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Career pathways for staff nurses

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Introduction

Welcome to this careers resource which aims to help registered nurses to understand the wide variety of opportunities within health and care, and to plan their careers more effectively. As development of this resource progresses it will become a tool which provides career guidance for all nurses, nursing associates and care staff.  

Nursing is an ever growing and innovative profession and nurses are working in multi professional teams across health and care settings. Nurses are in a unique position to deliver care in partnership with people and carers, wherever care is needed.  

Across the health and care system there is an increased focus on preventing ill health, enabling people to self-care, to be partners in their care and to stay well for longer. This, in addition to the rapid pace of advances in medical and nursing care, treatment and technology are creating new career opportunities for the nursing family, for example in the fields of genomics, mental health, advanced clinical practice and telehealth.  With so many career opportunities available it can be hard to navigate a path which is right for you. 

Using the career pathway tabs on the left, browse different roles within clinical, leadership, education and research settings and gain an understanding of the knowledge and skills needed as well as the possible routes into these roles. 

Moving up

This section is for nurses who wish to develop into a leadership or managerial role.


Introduction

Pam - District nurse

Name: Pam

Job title: Staff nurse 

Setting: Community 

Pam is a community staff nurse and has been working in this role for a few years. She has one child who will be going to university shortly and will have more time to undertake the District Nurse education and qualification. She has a large case load, lives in a diverse population which includes both rural and urban areas. She is often asked to see patients at short notice. She has several years of experience, has built up a good relationship with her patients and community and feels that she would be an excellent DN. 

Goals and Needs: She is ready to take the step. It will give her more responsibility and make full use of her experience. She is ready to undertake the DN training and would welcome the increase in salary that a band 6 will bring to help with her daughter’s student costs.


How do you make this change

Trusts have their own requirements as to who is eligible for current secondment onto the DN programme – this secondment requirement is the current model. There is an expectation that you would have post registration experience, however there is nothing to stop newly registered nurses applying. Opportunities for acting band-6 posts are a positive step in terms of gaining a place on a programme. At the present time there are significant changes to the way programmes like this are funded.

The DN apprenticeship is currently being developed and when underway will provide funding, so this will change the way in which the programme is delivered. Instead of being seconded for a year to undertake the course full time in education with supernumerary placement hours, nurses will undertake one day per week in education and have a practice placement in order to undertake the development of knowledge, skills and competence in this new role and gain experience of the holistic skills of District Nursing. This will probably be over a 2 year period. 

What do you need to do to become a DN

Staff ideally need some experience and insight into the management of complex patients in a community setting. The DN programme includes all elements of the advanced clinical practice programme and more – insight into the community as a clinical area and an awareness of the regional demographics, in addition to team management and all of the challenges that this brings. All of these elements are taught and enriched on the programme, but some insight is useful.

Aside from the experience, DNs are caring, supportive, competent, reliable, have appropriate clinical skills, team players, managers, key members of the multidisciplinary team and assertive advocates of their patients and colleagues. Again, a range of skills and attributes that are developed whilst undertaking the DN programme.

Education and training

Currently the Specialist Practice Qualification is available at degree and master’s level and includes elements of research, leadership, advanced health assessment and prescribing alongside specific community modules that cover leadership, community profiling, commissioning, governance roles and risk management.  Some incorporate throughout the programme or have separate modules to address mental health across the lifespan, palliative care in the community and health promotion and wellbeing. The DN apprenticeship will only be available at Level 7, as this is the academic level that signifies this level of practice. The programme will meet the requirements of advanced practice with the additional community focused skills of insight into specific communities, profiling, team management, MDT working.

Previous success in academic study is useful.

The DN qualification is recordable with the Nursing and Midwifery Council (NMC), and the DN title comes with this qualification. 

Personal characteristics

District Nurses may be the only point of contact for a patient and, indeed, the final point of contact. District nurses need to be reliable and act on information derived from consultations. They require good leadership qualities, resilience, and the ability to work alone as an autonomous practitioner and make life and death decisions on occasions.  An essential skill and characteristic of being able to listen, see and hear in order to carry out an accurate assessment of the patient. Information needs to be transferred to the appropriate professional succinctly and effectively and as such, DNs need to assimilate a range of information and effectively relay this to the appropriate services. A caring nature, non-judgemental in terms of how people live, clinically excellent with credibility with patients, carers and colleagues. Hardworking, resourceful, problem solving, etc.

