Adult nurses care for adult patients who are suffering from a variety of health conditions, ranging from minor injuries and ailments, to acute and long-term illnesses and diseases.
They support recovery by using care plans, carrying out care procedures and assessments, and evaluating and focusing on the needs of the patient rather than the illness or condition.
They also promote good health and well-being through education and clinics on certain topics such as diabetes, weight loss and quitting smoking.
Nurses usually work within a multidisciplinary team but are the main point of contact for patients, often providing the most continuity of care. They will have contact with the patients' families, particularly in cases of chronic illness where the patient may be returning regularly for treatment.
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 and their main aim is to improve the patients' quality of life.
Exact duties may vary depending on your role but will usually include:
- writing patient care plans;
- implementing plans through tasks such as preparing patients for operations, wound treatment and monitoring pulse, blood pressure and temperature;
- observing and recording the condition of patients;
- checking and administering drugs and injections;
- setting up drips and blood transfusions;
- assisting with tests and evaluations;
- carrying out routine investigations;
- responding quickly to emergencies;
- planning discharges from hospital and liaising with GPs and social workers;
- communicating with and relieving the anxiety of patients and their relatives;
- advocating on behalf of patients;
- educating patients about their health;
- organising staff and prioritising busy workloads;
- mentoring student and junior nurses;
- maintaining patient records;
- making ethical decisions related to consent and confidentiality.
- Fully qualified nurses start on salaries of £21,692 rising to £28,180 on Band 5 of the NHS Agenda for Change Pay Rates. Salaries in London attract a high-cost area supplement.
- With experience, in positions such as nurse team leader on Band 6, salaries progress to £26,041 to £34,876.
- At more senior levels such as nurse advanced, modern matron and nurse consultant (Bands 7 to 8c) salaries range from £31,072 to £67,805.
- Comparable rates of pay exist in the private sector.
- Payments for unsocial hours are made to NHS staff. Details of pay for unsocial hours in the private sector may vary so contact employers for information.
Income data from NHS Agenda for Change (AfC) Pay Rates . Figures are intended as a guide only.
The NHS offers a pension scheme, sickness and maternity benefits. Nurses employed outside the NHS may not have the same terms in relation to pension provision or benefits, but may be offered other incentives such as private health insurance or, occasionally, a company car for senior roles.
Shift work is carried out in hospitals, which includes regular unsocial hours. There is increasing scope for 9am to 5pm working in other locations, not only in the community and in specialist units and clinics, but also in industry and commerce.
What to expect
- Flexible working has become available as a means of retaining staff, but tends to vary according to whether there are nurse shortages. Currently, workforce levels are stable.
- The environment and working conditions vary between hospitals and wards. You might be looking after many different patients on a ward, or one or two patients in intensive care or on a high dependency unit. Alternatively, you could work on your own in patients' homes.
- Nurses often work in multidisciplinary teams.
- Career breaks and retraining opportunities are often available.
- Freelance work is possible through agencies or as a private nurse or, for senior nurses, as a consultant.
- Opportunities exist in most major towns and cities. In rural areas, opportunities are more limited.
- In the NHS, a clothing allowance/uniform is provided. This may not always be the case in the private sector.
- Nursing can be physically and emotionally demanding but it can also be satisfying when you see that the care you have provided has resulted in improvement of health, recovery or reduced suffering.
- Ward-based adult nurses may occasionally need to travel within a working day, for example between two hospitals or units in a trust. Progression into specialties such as district nursing or health visiting, or other community roles, often involves regular travel to visit people in their own homes.
- There are opportunities to travel or work overseas.
To work as a nurse in the UK, you must be registered with the Nursing & Midwifery Council (NMC). You need to have completed an accepted pre-registration nursing programme in order to be eligible to register and these are only run at NMC approved educational institutions (AEIs).
Half of the programme is based in clinical practice, giving you direct experience of working with patients and families. You could be based within a variety of settings including hospitals, the community, patients' homes and independent organisations.
You may be able to get accreditation of prior learning (APL) if you have a degree in another health-related subject or other practice-based learning. Relevant subjects may include:
- biomedical science;
- human biology;
- life and medical sciences;
- social work.
