US RN moving to London UK

kaitfinder, BSN, RN · May 13, 2019

On 4/15/2019 at 12:44 AM, Smitty555 said:
Hello all!
I am in the process of transferring my license to work as an RN in the UK. I am looking for any studying advice for the NMC CBT and/or the OSCE. Any one have experience with these exams? Preparation they used? Tips/advice?
Anything is appreciated!!
Thank you ?
Randi

Heyoo

I'm a US RN just moved to the UK in January and been working as an RN since that time as well.

Studying advice for CBT:

Get the Royal Marsden Manual of Nursing Procedures textbook. That will help you loads with both CBT and OSCE. CBT is not as difficult as NCLEX by any means, but you do need to pay attention. Brush up on your med calculation and get used to doing them without a calculator because you won't be provided with one. Also look up how to manually calculate drip rate as that is not something we do at all in the US and is something you will do frequently in the UK. I had a few questions about it on my CBT. CBT is mostly patient safety and safeguarding rather then pathophysiology and complex pharmacology questions. You will have plenty of time to take the test so don't stress from that perspective.

OSCE:

Same. Royal Marsden Manual of Nursing Procedures textbook. Most hospitals though, as far as I can tell, will have an OSCE prep course they'll force you through. Definitely ask if they do this when you interview for positions but most hospitals will provide a training course and practice for OSCE as you are a huge investment and they want you to pass. OSCE is frustrating and challenging only for pedantic reasons. It is a practical exam and will have you demonstrate compentency in certain skills (like giving an IM or subcu injection) and also a writing section where you have to write a care plan. You don't write care plans in nursing in the UK though???

In any case I wouldn't worry about OSCE until you have a job offer and pass the CBT as you can't prepare for OSCE really. My hospital ran us through a roughly 2week course with 2 weeks of studying after to prep for it and I passed both CBT and OSCE on the first try.

When are you due to take your CBT and do you have a job offer in the UK yet?

canadian.j, MSN, RN, NP · May 20, 2019

Thanks for all this info, Kait!!

clairedelune08 · May 23, 2019

Hi. I'm looking forward to working in the UK as well and I am currently in the same page as you are - studying for the CBT. Everywhere I go, people keep telling me that the Royal Marsden textbook should be our bible when studying. For me, it's a bit exhausting to actually finish reading the entirety of the manual. What I did is I looked up some CBT mock tests online (the Royal Marsden website also has one) and just answered them. For the items or questions I'm not aware of, that's the time I consult the textbook. Indeed, the CBT is fairly easier than any nursing exam I've encountered.

Hopefully we could pass and be in UK soon. My job offer is from a private home care agency and I could not wait to start working.

Blood Chemistry · Jun 26, 2019

How much can you save if you are working in London?

Daise · Jul 18, 2019

For a band 5 nurse starting in 2019-20 will get a take away salary of 1800-1700 in central London

Blood Chemistry · Jul 20, 2019

Will that be a clean 1800 with all the deductions and housing

Daise · Jul 20, 2019

Housing is not included. It would be the salary credited to your account by the employer after all the taxes and other deductions.

alainamarieowens · Jul 31, 2019

Hello,

Can I ask how the both of you were able to get job offers before actually having your NMC pin number? I just moved to Glasgow, Scotland and am in the process of applying for jobs and just passed my CBT. I have not been able to even apply for a job without a PIN number. Any advice on how to find a job? I would love to have a hospital sponsor me for the OSCE since it sounds like such a ***** haha.

Thanks for any help! feeling a bit useless right now!

Alaina

kaitfinder, BSN, RN · Jul 31, 2019

3 hours ago, alainamarieowens said:
Hello,
Can I ask how the both of you were able to get job offers before actually having your NMC pin number? I just moved to Glasgow, Scotland and am in the process of applying for jobs and just passed my CBT. I have not been able to even apply for a job without a PIN number. Any advice on how to find a job? I would love to have a hospital sponsor me for the OSCE since it sounds like such a ***** haha.
Thanks for any help! feeling a bit useless right now!
Alaina

Hello!

