What’s Special About Being Here brings you candid conversations with simple people like you and me, who made the right choices and daring moves to carve an extraordinary career for themselves in a beautiful country they now call their home. Read on and find out what Ms. Liril Jacob, Advanced Nurse Practitioner at University Hospitals Bristol NHS Foundation Trust finds so special about living in the UK – the world’s 10th biggest tourist destination, with over 36 million visiting in 2018.
- As a nurse, it’s a privilege to be a part of people’s lives at their most vulnerable moment. What made you choose this profession?
What separates a great nurse from a good one is one’s attitude and desire to do one’s absolute best for the patient under our care. I must confess that I didn’t fully appreciate the enormity of the responsibilities I will be taking on when I chose this profession. So, in a way it would be true to say that the profession chose me rather than me choosing it. During my formative years as a nursing student, I realized that the career of a nurse is not as narrow as the public generally perceives it to be. It has a wide range of career pathways with overlapping responsibilities in clinical practice, management, teaching, research and more. I knew then that I had made the right choice as I was in for a career full of opportunities and challenges to relish while making a positive impact in society. I guess you can’t ask for more from a career.
- Why UK of all places?
I was working in Dubai with the Department of Health when I learned of an opportunity to join the UK National Health Service. As a nurse I was aware of the NHS as being a leading health service provider in the world. So, I grabbed the opportunity with both hands as I was sure this would be a good career move.
- How is life in UK and what are the major lifestyle differences compared to your homeland, India?
Like most western societies, the culture and societal attitudes in UK are geared towards openness and promoting the “individual”. People here place a lot of importance to following rules and regulations, being polite, punctual and kind. Pride in your profession, whatever the job you do, is another aspect of British life. There is also the expectation here that you get on and do the best you can rather than wait for others to come to your help. A “can do” attitude can take you a long way here. On the whole, I would say that life in the UK is super busy, but at the same time it is peaceful and fulfilling – both professionally and personally.
- Nursing is not a normal 9 to 5 job where you can leave when your shift is over. Sometimes you will stay longer if patients need you. So, is nursing worth all this sacrifice?
Most certainly. There are not many jobs where you are holding someone else’s life in your hands, sometimes quite literally. As they say, with great power comes great responsibility. So, it is only appropriate that you are expected to put in a little bit more than what your contract obligates you to. Having said that, here in the UK, it is only very rarely that a Registered Nurse (RN) will end up staying at work beyond their normal hours. The Nursing Manager is responsible to ensure that this doesn’t happen or at least only as a last resort. And if you do, you are very well compensated for those hours. My personal opinion though is that the smile on your patient’s face after a difficult shift and their heartfelt words of gratitude more than makes up for the long hours.
- What study program did you take up to pursue nursing in UK? Was it easy for you to get a job soon after?
I came to the UK as an international recruit of the NHS so I didn’t take up a particular training program to come to this country. My graduate course in nursing from India was recognized by the NHS as equivalent to a degree in nursing from the UK and I only needed to clear the language proficiency test (IELTS) in addition to my degree.
I believe it would be quite easy for a qualified and experienced nurse to find a job in the UK as there is still a significant shortage of nurses here.
- How important is ongoing education as an RN in UK? Is continuous education possible, especially when you are tied down to a full-time job?
Ongoing education is of huge importance in the life of an RN here. Most Hospital Trusts in the UK have dedicated training departments to plan and deliver effective in-service education to their nursing staff. As practitioners, we are duty bound to follow where the research evidence leads us. So, it is imperative that we keep ourselves up to date with developments in our chosen area of practice.
Continuous education of a formal nature, however, is a much bigger commitment. Especially, given the demands on your time from your work and family life. It certainly calls for quite a lot of personal sacrifices. Of course, you need ample support to make it possible, both at work and home. In my experience, Trusts tend to support continuing education especially if you can show how the program you are enrolling into would eventually help the unit you work in. I have also been fortunate enough to get part of my post-graduate program funded through a scholarship award instituted by the Trust I work for. So, yes, it is a tough slog to go into formal education while also doing a full-time job and managing your busy home life. But it gives you a deeper appreciation for your job, improves your clinical skills and most importantly, gives you a great deal of confidence and an edge as a professional.
- How long have you been here in UK? Which is the best place to chill out and de-stress after a long, tiring shift?
I have been working here for about fourteen years now, starting as a Band 5 Staff Nurse with the NHS and later moving to the role of a Senior Nurse in the cardiac ICU. Currently, I am working as a cardiac surgery Nurse Practitioner. Over the past couple of years, I have also been working as an occasional Associate Lecturer at the University of the West of England (UWE Bristol).
