Green_Grass

Hi MissMichi, congratulations on your degree and your job, and it is wonderful that you are planning to go to the U.K. There are plenty of nursing jobs in both the NHS and the private sector. 1. The OSCE is not a difficult exam in terms of content, but it requires the taker to be very precise with details. For example, if there were such a question about demonstrating the proper way to prepare a salad, the examiners are looking to see that you verbalise things like, "first I would wash my hands, then I would look at the vegetables to make sure that they are ripe but not showing signs of spoilage, then I would get a colander to wash the vegetables for 15 seconds..." They also want to see that you demonstrate critical thinking such as knowing to add ice cubes to the Boston lettuce if you noticed that the leaves were wilted, or that you can identify that a very firm lemon means the inside is desiccated and would not be good for juicing. They are also looking to see that you are aware if you make any errors and this is considered fine so long as you make note of it to the examiners and you explain what you would do to correct the issue. For example if you accidentally dropped a sliver of cucumber along with the knife on the floor, you would simply say, "I will no longer use this piece of vegetable since it is likely contaminated, and I will wipe the affected part of the floor with paper towel, place the cucumber in the compost or rubbish bin, wash the knife or just get a different one, and wash my hands before resuming the salad preparation." It sounds very simplistic and obvious, I know, but this is the way they have structured the exam and I think it would be pretty standardised regardless of the university where it is taken. People have definitely passed after the first try, among those who do not, the majority pass after their second. 2. In terms of interviewing for a nursing job, I agree with the other poster who suggested an agency. Another one that I can recommend is Continental Nurse in London, U.K. at https://continentalnurse.com. They are organised, friendly, and professional, and have fantastic recruiters who really do their best to help in every way throughout the entire NMC process, including the OSCE. There are many nurses on their books from the US, Canada, Australia, and NZ, so the staff at the agency understand the differences in nursing practice. I think that a good agency like Continental will be your best source of good, reliable information on what to expect from a job in the U.K. and how it compares to Canadian nursing. Note that I am not sure whether this agency currently offers Tier-2 sponsorship; this is something you can ask them. You can also look on hospital websites, for example, as depending on the job and hospital, and you can definitely ask them directly if Tier-2 sponsorship is available. 3. Regarding immigration and arriving at the U.K. border, if you are staying temporarily for your OSCE for example, you will feel better prepared and at ease if you bring proof of funds to show that you will be able to support yourself during your stay (a bank statement), a return ticket, and even things like an upcoming work schedule at your current job should satisfy them that you have commitments back home and are only in the U.K. for a visit. The Tier-2 visa allows multiple entries and exits, so travel is of course permitted. The first time you arrive on the Tier-2 visa, it would be good to have your CoS (certificate of sponsorship) just in case they ask to see it as well and you would not be expected to have a return ticket that far in advance. Best wishes to you, I am sure you will have plenty of good jobs to choose from and it will all work out for you.

It's easier said than done, but try to go to work each day with the singular goal of learning new procedures, improving existing skills, and simply getting more familiar with the layout and flow of the new setting. These colleagues who sneer or make snide remarks were all in your shoes at one time. Try not to let this distract you from the overall picture which is of course presumably to become an experienced nurse and to savour the opportunity to learn as much as possible from this fast-paced setting. Remind yourself that you were hired because your CV and interview stood out from the competition and those in charge of personnel saw fit to invite you to contribute to this unit. Perhaps when you receive feedback from a physician, you could see it as a valuable contribution to helping you grow as a clinician. The next time one of the ED techs asks you to collect items from the clean hold, perhaps you could reply that you are happy to do that and additionally are available to assist with whatever they are doing. This would build some solidarity, invite them to share their expertise with you, and also establish a different sort of rapport, one in which you are taking ownership of the experience and demonstrating initiative. Lastly, consider keeping a log of new skills, pathologies, patient cases for which you are becoming more competent in managing. This will give you a new focus and an objective way to calibrate your experience. When you see the list expanding as you progress, you will see merit in your position in this ED.

It's been 5+ years since I've practised nursing in a U.S. hospital at the bedside and while living in the U.K., have come across wound care using Aseptic Non Touch Technique (ANTT). Wound dressing change using ANTT begins by cleaning a designated trolley, donning a plastic apron, and placing dressing supplies on the bottom shelf. My nursing degree is from an American university and I am unable to recall learning about ANTT, but perhaps this is just a newer word for sterile technique. Is ANTT being taught in American universities and used in U.S. hospitals? Is it synonymous with sterile technique, and if not, what are the key differences? Appreciate your feedback.

