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A top-down system also means uniformity for nurses
across the United Kingdom. For example, the 2002 salary
for every registered nurse with no special license in
the United Kingdom was the equivalent of $27,266, except
for those working in London, who earn extra money for
living in one of the world's most expensive cities.
In the United States, the 2001 average salary of a
nurse in Jackson, Miss., was $40,360 and the average
salary of a nurse in Los Angeles was $55,860.
The British system may be moving toward an American
model. Clark cites the phrase, "When America sneezes,
Britain catches cold," she added, "and the
incubation time is getting shorter."
Although private care is not comprehensive in the United
Kingdom, it offers certain elective surgeries and most
long-term care. At present, about 100,000 nurses work
outside the NHS, most in nursing homes that are subsidized
but not run by the state.
"Many thought they were moving into an area where
they could provide better quality care," Clark
said. And, in the beginning, things were better.
"They were never paid better, but the environment
was better and they tended to have more autonomy,"
she said. But long-term care is subsidized at a cost
lower than actual price. Consequently, working conditions
for nurses have declined.
American Magnet hospitals also have caught the attention
of British policy-makers, said Sue Machell, MBA, RN,
a registered midwife and registered health visitor.
Like Yaseen, Machell visited the United States to observe
American nursing practices as part of her job as a fellow
in education and leadership development. Some NHS entities
may be allowed to entice good nurses with extra incentives.
"In the United States, people probably wouldn't
be too bothered about that," she said. "Here,
people would be incensed. Socialized medicine is kind
of stamped through us like a piece of rock."
Nevertheless, Machell has seen a lot of American ideas
work in Britain. When she worked on the floor, colleagues
consistently looked across the Atlantic for new ideas.
For her part, Siviter likes aspects of both the American
and the British systems, although she said the changes
in education, pay and responsibilities make the United
Kingdom an exciting place to work right now.
"Nursing here is not the same as America, but
it's good," she said. "I wouldn't be an RN
today if it wasn't for British nursing."
Contact Heather World at H_world@yahoo.com
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