These vacancies are filled by nurses from abroad. Newly published figures for 2021 and 2022 from the Nursing and Midwifery Council (NMC) show record numbers of overseas-educated nurses coming to work in the UK – almost half of all new registrations. We spoke to four of them about their experience of working in the UK.
Stephanie Padilla-Madriaga, critical care nurse, Surrey and Sussex Healthcare NHS Trust
Stephanie Padilla-Madriaga outside East Surrey Hospital, Redhill. Photo: Anna Gordon/The Guardian I landed in the UK from the Philippines for the first time on a freezing January day in 2016. I didn’t know anyone in the UK apart from some distant relatives in Northampton and Birmingham, and I had left my husband at home. Even though I had a degree in nursing, I had to pass a series of tests to work here, which cost me around £600. After this the trust sent me sponsorship documents and a one-way ticket to Gatwick. There is one more exam to pass in the UK, called the objective structured clinical examination (OSCE). This meant that when I first came here, while I was studying for it, I was working as a healthcare assistant, even though I was already an experienced nurse. The support that the Filipino community gave to my team after our arrival was very warm. They helped us with everything from preparing for the OSCE to figuring out the transportation system, which is culturally shocking for us. In the Philippines, we don’t follow schedules. If you want to take a transport vehicle, you just wave to him. I appreciate the way we treat patients in the UK with dignity and respect. I have learned to recognize dementia, which is still taboo in the Philippines and not treated as an illness. I saw the value of nurses, who help and support affected families. The only downside to moving to the UK is the way the government asks you for so much money. They ask you to leave your country and then you have to reapply for your visa every three years and pay £1,000+ in health charges during that time. After that, to get permanent residency I paid almost £3,000 and that’s an extra £1,000 for citizenship. We pay our taxes and we have to work hard for that money. Every now and then, I experience racism from patients: that we are taking their jobs, that we have to go back to our country. You should respond politely, saying, “I didn’t ask for the job. It was your fellow human beings who came to our country and asked us why they needed us.” And then there is unconscious bias. During the hardest part of the pandemic, a senior colleague told me, “You are strong enough to get through this,” and I felt like: because I’m Filipina, don’t I have the right to be stressed or struggle? The trust condemns racism and we have ‘Freedom to Speak Guardians’ among our colleagues who you can talk to in confidence. There were times during the pandemic when I questioned my passion for nursing. I was working in the intensive care unit, there were deaths left and right and I had to resuscitate patients. They all had PTSD and we were given psychologists and encouraged to talk about our experiences. Although it was difficult with staffing, in 2021 the trust let me go for a leadership secondment in the general medical wards. It has made me a better and more resilient nurse. I just got back into intensive care and I see the value in what I’m doing again. During the pandemic, I needed an outlet to express myself, so I started a vlog, Absolutely Stephanie, to help international nurses settle in the UK. My husband joined me in the UK in 2017. I am happy where I am.
Lucy Muchina, Regional Director for South West England, RCN
Lucy Muchina at the Royal College of Nursing. Photo: Adrian Sherratt/The Guardian I was educated in Nairobi, Kenya and came to this country in 1998 to further my studies. Back then we only did Diploma in Nursing in Nairobi but I wanted to do BSc. I was hired directly by a person who ran a care home in Bristol. I think I was paid £3.20 an hour, but if you come from a country outside England you think it’s a lot of money – until you get there and realize how many hours you have to put in to be able to do what you need. Before I could register as a nurse, I was paid about the same as a cleaner or laundry person – and you’re not given a timetable for how long you’ll be doing that. You’re stuck in a dark place. I had left a relatively good job in Nairobi, where I was a head nurse, so it felt like a big step down. Of course, there were cultural changes, but if there was one thing I really liked it was the elderly patients, who were very dear. Half the time, I’m sure they couldn’t understand what we were saying because of our accents, but they were great. We took the time to talk to them and learned so much from them, and taught them a few things about where we came from. It’s such a beautiful feeling knowing you can make an impact in someone else’s life in their time of need. I spent more than two years in care homes, then moved to an NHS job where there were opportunities to learn on the job and apply to local universities. My kids were young enough to be in preschool so it worked out well. I did my bachelor’s in health and community studies, followed by a master’s in public health, while still working as a nurse. At the time, there was NHS funding available for black, Asian and minority nursing staff to study to further their careers, so I jumped at the chance and later joined the public health team in Bristol, where I worked for several years before progressing into clinical area assignment group. Equality is an area we need to work on. We are doing ourselves a disservice if we do not acknowledge and recognize that nurses come to the UK with much more to offer than we expect. This may sound frustrating to new recruits, but it will take five years to feel like you belong and not keep wanting to pack your bags and leave. But I have thoroughly enjoyed my experience here. Sharon Sandersing at her home in Luton. Photo: David Levene/The Guardian
Sharon Sundersingh, senior, Luton and Dunstable Hospital
When I was 26, just after my first wedding anniversary, I traveled alone to the UK. I am from Tamil Nadu in southern India and came here in 2009 after Luton and Dunstable hospital had come to India to recruit nurses. I had a degree in India and trained in one of the best college hospitals in the country, but back then doctors were giving orders with little input from nurses, so I thought it would be better to explore outside the country. I have stayed with the same employer here all these years and luckily my husband, an IT professional, was also able to find work with the trust. Back home, there is a very different picture of what life in the UK will be like – that you come here, earn money and live a life of luxury. You tend to have obligations to send home support, so when a lot of nurses come here, all they do is work – regular shifts plus overtime. But they must also live their lives here and advance in their careers. I am a member of the British Indian Nurses Association (BINA). we run workshops to help people apply for jobs and learn how to perform in an interview. Most of all, patients are happy to see an international nurse. We are liked and appreciated, but you get comments that hurt sometimes. Once, on a ward with mostly black and Asian nurses, a man said: “I’m in the middle of a foreign jungle with all these nurses here.” They call us names like “brownies” and say, “Go away, I need a different nurse.” But we think, “Okay, they’re not in good health, they’re not in a good state of mind.” You also get a lot of appreciation and recognition as people recognize that you’re worried because you don’t know what’s going on at home during the pandemic while you’re here supporting them. During Covid, trusts have tried to be supportive, but international nurses tend to keep things to themselves. BINA has representatives all over the country and I think the Philippine Nurses Association also made an effort to talk to nurses so that the trusts can help them solve their problems. There are many international nurses here who do not have NMC registration and are still working as healthcare assistants because they failed to clear the English language requirements. Why is NMC not harnessing this workforce? Meeting these requirements is cheaper than hiring someone from abroad. But I would recommend coming to UK as a nurse. The NHS is a very good place to bring your skills and knowledge and explore and learn new skills – it gives and takes.
André Santos, Registered Administrator and Learning Representative, Suffolk Branch Chair and Eastern Region Council, RCN
André Santos in Stowmarket, Suffolk. Photo: Si Barber/The Guardian It’s been 11 years since I came to work in the UK, with all my dreams in my bags. I was a registered nurse in Portugal but, like most Eurozone countries at the time, we were in recession. Many of my generation could not find work and decided to leave. It was a leap of faith, but the UK had a good track record for career development for…
