Adult nurse

Working as an adult nurse offers you the chance to make a real difference to the lives of others

As an adult nurse, you'll care for patients suffering from a variety of health conditions, ranging from minor injuries and ailments to acute and long-term illnesses and diseases. You will support their recovery by observing and assessing their needs, using care plans and carrying out care procedures.

You will need to build trust with patients and may also have to contact their families, particularly in cases of chronic illness where the patient may be returning regularly for treatment.

Nurses usually work within a multidisciplinary team with other healthcare professionals but are the main point of contact for patients, often providing the most consistent care.

Responsibilities

As an adult nurse, you'll need to:

• write patient care plans
• implement plans for tasks such as preparing patients for operations, treating wounds and monitoring pulse, blood pressure and temperature
• observe and record the condition of patients
• check and administer drugs and injections
• set up drips and blood transfusions
• assist with tests and evaluations
• carry out routine investigations
• respond quickly to emergencies
• plan discharges from hospital and liaise with GPs and other healthcare professionals
• reassure patients and their relatives and communicate effectively with them
• advocate on behalf of patients
• educate patients about their health - this may include running clinics and education sessions on topics such as diabetes, weight loss and quitting smoking
• organise staff and prioritise busy workloads
• mentor student and junior nurses
• maintain patient records
• make ethical decisions related to consent and confidentiality.

Salary

• Fully qualified nurses start on salaries of £28,407 rising to £34,581 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 senior nurse on Band 6, salaries progress to £35,392 to £42,618.
• Two of the highest paid positions in nursing are nurse consultant and modern matron, where salaries start on Band 8a, ranging from £50,952 to £57,349.

The above figures are for jobs within the NHS although comparable rates of pay exist in the private sector.

The NHS offers a pension scheme as well as 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.

Income data from NHS Agenda for Change (AfC) pay rates. Figures are intended as a guide only.

Working hours

Shift work is carried out in hospitals, which includes regular unsocial hours, covering nights, weekends and bank holidays.

There's 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.

Adult nurses usually work a standard 37.5 hours per week.

Career breaks and retraining opportunities may be available, as is overseas work.

What to expect

• You'll work as part of a multidisciplinary team with other healthcare professionals, such as doctors, therapists and social workers, and will also liaise closely with patients' families and/or carers.
• The environment and working conditions vary between hospitals and wards. You might be looking after many 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 or be part of a team at a GP surgery.
• Jobs are available throughout the UK in hospital wards, clinics and outpatient units, for example. Freelance work is possible through agencies or as a private nurse or, for senior nurses, as a consultant.
• Nursing can be physically and emotionally demanding, but seeing that the care you have provided has resulted in improvement of health, recovery or reduced suffering is incredibly satisfying.
• You may need to travel during the working day between hospital units, homes and clinics.

Qualifications

To work as an adult nurse in the UK, you must be registered with the Nursing & Midwifery Council (NMC). To be eligible to register you must complete a pre-registration nursing degree or registered nurse degree apprenticeship (RNDA) delivered by an NMC-approved educational institution (AEI).

Degree courses usually lasts three years full time (four years in Scotland or if you're taking a dual-field degree that leads to registration in two fields of practice). The programme is a mix of clinical practice, giving you direct experience of working with patients and families, and academic learning. 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 experiential learning (APEL) if you have practice-based learning or a degree in another health-related, biology-based or social sciences subject. Having APEL may shorten your course to two years but this is at the discretion of individual institutions so it is best to check with course providers. For a list of recognised programmes, see NMC Approved Programmes.

A non-repayable training grant of at least £5,000 a year is available to nursing students while at university. For more information, see Health Careers.

Registered nurse degree apprenticeships (RNDAs) are also offered by some employers and these are expected to grow. They are a more flexible way to study as you're not at university full time. Instead, you'll need to secure a RNDA position with an employer and they will release you for part-time study at university. You'll complete training in a range of settings from hospitals and mental health facilities to patients' homes.

RNDAs typically take four years to complete and the cost is covered by your employer. You may be able to do it in a shorter length of time if you have APEL.

The NMC states that good health is necessary to practise as a nurse, but this doesn't mean that you'll be exempt if you have a disability or health condition. Before you start a pre-registration programme, you'll also need to take a criminal records check.

