How To Move To Australia As A Travel Nurse
By Mariam Yazdi
“As nurses, we’ve worked so hard and have paid so much to get our degrees. Why not utilize them to their maximum worth? Take advantage of this versatile license and go to Australia, go to Saudi Arabia, go to Dubai. America is a wonderful country, but there’s a huge world out there.”
These are the words of Karel Wiggins, an international travel nurse who after caring for patients all over the United States, took her nursing skills and experience to Australia where she spent a full year working in hospitals all around the country.
International travel nursing
Karel describes to the Nurse.Org community about her experience as an American nurse in Australia: how she got there, the differences and similarities, the various patient populations, the challenges, and wonders. For those nurses who are considering taking an international travel assignment, Karel has one main piece of advice for you: do it!
MY: What is your background in nursing?
KW: I started out in Boston at Massachusetts General where I got a job on a General Medicine Telemetry unit. It was an amazing place to get my experience and to build a solid foundation for travel nursing. I took my first assignment in Florida after almost four years and it was a big shock. Coming from Boston where I had a lovely patient ratio of 4 to 1 with great support, it was quite an adjustment. Having eight patients and no help was definitely a great way to prepare me for the challenges of travel nursing. After I finished that assignment I thought, well I can survive with eight patients, so bring it on!
MY: Why did you pick Australia?
KW: I found out about the Australian work-holiday visa, which was implemented a few decades ago as a way to facilitate cultural exchange and bring people from other countries to work in Australia, particularly from the United States. It seemed like a neat idea so at first, I thought about taking a break from nursing and heading over there for a year. Then I found a nurse on Instagram who was working as an agency nurse there. She had been with the agency for eight years and was quite happy with it, so I reached out to her and she gave me her recruiter’s information. The very next day I started my application and the process began.
Starting the process
MY: What is the process to move to Australia?
KW: The application begins with the AHPRA, the Australian Health Practitioner Regulation Agency, which is the board that certifies nurses in Australia. The application mostly consists of getting in touch with your nursing school and requesting documents to be sent to the Australian board. They require proof of a medication administration class, a pharmacology class, and 800 hours of clinical time, which is pretty standard in nursing curriculum. It can be a tedious process but if you’re really interested, it’s just a matter of committing and doing the paperwork. Once you get approval from the AHPRA, you are eligible to register as a nurse.
MY: How long did the whole process take?
KW: I started my application in November and it took me about two months to collect all the requirements: documents from my nursing school as well as certificates of good standing from every state I am licensed in. I submitted everything in January and by March I was granted eligibility to register. I was then given till mid-June to present in person with my passport to verify my identity. My last contract was in Los Angeles and it ended around May 15th, and on May 31st I was on a plane to Australia.
MY: Is there a board exam to gain an Australian license?
KW: Being a nurse in Australia does not include a major licensing exam. As long as you pass nursing school, you graduate as a nurse and you’re eligible to register as one. The same goes for international applicants. Once the AHPRA has determined your nursing program matches their requirements, they will give you permission to register as an Australian nurse.
MY: Are there visa restrictions?
KW: There are different types of visas based on age. If you are under thirty, you can apply for a work-holiday visa, which is the simpler option. As long as you don’t have a criminal background, you are typically granted a work-holiday visa for 12 months. The only requirement is that you cannot be employed by the same employer for more than 6 months. Travel nurses easily get around this because every time you are floated to a different hospital, it is considered a different employer. And I was floated to 29 hospitals in the year that I worked abroad.
If you are over thirty, you apply for a sponsorship visa where a hospital sponsors you to work in the country for up to four years. If within that time window you say, “I’m not going to move back home, I love it here!” then you can apply for permanent residency. It’s not as easy as the work-holiday visa, but it’s still doable. Australia is not as strict on immigration laws as the U.S. is, and that’s partly due to their population size. Although the country is about the size of the United States in terms of land mass, the population is similar to that of Texas.
MY: How long are the contracts?
KW: There are two aspects to agency nursing: the day-by-day component or contracts. I chose to work day-by-day, which means I am not contracted by any one hospital for any length of time. Whatever needs presents itself on a day to day basis is the need I fill. Any area, any shift, and any specialty. I worked full-time hours but never at one particular hospital. It’s similar to registry nursing in California, except they pay you after every shift you work.
