As an assistant director of nursing in Nigeria, I never imagined I would find myself starting over in the UK. Yet here I am, sharing my journey and shedding light on the often-overlooked costs of nurse relocation. This story isn’t just about me; it’s about the thousands of internationally educated nurses (IENs) who make the life-changing decision to work abroad.
You see, it has taken me a few months since Dr Josephine NwaAmaka Bardi’s suggestion about blogging to decide whether to share one of the culture shocks of relocating to the UK as a nurse and one with family.
The allure of relocation
It all began with a friend’s recruitment drive. I gathered 100 nurses on a WhatsApp platform using my influence and persuasive skills within 24 hours. The relocation package was enticing:
- IELTS and CBT exam support
- NMC registration assistance
- Flight ticket refunds
- 3 months of paid accommodation
- Salary range of £24,000–£28,000
Converted to naira, these figures were jaw-dropping. At the meeting, it was clear many were already dreaming of their new lives abroad. You may question why relocating to the UK remains a culture shock despite having information about it and, as such, “knowing what to expect”. I had doubts, so I was reluctant to pass the CBT and IELTS because I was thriving in my nursing career in Nigeria. From volunteering with various NGOs, serving as Assistant Director of Nursing and Ward Manager, to being a UNICEF Master Trainer, I was making a remarkable difference in my country. But my country was not making a remarkable difference in my career, personal development, or that of my children.
What was my intrinsic motivation to relocate?
The pressure to relocate to the UK came from an unexpected source: my children. They recounted how their friends who had relocated were experiencing better socioeconomic status associated with nursing salaries, better education for the children, and social resources such as constant electricity, good roads, and a higher perception of safety.
My children pointed out that, as a nurse, I could give them “a good life and education” abroad. Initially, I declined, but as a mother who wants the best for her children, their persistence wore me down. One heartfelt phone call changed everything: “Mum, thank you for all you’re doing for us. Travelling abroad isn’t about you but about us. Do it for us as one of those sacrifices.”
That’s when i decided to take a leap of faith and relocate to the UK. While I am happy that my children are happy for the opportunity to receive a better education, nothing prepared me for the “other side of the nurse relocation coin”, including “the cost of leaving”.
The other side of the coin
So, the day came when we were to travel to the UK amid excitement and doubt about this choice. I relocated alone, and my family joined me six months later. I remember standing at Muritala Muhammed Airport in Lagos as my family bid me farewell with a look of “See you soon”. I walked past the barrier with high anticipation, stepped on the plane, and within seven hours, I was at Heathrow Airport, where I felt the first sign of cold that I had never experienced before. I soon realised that the cold was the least of the relocation challenges, aka the “other side of the nurse relocation coin”. For example, it was a struggle to find somewhere to rent after the three-month accommodation relocation package came to an end. You see, three months might sound like a long time, but when you arrive and start working in a cold country while navigating new experiences, searching for and finding accommodation for you and your family, who will join you in six months, becomes the bane of your existence. All these challenges came alongside what I call detrimental professional setbacks.
Professional setbacks
For me, the other side of relocating to the UK was professional. I went from Assistant Director of Nursing to working as a Health Care Assistant (HCA). That was a huge challenge because, while the role of an HCA has fewer responsibilities compared to my previous managerial role, there were challenges that impacted my confidence and self-esteem, such as (1) being looked down upon despite years of experience, (2) stereotyping and disregard for different perspectives, and (3) the constant reminder that “you need to be trained” before you can fit into the UK healthcare delivery system, yet I was being asked to carry out the role of nurses.
Notwithstanding the downgrading of my extensive nursing skills and knowledge, one thing kept me going and continues to be my extrinsic motivation: My children… and the future that this relocation will afford them through better education and an environment that nurtures the perception of safety through the provision of basic needs.
With my children’s words in my mind and my love for them in my heart, I smiled through it all while reminding myself that I was probably the lucky one who discovered the other side of the relocation coin alone, without my children. Imagine arriving in the UK, cold, with children, working, searching for and paying for childminding, searching for a new house as the three-month accommodation came to an end, and doing all this while feeling low due to microaggressions and rude and condescending remarks by staff members on the ward who still ask you to carry out full nursing responsibilities without supervision. Yet, I needed to be trained.
Amidst the challenges, I found unexpected support: an angelic first manager, Jane Robson, who eased my transition into nursing. She shared her personal phone number so I could reach out at any time, created a WhatsApp platform for the IENs to share information and offer support, and organised a lot of social activities, including street dances and periodic lunchtimes. The Nigerian Nurses Charitable Association UK (NNCAUK), which is similar to the NMC but specifically for Nigerian nurses in the UK, organised the 25th anniversary conference and gala night in Coventry, which created a home environment again. I signed up with a $5 monthly subscription. This association represents nurses in crises, as seen during the CBT saga. They sponsor activities, such as online education programmes, and they sponsored a leadership training in collaboration with London South Bank University for 40 nurses, though sadly only 15 attended. Where were you?
There, I connected with Dr Bardi, who has become a mentor and coach. She encouraged us to document and share our experiences through blogging. In addition, I have acquired new nursing skills blended with my existing skills and knowledge from nursing in Nigeria. This acquisition of skills, I believe, now makes me and my IEN colleagues holistic intercountry nurses and, as such, more skilled than those who used to tell us, “You need to be trained.”
A call for better integration
The UK and other countries benefiting from this migration wave are receiving a rich blend of skilled and experienced professionals. Therefore, it is crucial to (1) develop better support systems for IENs through, for example, post-relocation integration mentorship and coaching initiatives, as Dr Bardi highlighted in her Nursing Times article, (2) recognise and utilise the leadership potential that IENs possess, and (3) acknowledge the diverse years of experience many IENs bring to the UK workforce. In other words, as healthcare systems continue to rely on international recruitment, it is essential to create environments where integration is key to us settling down with or without family members, which ultimately contributes to enabling us as experienced professionals to truly thrive and contribute valuable skills and perspectives to the UK National Health Service.
Are you planning to relocate or in the process of relocating?
Relocating as an internationally educated nurse is a complex decision with both opportunities and sacrifices. Think mentor and coach for integration before relocation because there is more to the UK than you could ever imagine. While the financial benefits can be significant, the personal and professional costs should not be underestimated. Therefore, for those considering this path, remember that every coin has two sides. Weigh your options carefully and prepare for both the visible and hidden costs of relocation. Your skills and experience are valuable; do not let anyone convince you otherwise.
Edith Uwugiaren is a dynamic registered adult nurse with over 20 years of clinical practice and expertise in leadership, patient care, and public health. She is also the founder of a humanitarian NGO, an active volunteer in medical missions, and a musician.
Dr Josephine NwaAmaka Bardi (RN) is the associate dean for education and student experience at the School of Nursing and Midwifery, London South Bank University. Additionally, she founded the campaign to Raise Awareness of Mental Health in Higher Education (RAMHHE).
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