I completely agree with the sentiments expressed by the OP. All nurses trained outside of the UK and EU must pass not one, not two, but three exams to earn the privilege of working as nurse in the UK. There is the IELTS exam to prove proficiency in English, followed by a computerised test (CBT), and lastly the in-person skills test which has the reputation of failing candidates for pedantic reasons unrelated to their professional competency. For first-time OSCE-takers, there is a 49% pass rate. The competency of a nurse trained in Spain or Hungary, with a rudimentary command of English is not measured by these three exams prior to receiving a pin, which of course means that a Romanian nurse with two years of experience who is not fluent in English has a significantly shorter, less challenging path to employment in the UK than an American nurse with an MSN and 15+ years of experience. In that way, there is a lack of uniformity as it pertains to standardising entry requirements. While I can understand the responsibility a professional licensing body must undertake in order to protect the public, I challenge the gross disparity that exists in the vetting process between EU and non-EU candidates. On a more positive note, it appears that 99% of the candidates who retake the OSCE pass the exam, and, the NMC has been known to overturn decisions after reviewing a reasonable appeal. The OSCE is unlikely to stay around for much longer given the harsh criticism received and maybe it is more palatable an experience to think of it as a sort of practice run in a nursing 101 skills lab. Perhaps OSCE candidates should just try once more, and not give up after a first trial, because even if they choose not to work in the UK after all, it is still an accomplishment to complete the difficult journey and earn a place in yet another country's registry.

I think the issue for many people with back/hip/knee/wrist problems is not that they are inherently lazy or entitled when they file for disability; it's that sometimes they really don't have any other skills besides the ones that they used previously to earn a living, which may or may not have contributed to said disability in the first place. Learning a new skill takes time and money, and depending on the age of the person and their other commitments, it may not be a realistic endeavour. Most people who are overweight are aware of it, and would like things to be different, but again, it can be difficult to break an old routine or to stay motivated when there is a lot of weight to lose and progress seems too slow to make apparent the difference that would propel them to continue. Also if the person is depressed because of their pain, it is hard to be resourceful or think strategically, and the person may not have the sort of family / community support that would help to jump-start a new trajectory.

Perhaps an attorney familiar with the RN's cultural background may make for a higher probability to mediate outside a courtroom. It may come down to a misunderstanding stemming from a cultural difference. The way an American nurse would communicate v. the way a nurse newly arrived from Singapore or India would is very different. What content and manner of speaking in the U.S. is understood to be helpful, straightforward, and constructive feedback may be viewed as hostile and intimidating in another culture. This does not mean that one cannot opine in the workplace but rather that ideas are expressed in a more roundabout and diplomatic way. Certainly you were trying to help her at work and ideally this would be well-received, but it's possible that with the combination of personality, background, job expectations, she was limited in her ability to understand, and processed the experience in a way that does not accurately reflect your good intentions. Trying to step back and see where the RN was coming from as well as making allowances for her communication nuances could hopefully help with resolving this matter without massive legal expenses and stress. Hope this works out painlessly.

I wholly agree with these sentiments. It has been stated over and over again this business of "paying your dues" as though there's a requisite waiting list and a hefty fee to gain admission to the exclusive day shift club. In Silicon Valley, bright twenty-somethings or even recent high school graduates are applauded for working hard to showcase their ideas and start their own companies because they decided that they did not wish to work a traditional salaried position at Apple or Google first. The OP was simply expressing an opinion about a work schedule preference that perhaps would have been received differently had the post exclaimed, "Seeking Nights, Weekends, and Holidays only!" It's wise to work as a floor nurse for at least a couple of years as a new graduate, but its virtue lies in the rich acute clinical experience. Consistent with the law of supply and demand, more RNs are competing for the same positions, so by default it is easier in more popular geographic areas to find less-sought-after posts. But at the end of the day, the goal is simply to be a clinically sound professional with good judgement and if someone demonstrates this in their work in public health administering travel vaccines to healthy people in the daytime, well then, wonderful! Suggesting that people can or should only follow a prescribed pathway to their desired job description is of questionable value. Such seems removed from the essence of nursing which teaches to compassionately accept others' choices and objectively disseminate information without judgement or making personal which ultimately is not.