Where can I find out more

Information may be gained from the workforce development department of most community Trusts, Professional Leads for community services, Higher Education Institutions who deliver the programme, NHS sites. 

Where the role can lead

Case load and patient management is the role that the SPQ leads to. Here the DN is responsible for an area of patients, either geographic or based on a GP location. They promote innovation, lead teams and delegate to ensure the right nurse with the right skills is supporting the team and above all ensures patient centred care.

A large part of the role is to work in partnership with other agencies and professionals. They will oversee care, allocate visits, represent their patients and staff at meetings, ensure compliance with standards of care delivery. Team Leader roles manage a range of case load holders and their teams and it is suggested that they are SPQ qualified DNs. The role of a District Nurse is multi-faceted, challenging and yet rewarding, fulfilling and exciting.  

Introduction

Geeta - Cancer care specialist nurse

Name: Geeta

Job title: Staff nurse 

Setting: on a cancer ward. 

Geeta has been working in the oncology department for several years and really wants to specialise in this area. She has developed a lot of knowledge and is now is very keen to pursue training and development to be a Cancer Nurse Specialist. 

Goals and needs: She would like to develop specialist knowledge and skills with this group of service users and be able to meet their needs in the best way possible. She is ready to take make the commitment to additional training and education.  

How do you make this change

Many Cancer Clinical Nurse Specialists (CNS) work within a site-specific speciality, such as lung, breast and hepatobiliary to name a few. Some posts may be within Acute Oncology, which covers generic Oncology, rather than being site specific.

Whether you have decided on the exact area you would like to work in as a cancer CNS or not, getting some experience by shadowing an existing Cancer CNS is recommended, to learn about the role. This may include the importance of Multi-Disciplinary Team (MDT) working, how the CNS fits into the team, observing MDT discussion and seeing the patient pathway from referral to diagnosis. If possible, it would also be good to observe a Cancer CNS in clinics, diagnostics and undertaking the daily management of patients. 

What do you need to do to become a CNS

Depending on the site-specific speciality, it is advisable to read around subject. Look up government guidelines around the 2 weeks wait pathway to gain greater understanding.

Some roles will require prior experience in an oncology setting and Acute Oncology CNS roles often require experience administering chemotherapy.  

Look out for secondments which are often aimed at Registered Nurses working in more junior roles (band 5 or equivalent) providing opportunity to gain experience in a more senior position (band 6 or equivalent). 

Education and training

Prior to applying for a Cancer CNS position, it would be beneficial to have undertaken a communication course, such as Sage and Thyme, or to develop skills which enable you to hold and manage difficult conversations.

Once in post you may be offered a Foundation in Cancer care course, which enables greater understanding around the pathophysiology of Cancer.

Further training may include developing advanced communication skills and developing knowledge of psychology.

Macmillan have developed an EXPLORE programme, which is aimed at new CNS’s to guide through challenges using reflective learning.

Personal characteristics

  • Organised
  • Flexible - Adhoc tasks
  • Passionate around chosen speciality
  • Ability to communicate within wider MDT often directly with Consultants
  • Willing to act as patient advocate
  • Willing to learn how to offer psychological support and holistic care
  • Compassionate
  • Resilient

Where can I find out more

  • Online resources - functions of CNS 
  • Talk to a fellow CNS
  • See if any education or study days that could attend within chosen speciality that could attend.
  • Macmillan Excellence in Cancer Care: The Contribution of the Clinical

Where the role can lead

  • Education, teaching both in-house and formally at a university
  • Management within specific directorate
  • Advanced Practitioner
  • Nurse Consultant

Change settings

This section is for nurses who want to move from the setting they are currently in. We have highlighted the move from acute hospital based setting to a community or primary care setting.


Introduction

Priti - GP nurse

Name: Priti

Job Title: Staff Nurse 

Priti was a staff nurse on an oncology ward. She loved her job but felt she wanted to move into the community or working in General Practice setting. This is something she had always thought about doing following a placement during her student nurse training and now felt confident to do this. 

Goals and Needs: Priti wants more responsibility and feels able to work in an area of practice that mean she should be working alone and more independently. She also wants to undertake more education and training.

