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Ever wondered what it’s like Nursing abroad? Laura Young compares the key similarities and differences between the NHS and Australian healthcare.
3rd July 2018
Questions by Ruth Underdown. Answers by Laura Young
What Is Your Background, Role And What Led You To Consider Working Abroad?
I qualified from the University of Stirling in 2008 with a BSc in Adult Nursing.
After that, I moved to Milton Keynes where I worked in the hospital for 4 years in several areas including a Coronary Care Unit (CCU) and the Emergency Department (ED).
I then took a year out travelling late in 2012 with my partner.
We continued our travels onto Australia, arriving in June 2013 where I originally planned to take a break from nursing as I didn’t want the stresses of the job taking over my gap year.
However, after working as a healthcare assistant in Melbourne for a few months, I began to see how different nursing was in Australia, and I decided to go for my registration.
I missed nursing, and was also becoming aware that if I took more time off, I would have to do a return to practice (a course undertaken to re-join the register where required practice hours haven’t been met).
What Preparation Did You Need To Do Before Considering Nursing Abroad?
If you want to come to Australia, getting registered is relatively straight forward.
I applied for my transcripts from university, along with the usual documents such as a resume, references and proof of hours worked. I also needed my secondary school to write me a letter stating that I had been taught GCSE English for at least 4 years.
Additionally, I had to undergo a medical, which consisted of a physical exam, chest X-ray and blood tests.
Once this was submitted the process didn’t take very long at all.
One thing to consider would be that Australia requires you to hold a degree in nursing and no longer accepts diplomas, unless a bridging course or further study can be obtained.
Was Australia Your First Choice For Working Abroad?
Although I found myself working in Australia by accident, I have had the opportunity to think about nursing elsewhere in a country such as New Zealand.
I believe Australia is a pretty great place to work as we have higher nurse-to-patient ratios, and the wage is slightly higher. There is however still quite a difference in pay and conditions depending on which state you live in.
Western Australia is one of the highest paid, whilst Victoria is one of the only states with strict patient ratios.
How Does Nursing In Australia Compare To The UK?
Nursing in Australia varies greatly.
There is a public healthcare system similar to the NHS, as well as a private system alongside it. This means that the public system isn’t under as much pressure as in the UK, as a large proportion of people will have private health insurance.
Nursing is much more respected here, and has been voted the most trusted profession in Australia for the last 20 years. I find people tend to have more respect for you, but there are still issues with verbal and physical abuse.
Public vs Private
The working conditions are quite different too, mainly due to the implementation of ratios.
In a public hospital, the average number of patients a nurse will look after during the day is 4. In a private hospital, it tends to be 5 or 6.
Healthcare assistants (nursing aids) are not as common here, so you look after the patient in a more holistic fashion, although you do sometimes see nursing aids in public hospitals assisting with showers or fundamental care.
There are also a larger number of enrolled nurses, which is something the NHS has phased out.
The majority of nurses here work 4 days a week instead of fulltime, which is quite different from the UK. I guess it’s no surprise considering the Aussies invented the 8hr day.
Conditions vary depending on whether you work in the public or private sphere. I spent most my time here working privately, as most backpackers do.
During my time, I have on occasion been shocked at the way Doctors would speak to you (if they acknowledge you at all). They are surprised if you do the rounds with them, and the way they spoke to me often shocked me.
Generally, you are allocated a larger number of patients in the private system and are more overworked with fewer support systems in place.
The pay is also marginally better.
I have found the public a complete contrast to private, and very similar to the banter and team work of the NHS.
I now work in a public ED and often find the Doctors hanging fluids or giving meds. The profession is better supported here than the UK, and the unions work well.
Nurses in Victoria were in talks last year and threatening strike action as they weren’t happy about the pay difference between the states (Victoria is one of the lowest paid). It never reached industrial action as their demands were met where over an eight-year period, nurses and midwives will get between a 3.17% and 17% pay increase.
I believe the UK are still fighting for a 1% pay increase, and that hasn't changed since I qualified.
Salary also differs from the UK. On average a nurse in Victoria in a public hospital will earn $30-35/hr (£18-21/hr) without unsociable hours pay, which can take it to nearer $40/hr (£24/hr). Private nurses generally get paid more.
Nursing is a lot more supported here.
Generally, the nurses complete a graduate year on qualifying, which allows them to work in several areas gaining experience whilst being supported. You wouldn’t find yourself working in triage or resus, without first completing your post graduate certificate.
You don’t ever feel like you are drowning as there is always someone to help you.
Do You Prefer The UK Or Australia And Why?
Lifestyle wise, I prefer Australia as there’s more encouragement for a work life balance. Employers support that, offering things such as family days or mental health days, as well as night shift rotations so you get them in blocks over a three-week period and shift swaps are easy.
I would say the work life balance is much better here as most nurses work four days per week, and then take casual shifts if they want the extra money.
The wages still allow you to live a good lifestyle.
I feel it makes a huge difference having set ratios. There are enough staff so that you rarely feel like you're drowning, and there is often someone to help.
Annual leave, in blocks of one or two weeks are also given over the Christmas and New Year period.
There is a good emphasis on mental health here, and although it's still a taboo subject in a lot of respects, I feel it's better identified and talked about here.