In 2004 as a new graduate RN, I worked on a medical floor run by a nurse manager who believed that staff would perform better if they did not need to go between night and day shifts. It was at a 900-bed level-1 trauma centre and the staff on that floor was cohesive and wonderful. My schedule was three 12-hour day shifts during the week and an optional one weekend day per month, if patient and staff census dictated a need for it. Many nurses enjoyed three 12-hour night shifts and still others preferred to work all weekend because of the pay increase so demand for day shift positions did not outstrip the supply. I also worked at an agency, working some additional day shifts on orthopaedic and med-surg units. I suppose things have changed in recent times and as there are more nurses than available jobs, day shift may sometimes be elusive. As others mentioned; working in a public health clinic, occupational health clinic, ambulatory care centre, catheterisation lab, are all good options for daytime schedules. It is a worthwhile experience to work as a bedside RN in a hospital at least for a couple of years. The experience and little pearls gained from more seasoned nurses in an acute setting; the experience in critical thinking, disease pathology, time management, and teamwork is invaluable and really is a solid foundation for a nursing career.

Perhaps you could talk with your supervisor about taking time off to reset. I'm not absolutely certain, but you might be able to qualify for unpaid time off under the Family and Medical Leave Act (FMLA). Nursing is a service-oriented profession so the element of handling expectations, pathologies, patients, families, and colleagues will be present in any job that is direct patient care, whether working as an RN or an NP; in a jail, a school, a free clinic, or a hospital. That said, it's difficult to be a new hire, a new graduate, in probably many industries, but in nursing, especially on a busy medical-surgical ward, the demands are greater, the pace faster, and the stakes higher. If you always remember that at the core of why you are getting in your car and driving to work is because the patients need you, perhaps it will give you the necessary fuel. You might remind yourself that you've worked hard to earn your degree and now have the privilege of applying noble skills to a population that needs them. As a nurse, you're a valuable part of a ward, a clinic, a hospital, and you can be counted on to give people good quality care so that they can get better and return to doing whatever it is that they love. Sometimes stepping back and seeing the value in what you do every day can increase confidence in what you're doing and decrease the fear that it won't be done perfectly. Finally, this experience is only a small snippet in what would likely be a long and rewarding nursing career. It will get better.

From what I've seen in a UK hospital, at least medical and surgical wards have CNAs, but the RN will often assist with AM care for her own assigned patient cohort, giving bed baths, changing linens, and helping with meals. Trolleys, waste disposal bins with wheels, hoists, helpful colleagues, and many circulating physiotherapists help to make the physical workload lighter. There is a national initiative to reduce incidences of pressure ulcers and there are fairly well-developed physical rehabilitation programs. The time spent washing, chatting, tidying the patient and surrounding space is a great opportunity for a comprehensive psychosocial and pain assessment; an easy way to evaluate tissue viability, integumentary system; and a time to get to know the patient better as well as offer encouragement and reinforcement of what the occupational and physical therapists have taught.

Attachment is a term used in Singapore and refers to a clinical rotation. I think it is also used in the context of a qualified nurse training for a higher level position, e.g. to become a nurse with a speciality in renal diseases.

It's a common practice, at least now, in nursing and other industries for prospective employees to go through several interviews. Maybe it is because of the slow job market. The nurse manager may just want to get an idea of how you might interact with the other staff, and give you an opportunity to see if you can picture yourself working in this environment. It is probably similar to interviewing for an office job; usually you will be shown around and introduced to your prospective colleagues. A second interview is a very good sign. Just arrive with the same mindset that you did with the first interview.

Not necessarily; it probably depends on the facility I think. I worked full-time, 12-hour days on a medical-surgical unit a few years ago when I was a new graduate. It was a very fast-paced unit with 7 patients per RN but I liked the intensity and had very knowledgeable preceptors and a really cohesive team of co-nurses.

Send a "Thank You" e-mail or card to the recruiter today. Often it takes a couple of weeks (and sometimes longer) for the employer to respond after an interview. They may be discussing your file with the hiring manager at the hospital or they may just be busy filling some other vacancies/positions. All of the feedback you've had from the recruiter so far is very favorable, so just send your note and follow up with a call in another week if you still have not heard anything.

The job market for RNs is more competitive currently, and some employers might favor orienting an RN whose last job was just a few months ago, often just because these facilities don't have money to accommodate the longer orienting that someone with less recent experience might need. However, you definitely possess relevant work experience: six months on an L & D unit. The skills you learned while working and while studying to become an RN will be to your advantage when you begin your BSN program. There are plenty of students who begin a four-year baccalaureate nursing program immediately after high school. You have the advantage of already having some idea of what it is like to put those clinical skills into practice. I don't think you will be considered a new graduate after you complete your BSN, and of course if the economy turns around by then, you shouldn't have any problem getting hired. In any case, there are hospitals that hire nurses who are returning to the profession; it just might take a bit longer to find something. Therefore, if you have the ability to put aside even a few hours during the week while in school, perhaps continue your job search now to find an RN position. If you are persistent, I think you will surely find a job even in this market.

