be waiting for your pin. You also probably won't be administering meds for a while as a lot of Trusts require you to pass a drugs exam before you can administer and that's usually several months after you start. ITUs also always tend to have lots of practice educators attached to them. As for reading up on the subject - a good understanding of anatomy and physiology is vital. It makes it so much easier for you to understand why you administer some medications and not others. As you are still a student it might be worth checking out your library for ITU nursing books or journals. You'll still be able to access journals for free whilst you are there, so use it! There's no harm in reading around the subject and understanding why we do certain tasks in ITU even for basic care. I.e. Oral hygiene, suctioning, assessing sedation, sedation holds etc... You'll likely learn all of this in your first few months anyway so no pressure! Lastly, ECG waveforms. Take the time now to learn how to recognise different rhythms!

Hi Rocknurse, good to meet another British informatics nurse! I agree the visa is the hardest part to be honest and I don't think I could get a work visa without relying on my nursing skills. I've looked at OGP a few times and I enquired about informatics positions last year but I don't think they regularly have jobs for that specialty. I'm also thinking that if i post my CV to the HIMSS job section then I could be approached directly be interested employers there... I'm really feeling indecisive about it all to be honest, if I were to move, I potentially would have to go back to being clinical in order to secure visa sponsorship and it would interrupt my career progression in informatics. It's also been a while since i've been clinical and I don't particularly have a desire to return to it. Actually out of interest what's been your experience with US employers valuing your British Education (I presume you trained in the UK?!). I'm tempted to do a master's in informatics but US courses are much more expensive than here in the UK. However if a MSc in the UK doesn't carry any weight in the US for nurse informatics then I wonder if there would be any point in doing it. Thank you!

Thank you Ikarus7401, do you think employers would be desperate enough to give me a work permit based on my epic certification lol?

Band 3 & 4 are health care assistants and not registered nurses. Although from next year we'll be getting a new band 4 called a nursing associate.

I'm a British registered nurse and have been looking at moving over to the States for a while now. I've just started working in EPR implementation and am Epic Certified. And I am loving my job. (First time in a long time!) My project is not due to finish for a while but being the planner that I am, I'm already looking at my options after the project ends. What i'd love to know is how important is it to maintain active nursing registration in informatics jobs in the US? Because UK nursing education is very different to US nursing education, i'd have to make a significant financial investment into topping up my theory/practical hours in certain areas in order to get a license. I'm trying to weigh up the cost of doing that and assess whether it is worth it as when i've been looking at Epic consultant jobs they don't always mention needing to be licensed. So maybe it's not a requirement? Do you get paid more if you have an active nursing license? Or is it an insurance requirement for hospitals that their clinicians are registered and therefore accountable to professional bodies? Any advice and setting me straight on this is gratefully appreciated!

My first job was in Cardiac, which is a long time ago now. I remember people saying that the first 6 months on the ward were the hardest as a new graduate and they were absolutely right. I hated it. I liked my team and I loved looking after the patients. But I was absolutely terrified of patients arresting! Two things that helped were 1) we had a really supportive practice education team and 2) I would read up on all things cardiac in my spare time. Anyway, I survived and actually eventually liked the acute patients so much that I moved to ITU. Also, I'd be cautious about moving so soon. It looks better on your resume if you manage to do 6 months rather than 2 weeks.

Do you think your hospital could think about investing in building nurse's accommodation? I'm a British trained nurse and i've known several of my friends go off to Australia to work for a couple of years - some haven't come back! Like you, they also have terrible problems recruiting nurses to rural areas. Nurses working in remote areas in Australia get their travel expenses, accommodation, meals and incidental expenses paid. There are other financial incentives available, like better hourly rates, tax breaks and good on-call rates due to the nature of the job. (From: Remote Area Nursing - HealthTimes) It might not be useful but I thought it might be interesting for you to see how another system addresses the same problem. And also to add to swaying the hospital executives into the long term investment of your staff. Maybe the other thing you could do is think about offering a rotational program for newly qualified nurses to experience different areas of care and gain experience. Accept the fact that most will move on but utilise the fact that you can give them experience! I see so many posts on here about how someone or other wants to get a job but lacks the experience as a new graduate. Now if only I had my US nursing license (which i'm working on) and I wasn't working in Nursing informatics... Because you had me at Rainforest and being from London, I'm pretty used to rain...

Scabies as a student nurse when I had a placement on a long term neuro rehab placement. Judging by this thread, seems like rehab is a popular place for scabies... It didn't present as classic scabies either as it didn't start on the back of my hands - so my handwashing was effective! Being bare below the elbows is what got me! :-)

Thank you NotReadyforprimetime!

