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Working in the U.K. as an American-trained nurse

Posted in: Overseas nurses | Main nursing areas

24-Sep-2009 5:05 pm

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11-Oct-2009 5:35 pm

Here is the story of my (unsuccessful) experience applying to work as a nurse in the UK. (I think it is important that you hear this side of the story, too.) I am from the US and completed my nursing education there. When my husband's job required that he go to London for 18 months, we assumed I'd be able to work as a nurse since nurses are needed everywhere. We knew that I would have a work permit through his visa, so now I just needed to apply to the NMC. They informed me that they couldn't send me any information until I had successfully taken the IELTS exam. Though I groaned at the idea of waking up early on some Saturday and taking a standardized test to prove I could speak English effectively, I figured it was worth it in the long-run. (My husband and I even had a good laugh when my results came in the mail that I had passed the test with flying colors). I sent my IELTS score and a hefty application fee to the NMC and waited. The application arrived in the mail a few weeks later and I started the process. After much paperwork, I sent my application back to the NMC, along with another hefty application fee. A few weeks later, many more pieces of paper arrived, including several forms to be completed by "the head" of my nursing school. (The Dean of my nursing school was definitely NOT available to complete my paperwork, especially during the summer. The NMC conceded that a professor could fill in the paperwork instead). Besides two letters of recommendation from employers and/or professors, there was also a request for the details of my nursing education. The form stated that nurses must prove they have had 4600 credit hours (in nursing-relevant classes only). This seemed impossible so I called the NMC to verify. Yes, 4600 hours. I also explained that most American schools don't measure education in terms of hours but just plain 'credits'. The man on the phone sounded very unmoved and said that my school should have "some sort of conversion formula". I phoned my school and they assured me they had never heard of anything like this. But they, very kindly, offered to help calculate the total number of hours. The NMC had informed me that any schoolwork done outside of the school was not to be counted, even, for example, required online discussions and weekly study groups. Counting only the hours I PHYSICALLY spent in lectures or labs, the total was FAR short of the required number of hours. (The NMC's official requirement is that a "foreign" nursing program must have a total of 4600 hours of training, at least 2300 of which have to have been in the classroom and at least 1533 of which have to be in a clinical setting). I politely explained to the NMC that no nurse trained in America (or anywhere?) would meet these requirements. It didn't seem to matter that I had already been working successfully as a nurse in one of the top ten hospitals in the country or that my nursing education was in a very well-regarded program. I was not going to receive my nursing license from them.
Sadly, my husband and I still needed to move to London for his job. So, I spent over a year in a city with a shortage of good nurses who are also fluent in English and I wasn't allowed to help. It was extremely frustrating, too, when I learned that this had only changed a few years ago when the EU expanded. To encourage nurses to come to the UK from newly-added EU countries, the EU directive stated that the NMC did not have to administer English proficiency tests or require detailed transcripts of nursing education to the candidates from the EU. I understand that the EU wants the UK to "hire from within", so to speak; so many of the UK's nurses are already from overseas. However, the flow of nurses from Canada, the US, Australia, etc is not a pipeline that can be switched on and off so easily. The EU and UK need to work together to create realistic standards so that talented and qualified nurses from all areas can be allowed to work.

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Caroline Broadhead

Caroline Broadhead

Posts: 22

11-Oct-2009 6:34 pm

Thank you so much for your reply. I really appreciate the information you provided. I agree with you about many aspects of the current application process here for overseas nurses (non-EU).

I applied to the NMC in 2002 before all these changes came about. I had heard about some of them, namely the English test, but I hadn't realized the extent of all these new requirements until I started doing research for my article. I can understand some of the changes, but I think the NMC is making the application process way too difficult for American nurses to get their UK nursing license compared to when I applied. It's quite over the top. I am sorry to hear that the NMC made it so difficult for you.