To gain an accurate picture of what the role of a GPN is Priti had spoken to their own GPN and had an opportunity to speak to and shadow the GPN in her surgery. 

How do you make this change

Prior to applying for a position of a General Practice Nurse:

  • gain a good understanding of how Primary Care is organised including the role of Clinical Commissioning Groups (CCG), the role of the GPN lead and how General Practice is financed and managed
  • gain an understanding  of the role of the GPN and  consider what skills you may need  to work in the primary care setting
  • be aware of the political climate that influences the future of  Primary care such as the ‘Five Year Forward View’ and the ’10 Point Plan for growing the GPN workforce'
  • before completing a CV devise a list of the transferable skills you can bring to the role ensure you consider your strengths
  • make contact with your local Community Education Provider Network who will advise on GPN education and placement opportunities e.g. the GPN Ready scheme
  • apply for jobs even if they ask for GPN experience, make an informal visit, sell yourself and demonstrate a willingness to develop clinically and professionally
  • gain an understanding of the legal, ethical and professional issues faced by health professionals working in the general practice setting
  • make contact with local GPN Forum/networks
  • the GPN lead in the Clinical Commissioning Group, Training Hub (TH) or Community Education Provider Network (CEPN). They can help with finding employment at a suitable practice with a supportive team that may be able to assist with finding a mentor or a supportive preceptorship programme.

What do you need to do to become a GPN

There are not always additional set qualifications over and above your nursing registration with the NMC to apply for a position as a GPN. However you should be happy to work independently, be a leader, enjoy teaching patients and mentoring students and other staff groups and delivering nurse led clinics. If you enjoy a role where a day’s work is variable GPN is for you. 

Good interpersonal and people skills are required to be a good GPN, to read the subtle cues of patients who may not communicate their needs clearly are of utmost importance. GPNs need a sharp eye to see when gentle probing is needed, to uncover the really concerning issues going on in patients’ lives.

Experience in some of the areas listed below is advantageous but not essential:

  • wound care
  • management of long term conditions
  • health promotion and education
  • family planning and sexual health including cervical cytology
  • triage
  • minor illness
  • minor injury
  • mental health
  • vaccinations and Immunisations
  • non-medical prescribing.

Education and training

Where possible nurses should seek courses or modules that cover the essential knowledge and skills required to work in the general practice setting.

The RCGP GPN competency framework (2015) will support you to develop core skills and competencies.

Access to the Fundamentals of GPN Course through a university is not uniform in all areas, again THs or CEPNs can help signpost.

A foundation GPN course should cover topics that include:

  • Confidentiality, Information Governance, Infection Control, Safeguarding including the Mental Capacity Act. Professional accountability
  • Communication, Consultation and assessment  skills, Medicines management working with Patient Group Directives and/or Patient Specific Directives
  • The role of the nurse in the  management of Long Term Conditions in Primary care
  • Safe delivery of Vaccinations and immunisations
  • The course could also include: Travel Health, Ear care, Wound care, cervical cytology

As you progress through your career completing specialist courses in areas such as respiratory disease and Type 2 Diabetes will allow you to develop your expertise in some areas and increase your scope of Practice.

Personal characteristics

  • excellent communication skills
  • ability to work as part of a part of a multi-disciplinary team
  • ability to work autonomously
  • ability to make clinical decisions
  • personal resilience
  • willing to develop new skills 
  • to work within your scope of practice.

Where can I find out more

Please find some links below on becoming a GPN:

Where the role can lead

  • take the lead in a clinical area eg diabetes, respiratory disease, sexual health, prescribing lead, infection control, safeguarding
  • Team Leader
  • Non-medical prescriber
  • Advanced nurse practitioner 
  • Consultant GPN
  • Leadership role within the CCG/GP Federation or Neighbourhood 
  • RCN GPN Forum
  • Queen’s Nurse.

Introduction

Name: Svetlana

Job title: Oncology staff nurse 

Setting: hospital ward

Svetlana is a staff nurse in an adult ward. She has been working in a hospital for 15 years and now feels she is ready for a change. 

Goals and Needs: She would like to increase the level of responsibility and wants a different setting. She would like to spend a bit more time with her daughter as she is a new single parent.  She knows she has a lot to offer and wants to make a difference.

