Nursing is a unique, challenging and dynamic profession. Find out what opportunities are available and which key attributes you need to succeed.
Nursing is scarcely recognisable since the days when the nurse was the doctor’s handmaiden. Nowadays, a nurse may be leading a multidisciplinary team in a specialist hospital, helping a 40- a-day smoker to quit or caring for a sick baby in an intensive care unit.
The Government has attempted to reshape the health service, placing greater emphasis on staying healthy by giving up smoking, drinking less and eating a balanced diet. Nurses are playing a leading role in health promotion campaigns throughout Britain.
In GP practices, senior nurses have their own caseload of patients or run clinics on conditions such as diabetes. Nurses work in schools, care homes, hospices, prisons and in the pharmaceutical industry. But hospital nurses still play a crucial role and some perform minor surgery and medical procedures previously only carried out by doctors. Ward sisters are still the lynchpin in any hospital – making a tangible difference to the patient’s experience of hospital care.
Key attributes needed
Yvette Wells, until recently a modern matron, now an independent community consultant nurse, has acted as a nursing ambassador for NursingStandard magazine, taking the message out to schools and colleges. Wells believes that good nurses need certain qualities. These include empathy, flexibility and the ability to remain calm in a crisis. Strong communication and observation skills are crucial, as the nurse must observe any changes in the patient’s condition and act to ensure they receive the best care. “Nursing is a unique, challenging and dynamic profession. Nursing places the nurse in a position of enormous trust and responsibility and gives you the opportunity to follow many career paths all of which make a difference to people’s lives,” she says.
Training to be a nurse
You can apply directly to do a university course or if you are working as a care assistant, you can go on to train for a registered nursing degree or diploma. To work in the NHS, you must have a diploma or degree in nursing and be registered with the Nursing and Midwifery Council (NMC). Nurses who work in the NHS benefit from flexible working and have excellent opportunities to progress. There are no national minimum entry requirements as each higher education institution sets its own criteria. However, these are generally around five GCSEs (or equivalent) at grade C or above for a diploma programme, and five GCSEsplus two A-levels (or equivalent) for a degree.
Diplomas (Dip HE nursing) normally last for three years and degree courses last either three or four years. Courses begin with a 12- month common foundation programme, followed by two years in one of the four nursing branches: adult, mental health, learning disabilities or children’s (paediatric) nursing. Students spend 50 per cent of their time on supervised practice placements in the field of their choice in community and hospital settings. Nursing students are taught how to assess, plan, implement and evaluate care for patients and how to keep accurate patient records.
Healthcare is constantly developing and fully qualified nurses have to keep their knowledge and skills up to date. To work in the NHS, midwives must hold a degree in midwifery (or if a qualified nurse, have completed a pre registration midwifery programme), which leads to registration with the NMC. Graduates with a health related degree can take an accelerated programme. These last at least two years, with a minimum of six months on the common programme and 18 months in one of the branches. Part-time pre-registration nursing programmes are provided by some universities and normally last for five or six years. They are available to NHS staff – usually healthcare assistants who have qualifications up to NVQ level 3 or equivalent. NHS employees attend the course on a part-time basis.
Adult nurses work with adults of all ages with the full range of health conditions. Depending on experience and training, adult nurses can reach the highest levels of the NHS. The public’s expectations of the health service has risen steeply in recent year and he emergence of the “expert patient” means that nurses may find themselves dealing with well-informed or even challenging patients. The nursing mantra is about delivering “holistic patient-focused care”, attending to the whole person, not just their condition or disease. Nurses who work with adults must be able to respond to their different needs in an unpatronising, honest and confident way.
Children’s nursing can be tough but enormously satisfying. Children react to illness differently to adults which is why they need specially trained nurses. Children’s nurses learn about child development, how to minimise the impact of illness on the child and how to allay their fear and anxiety. Communication is particularly important. For example, children may not be able to identify the severity and nature of pain in the same way as an adult and the nurse must be constantly alert as a child’s health can deteriorate rapidly. Children’s nurses need the confidence to support parents and be able to teach them how to carry on with treatment at home. Health problems can have a devastating effect on a child’s development and it’s important to ensure that the child is able to live s normal a life as possible. Children’s nurses can choose from a huge number of specialities ranging from child protection to cancer care.
Mental health nursing
Mental illness affects one in three of us at some point in our lives, often triggered by a crisis. Mental health is one of the most complex and demanding areas of nursing and the key challenge is to form therapeutic relationships with mentally ill people and their families. A broad range of psychological and personality disorders come under the heading of mental health nursing and nurses can specialise in areas such as rehabilitation, child and adolescent mental health and substance misuse. Most mental health nurses work in the community, based in day centres, outpatients departments or specialist units. As a member of a multidisciplinary team, they may be working with people who have been excluded from services through drug or alcohol abuse. Helping patients and their families to deal with the stigma attached to mental illness is a key part of the job.
Learning disabilities nursing
People with learning disabilities often have complex needs and nurses can help them to improve their physical and mental health and support their efforts to pursue a fulfilling life. Learning disabilities nurses work in adult education, residential and community centres, schools, and patients’ homes and they can specialise in education, sensory disability or service management. Those who work in residential settings often do shift work. It’s important to have highly developed communication skills and be assertive to ensure people with a learning disability do not suffer discrimination. The job can be stressful and demanding, but seeing someone learn a new skill or gain in confidence can be extremely rewarding.
Apart from the obvious satisfaction of supporting women to give birth, midwives bear a huge amount of responsibility. More midwives now work in the community but many are still based in hospitals on antenatal, labour and postnatal wards and neonatal units. Becoming a midwife means undertaking professional education at degree level. Some midwives are qualified nurses. Others begin their career by working their way up via support roles before going on to study for a registered degree.
The Royal College of Nursing
Tel: 020-7409 3333
England: 0845 60 60 655
Scotland: 0131 313 8000
National Leadership and Innovation Agency for Healthcare
Tel: 01443 233472
Queen’s University Belfast
Tel: 028 9024 5133
SKILL – the National Bureau for Students with Disabilities
Tel: 0800 328 5050