Returning to NZ

uswoman · May 21, 2020

Hi! I realise you posted this a long time ago. I’m a nurse in New Zealand, moved here 12 years ago from the US. I don’t know how much nursing has changed here is 25 years, but I do know most of the polytechnic institutes have “Return to Nursing” classes you can take. When I got my registration here, I had to take a Competency Assessment class, and they combined our class with a small return to nursing class. I took mine in Hamilton when I was working at Waikato hospital. It was 2 weeks of (very easy) classroom, then 4 weeks on a ward with a preceptor. That is probably all you would need to feel comfortable again.

tiddles · May 21, 2020

Thanks for responding. That doesn’t sound too difficult then. I was hoping they would have some kind of RN to BSN Programme but I haven’t found one. Doing it here is way too costly.
BTW Waikato Polytechnic (what it was called then) is where I did nursing school!

uswoman · May 22, 2020

You wouldn’t have much trouble getting back into it! I live in Whangarei and have worked at Bay of Islands hospital and at White Cross (not sure if there are any near where you might want to be, but the hours might work for you.) Now I work at a small private surgical hospital in Whangarei, 3 shifts per week, which suits me! I don’t have a BSN and I work with nurses that pre-date that route. Things are really starting to pick up again in a big way with elective surgeries being done to try and clear a 6 week backlog on already full lists. Pretty sure that is the case everywhere, and I doubt you would have any trouble finding a job. If you trained here, I think you would only need that short course and you could get a practising certificate easily.

Shannon Iraniha-s · Jun 1, 2020

Uswoman I was reading your post from before in regards to moving to new Zeeland as a nurse. Did you ever move to Australia? How was it? Are you back in NZ? I'm thinking of moving from USA to either Canada, nz or Australia. Both my husband and I are nurses. He is a np I'm an ICU nurse. I would really like to chat with you a bit some time about your experiences

uswoman · Jun 2, 2020

Hi, Shannon!

I did move to Australia for a short time. I worked in Victoria, in Melbourne. I absolutely love that city! The job I got was through an agency. It was a horrible job, and I left after 4 months. (There were other circumstances that also led me to leave, but that is another very long story!) They have ratios in place and I worked a medical ward with 4:1. And it sounds great but that 4 can be total care plus feeding and giving meds and treatments. I was told 10 nurses had left in the previous 6 months. I burned out and no doubt the others, did, too. Unless they were able to adjust and provide minimal care to get by. (I could not do that.) I had a friend from New Zealand who worked on a different ward and said it was great, and she made more money than I did! Because of the visa I was working under, I had to have full time employment. There is a trans-Tasman agreement so registration in Australia is a breeze if you have New Zealand registration. So you also rotate all three shifts. Night shifts were 10 hours and 4/week. It would not be uncommon to be rostered to work an afternoon shift followed by a day shift. I hated that and asked not to have that done as I had a very long commute by tram and tram. It was not unusual to get home after midnight and be expected to be on the ward ready to go at 0700. I had to get on the train by 0500 to get there in time. And, yet, that sort of rostering continued. I just can’t function safely on 3-4 hours of sleep. So that part was terrible, too. No pharmacist in the hospital after 5:30PM, so you have to use a cross-reference and find a ward that had a medication you need, sign for it and get it yourself. I worked with some wonderful nurses, though, and the pay and benefits were great. (I was rostered a paid day off every month and that did not come from my annual leave.) I also had to have private health insurance as part of the immigration policy, but it wasn’t terribly expensive in Australia. There are some really awesome places to visit in Australia. My husband and I went back for a visit to Melbourne and I finally got to go to all the places I wanted to go when I lived there and never had the time! I used to go by the National Gallery every day - saw the Terracotta Warriors display and went through the entire art gallery, and I’m not typically an art gallery type of person but it was fantastic - and free (except the Terracotta Warriors). We were going to go on a tour to see the little penguins on one island but it was too cold and wet (plus I was sick). I’ve been to Brisbane and that is a gorgeous city, too. Went to a place that was a koala rescue place and got to hold one, which is legal there but not elsewhere. (That was a bucket list experience, to say the least.) Plus you could hand feed and pet kangaroos (with their HUGE claws!) and they had a cassowary but we didn’t see it (a bird that can kill you and fairly rare), and emus. The magpies and cockatiels are amazing!