How do you make this change

  • Think about what skills you have to bring to this role, for example: good at listening, undertaking telephone assessments in current or previous work settings
  • List down your skills and experience and bring your CV up to date
  • Look at NHS Jobs and look at the job descriptions for Telephone Nurse advisors and see if you have any gaps in experience
  • Think about how you can gain additional skills. If you have friends or colleagues working in a telephone advice setting, ask if you can shadow them, although appropriate local governance processes will need to be adhered to. 

What do you need to do to become a telehealth nurse

  • Competent with IT equipment, you don’t have to be a touch typist however you will need to talk and type.
  • Ability to type brief notes, most services voice record all conversations and this makes up most of your consultation and patient record.
  • Broad experience in a variety of clinical settings is helpful.
  • Most telephone assessments services use an assessment tool, some of these are prescriptive and will help support gaps in knowledge, others rely on your own clinical knowledge.
  • Use of evidence based IT resources assist with consultations.
  • Willingness to learn new skills.
  • Supportive to junior colleagues as most telehealth nurses work with Health Advisors/Call Handlers and support them to give quality patient care.
  • Teams are multidisciplinary with pharmacists, GPs and paramedics; either based in the same location or working virtually across large geographical areas.

Education and training

Training usually consists of four elements:

  • How to book a patient into an IT system such as Adastra, SystmOne. 
  • How to use the telephony system. 
  • How to use the clinical assessment tool. 
  • Training scenarios and observed call taking. 

Training can be from one week up to 12 weeks depending on the system used and the nurses previous experience. Most services have competencies that need to be achieved to ensure safety.  Call audit is also important to ensure reflective practice and learning. Ongoing CPD is also important due to the fast changing nature of the queries received. 

Personal characteristics

  • Clear communication skills.
  • An ability to negotiate with patients and other health professionals.
  • To listen to what is said and what isn’t. To have a natural curiosity and an ability to assist patients to navigate the NHS, Social care system with patients and families.
  • The environment is fast and no two calls are the same, the nearest face to face example is an Emergency Department. However, a primary care background is also beneficial.
  • Nurses need to be able to confidently consult and complete calls.
  • Self resilience and a realisation that most of the patients telephone out of hours when other primary care services are not available. This allows for flexible working across 24 hours/365 days per year.
  • Experienced telehealth nurses may be able to work from home, if they meet the right criteria.

Where can I find out more

  • NHS Choices explains what NHS 111 is as a service
  • NHS England, has lots of back ground information and statistics
  • NHS Jobs will advise on the types of telehealth roles available. Review job descriptions to assess your skills
  • YouTube has a number of clips showing NHS 111 telehealth services.

Where the role can lead

  • Health Education England have developed a career pathway for staff with NHS 111.
  • Nurses have the opportunity to be clinical advisors, senior clinical advisors a role which assist other more junior staff.
  • Clinical Team leaders a similar role to a charge nurse who clinically runs the shift. There are clinical trainers i.e. experts who train other clinical and non clinical staff. 
  • There are more senior opportunities to work in Governance teams, and to take on clinical service manager band 7 roles.
  • There are also clinical specialists who are educated to Masters level in telephone triage who can take calls and assist others to improve their clinical practice.
  • Realisation that this role can be used to re direct your nursing career.

Introduction

Charlotte - School nurse

Name: Charlotte

Job Title: Child nurse

Setting: in a hospital

Charlotte is a staff nurse in a children’s ward. A period of ill health had given her an opportunity to reflect on career opportunities. She had been in a placement with a school nursing team and found that the hours were good and she enjoyed working out in the community.

Goals and Needs: Charlotte recognises the benefits of working upstream and preventing illness and unhealthy lifestyle and behaviours. She has always enjoyed working with teenagers and feels that school nursing gives her more access to this age group as well as younger children.

We would like to have the questions answered below form your expert perspective. 

