My husband and I just moved to the UK from the United States. I’ve been a nurse in the States for 5 years and just started working for the public health care system in the United Kingdom. From day one I’ve tried to keep a collective list of nursing and healthcare differences in the UK.  For all you medical people out there, I thought you might find this intriguing! Here’s what I got so far!

1. NHS

The UK’s public healthcare is the National Health Service founded in 1948. When I started working, I was surprised that I did not have to clock in and clock out with my badge. I just get paid for my 37.5 hours a week. I would get paid more obviously if I wanted to work overtime though. When you pick up an extra shift, it’s referred to as a “bank shift”. On the other hand, if I stay over at the end of the day, I do not get that time added to my paycheck but recorded in a log book. When I have time accumulated of working extra I can use that time to leave early.

2. Adult, Child, Mental Health vs. Learning Disability Nurses

When you go to nursing school in the UK, instead of rotating through all of these specialties, you choose one of these before you apply. The degree is 3 years here. You do not have to go to nursing school first before you apply to the midwifery program either.

3. A&E

Accident and Emergency. This would be our Emergency Department.

4. Theatres

The Operating Room. Be sure to check out more detailed OR differences from a post here!

5. Ward

A ward is a nursing floor. Most of the wards are set up like Pre-op or PACU areas at home with only curtains between the rooms. There is a newer ward at my hospital that has individual rooms though. Where I work, the wards are named after villages around the area. I think this is cute, but it does not help identify what type of ward it is. Some examples of the names are Copthorne, Buckland, Abinger, Nutfield…just to name a few. But who would know that Buckland is a Urology unit?!

6. Sisters and Matrons

There is a hierarchy of nurses here. I am a Band 5 level nurse and if you have a registered nursing PIN, that is where you start. If you are a Healthcare Assistant/Nursing Assistant, you are a Band 2 up to 4. The bands go up to 9. When you get to a band 6 you are a “Sister”. So one day I could be Sister Brooke! I still get confused by most of it honestly. I do know that the Sister term comes from when nursing care was done by nuns. I asked a male nurse if I should call him Brother, but you don’t have to say anything in front of their name. They are just referred to as a Charge Nurse. On the wards, your uniform changes based on what Band you are.

7. Tunic and Trousers

Sporting the tunic and trousers uniform.

Nurses don’t wear scrubs but call them tunic and trousers! You can also choose to wear the dress version. With the NHS, the hospital provides you with your uniform. I think this is pretty awesome. I was provided with 2 sets of the nurses uniform only, because I work in the operating room. We wear a different uniform that are the same scrubs from home and washed in-house. When you work in theatres, the first pair of shoes are given to you by the hospital too! I chose the style and size from a catalog.

8. Observations

Vital signs. You get “observations” on a patient, not vital signs. “Can I just get your observations?” (Try out saying this in your best British accent)

9. Male Catheterisation

Nurses in the UK don’t receive nursing school training on male catheterisation. To be able to do this, you must take a course given by the hospital. (Yes, the “s” in catheterisation is on purpose 🙂 )

10. Milliliters

This is the same as the US, but you don’t hear people saying “cc’s” for a measurement of fluids here. I have said this a couple of times from habit. It’s usually commented on if I say it and only heard in American TV shows.

11. Stones

Stones conversion chart.

A unit of measurement for the weight of a patient, even though kilograms is the proper one to use. I even received a conversion chart when I started here because it’s what patients and staff know. 1 stone = roughly 6 kilograms. “I gained half a stone in just one week.” is a phrase I heard once…how strange is this?

12. BM

This does not mean “bowel movement” here! It is “blood monitoring” which they are referring to a patients glucose levels.

13. Inco Pad

Short for an incontinence pad.

14. Brooch Tunic Fob Watch

Example of what a tunic fob watch looks like. The bar clips to your shirt and hangs down.

No wrist watches allowed, but a watch that pins to your tunic (shirt). This is for infection control as the wrist watch can harbor bacteria.

15. CPR

It’s not the standard to check the parotid pulse when it comes to the CPR sequence. The rationale is that, you can waste time by trying to find it, so it’s best to start compressions if you find someone unresponsive and not breathing.

16. Paper Charting

It’s not completely all paper charting but a majority of it is! The NHS is working towards electronic health records but it’s a slow process here. The medication administration is paper charting as well. This makes me glad I work in theatres.

17. Cannula

This is what they refer to as an IV. “Do they have a cannula?”

18. Starting IV’s

When you are hired by a hospital, you also must first take a IV course before you can start any cannulas. The one at my hospital is 2 days long, followed by a test.

19. Drug Administration Test

More tests! When I applied to the hospital, I had to pass a drug calculation test before they offered me the job. This is true for everyone and other hospitals in the UK. When you are hired, you take another one before giving drugs! I work in the OR though, so I did not have to take this.

20. No Stethoscopes

Using a stethoscope is not a part of the nursing assessment here unless it’s in a specialized area I believe. It’s the doctors that mainly do this.

21. Nil by Mouth

Means “NPO”. Don’t even try to say NPO, it won’t make sense here.  The sign that is hung on the bed or door is NBM. Another question they ask before a patient has surgery is “Has the patient been starved?”. It’s just a way to ask if they have been NPO for the right amount of hours before surgery.

22. Hospital Accomodation

Many hospitals provide on site accomodation. They aren’t literally connected to the hospital, but close by. The idea reminds me of nicer dormitories at college. Marvin and I would have gone with the couple accomodation but there was a waiting list, so we decided to find our own flat.

23. Hospital Library

Hospitals have libraries too! I think this is really cool. I’ve been reading the Call the Midwife collection that was made into a major BBC TV series (you can watch on Amazon Prime!). It’s about the life of a midwife in 1950’s London’s East End and real stories of her encounters.

24. Hospital Trust

Term for some NHS hospitals. It’s common to just refer to a hospital here as a “Trust” for short.

25. Supernumerary

What they call nurses that are on their training because they aren’t supposed to be counted in the staffing numbers. If you work on the wards, this is only 2 weeks.

Don’t forger to check out a list of differences specific to the Operating Room! Leave your comments and let me know your thoughts of these so far, I’d really love to hear!

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