Jolana Dolha - my job as a renal nurse, and working in Europe and the Middle East

We talked to Jolana about nursing in the Middle East, Europe and the UK and how she's coped with transferring her nursing skills between countries.

What is your current job title, and what kind of patients do you work with?

I am a staff nurse or RGN, equivalent of band 5 at the moment. I am working on a satellite hemodialysis unit so my patients are renal ones.

As their kidneys don’t work anymore they need to come for hemodialysis or hemodiafiltration treatment three times a week to our unit.

You don’t have to give the exact name, but what kind of organisation do you work for?

As a dialysis nurse I work for a private company, although our customers are NHS patients.

You began your nursing career in the Czech Republic, what made you decide to move to the UK?

Before, I never would have thought I would want to live in the UK as knew it as a cold country with plenty of rain! My first time in the UK was 2005/2006 and I came only to study English as I had a dream to visit the Middle East and work in Saudi Arabia.

I travelled around England a bit so I could get to know the country, but my dream of working in Saudi Arabia became a reality. It was time to move on, and it was quite easy to move there as I wanted to live in a country where English is used as the main language.

While I was in Saudi Arabia I made trips to the desert and saw sandstorms, which was an amazing experience but I just felt I wanted to back in a place with green fields and scenery so I returned to England.

How does nursing differ between the UK and the Czech Republic?

In my field of nursing, which is dialysis, I can say that units are running nearly the same way.

We get three shifts of patients every day. The equipment and the technologies used are pretty much the same. The are also the same difficulties with arranging patient transport to and from the unit.

The main difference in nursing between the two countries is about law and procedure. I would say nursing in the Czech Republic is more about loving your job and providing the best care possible for the patient.

Once you have learnt procedures you just have to be aware of the laws in place, support your patient, communicate well, smile, use your common sense and work hard.

In the UK you have to learn all the time about new laws and procedures, it feels like it never ends. You must still take good care of your patient, but very often they do not understand any English.

You always have to be aware of which law affects each action. In my home country I never knew a foreign worker to speak their native language while on the unit, and in the UK I have experienced some days when there is not one English patient to speak to, so there was no opportunity to speak to anyone during the day.

Another difference is that in Czech by law is not possible to have a patient on unit without a presence of doctor, but in the UK most satellite renal units are nurse led.

Did you have to do a conversion course when you moved to the UK in order to register with the NMC? If so, what was it like?

No, I didn’t need to do a conversion course. I just asked the NMC for registration pack, which I completed with all my information.

I lived in an EU member country, so I think this had something to do with it. It’s a very complicated system, and I didn’t understand it all at the time.

Did you experience any difficulties when moving to the UK and trying to find a nursing job?

I asked an agency to find me a job before I moved and there were no possibilities except in nursing homes, so I had to take it and when I had settled down here, I started looking for a job on a renal unit.

There was quite a lot of disappointment regarding work and accommodation in the beginning.

You have worked in the Middle East as a nurse as well. What were the key differences between being a nurse there and being a nurse in the UK?

I see fewer patients here in the UK whose religion has a direct impact on their nursing care. For example, in the Middle East during the Ramadan fast, some medication was not able to be administered until the evening when fasting was over for the day.

Nursing is more or less the same in every country because every patient deserves to be treated with dignity and respect. There were different systems to go through in each hospital I've worked in, and different challenges to overcome, but as a nurse it's your job to make sure your patient is receiving the care they need.

How have you found transferring your nursing skills from the Czech Republic, to the UK, to Saudi Arabia and back again?

Well, nursing is really taking heart, mind and courage anywhere you go. It’s important to remember what you learnt while training and over the course of your career, and it’s always important to learn more whenever you can.

So, working in the Czech Republic was easier for me to communicate, but we were also particularly careful with hygiene and infection control by virtue of a routine.

For example, we used to disinfect the skin before any injection, and even before we administered subcutaneous injection like insulin. When I wasn’t working in the Czech Republic, I did learn to be part of international team and I learnt new ways of doing things, and how to manage communication with patients speaking other languages.

Besides plenty of nursing skills I have also learnt a bit of Psychiatry / Psychology, and more about the aseptic environment, all of which can be used anywhere in the field of nursing.

In Saudi Arabia I had more experience in Cardiology than previously in my nursing career. There are cardiology patients across the world so those skills are very transferrable.

In England I am using what I already know and looking forward to any opportunity to enhance my nursing knowledge and skills.

How do you see your nursing career progress over the next 10 years?

As science is advancing, new technologies are coming and there is always new equipment to learn. For example, a new needle has just been introduced in my unit which I am becoming familiar with.

The laws of each country are always changing, and as a nurse you always have to be on top of current legislation.

Personalities of patients vary considerably, and most of all I learned to embrace every patient as an individual and help them to overcome their personal difficulties with dignity.

As a nurse you are one of the people a patient will spend the most time talking to when they are in a unit or on a ward so your communication skills are always improving.