I recall that form you mention that the dean from my college had to fill out - I just had a professor (who didn't even know me since she wasn't there when I was a student) complete that form. I seem to recall the NMC wanted loads of details and the number of hours spent in school and in training, etc., but I can't remember the exact numbers. I was quite amazed at the numbers currently listed on the NMC website (as stated in your reply).

Did you actually send in the completed application forms? Then were you subsequently told by the NMC you wouldn't even be considered for your UK license since you didn't meet the requirements in terms of hours?

Or did you not pursue it any further once you knew you didn't meet the required number of hours?

Did you ever contact a healthcare recruiter over here for any guidance?

As far as the English test goes, I think if anyone should have to take the English test, it should be nurses from the EU. Not that I work or have worked with any EU-trained nurses myself over here in the UK, but I deal with EU-trained docs some of whom should be required to brush up on their English (or actually learn basic English) before setting foot in a UK hospital. I can understand why the NMC wants overseas nurses to take the test, but I think it should be the same across the board for all applicants outside the UK.

Thank you again for your response. If you don't mind, I may have some more questions for you as I write my article, that is, if I continue to pursue the topic!



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Julie Bowers

Julie Bowers

Posts: 2

27-Oct-2009 4:04 am

Thank you for sharing your story! That sounds very frustrating, and not very hopeful. It's unfortunate that their ridiculous bureaucracy precluded a good nurse from helping their sick.

For personal reasons, I plan to move to the UK in the future (in 2-3 years), and have only just begun the research. I have not yet even graduated so I understand that it's premature to start any paperwork, etc. I am very curious about the whole process though, and the NMC website is a bit confusing, indeed. I would be very interested in reading your article when it is ready. Thank you.

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Caroline Broadhead

Caroline Broadhead

Posts: 22

27-Oct-2009 3:44 pm

Julie,

Thanks for commenting. Am still working on the article. If you would like to ask any questions about the NMC (I think I have a handle on the application process now), feel free to ask me.

Caroline

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Julie Bowers

Julie Bowers

Posts: 2

30-Oct-2009 3:39 am

Ah that's wonderful! I really would appreciate having a few questions answered. I really have more than possible to fit into this space, is there an email in which I can reach you? Mine is mysteriousme7 at yahoo dot com. I'd greatly appreciate it! :)

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stephanie  counts

stephanie counts

Posts: 1

31-Oct-2009 3:01 am

I was just starting the process and felt the giant road block the UK put up! My husbands job is moving him to the UK I really didnt think there would be a problem with me getting my license there, boy was I wrong! I cant stop crying to think of moving there and not being able to do what I love...I love my job! I have a little over a year b4 I have to move there and now I am scrabling to get my bachelors degree to see if that will help things d/t the fact I only have an associates degree, but they make it seem like you cant take any online courses that it wont count! could this be right? Oh and the 4600 hours?? really my school was clueless, i understand having standards why couldnt they figure out the conversion for this since we use credit hours help us out... plese...
If you have any advice or help for me let me know my email is trillionsands@yahoo.com
I dont know what to do.....

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Emilia Lum

Emilia Lum

Posts: 1

3-Nov-2009 9:55 am

Please help me. I am in the middle of the NMC registration process. I studied in the US please can I get some advice my email is emilia_lum@yahoo.com

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Anonymous

Anonymous

2-Dec-2009 1:50 pm

Hello Caroline,

I am pursing Nursing as a career in the UK. I would like to ask you some questions regarding the route I should take based on my situation. My email address is mobettabodies@hotmail.com

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Anonymous

Anonymous

21-Dec-2009 8:00 am

Hello,
I am a Canadian nurse and received my NMC license with hard work and perseverance. I did the research myself and did not use a recruiter, although there was one recruiter that provided advice, Continental Nurse. I did appreciate the woman's help( can't remember her name). But when I heard that I must take an ILETS test, I couldn't believe it. I was married to a British citizen and I still had to go through the process. But what really baffles me is that since I have met nurses whose English is well below the expectations of the NMC. I do not understand why, the NMC does not monitor the language component of being a nurse.

