Posición del Estado de Derecho Constitucional

There were three main differences that IRNs commented on between the UK system of health care and those of their home countries. The first was the level of bureaucracy that IRNs experienced as intrusive and demoralising (this is explored in greater detail in chapter 9). The level of bureaucracy related to the experiences presented above where IRNs felt that British nursing was more restricted in its scope of practice and by its legal framework. It also reflects their perception that British nurses did not focus on the patient and the following quote is another example of how IRNs understood this as a concern with the system rather than the patient:

My whole thing with nursing here, that the person that they’ve forgotten in the whole thing is the patient. They are so busy worrying about whether they’ve got the qualifications or whether you should do it, or whether you shouldn’t do it, that they’ve forgotten about the patient who could have been waiting for two days to have a cannula put in so that they can have antibiotics, and so they lose sight of the sense of it all. I mean, I just feel that they need to be refreshed in that area because they built up the Commonwealth on common sense and it’s gone in professional jealousy. We wouldn’t be here if they didn’t need us, but we are also here because we want to be here, you know what I mean, and we want to add, like you said, we also want to share our wealth of experience.

(female, 40 years old, Zambia, black, E grade)

The second difference was in care of the elderly and the different types of disease profile of patients encountered in the UK. It appears that for the African and Philippine IRNs, there is no tradition of caring for the elderly in care homes and IRNs were unaware of this form of care before coming to the UK. Often they were not clear before arriving in the UK that this group of people would be the focus of their care:

Yes, there are some of the things that I did not know, but I have experience, for an example we are not working in the old age home in South Africa, most of the time we are working in the hospitals, but here I started working in the nursing homes nursing the old people. What I experienced there it’s just exactly like in the book, you know, you must be patient when you are dealing with these people because they are old and they are, their movement is very slowly and you have to be very patient with them and most of ……they fall and then we are to, we have to use the hoist. (female, 53 years old, Nigeria, black, D grade)

We don’t have nursing homes, so I don’t know about (these). I wanted to work with the elderly though

(female, 46 yeards old, Ghana, black, G grade)

One IRN commented that learning about diseases previously only studied in textbooks was a challenge that she had coped with:

Even if you think about the illnesses, the common illness back home and in

developed countries are different. I had to face a lot of problems in this country even ….like back home we don’t do ECGs. These are the basic things in this country. (female, 40 years old, Ethiopia, black, D grade)

The third difference was resources. Some IRNs were used to nursing with fewer resources in their home countries than in the UK while others had experiences with better equipped nursing environments. African IRNs were not used to having the resources which were available in the UK, as these quotes suggest:

But I must say there are a lot of other that are not available at home like supplies and equipment that I’m exposed to that I’m learning to use, which I wish I could have had. My patients at home need those things. I’m getting experience as far as that is concerned and I wonder whether when I go back home will my government supply ……back home?

(female, 52 years old, South African, black, D grade)

If somebody needs urgent treatment it’s there, if they need urgent transport to hospital it’s there, if they need whatever, they need to be transferred to another hospital it’s there, if they need, you know, the cardiac monitor, is there. That gives me contentment, I really love nursing and I’m really loving it

(female, 47 years old, Zimbabwe, black, D grade)

I’m from South Africa and worked in you know the rural hospital and in black rural areas, the equipment is not adequate

(female, 53 years old, South Africa, black, D grade)

For the Australians, Europeans, Canadian IRNs and those IRNs who had experience of working in Saudi Arabia and the USA, it was the distribution of relatively restricted resources in the UK compared to their home countries, and the amount of resources combined with perceived poor standards, which was surprising.

I come from the Ukraine and our system is 60 years back from what it is here …very old-fashioned and how old the equipment is and educational needs…I was just shocked, I think Sainsbury’s is cleaner than any hospital you have and it’s absolutely shocking

You try and save everybody in a country where there’s not a lot of money. You save the ones you can and the rest you treat with dignity and just let them die…..there are not unlimited resources. When I got here and money was spent on patients who were never going to survive, it was like money was being poured in and you knew it was never going to be …. And the waste, the general waste

(female, 30 years old, South Africa, white, E grade)

A place which has an NHS and all the resources I don’t know why people wait for 6 months…It’s frustrating because there are the resources it’s not as if you have got to negotiate that money

(female, 52 years old, South Africa, white, E grade)

Conclusion

IRNs’ frustrations with nursing in the British system of health care were a complex mixture of prior expectations of the UK which were unmet by their experiences. Rather than contributing their experience and feeling valued for that contribution IRNs were surviving in an

unsympathetic environment. IRNs’ feelings of their treatment in Britain are summed up in the following quote that illustrates the frustrations many IRNs felt:

And fair enough, we’ve got a lot to learn but we’ve also got a lot to give. If they give us credit for what we do now, instead of being threatened by us and of just saying ‘Well, what would you know, you’re just Africans?’ Because they think we’ve got lions prowling around outside the theatre

(female, 55 years old, Zimbabwe, white, E grade)

The next chapter further explores how IRNs interpreted the experiences described in this chapter by presenting IRNs’ feelings of discrimination in the context of British health care and British nursing.

9. Discrimination – colour or culture

In chapter 8, we presented a picture of IRNs surviving in an unsympathetic environment rather than contributing their experience and feeling valued for that contribution. In this chapter, we discuss how IRNs interpreted these experiences as discrimination and racism and many IRNs expressed anger over how they had been treated in the UK. However, as

discussed in chapter 7, these experiences were balanced by IRNs’ desire for recognition as trained nurses, appreciation by British nurses and the wider health care system and a desire for trust to develop between UK nurses and IRNs. While this might seem an optimistic conclusion, we do not mean to diminish IRNs’ wishes for their racist treatment to be shared with the wider nursing and general public and for this to lead to better treatment of IRNs.