I am an RN, moved to the US 2 years ago. I worked in England for 5 years as an RN. I haven't been working here in the US yet so I have noting to compre it with but I can tell you a little bit about the UK nursing system from my perspective that is. Perhaps you can be so kind to shre what you think I should expect when I start working in the US. -Healthcare in the UK is national health( everyone is entitled for free healthcare) therefore you don't have to worry about PPO/HMO etc ( still can't get my head around that). -Unless you are working in ICU or OR you don't have to wear scrubs. Most hospitals provide you with uniform. -Most of the assessment such as listening to lungs and heart sounds are done by the doctors therefore you may not see many nurses carrying stethoscope. It is still okay to use yous. -You get paid once a month, not divided into two.( That is not only in nursing) So, I worked in a one of the best major teaching hospital (Guy's and St. Thomas' ) in London. It will depend on what kind of ward you will be working. If you work in a general admissions ward, the ratio could be up to 6pts. As it is an admission ward it will be fast paced. Lots of admissions and transfers. You will have Health Care Assistants(HCA) to help you with washes, obs and making beds etc...everything is still your responsibility, they are there to assist you only. If you work in speciality area like CCU,ratio would be 2 pts. I loved that, as you will have more time to give a full days of quality nursing care with less interference. Oh, I don't know if this is new but, Drs are called Dr. but surgeons are called Mr. :-) Hope it helps. Let me know if you have any specific questions.