Life and work here is quite hectic, and yes, it can sometimes be a bit stressful. But over time I have learned to maintain a good work-life balance. I make it a point to not bring any work-related stress to my home. I am usually quite relaxed by the time I get home and looking forward to spending a relaxing evening with my family.
- Do you miss your homeland? Do you wish to continue living here in UK?
If so, why?
Of course! I do miss India and am looking forward to my next trip to my homeland to be with my family. But I must say that most things “Indian” are readily available here in the UK, so, it’s more the land and the people itself that you miss. Then again, we have a significant number of Indians here – and even people from my own little corner of India and we have managed to reconstitute many aspects of Indian cultural life right here in the UK. I don’t think I will be returning to India any time soon! I think I’ve been living here with my family for long enough that I consider this my home and India to be my home away from home.
- What are the unique opportunities, facilities and healthcare technologies available to a nurse in UK? How does all this enhance the entire healthcare experience for patients?
UK is quite unique in the sense that as a country it attaches utmost importance to its health service. The National Health Service is considered a crown jewel. Nurses and doctors are routinely described as heroes in national media. This might seem a bit outlandish, but such is the importance UK and its people places on its universal and free health service. Given this context, you can see how nursing is a sought-after occupation in the UK.
Being part of the NHS, you can be sure that you are at the leading edge of healthcare – be it the policies and procedures you follow to the equipment, systems and technologies you get to use day to day. Nurses are only limited by their ambition and capacity to learn. If you are willing to put in the effort, you have a variety of career pathways to choose from. Be it becoming advanced/specialist practitioners or going into administrative roles which could take you all the way to managing entire Trusts. You can also branch out into research and teaching – which I admit, I have a special fondness for. In my case, I went into the advanced practice route and am currently working as an advanced nurse practitioner in cardiac surgery. I was also able to conduct audits and make changes in clinical practice from evidence gathered. I also teach nursing students at the University of the West of England in Bristol. I feel incredibly lucky to have been able to find and utilize these opportunities and am sure that this wouldn’t have been possible in many other places.
Empowering and upskilling healthcare professionals is considered the best form of investment by the NHS. Well informed and skilled staff are better able to diagnose, plan and deliver care, keeping the patients’ best interest at heart.
- How would you describe your first nursing job?
My first job after graduating was at CARE Hospitals in Hyderabad. It is a hospital focusing on cardiac care. My experience there certainly shaped my career and was instrumental in me choosing cardiac care as my focus area. I learned a lot from my stint at CARE and I still look back fondly at my days there.
- Any memorable experience you would like to share about the days when you were a student nurse in the UK?
I came to the UK as a full-time employee and not as a student nurse, so I have had quite a few years of nursing experience here in the UK before starting my post graduate studies. My experience of studying here has been overwhelmingly positive. There is a real emphasis on learning for yourself and developing your critical analysis skills here. A memorable experience is the highly positive comments I received from my module leader who suggested that I publish my work in a journal. For someone who has never earlier considered this even a remote possibility, this made me feel confident enough to attempt it and I now have a couple of articles to my name with the British Journal of Nursing.
- You are a very talented dancer. How do you juggle your passion for the arts with a career in nursing?
Thanks for the compliment. In my opinion, a busy career is no excuse for neglecting other aspects of your life; especially something that you have a talent and passion for. I am a student of Bharatanatyam and am lucky to be able to devote time to this pursuit of mine and perform at various events in the UK. It takes a bit of discipline and good time management to find the time for it, but it is certainly worth the effort. I think having an active hobby has a positive influence on your career although many people think the opposite to be true.
- Would you agree that international nurses who are trained abroad are taught to use their critical thinking in patient-related scenarios? If you agree with me, please site an instance of critical thinking practiced by nurses in UK.
Yes, it could be said that nurses trained in the UK are more adept at critically analyzing and responding to demanding situations. I must stress that, in my opinion, this is not due to any difference in capability on their part, but mostly due to the emphasis on critical analysis within the educational system here. Students are allowed, in fact, required and encouraged to be critical of the material they study.
This is a marked difference from the education system in India where conformity is rewarded over originality and free thinking. Some of this is probably even cultural. The society here is more liberal and free-thinking. I think this essentially fosters a climate where even youngsters feel confident and able to question received wisdom. Surely, this later translates to similar behaviours in work as well.
I can cite numerous examples of such qualities making a difference at work. A simple one would be an RN challenging the need for a specific prescription written by a senior consultant when they felt it was not the best option given the patient’s present condition. The real difference here is that an incident such as this is not considered abnormal or a challenge to the clinician’s authority but, in fact, just the right thing to do for the patient.