“Sometimes it’s best not to know what you are up against; if you are acutely aware of the challenges involved, you’d never do a damn thing. Being clueless is weirdly empowering.” Geraldine DeRuiter.

I happen to disagree. Unless you’re talking about childbirth and colonoscopies.

Nursing is a unique profession that faces a broad range of challenges no matter where you are in the world, and although the nature of nursing is the same, the experiences of nurses in different parts of the world can be vastly different. It is these differences that can lead to assumptions about other health systems, nurses from different places, and mismatched expectations. For these reasons it is important for any Internationally Educated Nurse (IEN) to use the interview process as a tool for making an informed decision.

Interviews are frequently seen as the chance for the prospective employee to share the best of themselves and to sell themselves as the best candidate for the job. This puts pressure on them to put only their very best foot forward to ensure they are successful and get the “perfect” job or opportunity of their dreams. I’m not sure I felt too much of this pressure when applying for a job as an expat and perhaps this is more to do with the fact that I had only heard about the UK Nursing Fair a few days prior so wasn’t expecting any outcome from attending. I do remember feeling this pressure when I first graduated university *many* years ago, and the significant fall in graduate program positions that year made it even more important to succeed at interview.

In my own experience interviewing Internationally Educated Nurses to come and work in the UK, I find that many are not necessarily prepared for the end of the interview where they are asked “do you have any questions for us?”. I know I didn’t have a huge amount of questions either when I interviewed, and looking back I wonder why I didn’t put a great enough emphasis on this. Is it because interviewees are not allocated an appropriate amount of time to ask these questions and they just aren’t sure what to ask, or is it more to do with the idea that the potential employer holds all the power whether intentional or unintentional?

I do believe that both employer and potential employees try to put their best foot forward with the very best of intentions and now that I have been on both sides as expat nurse and interviewer, I feel that this needs to change to allow for the realities of the expat journey and experience to be shared so that people can make truly informed decisions. If you are a nurse considering expat, I will share below questions I wish I had asked before I accepted my offer – after all, interviews should be mutually informative.

ACCOMODATION

1. Can you please tell me what accomodation support is offered?
2. What challenges do IENs face in relation to rentals and affordability?
3. What will happen if I am having difficulty finding accomodation?

OSCE

1. Do you have an OSCE training program?
2. If so, when will the OSCE training program commence after my arrival and how long is it?
3. When will I be eligible to sit the OSCE test and what are my financial obligations?

LEAVE

1. I understand I will need to request annual leave, how can I ensure that I get a fair chance at taking holidays in my first 6-12 months knowing that established staff will have already requested leave?
2. I may want to return home to visit family, how long can I take off at any one time for annual leave?
3. If I become unwell, am I entitled to sick leave and what are the expectations regarding this?

NURSING

1. What are the expectations of my role at each stage of my progression: arrival, NMC PIN, supernumerary period, preceptorship period?
2. How soon will I be expected to be in charge of a shift?
3. How soon will I be expected to do night duty and how often?
4. What additional expectations will be set: teaching others, link roles, additional training/competencies?

FINANCIAL

1. What costs are involved in working in this organisation: travel, parking, uniforms?
2. What is deducted from my pay: tax, national insurance, pension?
3. How often will I get paid and when does this occur?
4. What does progression look like and will my years of experience be recognised in my pay award?
5. Can I review the contract prior to accepting the offer – what is included and what are my obligations?

CULTURE

1. What are the current staffing challenges in the organisation and area I may be allocated to?
2. What does staff support actually look like and how easy is it to access?
3. What challenges are your current IENs experiencing?
4. If support has been provided to IENs facing these challenges, has this resolved them?
5. Can you share an honest opinion/experience/knowledge about the current culture within the organisation?
6. If there are current cultural challenges in the organisation, how are they being addressed?

Hindsight really is a wonderful thing and with four years reflecting on my experience, I would certainly have asked all these questions and more before accepting an offer to work in the UK. I would have still made the same decision, however having all the information would have ensured I was both prepared and that the timing was right for our family. Knowledge is power and we each have a responsibility to seek out information and ask for support in identifying the “you don’t know, what you don’t know”.

If you are an expat, what would you have done differently?

Cheers From Kent, Tams!