I am back in New Zealand and here to stay! When I first came to New Zealand, I didn’t have my nursing registration sorted out. I was very lucky to get a job as a health care assistant in a hospital. In retrospect, it was a good thing, because how nurses function and how the systems work is very, very different than anything I had ever experienced in the US. In many ways, I felt like I was stepping back decades in time. Nurses here are very expensive “go-fers”. Nothing is set up to help nurses utilise time efficiently. You will find medication rooms on every ward. Hospital wards are set up with 6 bed, 4 bed and sometimes 3, 2 or single rooms. No TVs at the bedside, but most hospitals have wifi so patients can use phones or tablets or laptops. Call lights are just that - every place I have worked has a button that is pressed, a light goes on over the door and sometimes there is a system where the room number comes up on a panel at the ceiling in the hallway. So you run to see what the patient wants, go get it and bring it back. You mix and give all your antibiotics. I’ve not seen a Pyxis machine anywhere. Every single injectable drug has to be checked and co-signed by another nurse before administration. (Even enoxaparin.) Any paediatric drug given any route has to be double checked and co-signed by another RN. The multi-bed rooms have shared toilets and showers, and not all the private rooms have bathrooms. Granted, the hospitals I have worked in have all been old, but one had a several million dollar update with new patient care areas and they were built the same - multibed rooms and shared toilets and showers. Where I worked in the US, I never mixed a medication - everything pre-mixed under a sterile hood and sent to the floor.

There are also two systems - public and private. Everyone is covered for health care, but not everyone takes advantage of it. Hospitals are always understaffed, and nurses are underpaid. I currently work in a small private surgical hospital. We have 19 inpatient beds, 4 operating theatres. We do a lot of day stay surgeries, but the inpatient suite has insurance cases, private pay, ACC (I’ll explain) plus we have a contract with the public hospitals to help them “get their lists down” (in other words, help shorten waiting lists for elective surgeries). (ACC is Accident Compensation Corporation - anyone in New Zealand (resident or visitor) is covered for care no matter what sort of accident they have, from skinned knees after falling off a skateboard, to being cared for for life if paralysed in an accident.) So we typically see a lot of sports-related orthopaedic surgeries. We have no medical backup “after hours” except by phone. Our emergency back up is the ambulance system. (I have successfully resuscitated someone with just 3 nurses, a far cry from a code team.) That was in a small rural hospital and the patient was awake and talking by the time the doctor arrived. You learn to be pretty darned autonomous and you also have to learn to trust the nurses you work with. Our private hospital has 1- 4bed room and the rest are all private rooms with an ensuite. Every room has a TV with remote but the usual old press-the-button-and the-nurse-comes-running call bell. We have a small medication room and “dangerous drugs” are locked up and require double sign in the old black books, and two nurses to check at the bedside before administration. We have to count and verify everything once a week.

As far as registration, I remember someone telling me (with my American education and experience!) that I was still a foreigner with suspect credentials until verified, as it apparently is not uncommon for some people to purchase degrees and paperwork needed to move here without actually doing any of the work! I also had to take a competency assessment course, which was 6 weeks long, cost $3600NZD. Two weeks of classroom and 4 weeks one a clinical ward with a preceptor, who assessed my practice according to the New Zealand Nursing Council competencies. (Which can be found on their website). It was fairly easy for me to do the course, and I found that a lot of nurses actually apply for the courses before coming to the country. I managed to get in because I knew someone who knew someone that ran the program and got me in. Now do keep in mind that all of this was about 2009, so things may have changed as far as registration policies and procedures as well as immigration.(A lot of “who you know” versus “what you know” here.)Also, nurses are required to do a Professional development and recognition programme every 3 years. In other words, prove you are competent and know what you are doing every three years. You can skip this in some places but then run the risk of eventually being audited, which is also a royal pain. Where I work, it is written in to the contract I signed to work there. Most experienced nurses find it demeaning. (It can be returned to you for revision if you have something out of order or pages done incorrectly - or if your example of practice isn’t clear enough.) At any rate, once I passed that course, which is not easy to get into, it was smooth sailing from there to registration and a practicising certificate (which is renewed annually). Meanwhile, you have to work on immigration paperwork which is tedious, and I recommend you do as much as possible before you make a move to any other country. It is time consuming and difficult to get some original document you may need from the US, and often certified copies are not acceptable! I went from being a resident to a permanent resident to a New Zealand citizen (I have dual citizenship in New Zealand and the US and I still keep my license in the states active.) You can go to the immigration website for New Zealand and I think they still have a points calculator on there to see if you are even eligible to apply for residence. I did all the bits and pieces myself, but if you have the money it might be worth finding a reputable source that can help with the immigration side of things. I worked with an agency that promised to help me find a job - but once I arrived in New Zealand, they basically said, “Great - call us when you are registered and have a practising certificate.” And that was what I could have used some help to accomplish. Jobs are available everywhere so I didn’t need help with that. There are ICU jobs and NP jobs but I can’t speak to how different those roles may be in this country.

