From Kerala to Manchester: my first 18 months as an NHS nurse

The trust paid for my flight, the OSCE, my first month of accommodation and the visa. In return, I signed a contract saying I would repay part of the costs if I left within two years.

The OSCE

This was the most stressful part. For eight weeks, I worked as a band 4 pre-registration nurse while preparing. The trust provided a training programme with mock exams. I passed on the first attempt, but several colleagues needed a second attempt. The practical stations are very specific. You must follow the UK way of doing things exactly, even if you have done the procedure a thousand times.

Pay

After passing, I started as a band 5 staff nurse at around 29,900 pounds a year. With night shifts and weekend enhancements, my monthly take-home pay is around 2,100 to 2,300 pounds. Rent for my one bedroom flat in Salford is 875 pounds.

The work

Nursing in the NHS is very different from what I was used to:

• Documentation is much heavier. Every action is recorded.
• Patients' autonomy is central. Patients can refuse treatment, and I must respect that.
• Staffing can be very tight. Some shifts I had eight patients with complex needs.
• Team culture is less hierarchical. Junior nurses question doctors, and that is encouraged.

My ward manager was supportive and gave me an experienced preceptor for the first six months.

The difficult moments

• My first winter night shifts were exhausting
• I felt isolated during my first months. My husband joined me after eight months on a dependant visa
• Some patients made comments about my accent. Most were kind, and my colleagues always supported me

The rewarding moments

• Being trusted and respected as a professional
• Continuing education: I have completed a course in wound care, paid by the trust
• A large Malayali community in Manchester. We celebrated Onam together with over 200 people

Advice for nurses considering the NHS

• Prepare seriously for the OSCE, and practise with the official marking criteria
• Read your contract carefully, especially the repayment clause
• Check which band you will start in and when you will move up
• Ask about accommodation support and relocation costs
• Connect with nurses from your community who have already moved. They know which trusts treat international nurses well

I am glad I came. I am now thinking about specialising in theatre nursing, and hope to apply for indefinite leave to remain when I become eligible.