Evidence of this learning may count towards the programme requirements of some of the approved degrees and postgraduate diplomas, allowing for the course to be accelerated. You should contact the relevant institution directly for more information. Details of all approved programmes can be found at Nursing & Midwifery Council: Approved Programmes.
The NMC states that good health is necessary to practice as a nurse but this does not mean that you cannot have a disability or health condition, just that you must be able to carry out safe and effective practice without supervision.
You will also need to declare any criminal convictions, charges or cautions. A criminal record may not be a bar to training, but would be the subject of full and open discussion at interview.
The NHS provides funding to cover tuition fees for students who are UK residents. Contact your chosen institution to find out if your course is eligible for funding.
You may also be entitled for a bursary to help with living costs. More information can be found at NHS Student Bursaries.
For bursary information if you are attending courses in Scotland, Northern Ireland or Wales see:
You will need to show:
- the ability to communicate with and gain the trust of people from a range of backgrounds;
- empathy, sensitivity and emotional resilience to be able to help people under what may be difficult circumstances;
- flexibility to deal with a variety of patients at one time;
- teamworking skills;
- organisational and managerial skills, particularly as your career progresses.
Pre-entry experience is not essential, but relevant work experience as a care worker or in some other work with people in the community is good preparation. It is a good idea to visit hospitals and talk to nurses directly about the role.
Adult nurses form the largest group within the nursing profession. Although the majority of adult nurses work within NHS authorities and trusts, a significant proportion work outside the NHS.
Healthcare in the community, health education and minor surgery in GP clinics means there are plenty of alternatives to working in hospitals.
Opportunities for experienced nurses can also be found in:
- health promotion;
- occupational health;
- overseas aid and development;
- private healthcare organisations;
- residential nursing homes;
- schools and universities;
- specialist units and hospices;
- research, teaching and education;
- leisure cruise ships;
- voluntary organisations.
Some adult nurses are employed by:
- general practices;
- nursing agencies;
- community and school health education units;
- air ambulance services;
- the armed forces;
- holiday companies;
- 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.
Look for job vacancies at:
- BMI Healthcare Jobs
- BUPA Careers
- NHS Authorities and Trusts
- NHS Jobs
- Nuffield Health Careers
- Nursing Times Jobs
- RCN Bulletin Jobs
- Websites of medical charities.
For nursing jobs in the armed forces, see:
- Queen Alexandra's Royal Army Nursing Corps (QARANC)
- Royal Air Force - Medical Careers
- Royal Navy Careers
There are many specialist nursing agencies, such as Pulse, that recruit for both permanent and temporary positions in the UK and overseas. For a searchable directory of agencies, see the Nursing Agencies List .
You must renew your registration with the Nursing & Midwifery Council every three years. To do so, you have to show that you have met the post-registration education and practice (PREP) requirements. These include:
- 450 hours of registered practice over a three-year period, which as well as direct patient care, can be made up of administrative, supervisory, teaching, research and managerial roles.
- 35 hours of continuing professional development - activities must be related to your practice and have to be recorded in a personal professional profile.
More information on the requirements can be found at Nursing & Midwifery Council: PREP Handbook.
There is a variety of post-registration training available to adult nurses via in-service training, secondments to university for short or long courses, and distance learning routes.
Training is available in an increasing number of clinical specialisms, such as:
- cardiac nursing;
- infection control;
- theatre and recovery;
- multiple sclerosis.
Many universities offer structured part-time learning programmes, which may lead to MSc or even PhD qualifications.
Nursing begins with a period of preceptorship, which is a transition phase designed to help newly registered nurses to further develop their practice. It covers fundamental competencies in patient care as well as broad skills in leadership, management, teaching and communication.
After successfully completing this, you can begin to progress through various different roles, including:
- senior staff nurse;
- junior sister;
- ward sister;
- nurse practitioner;
- nurse consultant.
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 roles such as ward sister, ward manager and team leader depends on the development of management skills and level of specialist knowledge. You may then progress either within a clinical specialism up to posts such as 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. As well as spending time providing direct clinical care for patients, they develop and deliver education, service development and research within their area of expertise.
For more information on possible career pathways see the NHS Career Planner for Nurses.
There are many specialist branches of nursing, and you can choose to undertake further training in order to specialise in an area of interest. Popular roles include:
- district nurse;
- occupational health nurse;
- practice nurse;
- sexual health nurse;
- 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.