How do you make this change

  • You can consider a career in generic school nursing, special schools and private schools.
  • Contact school nursing services in your area and ask if there is a possibility of shadowing/meeting a SCPHN school nurse/team leader to talk/observe their public health role.
  • Follow health boards/trusts/organisations on Twitter/Facebook and sign up for emails regarding jobs/posts in school nursing and/or immunisation teams working with school nursing teams.
  • Contact your local university and attend an open evening/day to discuss the Specialist Community Public Health Nursing course in School Nursing – how you apply/requirements/financial and time implications.
  • What do you need to do to become a school nurse

  • You may be able to apply for a staff nurse post in the School Nursing Team as and when they become available. 
  • Let service/locality leads know you are interested and are willing to learn and develop to meet service requirements.
  • Keep yourself up to date with contemporary issues affecting children and young people’s health and wellbeing, professional drivers, Government policy, legislation and research.
  • Education and training

  • The SCPHN qualification is usually essential for a band 6 post and desirable for a band 5.
  • The course can be undertaken full time over 1 calendar year or part time over 2.
  • The course is 50% theory and 50% practice, you will be supported in the practice area by a qualified Practice Teacher.
  • In Wales, Shared Services Partnership pays the applicants’ course fees and salary, for the duration of the course.
  • In each country of the UK the funding streams are different, but the University will advise you on current funding streams.
  • The SCPHN qualification leads to registration on Part 3 of the Nursing and Midwifery register.
  • Personal characteristics

  • This is not exhaustive but should include: Friendly, approachable, excellent communicator, kind, caring, discreet, professional, flexible, honest, supportive, good humoured.
  • What is really important is that you enjoy working with children and young people, often without parents or teachers present.
  • You will be a very autonomous practitioner.
  • Where can I find out more

    In addition to the links below, make contact with a university who is delivering the course. They normally have an intake once a year in September. You will need to apply and can be interviewed as part of the selection process.

    Where the role can lead

  • A leadership role, for example a Team leader or a Practice Teacher.
  • You may have a special interest, for example in enuresis, obesity, mental health, substance misuse, sexual health, that could potentially be developed into a specialist lead role.
  • Introduction

    Patrick - Public health nurse

    Name: Patrick

    Job title: Staff nurse 

    Setting: Hospital ward

    Patrick has worked in the hospital setting for several years and would really like a change and would like more variety in his role. He has been developing an interest in public health nursing and is particularly interested in becoming a public health nurse but he is not sure what the role really encompasses.

    Goals and Needs: He likes the idea of a career that prevents people becoming ill so he is interested in public health, working at the prevention end of the health spectrum.

    How do you make this change

    The first thing is to narrow down the role in public health that Patrick would like to do. Public health nursing covers a range of roles such as travel health, health visiting, TB nursing, HIV and sexual health, occupational health, homelessness, immunisation and health protection.

    It may be worth Patrick thinking about this current skills, knowledge and experience to identify a specific role and speak to nurses who are already working in this role to gain a clearer insight, understanding and the opportunity that a role provides.

    What do you need to do to become a public health nurse

    A range of clinical experience can help you decide which area of public health nursing you would like to join. The key thing to remember that working in a hospital or community setting provides valuable experience for a career in public health. Talk to people about areas that interest you and see if you can visit a service to learn more about it. Public health nurses work for a range of organisation, not just for the NHS so look around for opportunities.

    Register with relevant recruitment websites e.g. NHS Jobs Voluntary work may also help you to develop new skills and knowledge. For example, volunteering for a homeless charity or a young person’s charity and you do not have to volunteer as a nurse as there are so many volunteering opportunities available.

    Education and training

    You may need to undertake a specialist course for some roles such as health visiting. For other roles you may start as a staff nurse and gain experience and be offered in-house training or a university course. There is a range of free online learning that is available on public health that may help you get your first job in a speciality or give you a wider understanding and insight into public health nursing. The key thing to remember is over your career consolidating your learning and experience alongside developing future learning opportunities.

    Personal characteristics

    The ability to work in a team as well as manage your own work load, a strong motivation and commitment to public health to promote change and reduce health inequalities, good communication skills and the ability to work with a wide range of team members/colleagues from different career groups.

    Where can I find out more?


    Where the role can lead

    There are so many opportunities for public health nurses throughout their careers. A career in public health nursing can lead to becoming a specialist practitioner, working in education, community or hospital based roles including roles outside of the NHS through to director level roles.

    Change fields

    This section is for nurses who are thinking about additional registration in another field of nursing – Adult, Children, Learning Disability, Mental Health.



    Introduction

    Diego - Mental health nurse

    Name: Diego

    Job title: Staff nurse 

    Setting: on an acute mental health hospital ward.