One thing that is cool - we all call each other by first names - including doctors and surgeons (and surgeons are “Mr.” by the way, unless female, and they are still “Dr.”) Anesthetists (anaesthesiologists) pretty much order all of the medications for the patients and handle day to day problems. The consultants (attending) make rounds and do surgery and see post ops. The junior doctors and registrars do all the scut work. (We have one ortho surgeon who occasionally has patients in our private hospital and we have to remind him to write orders as he has no minions in the private hospital to do it for him!)

In any case, I would highly recommend that if you are thinking about moving anywhere else in the world, you contact a couple of hospitals in the area and see if they would have the time and interest in showing you around. I think I might have drowned if I had been thrown into the deep end without seeing the way things work as a health care assistant (with relatively few responsibilities) before going forward.

I obviously can’t speak to how things are in Canada. It has the advantage of not being so far from home. In New Zealand, we have been through CoVid19, and presently have no active cases. Our lockdown has been nation wide and far more strict than anywhere in the US, but we also have the advantage of being a couple of little islands way out here in the Pacific Ocean. Our borders are 95% closed, and some domestic flights are just starting up. My husband and I were in the US in March for a wedding and had to hustle back, or we might not have made it. We had to do 2 weeks of strict self isolation - only could go out to walk our dog. A friend went to the grocery store for us and I ordered online once and waited a week for groceries to arrive.) I live in the north part of the north island, where it is subtropical, so mild weather year round and no snow. We occasionally get a day of two where there is frost in the morning in July. We are close to some of the most beautiful beaches in the world. There is a gorgeous waterfall about a mile from our house. The lifestyle is a bit more laid back that in the US, and you have to get used to nearly non-existent customer service. You don’t tip anyone, but one memorable dining experience - our food was served and the server disappeared - and we had no silverware! Had to go find someone and ask for it. But there is no point in getting upset about it. If you like Winter sports or hiking, this is the place to be! Lots of beautiful walking tracks from easy to more difficult and requiring good skills. Someone told me once that you can go surfing in the morning and skiing in the afternoon and that’s the truth! There is nothing deadly in New Zealand as far as creatures - just a little spider that can give you a nasty bite. (Unlike Australia where there are deadly snakes, creatures that jump out in front of your car, etc. Very weird to see dead kangaroos along the highways, and wallabies look like giant rats hopping out in front of your car at night! I’m told hitting a wombat is like hitting a concrete barrel.) There are glaciers on the south islands, a mountain range called the Southern Alps. You can ski on a volcano. There is a huge lake that is a cauldera. The South Island sits over a major fault so it can be shaky in some parts (New Zealand is part of “the ring of fire” in the Pacific. There is also a place called “Hell’s Gate” that is where geothermal activity is at the surface with hot bubbling mud and sulfur in the air.) And hot springs in several places. One beach is called “hot water beach” and you dig a hole in the sand, and when the tide is out, it fills with hot water from underground springs. I’ve been to one where there is an Olympic sized pool of natural heated Mineral water, warmer than a bath, and a smaller pool that had hot Mineral water like a jacuzzi. No wonder tourism is the number one industry in this country! But, if that isn’t enough, there are plenty of little pacific islands with resorts that have you sipping tropical drinks on pristine beaches only a short flight away. It is also expensive to live here, and the larger cities are even more expensive. Your American dollars will stretch farther, but don’t expect huge wages.(I am a very senior nurse with 43 years and am on$35.74NZD/hr. A liter of gas is $1.91 at the moment. Get used to buying groceries by grams and KG, as well. People are complaining about the cost of beef in the US and we are paying about $20/kg for ground beef - on special. most people have some sort of little vegetable garden or fruit trees in their yards. Rent is about $350-$450 per week. You can look on trademe.co.nz to get an idea of what is available and the costs for rent or housing in different areas.

