The face of nursing is changing. Long gone are the days when nurses were uniformly white, young, and female. A clearer career structure and greater responsibility are attracting people from more diverse backgrounds into the profession.
One big change is that more immigrants are now taking up nursing. Even in the two years from 2004 to 2006, the percentage of ethnic minority groups in nursing increased by 2 percentage points, to nearly 20 per cent. Many of this new generation of nurses are coming from overseas, 3,500 from India alone in 2006.
Nursing is a uniquely accessible career. Access programmes mean prospective students can qualify for university in months. The Government pays nurse course fees, and nursing students are eligible for a £6,500 living costs bursary.
Steve Shelukindo, 35, arrived in the UK from Tanzania in 1995. At first, he worked in business. That changed in 2000 when he got a part-time job as a healthcare assistant at the North London Clinic. It was, he says, an eye opener.
"I found my interest in the field starting to grow," says Shelukindo. "Working with the mentally disadvantaged is exactly what I want to do, it's an exciting career."
Shekulindo has enrolled on a BSc nursing course at Middlesex University. "I reached as far as I could in management," he says. "Now I want to give whatever help I can to others."
Like Shekulindo, more people are being attracted to nursing as a second or third career. "Now that they are able to do a degree or a diploma, prospective students see it as a real educational, as well as a vocational opportunity," says Kay Caldwell, head of the Institute of Nursing and Midwifery at Middlesex University.
Fifty seven per cent of nursing students at Middlesex University are now over 25, with 28 per cent 37 or older. These students come from every walk of life, says Dr Caldwell.
And attitudes to nursing are changing, too, with more men willing to brave raised eyebrows to take on careers in the field. The owners of those eyebrows seem increasingly behind the times, with 10 per cent of nurses now men and many more in mental health nursing.
Alex Neve, 33, studying for a higher diploma at Middlesex, is typical of the new face of nursing. Neve left school hoping to get as far as possible from his native Wokingham, Berkshire. "I was never too sure of what career path to take," he says.
After travelling through the Middle East and South East Asia, Neve moved to London to study psychology at Goldsmiths, University of London. When Neve graduated he went to work in the prison service, and later in probation and substance misuse services. He realised that the root of many of the problems he encountered were in mental health. "Something I discovered very quickly was that a very large number of people in prison have undiagnosed psychiatric disorders," says Neve.
Neve's work brought him into contact with mental health nurses. "I was always impressed by their assessment knowledge," he says. "They always had a clear idea of what someone might be suffering from. They seemed to be vastly more knowledgeable than me."
Neve realised that for his career to develop he needed nursing training. "It's a real investment in my career," he says.
To attract more into the profession, a clearer career structure, through the Knowledge and Skills Framework, has been developed and nurses have been given greater responsibility. With a post-registration prescribing course, an increasing number of nurses can now prescribe.
Funding from Neve's local drug and alcohol unit has meant he could afford to go back to university, although it has still meant a 50 per cent pay cut. It is, he says, well worth it. "It's challenging work," says Neve. "I never wanted an easy life, I wanted to make a difference. And this is where people like me are needed."
Bringing in nurses from more diverse backgrounds is a great benefit for the service, says Cathy Taylor, nursing careers adviser at the Royal College of Nursing (RCN). "They have a lot to offer in terms of life experience and transferable skills," says Taylor. "They have a bit more of the wisdom of life that they bring to their role, which allows them to understand the experiences patients are going through, which can mean they are more empathetic." Taylor says this greater breadth of experience is welcomed in the service.
Lisa Sedgley, 37, decided she wanted to become a nurse after her grandfather died. "It made me reflect there was more to life than what I was I doing," says Sedgley, now a diploma student at Staffordshire University. With two children, and worried that she did not have qualifications to go to university, Sedgley shelved the decision for more than 10 years. It was only when her manager at her retail job noted that she had other ambitions that she took the plunge and got in touch with the university. It enrolled her on a two-month access course, and by January she was a nursing student. "It all came about very, very quickly," says Sedgley.
Getting back into study has been hard, and a year into the course she nearly quit, but she has stuck at it. She admits that the essays can be a drag, but the opportunity to provide help and comfort and her family's pride that she is following her dream, make it worthwhile. "The buzz you get when things are going well means you feel a glow that far outweighs the challenges," she says. "Knowing you care means so much to people. You come away and think, God, I've made a difference."
It is that commitment that makes students such as Lisa such valuable additions to nursing, says Gill Robertson, student adviser at the RCN. "It's very humbling what some mature students have given up to become nurses," says Robertson. "You name it, they've had it. But they've always wanted to do nursing, and now they've got to a point in their life when they feel they can do it." Robertson says part of the reason for more mature students taking up nursing is that school leavers are more often thinking of big money than a vocation. They forget that nursing can be racy stuff. Sedgley plans to move to Perth, Australia, when she graduates, and there are always more exotic demands for nurses. Nothing travels like nursing.
"It's an amazing qualification, it opens loads of doors," says Robertson. Robertson has worked in India and Kurdistan. After the first Gulf War she took up a call for nurses in the Kurdish safe havens in Iraq. "One week I was working at an HIV clinic in Glasgow," she says. "The next I was driving a jeep through Iraq to pick up 2,000 chickens."
For others, the chance to work flexible hours around children is a pull. And even if you stay at home, nursing will always be an exciting career. "It's so satisfying, so fulfilling," says Robertson. "It's a vocation."