Our hospital (in the UK) uses a mnemonic called WETFLAG. Each child has a sign behind their bed with these letters and the admitting nurse or bedside nurse will complete the relevant information next to the letters. W = Weight, E = Energy (joules), T = Tube, Fl = Fluids, A = Adrenaline, G = Glucose. Any clinician/nurse that attends the code or resus can immediately see this information.

Hi Fusionfire, I didn't realise that you were originally from the UK? How long have you been over in the US for? The UK is fast catching up with the States in terms of EPR. Although, Epic is pretty small here in the UK with only 4 hospital having selected it. Cerner has more of a presence here in tertiary care. The MSN I was looking at was Duke and actually I misquoted. The figure is about $60k as it is $10k per semester and there are 6 semesters. I think there will be some great opportunities here in the UK at some point. And in truth, I'm hoping for that too. However, as you probably are aware our salary here is terrible and that is not going to change anytime soon. Our pay is capped at 1% increase when inflation is 3%. It's been like that for several years now.

Thank you Ikarus7401! My colleague's response when I told her about it being a short term contract was 'well, then you make yourself indispensible!'

Thanks everyone for getting back to me! I really appreciate the advice! I have decided to go for the job and hold off on the MSc for the time being. My gut instinct was to take the job but I got swayed by my brother who works in a IT project management in a medical technology company and had doubts about where this job would take me. I'm actually based in the UK and as of yet there aren't many hospitals here that have implemented Epic and not so many people that know about the software. I'm feeling pretty good about my decision and handed in my notice today :-) It's only because I plan on getting my US nursing license at some point and researching health informatics jobs that I found out how valuable Epic certification is! I suppose the $64 million dollar question would be - which Epic module is the most useful? Or does it really matter? I know i'll be working on the one that deals with clinical documentation, not sure which one that one is. In an all seriousness though, one final question; with regards to postgraduate education in healthcare informatics (as I intend to move to the States at some point after I get my license) How do people rate a Non US master's in informatics? From a purely practical point of view, a British MSc in healthcare informatics is substantially cheaper than an American MSN (£9,000 versus $50,000+). However, if employers are going to overlook it because it's not from a university they are familiar with, is there any point doing it?

Hi everyone, I've just been offered a job as an Epic configuration analyst for a hospital that is going to be rolling out Epic EPR. However, I was also offered a place on an MSc in healthcare informatics at the same time. They're not really compatible together, it's either one or the other. So, I'm having a bit of indecision about the role as I was keen to move into healthcare informatics but i'm wondering if the role that i've been offered will be less analytics but more data entry. (I'm concerned about how you could progress from this role once Epic has been rolled out and the project is finished). So i'm stuck wondering whether it is worth postponing the MSc just to get Epic certification and experience of working with Epic? Would love to have a chat with anyone that had experience of working on implementing Epic into their hospital?

Thanks for that! That's super useful to know!

I'm ex-ICU and yes we do operate the ventilators. You wouldn't be expected to know how to manage the ventilator straight away, so don't worry! As with any job, you would be supernumerary for a short period of time to get used to the unit and the machinery! And with time, you learn how to manage the ventilator. We usually have a technician on the unit to help with any technical issues. But essentially your team leader and the medical team are there as well to help. Not too sure what the NICU set up is like but I imagine its similar. That's super useful that you are aware of generic drugs names! I think we do use some different drugs occasionally but not always. Here's a good link for common drugs in the UK with brand names and generic names. Although I imagine there will be some differences between US and UK brand names. Drug listings by brand and generic drugs | MIMS online For more drug info this is our drugs bible in the UK: BNF Publications but you might find it difficult to access in the US.

Hi Silverdragon, Thank you. Yes I'm aware of still needing to have the same hours in those disciplines in Canada but thankfully it seems that they have bridging type courses for nurses lacking in them! Sadly I don't hold out much hope for them to consider my postgrad experience as NNAS is basically run by CGFNS.

Hi Danceluver, If you want to use your skills as an FNP you could look into seeing if the US embassy are looking for NPs. They do occasionally recruit and they will only take on nurses with American credentials. I think there is also a small American military presence outside London too, they might be similar. If you want to try working as a nurse in England then you'd need to get licensed. FNP is similar to a nurse practitioner here. I work as a practice nurse which is a grade down. You could easily work as a practice nurse here if you want to try working in the NHS, once you've got all licensed etc... In terms of working privately, you still need NMC registration. I actually work in private healthcare for an American company in London, so yes you still need NMC registration for that. In terms of other healthcare associated jobs that could use your skills, there's not really a central place to look for these i'm afraid. But it's not impossible. There are health tech start ups, medical sales, medical research etc all looking for jobs. Use linked in, set up a profile and get yourself seen. I always have recruiters trying to add me on there. Where you will be living is close to the M4 corridor so lots of science/pharmaceutical companies there.