This as-told-to essay is based on a conversation with Kacie Rose, a 29-year-old TikTok content creator in Florence, Italy. It has been edited for length and clarity.

Business Insider – I was a professional dancer in New York for 10 years. Back in 2018, I decided to do a solo trip to Italy and visit Venice, Florence, and Rome. On my first day in Florence, I met my now-boyfriend.

We did long distance for a year, and then he came to live with me in New York. In January 2021, we decided to move back to Italy together.

I remember when I visited Venice for the first time. The water and canals were so stunning that it took my breath away — they looked just like every single picture of Italy I’d ever seen before.

My biggest takeaway from living in Italy is that life is meant to be enjoyed — not rushed through. It’s a concept Italians have as a cornerstone in their culture — take time to pause, rest, connect with others, and enjoy the little things in life. 

As an American navigating Italy, here are the six biggest culture shocks I encountered: 

1. In Italy, it’s cheaper to visit a hospital than in the US 

In the US, I don’t go to the hospital unless I’m dying because it’s so expensive. I remember it shocked my boyfriend, who’s Italian, when he found out that an ambulance costs $1,500 to $2,000 in the US. 

One time during an Italian skiing trip, I ended up breaking my knee. My boyfriend convinced me to visit a hospital, and I finally went. At first, I was expecting to pay an exorbitant amount of money, but it turned out the whole thing, including an X-ray, only cost me 40 euros. Advertisement0 seconds of 15 secondsVolume 0% 

In Italy, universal healthcare is built into the tax system.

2. Italians are allotted 180 paid sick days per year

In addition to 180 sick days every year, Italians by law have four weeks of paid vacation from their job. That’s not the case in the US — there’s no federal law requiring companies to give paid time off, although some states do have laws requiring companies to offer it. 

When I tried explaining the concept of sick days to Europeans, they often got confused. In many of my US jobs, I was never given sick days, and at one of them, I was given one sick hour every 40 hours I worked, meaning that in order to earn one full sick day of nine hours at that job, I had to work almost three months. 

If someone in the US is lucky enough to have a job that gives a certain amount of sick days per year, it’s not uncommon to hear about Americans using these allotted “sick days” in conjunction with their allotted vacation days, which they are also allotted very little, to be able to take a longer vacation. Advertisement0 seconds of 15 secondsVolume 0%This ad will end in 9 

In Italy however, that is unheard of because they are already by law given four weeks of paid holiday time per year and have 180 allotted sick days per year. 

3. Bureaucracy can be quite a struggle in Italy 

In Italy, Poste Italiane — the Italian Postal Service — has evolved to be so much more than the postal system: people can handle government paperwork, purchase cell plans, and get packages there.

But it can be super messy: Sometimes packages show up and sometimes they don’t. One time I got a Christmas card from my parents in July when they sent it in December. It was funny. You have to laugh at it — all the Italians do. It is just what it is.

In my experience, the appointment times in Italy are just a suggestion — you have to be there early anyway to avoid long wait times, appointment or not.Advertisement1 second of 10 secondsVolume 0% 

For example, when I was on a visa to study Italian at an academy, I had to go to the immigration office to renew it every six months. What I found was even though my appointment slot was at 11 a.m., I’d need to get there at 6 a.m. in order to be seen. If I had shown up at 11 a.m. sharp for my appointment, I would have been waiting all day.

4. Experience is valued more than a college degree — people choose careers at the age of 13 

In Italy, students don’t necessarily have to graduate from a traditional university to get jobs. 

At just 13, students choose vocational schools that are aligned with their career aspirations: for example, there are hospitality, tourism, and fine-arts high schools. My boyfriend, who works as a chef, went to a hospitality high school, where he learned about cooking, wine tasting, and running a restaurant. 

In the US, going to a good university and getting a degree is how people make a career for themselves. This doesn’t mean that that’s the only way people make careers for themselves, but there is a higher pressure to attend university after high school. In Italy, going to a university just doesn’t have the same weight as it does in the US.Advertisement0 seconds of 0 secondsVolume 0%Loading ad 

5. Alcohol isn’t considered a forbidden fruit, even for teenagers

From my experience as an American, I’ve noticed that Italians don’t perceive alcohol as a “forbidden fruit.” When they’re 12 or 13, it’s very normal to have a glass of watered-down wine on holidays with family.

To be clear, the legal drinking age in Italy is 18 years old, and when Italians finally turn 18 they might have a healthier relationship with alcohol — in the sense that it’s not an atypical or special activity to them. In the US, alcohol is often hidden away in a cupboard. When Americans turn 21 and are finally allowed to legally drink, we can go absolutely overboard. 

Drinking in public is also normal in Italy, too. When I went hiking with about 20 friends, we trailed up into Tuscany and were exhausted. When we got to the top, I looked around and people were pulling out wine bottles— everybody was so normal about popping champagne on a hike. 

6. Italians have a knack for making a one-way street into a two-way street

The roads in Italy are mostly old, especially in the countryside. It was fascinating to see how Italians have a talent for making a one-way street into a two-way one.Advertisement0 seconds of 0 secondsVolume 0%Loading ad 

One time, my boyfriend and I were driving along the Amalfi coast in the south of Italy, near Naples, a very popular coastal destination. The roads were very windy and narrow, and we were on a cliff. There were massive buses coming around the corner, and we came face to face with one. 

In that situation, we had to back up and parallel park in order to let this bus go by. It was so close to us, but everybody was just so normal about it.

The thing I love most about living in Italy is the sense of community here

Italians have really taken the concept of “it takes a village” to be a fundamental part of society that extends beyond bloodlines to encompass the community as a whole. They protect each other, look out for each other, and help each other through all the highs and lows of life. 

The thing I’d say I like the least about Italy is the bureaucracy — it can be an incredibly confusing, chaotic mess for both Italians and foreigners alike. Advertisement0 seconds of 0 secondsVolume 0%Loading ad 

Sometimes I really miss the States, even though I love living in Italy. I think it’s normal to miss your home, your friends, your family, and your own culture, tradition, and language.

Living abroad can at times feel like you’re three years old again relearning how to essentially “do” life, and at times it can leave you really homesick for the things that feel normal and comforting to you. 

I don’t know if I want to move back to the States, because I have no idea what the future holds — my boyfriend and I really love the life we’ve built in Italy, so this is where we see ourselves for the time being.

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