International Nurses Culture Shock

I could not have been any less prepared for the expat experience than I was, and I certainly didn’t expect to experience any culture shock. This naivety caught me off guard because like many others I am sure I thought it would be so like Australia that we would slide right into life here in England. Of course, the challenges of integrating into a different culture is difficult enough, but this lack of insight to what it would really be like perhaps created a greater sense of displacement than any of us expected.

I am not the only one who believed that the differences between life and work in Australia and England would be minimal, but the inference from people working in the health care sector that my experience of culture shock is negligible was disheartening. It felt dismissive to have our experience invalidated by the very people who should be seeking to encourage and embrace others to make the move also. It certainly is no small feat to leave a way of life, a history, a family, a social network, and a structure of working to embark on the expensive and emotional journey to building a life abroad which is why I wanted to share some of our expat experiences now.

I grew up, trained, and raised a family in a place that was small, community-minded and encompassed year-round lifestyle living by the ocean. As a nurse I was paid well and being a nurse was all I really wanted to do. We moved to England not to escape this but to watch my nieces and nephews grow, experience nursing in a different country, and to make use of the proximity to Europe for travel. We found that once we caught our breath here in England, the experience was very different for many reasons.

There are so many differences that have been surprising both in my nursing life and my personal life that I had not anticipated, and the collective impact of these has had a direct impact on my experience here. I could go on forever about these but will stick to those that have had the greatest impact on both myself and my family.

We were only going to stay for a maximum of three years so our temporary mindset would surely have had an impact on the way we have integrated, we didn’t know how much to invest into this life with the knowledge that we would be going back home. I know the jury is in about the importance of social engagement and psychological wellbeing. This is the one thing I would change if I had a do over, I would have invested more into friendships and would have joined more community events in a bid to create that sense of home here. The difficulty we have found is the insular nature of the community in which I live, both myself and many other families I have spoken with said this has been the most challenging although it appears not to be the same for younger people and those with younger children. I do believe that having a larger Australian expat network in our area (with families of similar ages) would have almost negated this, and we have been lucky to meet another Australian family even if they do live quite a way from us.

The cultural differences here that really surprised us here is how much people try to avoid offending others even if “telling it like it is” is needed in a particular situation. Of course, I am generalising, but this differs from the way Australians communicate in that we are often honest to a fault and not easily offended. I do find it interesting to see how resilient people present themselves here in the UK but wonder how healthy that “stiff upper lip” is in the long run?

The lifestyle differences included the move from an incredible outdoor lifestyle to one where the summer is too short and the winters too dark, leading to a massive change to the outdoor activity we were used to. No more swims in the ocean in the afternoon after work, no more regular mountain climbs, no more long walks all year round and certainly no more spontaneous beach BBQs with a bunch of other families. Although we tried the whole gym life, we did miss the outdoors and random conversations with strangers on our walks and how embedded that lifestyle was in our everyday.

The physical differences shocked us the most however as we began to understand more about winter blues, and the hardness of the water sent my girls nuts with dermatitis. The taste of food here was surprising including all the fresh produce, I have spoken to many of my colleagues from warm climates around the world who have also noticed this difference – lets be honest, there is nothing like a mango from Bowen! Accessing healthcare here in a timely fashion has also had a massive impact on my personal health and being bound by the 37.5 hour working week in my visa has made it difficult to take the time I probably needed to heal and recover in the way I should have.

There are other differences too that have been surprising and in particular nursing, because I thought nursing was nursing no matter where you were in the world and whilst that is somewhat true, the differences are greater than you expect. I had worked in a renal unit for the four years preceding our arrival, only to find I had been put in a totally different area of acute care. I arrived with very little induction, different terminology, reporting systems (which are exceptional here by the way), and nursing roles but the biggest shock was the risk aversion, excessive paperwork, and the level of blame culture particularly heightened by the media.

WE ARE ALL NURSES. WE ALL MATTER.

I am not sure I have been able to fully capture the whole picture in this post and some challenges I am bound by confidentiality to withhold, but what I do know is that cultural identity an important factor in self-worth no matter what country you come from. The UK is an incredibly diverse place when you look at the vast number of countries its citizens and residents originate from. To respect and embrace every culture goes a long way to building global intercultural understanding and continue to build better ways of supporting internationally trained nurses to flourish and enjoy this experience.