The other option is to work contracts. For example, I still get emails asking if someone would like to go to the Northern Territory for 6 months, or Queensland for 2 weeks. I didn’t choose to work contracts because I went there with one intention: to see the entire country. I didn’t want to get stuck in one area for a long time.
MY: Is it difficult to work at a new hospital every day?
KW: The good thing about Australia is that all charting is still on paper. The medication reconciliation at a hospital in Queensland is about the same as one in Victoria, another state down south. So it was easy for me to just work from hospital to hospital. I would get a quick two-minute orientation: they show me where the crash cart is, where the bathroom is, where the emergency exit is, and I take my assignment.
MY: Is the pay similar to U.S. travel pay?
KW: The pay is comparable to a contract in Florida but not as much as a contract in California. Nonetheless, contract and agency nurses are still making more than their peers who are staff. Because the public hospitals are government run, wages are posted publicly online. Nurses are paid based on years of experience and type of degree. The breakdown also tells you how much you should make in each state. So there’s no real negotiation for more pay or bartering for a higher wage because it’s already set on a sliding scale.
MY: Where did you stay?
KW: Because I bounced around so much I used Airbnb and the Australian version of Craigslist. Sometimes I would move to a town not having any accommodations and I would just figure it out by the end of the day. There’s also always camping, which is as common as staying in hotels for Australians, it’s just a part of their culture.
Australian vs U.S. hospitals
MY: Is there a difference in workflow at the hospitals?
KW: The biggest difference is that most of the hospitals still use paper charting. There may be a couple of major university hospitals that use electronic health records, but otherwise, paper charting is the mainstay. It takes some getting used to, especially when trying to decipher medications that were written by hand.
MY: What advice do you for others to succeed at travel nursing in Australia?
KW: Go with an open mind. Although Australia is a first world country, the healthcare system can feel very different from ours. There were many instances where I felt like the nursing role was less independent than what I’m used to in the States. Sometimes even changing a dressing-type on a wound wasn’t allowed unless approved by the MD. Another challenge I would run into is being assigned the lead nurse. Even though I was an agency nurse, on some shifts I would technically be the nurse with the most formal education, which at that particular hospital was considered most qualified to lead – even if it was my first day on the job and I didn’t even know where the bathroom was.
So just be ready to adapt and to realize that you’re not in familiar territory; you’re there to help and not change the nursing culture. Once I stopped resisting the way they did things, it became much easier and more pleasurable for me and for everybody.
MY: Was there anything that surprised you?
KW: The indigenous population of Australia, the Aborigines, are a group with a very rich and recent history with the rest of Australian culture. I had known about the troubled history between the Aborigines and white Australians, but it wasn’t until I began working that I realized it’s severity. Being a person of color, I believed the Aborigines and I would share similar struggles, and I thought I would create a connection with the people instantly. But that wasn’t the case. Because I am American, I was also resisted by the Aborigines; it was their belief that, as an American, I can come to this country and be treated fairly, equally, and receive more rights than the indigenous population. I began to understand that my struggles of being a colored person in American is not like the Aborigines’ struggles in Australia. But the biggest takeaway for me was to experience this culture and its beauty first-hand, not just in textbooks or on television.
Back home in the U.S.
MY: What are you doing now?
KW: I recently accepted a staff position in the Emergency Department at a Level I Trauma Center! Back in nursing school, I had an experience in the ED of being completely emotionally wrecked after two young trauma patients came in back to back, both passing away tragically. My preceptor at the time verbalized to another nurse that I would never make it because I was so shook. I took this to heart and decided to take the telemetry position at Mass General, and the desire to work in an ED became dormant until I moved to Australia and was floated to an Emergency Room. This rekindled my desire and so I decided to make a big change in my life: I applied to every level I trauma ER in the entire state of Florida as a staff nurse. I put way too many miles on my car driving to all the interviews, but I recently accepted a position in southern Florida!
This is a big change for me but it’s what I’ve needed. I’ve always told myself – if I feel like I’m beginning to plateau in my career, it means it’s time for a change. When you plateau, you can become unsatisfied with your job and it may begin to reflect in your work ethic. That’s the great thing about nursing- you don’t have to be stuck in one specialty or one way of life. There are so many avenues to explore and so many new challenges to overcome.