    Diego has been developing an interest in Mental Health nursing and feels he has a lot to contribute to this area.

    Goals and Needs: He would like to use his skills and knowledge but in a different field of nursing. He knows that by having the two qualifications he will have an opportunity to use both with his contact with patients and service users.

    How do you make this change

    As a registrant employed to work on an adult mental health ward, Diego is performing this role on his current skill set. He may well need some additional post registration qualifications in mental health to support knowledge, skills and competence further in this field, but may not need to complete an additional nursing pre-registration programme of study.

    What do you need to do to become a mental health nurse

    The UK register the four fields of nursing independently, so Diego would need to enter a programme of learning leading to registration with the NMC as an RN (Mental Health). This he would then need to keep this registration current and revalidated alongside his existing qualification.

    The field of mental healthcare is varied and to ensure people are cared for holistically, a range of different professionals work within mental health. Physiotherapists and Occupational Therapy are common, as are specialist mental health midwives or health visitors.

    Diego may therefore consider remaining an RN (Adult) and completing one or more of a number of postgraduate programmes of study in the specific areas of mental health where he feels he lacks skill.

    Education and training

    If Diego wishes to add the RN (Mental Health) qualification to his registration he must complete a pre-registration programme in this field. There are opportunities to complete an MSc pre-registration, often offered as a shortened programme, and as some of the modular content is shared across fields, ‘Accreditation of Prior Learning’, either formal or experiential (APL or APEL) is a possibility but varies across universities.

    Personal characteristics

    Working in mental health nursing often appeals to people who are happy working within the biomedical model of healthcare, but also need to practice in a fundamentally humanistic way. In mental health, no two people with technically the same named condition present exactly the same way, and treatment plans often vary greatly. The art of nursing is key here, and mental health nurses need to be comfortable with rapid flexible change.

    Being able to deal with the sensitive management of risk is another key facet of a role in mental health nursing. Balancing people’s right to their independent lives with the possibility that they may cause harm to themselves (or more rarely someone else) is something we work with often, and you may have a role in protecting their or the public’s safety.

    In mental health nursing, hearing about and helping people who have suffered trauma is routine. Not always physical trauma, like our acute A&E colleagues (but sometimes so), equally traumatic can be working with people after or through life events that have been deeply traumatising and going on to help them make sense of that and move towards recovery. People who are distressed mentally can also sometimes be abusive towards and traumatise the workforce. Dealing with this over many decades of successful career takes someone who can (or who can learn and develop) the skills to look after themselves and their colleagues both physically and emotionally.

    Where can I find out more?

    Where can the role lead to?

    Being a mental health nurse is a great role with an abundance of future opportunities; teaching, management, research and further clinical specialism are all possible.

    Introduction

    Andreas - Learning disability nurse

    Name: Andreas

    Job title: Staff nurse

    Setting: on a medical ward. 

    Andreas has been developing an interest in Learning Disability nursing and feels he has a lot to contribute to this area.

    Goals and Needs: He would like to work with this group of service users and be able to meet the needs in the best way possible. He is ready to take on the training into this different field.

    How do you make this change

    Andreas needs to be able to access a programme that will provide him with the second registration of a learning disability nurse. This will be a shortened programme which will allow him to be dually registered as an adult and learning disability nurse. Alternatively Andreas will have the opportunity to work with people with a learning disability within his own organisation and should be able to identify this as an area for development with his service. He may be able to work alongside the service’s acute liaison team or specialist nurse to support access to health care for patients in the service as per the Equality Act 2010.

    What do you need to do to become a LDN

    Learning disability nursing requires the same qualifications as all fields of nursing. Applying through UCAS as part of the university access system and visiting universities that provide a learning disability nursing programme is a good start. Universities are always keen to put potential students in touch with programme lecturers and practitioners who can provide further information. Attendance at open days can be really useful and provide the opportunity for interested people to speak with practitioners, students and users of services to discuss the programmes. Information can be gathered related to the programmes and the commitment required of individuals to undertake this full time adventure!

    Education and training

    Prospective candidates will need to gain the appropriate UCAS points in order to apply for a programme in learning disability nursing. All this information is available on university websites and can be looked at through NHS careers guidance etc.