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Caroline Broadhead

Caroline Broadhead

Posts: 22

29-Dec-2009 1:03 pm

Thanks for your post, Anonymous. I agree it is unbelievable that nurses who are native English speakers have to take the IELTS test while nurses from Europe where English is a second language do not. I personally haven't encountered nurses here in the UK who are not native English speakers, but I definitely have come across quite a few doctors from abroad who need to brush up on their English language skills.

I'm still working on my article (nearly finished). Would you mind if I asked you a few questions via e-mail about your experience applying for your NMC license and getting a job in the UK? If not, I understand.

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Beth Storen

Beth Storen

Posts: 2

18-Jan-2010 10:18 pm

I am glad to see that I am not the only overseas trained Nurse having some very ridiculous times with the NMC!
They are a joke and am currently on page 4 of my complaint letter in the way that they handle the whole process!
I trained in Australia and clearly speak only English. I am also trained in ICU so you think they would be crying out for someone with such experience-apparently not!
I am nearly into my 10th month since I began the application and am so close however I am very much over the situation!
I am also dealing with Continental Travel Nurse (they are the only reason I haven't packed up and gone!)
By the time it is all approved and I do the ONP it will be 12 months (or more!) since I began the application.
In the process the NMC has lost, or misplaced, no fewer than 12 separate pieces of paper-be it application packs, my references, even lost a piece of reference that was stapled with the rest-but it was held up as this item was needed to be redone by ME and returned AGAIN!
My friend who started the application with me has had the NMC loose the same reference three times! And then they had the audacity to state that unless he hurried up and got it in then he would loose his registration place and would have to start the process again! Absolutely ridiculous.
There needs to be some serious changes within the NMC and like I said previous that I am writing a very long complaint letter about their processes and general lack of been able to do what they are paid! The health minister's will also be receiving copies of this, not to mention publications as something seriously needs to be done about this ridiculous situation!
I wish others luck in their applications and hope that you don't have the same problems that I have endured!

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Heather Richards

Heather Richards

Posts: 11

21-Feb-2010 5:38 am

Caroline,
I am very interested in reading this article once it is done. I am a US nurse and I have been doing some research on getting my nursing license in the UK. I have decided that it is not a big deal to take an english proficiency test as I will obviously pass it as english is my native tongue.
I am hoping that because I am a surgical nurse, this will help me along in some way. Surgical nurses are on the UK occupation shortage list that came out in December.
The one thing that is confusing to me is the ONP. Is it actually 20 days in the classroom somewhere and do you have to pay for it?
Again, this whole process couldn't possibly get anymore confusing even if it was in a foreign language.
Please let us know where we will be able to find this article.

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Caroline Broadhead

Caroline Broadhead

Posts: 22

27-Feb-2010 5:10 am

Hi Heather,

Thank you for your interest in my article. I just found out that it has been accepted for online publication. I will let you know when it's published.

I agree with your attitude that it's no big deal to take an English language test since you are a native English speaker. However, I can understand that it is surprising and seems a bit unfair that nurses from native English-speaking countries need to take the test while nurses from EU countries where English is not the main language are exempt. An American nurse working in the UK whom I interviewed for the article said that she didn't even bother to study for the test at all and easily passed.

I agree the ONP part of the process is quite confusing. I was baffled about it since I didn't have to do an ONP when I registered with the NMC in 2002. I spent most of my time researching this part of the application process for my article.

Yes, you have to pay for it, but I have come across some UK employers who are willing to reimburse you for some of the cost, obviously with the condition that you work for them for a period of time.

Each ONP varies in price (ranges from £300 to £1200) and in length. The 20-day description is quite misleading. Some ONPs last only three days in the classroom while the remainder of the course is completed as self-directed online learning. Others last longer, up to 12 weeks.

I cover the ONP in my article. If you would like to read that part of the article before it's published, please e-mail me at cpolt@hotmail.com.

