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A Disillusioned British Speaks

Hello, I would like some advice. I am a registered nurse in the UK. I qualified in 2005. I was newly qualified, absolutely terrified and fearful of going into the clinical enviornment. I was expecting preceptorship and guidance, needless to say I did not get that and two years down the line my confidence has gone.

I would like to work in America particularly in California. I would like to ask how does one go about working as a nurse in the United States? I would like some advice would be grateful for any tips anyone is willing to give.

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7 Responses to “A Disillusioned British Speaks”

  1. Katie Says:

    It is great that you are interested in coming to the United States to work!

    Each State in the USA has a Board of Nursing. I actually looked up California’s Board of Nursing on the Internet and discovered that California also has a California Nurse Outreach website If you check out that website click on the link “Getting a Nurse License”. Then click on “RN” and then “International RNs”. There you should find information on the steps you need to take to obtain a license in California.

    Do you have any leads on a possible job? If not, when you are looking I would suggest calling the Human Resource Departments of the hospitals that you are interested in and ask them what orientation is provided for new-hire nurses. Keep in mind that there is a tremendous need for good nurses and if one hospital is not willing to provide the training necessary than keep looking for one that is.

    Hope this helps. Good luck!

  2. Kristin Says:


    Hope your move to the US goes smoothly! I think it will be really exciting for you and also a confidence booster in your skills working here as a nurse.

    I recently moved from one state to another and I needed a lot of paperwork to get a license in my new state of residence. As Katie mentioned above, every state here has different requirements and paperwork needs. So, I think if you refer to the website she suggested, that would be a good place to start. You may need proof of employment there in the UK, letter from your manager, college transcripts etc. But, I would start with the California website and see what info you need to gather. Also, no matter what state here, you can type in department of professional regulation and the state you are looking into and then it should guide you from there for the RN sections. Best of luck!


  3. Diane Kubal Says:

    Anyone who wants to practice nursing in the US must first sit for the NCLEX-RN exam. It stands for National Council Licensure Examination for RN’s. Also commonly known as state boards. Each state has their own procedures and requirements. If you want to practice in California, then I would refer you to the following web site: This web site has information and instructions on applying for the exam.

    In the United States, when you begin a new job as an RN, you need to ask your employer how long your orientation will be. For a new graduate nurse it should be a minimum of 6 weeks for a regular inpatient unit and at least 12 weeks for an intensive care unit. During your orientation, you will be assigned to a preceptor, who is an experienced nurse who practices on that unit. She/he will be responsible for teaching you what you need to know to function as a nurse on the unit. She/he will also be expected to evaluate your performance. You will start out with relatively “easy” patient assignments and gradually you will be expected to carry a heavier assignment. All of this is under the direct supervision of your preceptor. The preceptor is there to show you procedures, provide instruction and supervision of any skills you need to perform and answer your questions. You should also have classes provided by a “clinical educator” who will teach you about the most common disease processes and procedures that you will encounter on that particular unit. The clinical educator is responsible for assigning your preceptors and evaluating you during orientation. You can also use your educator as a resource for any questions or concerns that you may have.

    While you are in orientation, you should NOT count as one of the nurses in staffing for those days. In other words, if your unit needs to have 6 nurses assigned that day to take care of all of the patients, you are NOT one of the six. It should be 6 regular nurses plus you, assigned to your preceptor. You and your preceptor share an assignment. You may not have the same preceptor every day that you work. While that is ideal, it is simply not always possible. If you are having trouble with a preceptor, then discuss it with your clinical educator.

    Be prepared to feel overwhelmed! The real world is often very different that the world that you learned about in school. You will have more patients, sicker patients and will have much greater expectations placed on you, but you will be able to do it! There will be days when you may think, “Good God, what have I gotten myself into!!” But hang in there, it gets better. You will learn some difficult lessons and you will make mistakes. But you will learn from them and you will be a better nurse for it. Best of luck to you, and welcome to America!!

  4. Sharon Singh Says:

    Coming from the UK you will also need a work visa, I think you can find info on obtaining a work visa at Nurses may qualify for an H1B type work visa –depending upon how much schooling you had to obtain your nursing licencse. These visas are for people with specialized careers, so if you had 4 years of schooling you would probably qualify. I believe the other type of work visa is a H2B. The California board of Registered Nursing ( has a special site and packet for international application for the NCLEX-RN test. Good Luck, California is a great (if expensive) place to live.

  5. Amy Morton-Miller Says:

    The only other bit of advice I’d offer (in addition to the above) would be to check out websites of hospitals in the area you’re interested in living. Doing a web search of “hospitals in California” I found many listings, typically with internet links. Often, you can at least get a sense of a place just by looking at its website. Sometimes, you can even email a recruiter with the questions you have. Best of luck in your new adventure!

  6. Chris Ford Says:


    Just thought I would add a few comments. As a senior nurse in the UK I would advise that you prepare your self for the massive changes you plan to make. Begin by talking to nurses who have traveled from other contries to take positions here in the UK. They will be able to tell you how they felt and adjusted to life here in the UK. Whilst we share a common language with the US there is a massive cultural bridge to cross and you could find this may take a while.

    Start by joining an agency here in the UK. Each NHS tust will have a different work ethic and new ways of doing things. Take short jobs from different areas of the country and be away from home. This will build your confidence and give you a taste of something new.

    Finally don’t be afraid. We have all been there at some point. No one is perfect and however confident someone may appear they will also have their doubts and insecurities. Good luck!

  7. Joyce Glenny Says:

    Keep fighting the good fight.

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