We have nursing unions and this year the MECA (Multi-Employer Collective Agreement) is due for negotiation. All nurses are covered by the same umbrella contract but some (like our private hospital) and other areas of nursing, just as practice nurses or district nurses, have slightly different contracts as their areas are a bit different, but we are still part of the MECA. For example, private hospitals are considered a small step above the private hospitals so we typically have a slightly higher pay rate. There is no negotiating your salary; it’s all written out for all to see and every place has to abide by the rates, based on experience. If anyplace tries to overstep the boundaries and terms of the contract, you can bet the union legal people will step in right away and correct it. Our union didn’t do a very good job three years ago so we will see what happens this time around. (Probably will be told there is “no money for nurses” because of CoVid19). Yet they have already given millions of dollars to bail out the horse racing industry. We nurses are contracted through the District Health Boards (there are 22 of them in the country) who gets funds from the Ministry of Health (government). You will find there are a lot of pros and cons for the public system and if it was great, private insurance (which is more expensive the older you get) wouldn’t exist.

In some ways, its like everywhere - there are always the personality clashes and it takes a little while to get through the “trial” period where people are watching you with a critical eye and deciding if they can trust your knowledge and experience. Nursing here is very academically oriented. I’ve told my husband (he is a mental health nurse) that it seems like I see a lot of “great ideas” for different programs start up but then you never hear anything about them again, so no idea if they didn’t work, faded away, or were successful. And I will be perfectly honest - no one wants to know “how they did it in America”. The system is modeled very much on the NHS in the UK, so you have to keep that in mind. (Same in Austrailia). So that’s a big part of how I find things here to be somewhat backwards. (Rostering is for all three shifts because “you have to know what the other shifts do.”Really? After 43 years I don’t know what day shift does?) I don’t care to work days so I usually swap with someone to work evenings (which are our busiest shift) or night shifts. I’m not a morning person and never have been but that makes no difference, here. Some of us have mentioned working 12 hour shifts but “it’s too dangerous” and “more chances for mistakes” unless, of course they can’t cover a shift, then it’s okay for some one to work 4 hours over and another person to come in 4 hours early to cover it....... We do get paid more for evening and night shifts, and a higher rate on weekends. We accrue annual leave far more rapidly and much more generously - I work .6 and I think I have about 10 weeks, even though I have taken leave every year. Because we are so isolated, going somewhere for a week is just not worth it - so month long holidays are not at all uncommon. It's harder to use that leave if you work for a public hospital, not so difficult in the private sector. (Plus the private hospital closes for a couple of weeks over Christmas and New Years - which is mid-Summer!) We also get sick days that are prorated to the number of hours you work (so I have 6 per year.) We also get a little perk called “shift leave allowance” - you get up to three more days of leave depending on how many evening and night shifts you work. (So that’s an extra week for me!) So in some ways we are treated better than in the US! You get an extra $20 if you work an extra shift with less than 24 hours notice. We have a lot of holidays and if you work, you get time and a half (or double, depending on where you work) plus a “day in lieu” which means an extra day of leave. Where I work, we have an app that they can put available shifts on, and if you want to work, claim it, or otherwise ignore it. No phone calls begging you to work, and the contract also says you cannot be compelled to work more than your contracted hours (in other words, no mandatory overtime, and because I am .6 I can be forced to work extra shifts if they are short, just because I am contracted to work .6). So a lot of good things and some not so good. But I’m happy to answer any questions you might have or point you in the direction to look at jobs. Every district health board has a website and they list all the jobs available. There are plenty of opportunities everywhere!