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Caroline Broadhead

Caroline Broadhead

Posts: 22

27-Feb-2010 5:18 am

Beth,

Sorry to hear about all the problems you have had re: your application. A nurse who recently has received her UK license and whom I interviewed for my article recommended that the NMC nominate one contact person at the NMC for each applicant who has knowledge of the status of that applicant's application and can assist with any issues/questions that pop up as well as keep track of the application and supporting documents.

I hope the issues you've had are being resolved or have been resolved.

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Anonymous

Anonymous

27-Feb-2010 3:12 pm

I do have to comment on the nurse who thought the ILETS was easy? It was not easy, she must of had an easy exam. I am specifically referring to the reading part of the exam. This woman must of read academic journals daily, and/or worked with journals or research because you don't get good unless you practice in some capacity, like read a lot for example.

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Caroline Broadhead

Caroline Broadhead

Posts: 22

27-Feb-2010 3:40 pm

I did not mean to convey that the IELTS is easy. I just said this one particular nurse said she didn't prepare for the test and easily passed...I didn't say she said it was easy. She said she didn't find taking the test too stressful.

I have heard that the Academic module which is the module overseas nurses need to take is more difficult than the General Training module.

Here's a different perspective: other nurses told me they studied for the test and passed; some said they wouldn't have passed without studying while some said they probably didn't have to study as much as they did.

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1-Mar-2010 9:40 pm

As a native English speaker who has taken the IELTS, I can attest that as long as you can read and write at the college level, you'll do fine. I am not an avid reader of scholastic journals, nor do I work in research, and I was able pass easily. I agree, the reading section is the hardest. There are several tedious passages on esoteric topics each followed by a handful of finicky questions. You slog through them, do the best you can, and remember that the other three sections of the exam (writing, listening and speaking) will all come much more naturally.

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Niles Mekeel

Niles Mekeel

Posts: 1

4-Mar-2010 1:56 am

Dear Colleagues,
Would I ever have chance of obtaining NMC
registration with an ADN degree (Associate degree in
Nursing)? I realize the new regulations were changes re: clinical hours were implemented only
a few years ago, as 2 colleague of mine with
ADN degrees obtained NMC registration 7 or 8 years
ago, which ironically is when I first looked into it!
(I was living & working in Melbourne, Victoria, Australia
at the time; I've kept up my Victorian RN registration
ever since & by the way, is was actually a delightful,
user-friendly process to obtain my registration "Down Under" , ie no "hoops to jump through" & the
folks at the Nurses Board of Victoria are the nicest civil
servants on the planet!)
I am most grateful for any advice!
Many thanks

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Caroline Broadhead

Caroline Broadhead

Posts: 22

4-Mar-2010 3:52 pm

According to the NMC website, here are the requirements re: training/education in your home country

You must have completed a three year (4600 hour) full time course at post secondary level divided as follows:

At least half of this course (2300 hours) in clinical or practical training

At least one third (1533 hours) in theoretical training

The course must include theoretical and practical instruction in all of these areas

•general and specialist medicine
•general and specialist surgery
•childcare and paediatrics
•maternity (obstetric) care
•mental health and psychiatry
•care of the elderly
•community/primary care nursing

If you have undertaken training less than three years in length or did not follow the theoretical and clinical balance as outlined above, your application will not meet the NMC’s requirements and will be unsuccessful (according to the NMC website).

There is this added note for nurses who undertook training in the US:
If you completed an Associate in Science Degree in Nursing (ASDN) that was below three full time years in length you will not meet NMC requirements for registration. We will be able to consider your application if your programme was three full time years or more, and if you undertook a Bachelor of Science Degree in Nursing (BSN).

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Anonymous

Anonymous

15-Mar-2010 7:23 pm

I am in the process of seeking UK Licensure. I apppreciate all these input and sharing of information. The process ofseeking USA licensure from training in UK is similar as applying form one USA state to another.

If any one in the DC-metro area who may be interest in teaming up to accomplish this UK RN Licensure,please email me. Thanks/

My hope is to start an graduate program (not in nursing) in UK 2010,Sept.
thspromise@verizon.net

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