It's not uncommon for someone to call in sick for a 'mental health day' when they are feeling burned out. I also know people who have gone to their GP with anxiety, stress or burn out, and were signed off work and given CBT (cognitive behavioural therapy) within days, with their place of work being fully supportive and encouraging a return on lighter duties until the person felt better.
By addressing it immediately, people are back to work quicker as it's caught and addressed early with coping mechanisms provided.
We also have to complete regular surveys on our feelings and experiences at the hospital, and it feels like changes are actually implemented when necessary.
I think the culture in the hospital where I work is great.
Australia is also a great place to live, with generally better weather and more disposable income to enjoy your life. However, it is the other side of the world and so far from our families.
I have recently become an aunt for the first time, and it is heart-breaking not to be there. No amount of skype or pictures will ease that pain.
The only thing I would say is when we go home and see our family and friends, its quality time.
When I was working in the UK my shift pattern was so vile that I never saw anyone anyway, and when I did I was exhausted and not great company.
Now we see them for a full week or two, and its great quality time.
How Do You See The Future Of Nursing In Australia Compared To The NHS?
Nursing in Australia and the UK are very similar. Both experience the same pressures of any public health system.
However, having a private system available alongside the public system ensures the pressure is shared.
By having parallel systems, people who chose to pay for their healthcare can, thus reducing waiting times etc.
There are several similarities in care, but also things we could learn from each other.
Australia is research and evidence based practice, but in some ways, it feels old fashioned. For example, in Australia sheepskins are still used in pressure care management and restraints used on patients who are at risk to themselves or staff.
I believe Australia will continue to thrive as it recognises the importance of healthcare and ensuring it’s funded.
The NHS will slowly privatise as it becomes harder to fund and people stop fighting for it. I just hope it then follows a more Australian way of thinking and not a USA model where those in need can’t always access care.
Nursing-wise, Australia will continue to see a rise in drug related psychosis and violence that is becoming more prevalent due to methamphetamines (ICE is a huge problem here).
The NHS is an amazing organisation. The problem is, it’s very undervalued and underfunded. Logically, it is hard to fund a system where the money flowing in through taxpayers and government funding is a lot less than the cost of people using it.
With the NHS, there is a very British “Keep Calm and Carry On” attitude.
Staff run on goodwill, breaks are missed, nurses go home late, and if you’re sick, you would feel so guilty leaving the staff in the lurch, that you don’t. That’s the norm.
In Australia, the staff are supported if they’re overcome with work, you get told off if you don’t take breaks, and it’s very rare you don’t get home on time. The attitude is different.
You aren’t expected to work yourself to breaking point with little reward.
If you have a stressful shift you’re supported through it and it’s normal to debrief.
Nursing is a career here, as a profession and not a vocation where you can milk goodwill and fund a healthcare system on expectation. You are a nurse and you put yourself last.
There is an expectation you will be doing this job for the next 50 years, so they want to retain you.
No one is going to stay in a job if they have no money to feed their family, have no time to see friends and family as they are always at work, and feel constantly over worked and stressed.
Nursing is a highly educated and professional career, and that needs to be recognised through appropriate wages and conditions.
The NHS will improve when it is used as originally intended; a system that ensures those who are in need are able to access it.
The public system should be there for times of need, and not viewed as an entitlement.
In Australia if you earn over a certain amount per year, and don’t take the option of private health then you pay a small levy.
Same if you are over a certain age (31 years with no health insurance). For every year over the age of 31 that you don’t have private health insurance, the government add a levy of 2% per year for when you do take private health insurance. This will ultimately put your insurance premiums up if you take insurance later in life, thus encouraging people to commit early.
Also, to access an ambulance, or any sort of emergency transport, you must pay the ambulance service a yearly fee of approximately £50 a year per family. If not, you are charged the cost of that ambulance. In Victoria, it costs up to $1,174, and varies depending on where you live.
Do You Think That You Will Ever Return To The UK To Nurse?
Nursing is one of the reasons I wouldn’t want to move back to the UK. If I wasn’t a nurse, I’d be more open to moving back and settling down.
The thought of going back to a career where the government don’t value you enough to increase your wage to meet inflation or give you the safety of a set nurse to patient ratio fills me with dread.
Would You Recommend Nursing Abroad?
Definitely. Anywhere you work in nursing you will learn so much about the profession, pick up new skills and develop as a clinician.
If you choose to backpack in Australia or New Zealand, it’s a good way to earn money ($40-$100/hr depending on skills and experience). It is also a great way to meet people.
There are a few agencies that specialise in assisting backpackers and hold social gatherings. There’s always plenty of work, but you must be prepared for things to die down in summer, as a lot of the private hospitals stop operating over our summer.
This however is a great time to travel around. Some agencies will help cover the cost of your flights to Australia if you commit to working with them.
What Are Your Future Nursing Goals And Plans?
I work part time in a public ED and absolutely love it. I’ll continue here and gain my postgraduate certificate.
I also work part time for a medical device company providing education to clinicians on new products that are being introduced into hospitals such as a new infusion pump or a new intravenous cannula.
I love the education aspect, so would like to further gain confidence and knowledge, and continue down the education path as a clinical educator or facilitator at work, working with either students or newly qualified nurses on the floor.
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