shannonkhanom · Jun 2, 2020

22 hours ago, uswoman said:
Hi, Shannon!
I did move to Australia for a short time. I worked in Victoria, in Melbourne. I absolutely love that city! The job I got was through an agency. It was a horrible job, and I left after 4 months. (There were other circumstances that also led me to leave, but that is another very long story!) There are plenty of opportunities everywhere!

uswoman,

Thank you SO much for all your information. Honestly, before I was reading your previous posts, I wasn't even looking at new Zealand, but something about it is very intriguing. My only fear is, will we be able to afford living there with 3 kids? 35$ per hour seems pretty low for the costs. However, it does sound much less stressful than USA. I just took care of a very young guy who lost his job and therefore his insurance here and couldn't afford to buy his inhalation. He was confirmed brain dead and it was so heartbreaking. There is events like this that make me want to move to a place where my kids don't have to worry about that, or paying 70,000 per year for college. Would you say as a 2 RN income household (I don't know if my husband can find a job as a NP immediately), we would be able to provide a good life for the kids and be able to live somewhat comfortably? Canada seems much more affordable but also so colllllld... I am a little spoiled with the winters here so I am not sure I could survive that. Also for just moving, would you say Australia would be better to start or NZ? I've heard people there are great.

uswoman · Jun 9, 2020

Hi, Shannon - I’ll be honest: it probably would be difficult to start out here with three kids. But that would be the same in Australia. I guess it would depend on how far along in the immigration and registration processes you are on arrival. A lot of immigrants use New Zealand as a “back door” to Australia as (I think) the registration process in New Zealand is a bit easier, and its pretty easy to work in Australia with the trans-Tasman agreement. If you were both registered with practising certificates, you probably could be pretty comfortable. My husband is a nurse and works full time, and I work .6 . (Although he works on a mental health crisis team and is a DAO - Dually authorised officer so he can start a committal process, to put it briefly.) We live pretty comfortable, but then its just the two of us and a couple of cats and a dog. I did work with a family practise physician who was from Indiana. She and her husband and three kids moved here while she did a two year locum position at a rural hospital. Her husband completed his masters while here and the kids enjoyed a lifestyle you just can’t find in the US. Before you make any leap - have a good visit here and Australia. (I loved living in Melbourne and Brisbane is also pretty awesome.) Living in a different place is difficult to get used to, no matter where you go. I think it took me about a year and a half before I adjusted. You never realise how much you take for granted; mailing a letter was a mission. I remember driving my previous partner’s car and he was in Australia with his father who was dying - someone mentioned the car registration expired that day. I had no idea what to do but I was living with a lovely woman and she helped me get the warrant of fitness (a document and sticker on the car that means it is road worthy) and renew the registration (like the license.) And - they drive on the wrong side of the road which takes some getting used to and can be dangerous until you adjust and learn the road rules and how to function with roundabouts! I remember the feeling of what I called “adventure overload” when I just wanted something familiar and a trip to McDonalds or Burger King was the only thing like home. Immigrating is not for the faint of heart and I guess you just really have to want to do it, along with the rest of the family. Friends and family will be far away, even though you make new friends where ever you are.

When I worked and lived in Australia, I had to have private health insurance as part of the immigration process. Not so in New Zealand. I was applying for residence so I took my chances and paid out of pocket for any medical care I needed until that was granted. There is the Accident Compensation Corporation in NZ that covers anyone that has any sort of accident at any time, while in New Zealand. I don’t know if that would be prudent to forego insurance with kids, though.

I know you both could get jobs, here. Of course, New Zealand is still closed. We haven’t had any of Covid 19 cases for 18 days, so at Level 1 - no social distancing and sports and concerts will start, restaurants and bars back to normal. Once the world as a whole becomes safer, I think the borders will reopen. Right now, we don’t even welcome Australians, nor can we go there.

Cost of living will vary depending on where you might live. Auckland is something like the second most expensive city to live in in the world. (There is no amount of money that would entice me to live there!) I live farther north, where it is normally 50s in the Winter. It gets cold enough to have a fire in the fireplace, but no snow. We are about mid-Winter and so far I’ve only needed a sweatshirt outside.

Happy to answer any other questions you might have! I did the hard yards - resident for 2 years, permanent resident for 5 years and now I am a New Zealand citizen. (Dual citizenship.)