I remember the first time I laid my eyes on my employment contract in one of the NHS hospitals and saw a whopping £21,500 per annum! I thought I hit the jackpot! I will have 1.6 million pesos yearly or 133,000 Pesos per month! I wouldn't have to worry about money and would be rich. Working as a nurse in the Philippines who earns 15K pesos per month, I thought I would make eight times more if I worked in the UK.
The excitement of seeing my contract for the first time was the exact opposite when I saw my first payslip as a UK nurse. After the bills, rent, council tax, other deductions, and income tax, I was left with £300. And that's when I thought my expectation was far different from reality.
Don't get me wrong. The UK is a great place to be a nurse, and there are lots of opportunities, career development and overall a more comfortable life. The salary is still way better than what I get in the Philippines, but my expectation that I will be rich and earn millions of pesos hit me hard when I experienced the cost of living first-hand. Aside from my earnings, some things didn't match my expectations. It was only in my head, and I needed to come to terms with the reality of working and living in the UK.
Let me share what I expected before coming to the UK and what it really is to be a UK nurse.
1. UK hospitals are all modern.
I envisioned all the hospitals in the UK to have a modern architectural feel, luxury rooms, a sort of private suite and all high-end equipment. I was surprised to see that patients in the ward stay in bays, female and male, with a few separate rooms, called side rooms, which are used if the patient needs isolation due to infection risk or immunocompromised.
Having to work in a private hospital, I have used some equipment that is more modern than here in the UK. I'm not saying all of it but some of it. Undeniably, hospitals in the UK continuously invest in high-quality gadgets to improve efficiency and patient safety.
Even if hospitals in the UK are not all modern, they always strive to provide the best care to patients. Every hospital and staff should meet the standards set by the governing bodies and revolve around the clinical governance model to maintain quality service.
If working in a modern hospital is really important for you, research the hospital or Trust that you have been employed at and check whether their services and facilities meet your expectations. At the end of the day, the human aspect of nursing is more important than any machines and equipment that we have in our area.
2. The Healthcare Assistant (HCA) or the patient's relatives will handle the patient's personal care.
In the Philippines, relatives usually stay with the patient throughout their hospital admission. They help with patients' personal care, such as bathing, grooming, and feeding. We also have hardworking nursing assistants who tend to patients' individual needs and provide interventions delegated by the nurse.
NHS patients usually stay in bays (although private patients get their own room), which means visiting hours are very limited. Even if relatives are around, personal care is carried out not only by the HCAs but also by the nurses. This is not limited to aspects involving personal hygiene but also continence management, catheter care, dressing, toileting and anything that maintains patients' dignity and well-being. Nursing in the UK is all around.
Time management is a critical skill you must learn to work here in the UK. You may have at least eight patients, and it could be more if your department is facing staff shortages or sickness on the day. You still have to fulfil other duties such as implementing patients' treatment plans, administering medication, monitoring vital signs and tending to patients' physical, emotional and psychological needs.
Even though tending to a patient's personal care is an additional task to the mounting duties that a nurse must do in a shift, this is also a great time to build rapport and relationship with the patient and perform a physical assessment that can aid with managing their condition.
Undeniably, patients are grateful for the holistic care that nurses do daily. As the quote goes, "People will forget what you said, people will forget what you did, but people will never forget how you made them feel."
3. I will be rich quickly when I become a UK nurse, says who?
Not quite. You will earn more as a nurse in the UK than in the Philippines, no doubt about it! But you have to remember you will be spending Sterling Pounds ££££ for your rent, bills, taxes, services, and leisure activities. Going back to my story, my contract's £21,500 annual salary is before tax. Even if I converted it to more than a million pesos, I wouldn't have saved anything if I mindlessly spent and didn't stick to my budget.
The best take on this is, do not convert to pesos! You have to set a budget or a goal based on the expenses you have. Bear in mind that different places in the UK have varying costs of living. Some areas may be higher than others, and depending on your desired lifestyle, you can decide where to stay after you get settled and have adapted to life in the UK.
Being financially stable is not impossible if you're a nurse in the UK. We're living a much more comfortable life, and I wouldn't be able to have the things that we have if I were a nurse in the Philippines. But apart from working hard for extra shifts and side hustles, we're disciplined with our money. We set a budget, stick to it, monitor our income and expenses, save for an emergency fund and invest it for passive growth. No matter how much you earn, money can disappear in the wind if you're living above your means. Always remember that it's not how much you make but how much you keep.
4. More overtime and extra shifts don't always mean more money.
Overtime and bank shifts are the shifts you can do on top of your substantive post on your days off or annual leave. If you're on a Tier 2 visa, check the restrictions and guidance before you "work hard, play hard". Yes, you will earn extra money, but bear in mind the tax laws here in the UK.
You will have a personal allowance of £12,570, which is part of your income that you do not have to pay tax, and it's all yours. The next £37,700 is taxed at 20%, and most of us fall in this category as a basic rate. Add those two, which sum to £50,270. If you earn more than this, the next earnings bracket will be taxed 40%.
So be sure to weigh the implications of extra work that you will be saying yes. It might be worth recharging yourself and spending a day for a well-deserved rest and self-care rather than working straight seven days for a few pounds after tax.
5. Being a nurse in the UK is not all glamour and prestige. It is hard work too.
Filipino nurses often choose to work abroad due to low wages, lack of benefits and career progression in the Philippines. With the demand for nurses in first-world countries, working on greener pastures is not impossible. The United Kingdom being one of the "dream destinations" for Filipino nurses, I thought work would be easy without struggling.
Adapting to a new country with a different culture and work life can be hard in itself. You have to navigate ways to survive and thrive in your area. You must be brave and believe in your abilities because I'm telling you it won't be easy AT FIRST! But as you learn the norms, policies and procedures at work and build a routine, it will get easier, just like any other job.
Nursing is generally an active job and can be physically, emotionally and psychologically taxing. Ward nurses may have more patients than the recommended nurse-to-patient ratio, and care home nurses may experience more. It is arduous because you have to keep everyone safe and receive quality care at the same time. On top of that, you also have to make sure that your Continuous Professional Development (CPD) and mandatory training are up to date, not to mention your life outside work!
Every Filipino nurse in the UK probably has started as an entry-level nurse. But you can always progress in your career up to the top of the ladder as you build your confidence and competence in your area. There are lots of transferable skills that you can acquire as you practice as a nurse in the UK, so you don't have to settle in one area as well. I think that's the best thing the UK can offer the nurses. They can explore different specialities, and a robust training system is in place for those without experience in that area.
These are all the realities of being a UK Nurse, and I wrote this not to discourage you from working as a nurse in the UK but set a realistic expectation to avoid disappointment. The UK is a great country to build your experience as a nurse and have a comfortable life. All you can do at this point is to focus your energy on what you can do to have the better life that you imagined. Now that you know what to expect, are you ready to face the realities of being a UK Nurse?