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Graduate From the Registered Nursing Program Gained an Interest in International Nursing

July 24, 2020

Skye Lives In England and Learned how to use a ventilatorIt makes sense that Carrington graduate. from the Reno campus, Skye Steffens was born in California because only the Golden State could create a story quite like hers. Her parents met at a Janis Joplin concert while trading goods popular within the hippy Vietnam War era social scene. This was during the very late 1960s in Northern California—a place where many legendary characters were making art and playing music. Just northwestern of San Francisco Bay in Marin County was where Skye spent her childhood, playing with psychedelic singer Grace Slick’s daughter, and having legendary guitarist Carlos Santana buy her ice cream.

She eventually moved from the Pacific Coast to the Southwest as a young adult and married a Reno, Nevada native named Duke who works as a sergeant in law enforcement. They raised two now-grown sons and have three grandchildren. Skye might have married law enforcement, but she still retained her free-spirited Marin County roots. One of their favorite activities together is attending Burning Man in the Black Rock Desert of northwestern Nevada. They’ve gone six times and intend on going again.

Skye worked in restaurant management for twenty years, and, as a self-described, “staunch advocate for indigenous people,” she also worked as a USDA clinical nutrition educator for children at the Pyramid Lake Paiutes Tribe in Gerlach, Nevada. She enjoyed this work, but the entire time, she was being nagged by a calling that had originally come to her in the 1980s: she really wanted to be a Registered Nurse (RN). Unfortunately, she had been discouraged multiple times by a close relative and even a local public university in Reno about going into the field due to its perceived risks and even biases against her as a mother. The funny thing about callings, though, is they don’t go away. They stick around and whisper or even nag at you until you answer them.


Eventually, Skye took a position at St Mary’s Regional Medical Center in Reno as a diet technician. The RNs she worked with there often asked her if she had ever thought about being an RN. Of course, she told them she was still very interested in her early forties, especially with her sons grown and out of the house. It was a perfect time for her to pursue her dreams. They recommended that she do the Certified Nursing Assistant (CNA) program first through the hospital and see if she liked it. Skye quickly became a CNA, loved it, and knew that she wanted to move forward with becoming an RN. She briefly considered getting her education at the local public university but decided against it because they had discouraged her in the past for being a mother. Also, she had a friend that went to Carrington, and all of the best nurses she knew at St Mary’s had also gone there. Carrington nurses were the ones that “could hit the ground running” and “would really get into the nitty-gritty,” she said.


Life experience also had honed Skye in the years since she first expressed interest in nursing to be particularly observant and appreciative of nurses who go out of their way to be attentive and responsive to their patients. In 2005, her husband Duke battled and survived appendiceal cancer. She knew what it was like to be the wife of a cancer patient who is trusting that the medical team is doing all that they can to care for their loved one. It was clear that capable nurses with a lot of hands-on experience who are ready to act and go the extra mile during a time of crisis bring a lot of comfort to their patients. That’s the kind of nurse she wanted to be—not just someone who had memorized facts and was “book smart.”

In May of 2015, Skye started a five-term—instead of the normal six-term—RN program at Carrington in Reno. “It’s already an intense program in six terms, but in five terms it’s no joke,” she said. She graduated in December of 2016 and went to work in the Intensive Care Unit (ICU) at Renown Regional Medical Center in Reno. She loved the science of that department and it was a great learning experience, but it wasn’t the right fit. She really missed patient engagement because most of the patients were sedated in the ICU and didn’t say much. Hearing patient stories and talking with them is one of her favorite parts of being an RN. She was happy to move to oncology after four months, which was a much better fit. The hands-on learning she had at Carrington was critical to her success there. It also modeled how she worked with graduate nurses while being a preceptor nurse. With them, she utilizes what she calls the practice of “watch one, do one, teach one.”

Skye’s interest in nursing continued to grow and became more of a passion with time and experience. It expanded outside of Reno, Nevada—outside of the United States even. After about two years at Renown, she developed an interest in international nursing. That is how she found herself on a tour of Addenbrooke’s Hospital at the University of Cambridge in Cambridge, England, United Kingdom (UK). Her 45-minute tour of the hospital turned into a two-hour interview and a job offer. That was followed by a rigorous international licensing process, which was complicated by the fact that the United States has many variations on how they educate and license RNs. Thankfully, Carrington had Skye covered.

The Dean helped with the process and Skye said, “Carrington did such an amazing job with all of their clinicals and hands-on experience that I had more clinical hours in my two-year degree than was required… and what equivalent nursing programs in the UK offer in three years!”


Altogether, it took about nine months for Skye to get over to Cambridge and a year for her to be a licensed RN in the UK. That included a written and practical test. Pay is much lower for RNs in the UK’s system. She makes about one-third of what she made in Reno. Her expenses also are much higher in Cambridge than Reno. She knew about these adjustments and compromises going into being an RN overseas and feels as though they are worth it for the experience. Skye sees this as an opportunity for her to “learn, expand, travel, and be an internationally registered oncology nurse.”

Skye was seeking an international learning experience as an oncology nurse and there are few better places on the planet for her to get that then at Addenbrooke’s Hospital. The nurse corp she joined is composed of people from 94 different nations and she gets to sit in on classes at Cambridge for free (when they reopen after COVID-19). The oncology ward itself is always teaching new science. What is also exciting is the doctor she directly works with while caring for patients in the outpatient bone marrow ward is the head of hematology for Cambridge. Skye likes that specialists like him (“consultants” in the UK) go by their first names and give RNs more responsibility and equality, “They ask if you know why they are doing something while showing you how to do it, and then as a nurse, you are expected to do what they did from then on. You have more autonomy as a nurse and are treated like an equal,” Skye said.


“My mentor at Carrington taught me how to critically think,” she said—attributing those well-developed critical thinking skills to what helps her learn quickly and take over from the doctors, as well as what helped her quickly adjust from the USA’s largely private-sector medical system to the United Kingdom’s government-sponsored universal National Health Service (NHS).


In a system like the NHS, Skye said patients always get the most affordable option first and there are set protocols for most everything you do. Of course, those protocols become critically important when you are working with severely immune-compromised patients during a deadly pandemic. To reduce risk, nurses have had to follow strict practices and have been taking care of their patients in villages instead of asking them to come to the hospital. Skye also treated patients outside oncology for emergencies in a COVID red zone for a period of time. She had to learn how to use a ventilator when she moved there because they don’t have respiratory therapists in the UK.

Has all of the extra work, testing, and training been worth it for Skye? “I still have moments where I’m astonished thinking, ‘I’m in Cambridge, England!’ This is the third-best teaching hospital in the world!” Her deep appreciation and enthusiasm would suggest that yes, it has been worth it.

She has advice to others considering the field, “To be a nurse, this has got to be something that you want to do. You can not show up and say ‘I want to make a lot of money’ and then take good care of people. You have to have empathy. You have to have the desire to nurture people. Because if you don’t, you are going to be miserable and you are going to burn out.”


Skye sees at least another twenty years of nursing ahead for her. Her husband Duke is retiring this autumn and plans to join her in Cambridge. In the meantime, they talk multiple times each day and see each other every six to eight weeks. He has dreams of owning a Scotch whiskey distillery and she is looking at eventually treating patients on the remote islands in the Shire of Inverness where there just happens to be the Isle of Skye. This means that she is enjoying her time in Cambridge and learning all she can but in the background, Scotland has started calling. Skye’s adventures as an RN have only just begun.


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