Skills

You'll need to have:

• interpersonal and verbal communication skills in order to liaise with other medical and healthcare professionals
• the ability to gain patients' trust and support them both emotionally and through advice and information
• empathy, sensitivity and emotional resilience, to help those in difficult circumstances
• written communication skills to keep patient records and write care plans
• observation skills and attention to detail
• the ability to deal with a variety of patients at once
• excellent teamworking skills
• a flexible approach to work and the ability to work well under pressure
• good judgement
• good organisational and managerial skills, particularly as your career progresses.

Work experience

Nursing can be demanding so it's good to get some relevant healthcare and/or social care experience to get an idea of what the role involves.

Work experience as a care worker or working with others is good preparation for life as a nurse and shows you have a real interest in working with people.

It's also a good idea to visit hospitals and either shadow a practice nurse or talk to nurses directly about the role.

For free mentoring resources and experiences designed to support aspiring healthcare and legal professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

 Find out more about the different kinds of work experience and internships that are available.

Employers

As an adult nurse you can find work in:

• hospitals
• GP practices
• the community, possibly in patients' homes (attached to a health centre or general practice)
• residential homes and hospices
• specialist units and schools
• nursing agencies.

Once you've gained enough experience you may also work as a nurse trainer or deliver health education, rather than carrying out hands-on clinical work.

Other options include:

• air ambulance services
• emergency helplines
• health promotion
• holiday companies
• leisure cruise ships
• occupational health
• overseas aid and development
• prisons
• private healthcare organisations
• the armed forces
• voluntary organisations.

See the NHS Provider Directory for details of trusts in your area.

Look for job vacancies at:

• BUPA UK Careers
• Circle Health Group
• Health Jobs UK
• HSC Jobs - health and social care jobs in Northern Ireland
• NHS Jobs - for vacancies in England and Wales. Also includes adverts for registered nurse degree apprenticeships (RNDA)
• NHSScotland Jobs
• Nuffield Health Careers
• Nursing Times Jobs
• RCNi Nursing Jobs

For nursing jobs in the armed forces, see:

• Queen Alexandra's Royal Army Nursing Corps (QARANC)
• Royal Air Force - Medical Careers
• Royal Navy Careers

Specialist nursing agencies such as Pulse and Newcross Healthcare recruit for both permanent and temporary positions in the UK and overseas. For a searchable directory of agencies, see the Nursing Agencies List.

Professional development

As a newly registered nurse, you will usually start your first job with a period of preceptorship. This transition phase is designed to help you further develop your practice and gain in confidence. It covers fundamental competencies in patient care as well as broad skills in leadership, management, teaching and communication.

In Scotland, all newly qualified nurses are entitled to participate in Flying Start NHS. This is a personal development programme aimed at building your confidence and supporting your learning in your first year of practice.

Your registration with the NMC must be renewed every three years and in order to do this you’ll have to show you’ve met revalidation requirements. This includes completing 450 hours of registered practice and 35 hours of continuing professional development (CPD) over the three-year period. Find out more at Nursing & Midwifery Council - Revalidation.

Training is available in various clinical specialisms, such as:

• cardiac nursing
• infection control
• multiple sclerosis
• theatre and recovery.

Many universities offer structured part-time learning programmes in areas such as advanced practice, which may lead to MSc (post-registration) or even PhD qualifications. Search postgraduate courses in nursing.

Career prospects

There are various routes for career progression. Once you've completed your period of preceptorship, you can work in a range of settings and start to move up the career ladder into roles such as:

• senior staff nurse
• ward sister/charge nurse
• advanced nurse practitioner
• lead nurse
• matron
• nurse consultant.

You'll start by gaining some experience in a more generalist role, but can then choose to undertake further training in order to specialise in an area of interest. There are many branches of adult nursing, and popular specialisms include:

• accident and emergency
• cancer
• district
• intensive care
• occupational health
• practice
• sexual health.

All nurses have management responsibilities, 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 your 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.

It is also possible to move into roles within public health, teaching or clinical research.

For more information on possible career pathways see the Royal College of Nursing careers resource for registered nurses.