Working in the UK as an internationally-educated nurse (IEN) comes with its nuanced challenges, with career progression often obscured not only by the cultural and hierarchical barriers inherent to any organisational setting but also by myths and misconceptions surrounding it. I aim to demystify some of the prevailing misconstructions regarding professional development, in order to empower IENs to navigate their career pathways with confidence and clarity and forge a path to a more inclusive and diverse nursing workforce.
Many IENs bring a wealth of experience from working abroad, whether in their home countries or elsewhere, before coming to the UK to join the NHS, private hospitals or the social care sector. Despite qualifications and expertise, experienced IENs are often treated as new staff, as reflected by the current recruiting practices. Many NHS trusts place their IENs at the default lowest spine point of Band 5 regardless of overseas experience. This manifests the systemic undervaluation of IENs and undermines the rich contribution they bring to the NHS workforce. This practice fails to recognise their true value but also perpetuates a negative self-image among IENs as their salary falls short of reflecting their skills and competence.
Many IENs may believe that on joining the NHS or wider health and care sector, immediate career progression could be challenging. Although this could be true, leveraging your overseas experience that corresponds to the requirements of the job is crucial when applying for a more senior post. Nursing skills, including management or specialist roles previously taken on abroad, are readily transferable within your work setting. It is important to not see yourself as ‘new to care’ but as simply acclimating to a new work environment. Once you have familiarised yourself with the policies and routines, you could seize opportunities for advancement when they arise. Developing confidence in your expertise and embracing the potential for growth are pivotal steps in progressing your career.
Having that confidence and belief in yourself is indeed a crucial first step, but this needs to translate into the job application itself and convince the hiring manager that your skills match the job. As an IEN new to the hiring culture in the UK, it is crucial to identify skills and expertise from overseas experience that correlate with the requirements of the advertised position. In many countries where nursing is a generalised practice, registered nurses can work across all specialties and different fields, distinctions in titles and roles become blurry, and responsibilities may often overlap. Thus, IENs need to develop awareness and assign value to roles and duties that often have no formal title back home but were constantly practised or may have been practised within their professional career. These seemingly small yet important details can make a huge difference to your job application in the UK. Articulating such capabilities, both in writing and verbally, can increase your chances of securing the job.
Many IENs demonstrate high levels of language proficiency; in fact, there is a strict English language requirement to register with the NMC. Thus, the challenges in communication do not stem from language competence but from ensuring that the intended message is accurately conveyed and understood without being lost in translation. Communication practices and behaviours are deeply rooted in cultural contexts, and misunderstanding these subtle yet vital differences can pose significant hurdles, both for IENs and the broader working environment. Thus, effective communication strategies and interview skills tailored to IENs are paramount. This includes not only adapting to the nuances of communication norms in the UK, but also understanding the differences between hiring cultures and expectations and effectively showcasing the transferability of skills gained from previous work experience so that they can position themselves for success.
Accessing diaspora networks such as International Nursing and Midwifery Associations (INMAs) can be instrumental for IENs seeking support and resources. Many INMAs facilitate bespoke seminars and training opportunities. For instance, the Filipino Nurses Association UK provides professional development programmes and interview skill workshops designed specifically for IENs to help them with career progression. By tapping the resources that INMAs offer, IENs can develop a deeper understanding of the intricate and dynamic job application process, from writing a CV to accepting a job offer. More importantly, these programmes equip them with the essential skills and confidence to successfully navigate interviews and career advancement within the UK healthcare system.
Furthermore, numerous routes are available to IENs for career development within the healthcare sector. Contrary to popular belief, career progression in nursing is not only confined to roles such as charge nurse or managerial positions. Other career prospects for advancement include roles in education, research and specialist nursing practice. These alternative pathways open doors for IENs to discover and excel in areas that align with their strengths, interests, and aspirations. Opportunities for growth are abundant for IENs and are often not linear. Progression is not always about climbing a ladder or moving to a higher band. It could be redefined as investing in continuing professional development and acquiring specialised skills relevant to your scope of practice.
Also, visa sponsorship is often a significant concern for many IENs navigating their careers in the UK. Although Tier 2 work visas for IENs can pose certain restrictions, it is imperative not to let these impose restrictions on progression or career transfer. Organisations such as private practices, higher education and research institutes also offer visa sponsorships. While being aware of some implications, such as buying out a contract or repayment of fees, IENs can explore transitions between sectors – moving from the NHS to private health care or social care, and vice versa. This possibility paves the way for diverse career trajectories, permitting IENs to pursue opportunities that best suit their professional goals while still satisfying visa requirements.
In conclusion, the journey for IENs is marked by its nuanced challenges and myths regarding career progression. However, I hope I have highlighted the importance of recognising the value of overseas experience and leveraging it in job applications. Career advancement is not linear, and IENs should consider opportunities in specialised roles within current work and beyond. By dispelling misconceptions surrounding visa restrictions we can promote the possibility of mobility across different organisations. INMAs are worth exploring for external resources and support with skills needed for career progression. A deeper appreciation and understanding of career pathways for IENs should enable them to navigate their professional careers more confidently and thrive within the healthcare sector in the UK.