Well, you could ideally practice nursing and also work on your film career. You might consider looking for a job (after you've graduated) in Los Angeles; right now, make a list of hospitals in the vicinity of where you'd be likely to go for auditions/agencies, etc. If you worked the night shift (and I see that it's not your preference) however, this would allow you to keep the daytime free for auditions. It's actually an excellent way to make a decent living and still pursue your acting career. Most auditions are usually in the daytime so if you worked from 11 PM - 7 AM or even 7 PM - 7 AM, you'd have plenty of time. After you have a couple of years of experience, you might consider working for a nursing agency as a per diem RN. That way, you can tell the agency what your availability is at the last minute. If it is 3 PM and you've not been called for any auditions, you can call the agency and tell them you want to work a 7 PM - 7 AM shift. The downside of course is that you could get cancelled; Per diem is not really always reliable as a way to ensure the same monthly income. However, you wouldn't have to commit yourself to a rigid schedule either. As for blood, etc. well, there is probably no way around it if you choose hospital nursing (which is often the most flexible in terms of schedules). You can try school nursing, education, or legal consulting, but I don't know too much in terms of how much compensation you'd receive. I think for the most part, you would grow accustomed to the bodily fluids, etc. Most nurses do. You'll get used to your routine after 3 - 6 months on a unit and you'll probably have quite a few days where you'll feel like you did quite a lot. There are always resources at your disposal, i.e. charge nurse and other colleagues. The best part about nursing is that you can always try another area if you're not quite satisfied with where you are currently.

I think overall in the United States, there is probably a shortage of experienced nurses. There is a surplus of newly graduated nurses, simply because many universities and colleges recruited enthusiastically over the past several years. The economy has gone south, and with increased unemployment (in all job sectors), this has meant people have lost their health insurance and are putting off surgeries or trying not to go to the emergency room, etc. if possible. Also, hospitals have budget cuts and at this time many cannot afford to pay for the 12+ weeks of training it would take to bring a new RN up to speed. Many experienced nurses have postponed retirement or upgraded their schedule from part-time to full-time to compensate for an unemployed spouse. A poor economy with high unemployment and a flood of new nurses means very stiff competition for available jobs, even if one is happy to take a permanent night and weekend shift job on a high intensity unit. NPs have an easier time finding employment because fewer nurses have Master's degrees and on average, well, there are just fewer NPs! In California, the salary of a family medicine NP is far less than that of an RN who works in a hospital. On average a family NP with 3 -4 years of experience might earn $40 - $45/hour as compared to an RN who earns $55/hour. The per diem rates (if you get a job in the nursing pool at a hospital) can be $70 - $80/hour. The hourly pay in other states for RNs is not as high but I think the rates for NPs in major east coast cities is probably comparable to what it is in California. As for why not everyone chooses to earn their MSN, well, for some it probably has to do with the cost. Also once you've learned many of the hands-on skills required in bedside nursing, it's best to put it into practice so you don't forget. The job description of a family NP is different from that of an RN on a med-surg unit. Globally, nursing is still generally high in demand. There are other places to work as an RN besides the United States. Moreover nursing affords quite a few options. Working in a hospital is only one of many: you can choose home care, school nursing, case management, education, wound care (might require MSN), teaching, legal consulting, informatics, public health, or occupational health. There exists the opinion that hospital nursing is maybe more desirable than home care, but home care requires that you are extremely competent, independent, and possess the ability to think critically without relying on any backup. In the hospital setting, if in doubt, there exists a charge nurse and assorted colleagues so resources are more accessible than if you were in someone's home performing a dressing change and had a question. If you are just starting your education now, it's highly likely that by the time you've graduated, things will have turned around in terms of job availability.

There are job opportunities in medical spas, for example. You might learn to perform microdermabrasion and botox injections, which usually do not result in bloodletting, however I am not sure to what extent your job would be hands-on, as some places may require an advanced degree. You could also try legal consultation, school nursing (might involve administering insulin SQ injections though), or case management. Honestly, though, if you want to maximize your career opportunities, it is probably wise to keep up to date and in practice with your clinical skills.