Be sure to let me know your background (USA, Canada, Philippines, etc? )

To the best of my understanding, you should go through an agency that specializes in international nursing. You can easily google that and if you know which hospital you want to work at, you can google “XYZ Hospital international nursing agency” etc. I have heard about people approaching the hospital directly (recruitment department) and letting them know their situation and setting up an interview that way, but I haven’t done that so I’m not sure. What I do know is nurses in this country (and Scotland and Wales) are unbelievably in high demand so you shouldn’t have too much issue finding a job. I actually started speaking with agencies BEFORE I passed my CBT and they were willing to talk about job positions because of how badly nurses were needed. Once you get hired, the hospital puts you through a training course to help you pass the OSCE (and often/usually does cover the £1900 OSCE fee) so getting in with a hospital is a must because the OSCE is a huge pain and you need training for it.

Feel free to email me if you have any more specific questions at [email protected] !

-Kaitlyn

yam, BSN, RN · Aug 19, 2019

@kaitfinder I found your post so so helpful as many on this subject are outdated, so thank you! I have just passed CBT and am somewhat stuck. I am from the states, currently volunteering as a Public Health nurse in Peru hoping to return to the clinical setting next year.

I was wondering, from your point of view, how working in the UK has been, the NHS assuming you work in the NHS. Are you enjoying it? I´ve seen reports about how short staffed they are and how stressful it is, and it scares me away a bit lol. Was just hoping for an insiders point of view:)

I assume you moved to the UK before passing OSCE? Also, if you recommend the agency you went through, would you mind sharing the name? I was planning of doing everything on my own as I don't know what the agencies (if anything) expect in return for us using their service. Sorry for sounding so needy and all the questions... much uncertainty at this time and have been delaying my process of gaining licensure for over a year, but I think it´s time to set fears aside and go for it. lol

Look forward to your response and thanks in advance!

kaitfinder, BSN, RN · Aug 20, 2019

9 hours ago, yamilet said:
@kaitfinder I found your post so so helpful as many on this subject are outdated, so thank you! I have just passed CBT and am somewhat stuck. I am from the states, currently volunteering as a Public Health nurse in Peru hoping to return to the clinical setting next year.
I was wondering, from your point of view, how working in the UK has been, the NHS assuming you work in the NHS. Are you enjoying it? I´ve seen reports about how short staffed they are and how stressful it is, and it scares me away a bit lol. Was just hoping for an insiders point of view:)
I assume you moved to the UK before passing OSCE? Also, if you recommend the agency you went through, would you mind sharing the name? I was planning of doing everything on my own as I don't know what the agencies (if anything) expect in return for us using their service. Sorry for sounding so needy and all the questions... much uncertainty at this time and have been delaying my process of gaining licensure for over a year, but I think it´s time to set fears aside and go for it. lol
Look forward to your response and thanks in advance!

Hey @yamilet ! No problem, I don't mind the questions!

Some things I have learned about working for the NHS from a USA-prepared nurse perspective:

The NHS is short staffed. Likely more short staffed than the USA. However, nursing is short staffed pretty much the world over, indicated by the fact that many countries include nursing on a short list of occupations that will easily earn you a work visa since they're needed so badly (https://www.gov.uk/guidance/immigration-rules/immigration-rules-appendix-k-shortage-occupation-list here's the list for the UK, in case you're curious, just scroll to table 1). Pretty much every area of nursing in the UK is short staffed, but some are worse than others. Truthfully, it doesn't feel that much worse off than my experience in the US. I work in a major hospital in Emergency care.

The NHS does pay its nurses less than most countries; you can get paid significantly more if you work in a nursing home that is privatized or private hospital, but any sort of acute hospital nursing is not really available in private facilities and those patients will often get transferred to NHS run hospitals for acute management, so it depends on your personal interest. There are public health/community nurses in the UK and they do an extensive amount of work, but as I work in the hospital I have minimal knowledge/understanding for how that type of nursing is and how it compares to my (limited) understanding of community nursing in America. Many hospitals have a bank/pool system where you can pick up "short" shifts that the hospital releases and will pay an increased hourly rate to fill need for, so there is some opportunity to make more money if you need to.

