Adult nurse
Adult nurses care for adult patients who are suffering from acute and long-term illnesses and diseases. They support recovery from illness or operation by using care plans, carrying out care procedures and assessments and by focusing on the needs of the patient rather than the illness or condition. They also promote good health and wellbeing through education.
Nurses usually work within a multidisciplinary team but are the main point of contact for patients, often providing the most continuity of care. Adult nurses work mainly in hospitals and the community, attached to a health centre or general practice and in residential homes, specialist units, schools and hospices. Many nurses work with patients in their own homes.
Gaining the trust and confidence of each patient is an important aspect of the job for nurses, especially as they have more contact with the patients than other members of the medical team. This extends to developing a good relationship with the patient’s relatives as well, particularly in cases of chronic illness where the patient may be returning regularly for treatment.
Patients may have chronic conditions, such as diabetes or heart/kidney problems, or serious acute conditions, such as heart failure, stroke, hepatitis or burns. They may be in hospital for surgery, admitted to accident and emergency with injuries, attending an outpatient clinic or undergoing tests and assessments.
The trend for community-based care has led to an increase in the number of opportunities for working in the community. By giving people preventative treatment and meeting patient needs in the comfort of their own home, unnecessary travel to hospital for appointments and hospital admissions can often be avoided. It is possible for a newly qualified nurse to work in the community, although many gain a year’s hospital experience first.
Exact duties may vary depending on your role but will usually include:
The nursing diploma is being phased out and from 2013 a degree in nursing will be an essential entry requirement. Some universities are running only the degree with immediate effect whereas others are continuing to run the diploma until it has been phased out. Check with the institution.
A degree in the following subjects may allow you to accelerate your studies:
For graduates with a health-related degree, there are accelerated programmes that lead to an MSc or postgraduate diploma. A few part-time courses are available. The first step is to contact the admissions staff at the university of your choice and establish the courses on offer and the competition for places.
Entry criteria are set by individual universities, as required by the Nursing & Midwifery Council (NMC) to ensure that applicants provide evidence of meeting the minimum entry requirements, especially in literacy and numeracy. The minimum is usually five GCSEs at grade C or above (typically including English language or literature and a science subject), and two or three A-levels/Highers (or equivalent) for degree programmes. Check with individual higher education institutions directly.
Applicants are required to declare any criminal record and undergo an enhanced Criminal Records Bureau (CRB) disclosure. A criminal record may not be a bar to nurse training, but would be the subject of full and open discussion at interview.
You need to decide early on which branch of nursing you want to train in. On shortened graduate programmes, 18 months is usually spent on your branch specialism. Training covers the core nursing care skills and includes substantial assessed practical experience.
Pre-entry experience is not essential, but relevant paid or unpaid work experience as a care worker or in some other work with people is good preparation. It is also a good idea to visit hospitals and talk to nurses directly about the role.
Candidates will need to show evidence of the following:
Good health and physical fitness are prerequisites and some medical conditions may exclude you (but only after an individual occupational health assessment).
Applications for honours degree and diploma courses in England, Wales, Scotland or the University of Ulster are made through the Universities and Colleges Admissions Service (UCAS) .
Most students will be eligible for a bursary and to have their tuition fees paid and in some cases additional allowances will be available, depending on your circumstances. Use the bursary calculator tool to work out how much you are eligible for, or contact the relevant funding body in your area if living outside of England.
The NHS Student Bursaries scheme processes funding applications for nursing and midwifery courses in England. If you are attending a course in Wales you can access information from the NHS (Wales) Student Awards Unit , for Scotland see the Student Awards Agency for Scotland (SAAS) or for Northern Ireland see Student Finance Northern Ireland . Similar arrangements will apply but you will need to consult these relevant national authorities for details as the NHS Student Bursaries will not be able to administer your funding.
For more information, see work experience and internships and search courses and research.
There is a variety of post-registration training for adult nurses: in-service; through secondments to university for short or long courses; or via distance learning routes. Many universities offer structured part-time learning programmes, which give progression towards MSc or even PhD qualifications. Nurses can access courses in an increasing number of clinical specialisms, such as cardiac nursing, infection control, theatre and recovery, and multiple sclerosis.
Continuing professional development (CPD) is one of the requirements of the Nursing & Midwifery Council (NMC) to maintain professional registration and is commonly known as PREP (Post Registration Education and Practice). This takes the form of a portfolio of evidence of a minimum of five days or 35 hours of learning activity relevant to practice over a three-year period (although it is common for nurses to undertake much more).
For more details on post-registration training and opportunities for CPD, see NHS Careers .
Nursing begins with a period of preceptorship, which is similar to a supported probationary period. This entails acquiring and demonstrating competencies, including specific skills in, amongst others, cannulation, administering intravenous procedures, performing tracheal suction and handling blood products, as well as broad competencies in leadership, management, teaching and communication. After successfully completing this, the majority of nurses in the acute hospital setting move from staff nurse positions to junior sister/charge nurse within two to three years. All nurses have management roles, but some career paths are more management-orientated than others. As you become more senior, you may have less hands-on nursing responsibility.
Progression to ward sister/ward manager/team leader depends on the development of management skills and level of specialist knowledge. Ward sisters/charge nurses are responsible for annual appraisals of nursing staff and are appointed at band 6 or 7 of the Agenda for Change pay scale . At this level, progression is possible either within a clinical specialism to nurse practitioner and ultimately nurse consultant, or through further managerial responsibility as a matron and then up the executive ladder to a director of nursing post. Nurse consultants are highly specialised and need a Masters qualification. They spend at least 50% of their time providing direct clinical care for patients and the rest developing and delivering education, service development and research within their area of expertise.
There are many specialist branches of nursing and qualified nurses can choose to undertake further training in order to specialise in an area of their interest. Popular roles include district nurse, occupational health nurse, practice nurse, sexual health nurse and specialist nurse. Many of these roles involve working in the community or within alternative settings such as schools or GP practices. Other specialist areas of nursing include cancer care, women’s health, accident and emergency and critical care. Secondments to achieve the required specialist qualifications on a full or part-time basis are often available.
Adult nurses form the largest group within the profession. Healthcare in the community, health education and minor surgery in GP clinics means there are plenty of alternatives to working in hospitals.
The majority of adult nurses continue to work within NHS Authorities and Trusts , although, according to the Royal College of Nursing (RCN) around a quarter work outside the NHS.
Opportunities for experienced nurses can also be found in:
Others are employed by general practices (GPs), nursing agencies, community and school health education units, air ambulance services, the armed forces, holiday companies and emergency helplines.
There may be new opportunities for professional development as a result of changes in the boundary between medical and nursing staff. Nurses are increasingly taking on extra responsibilities such as drug prescribing and roles within surgery.
For nursing jobs in the armed forces, see:
There are many specialist nursing agencies that recruit for both permanent and temporary positions, in the UK and overseas. They include:
The Nursing Agencies List is an extensive directory of agencies of all sizes.
Get tips on job hunting, CVs and covering letters and interviews.
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