The short staffing is at times frustrating, but I find myself in situations where we are short staffed to the point where it causes a detriment to my ability to function as a nurse minimal, and roughly at the same amount as I did in America.

What I do find frustrating is the scope of practice for nurses in the UK is below that of most other countries (many countries in the EU base their nursing programs and guidelines on American guidelines and nursing standards of practice, whereas the UK writes their own). Nurses in the UK are more social care than they are clinical; bear in mind that I work in Emergency and thus am used to a higher degree of clinical scope and management than a general ward/unit nurse. From what I have seen, ward nursing appears to be roughly the same in the UK as in America, with the exception that nurses in the UK are ubiquitously not trained or expected to use a stethoscope and generally are expected to be less clinically prepared/knowledgeable. I find this very frustrating but other USA nurses do not always feel the same.

Personally, however, I do find it easier to work for the NHS/UK in general as the healthcare system is public and thus accessible to all patients regardless of income or ability to pay, something I have much respect for. Social care and community care is far more advanced and managed better than in the USA, as the NHS has a vested interest in spending as little money as possible. They accomplish this in part by focusing on primary care and care at home, in an attempt to prevent patients from having to come to the hospital in the first place, and thus GPs, social workers, home health care, nursing homes, etc. have significant support systems in place to help manage their load. Perhaps this is just the area I work in (Oxford) but I get the impression this is a nationwide motivation. CT scans cost more than regular GP visits and packages of care.

My timeline for coming to the UK is roughly thus:

May-June-ish 2018: research/looking for job opportunities and travel agencies

June-July 2018: applying to nursing agencies and interviewing/sending resume and rough credentials (I knew I wanted to work at a specific hospital in Oxford so this made my search easier since I knew where to look). July, after pre-screening and interviews with the agency they passed my information on to the hospital recruiting team where I interviewed via Skype with the hospital I currently work at. I was offered a position a few days later and signed a preliminary contract of employment. Then, I took the CBT (if I had failed the CBT more than a few times or was unable to pass, my contract would be void).

August 2018: gathering documents to send to UK Visas & Immigration to apply for my visa, as well as receiving Certificate of Sponsorship from the hospital I work for. My hospital also paid for my visa application ($780 I believe?) and the Immigration Health Surcharge fee (£200 per year of the visa, work visas are 3 years so £600). From what I understand most hospitals will pay these fees but will not pay for CBT ($120? I forget).

September 2018: visa applied for, documents sent, etc.

December 2018: I had an issue with my visa where they forgot/lost some documents and took about 2 months longer than the maximum wait time to get me my visa; it was originaly planned to arrive October 2018. Visa arrived sometime December and I flew out at the end of December to start work January 6th. My hospital also paid for my one way ticket over.

January 2019: work start, hospital mandated training for OSCE, very minimal attendance in a clinical area until the end of training.

February 17 2019: pass OSCE, PIN received some days later, precepting for a few more days and then independent from there.

The agency I went through was very good so I don't mind recommending them. I worked with NEU Professionals. From what I can tell, they service a variety of different areas, mostly in the south of England, but you can see where on their website under the "existing and historic trusts" tab. There are any number of agencies out there and it will make it easier to find them if you narrow down where in the country you'd like to work (a specific city, or area of the country like, southern, northern, etc.). I highly recommend going through an agency as they were very helpful with securing an interview with the hospital (and the hospital is likely more amenable to hiring through a trusted agency rather than someone who approaches them blind) and imperative to me filling out my visa paperwork and liasing with the hospital recruitment team. I wouldn't really advise not using an agency, but that's up to you. None of the agencies expect anything from you compensation-wise and they shouldn't require a commitment time either. The hospital will understandably require a commitment of time to them but that makes sense. If an agency is requesting you pay for their services or dedicate a certain amount of time to working through htem, I would recommend you find another agency as most agencies likely make money by getting paid a finder's fee by the hospitals they refer to.

Overall I would say it's a good experience to work in another country, but it is different. I wouldn't recommend putting off regular nursing as your skills get rusty with time. Feel free to ask any other questions you have!

-Kaitlyn