    Personal characteristics

    Learning disability nursing provides fabulous opportunities to work with a diverse range of people within a diverse range of environments. The role is designed to enable people to access their health, social and everyday needs to allow individuals to live THEIR best life. In order to do this LD nurses need to have excellent communication skills that involve actively listening to people with a learning disability and supporting them through enabling access and equity through multi-disciplinary working across all sectors. The LD nurse has the unique opportunity to be involved with people from birth through to older adulthood.

    Where can I find out more?

    NHS careers, RCN, local universities.

    Where can the role lead to?

    The LD nurse role has proven to be applicable across all environments that support people. This includes health, social care, the independent sector, education and all areas in which people require support.

    Education

    This section is for nurses who are thinking about a career in nurse or healthcare education, whether in the practice setting or the university setting.


    Introduction

    Robert - Educational role within practice

    Name: Robert

    Job title: Staff nurse

    Setting: In hospital

    Robert worked as a care assistant for several years before qualifying as a RN and has been working in a busy general adult ward since he qualified 7 months ago. He has developed a lot of knowledge and is now is very keen to pass on his experience to others.

    Goals and Needs: Robert feels he has enough experience and feels he would enjoy mentoring/supervising and teaching student nurses.

    How do you make this change?

     
    • Shadow educators and plan to commence a mentoring or assessment module.
    • Look at resources at work that might help support learners.
    • Become involved in supporting students in practice and link with educators for teaching.
    • Support a new member of staff could be a HCA with the care certificate so they can see how to assess defined learning programme in practice.
    • Support to develop coaching and mentoring skills, working alongside other nurses.
    • Be a buddy for new starters in area.
    • Become an educational link, develop communication strategies in area, develop learning tools for area. 

    What do you need to do to become a practice educator?

    • Broad and advanced knowledge
    • Enthusiasm for patient care and teaching
    • Professionally aware of changing landscape of nursing and nursing family
    • Experience with student nurses as a mentor
    • Length of experience 3-5 years. Although specific time frames don’t work for everyone, there is a level of practical nursing experience required for this role and a need for clinical credibility. 
    • Evidence of professional development towards this role.
    • Enjoy giving constructive feedback and feed forward.

    Education and training

    • Be willing to undertake Masters level education. A PGCert in Education would be helpful in this role and its development due to changes taking place in nurse and health care education.
    • Involvement in IPE so links with AHP, medical students, nursing associates - Practice Educators are involved with the educational delivery to a multitude of learners including  post registration, pre-registration and apprenticeships.
    • Mentorship/supervisor updates.  
    • Some Trusts may have a programme for Clinical Educators supporting the transition into being a practice educator or action learning facilitator training.
    • What do you need to become a student mentor? A minimum of 12 months experience. SLAIP course. Desire and passion for teaching and learning.

    Personal characteristics

    • Good communication and interpersonal skills
    • Flexibility
    • Resilience
    • Confident
    • Understand the importance of making students feels welcome and setting clear objectives for their learning. 
    • Understands best how to learn in a clinical setting.
    • Kind and supportive manner so student feel they can talk to Robert.
    • Enjoys linking theory to practice and keen to develop self.

    Professional skills

    • Good communication and interpersonal skills
    • Flexibility
    • Resilience
    • Management of change
    • Confidence
    • Professionally aware of changing landscape of nursing and nursing family
    • Experience with student nurses as a mentor
    • Research Skills: Research profile and publications is desirable and something to be is worked towards. Service improvement, audit.
    • Leadership: Being in a position of leadership.Teamwork, negotiation, collaboration capabilities. Positive role model.
    • Teaching: Teaching and assessing in practice – there may be opportunities and an expectation that you will be asked to be involved with HEI delivery. Digital literacy for workplace, teaching and assessing. Setting learning objectives, identifying and supporting a learner in practice and the environment in which they work. Developing an understanding of learning styles and adult learning.
    • Clinical Skills: Contemporary knowledge of delivering care to patients. Broad and advanced knowledge. Enthusiasm for patient care and teaching.

    Where can I find out more?


    Where can the role lead to?

    • CPF/Nurse Educator in practice
    • University lecturer
    • Senior roles in upper bands supporting others to educate learners, including a focus on assessment and feedback 


    Introduction

    Jimena - University lecturer

    Name: Jimena

    Job title: Staff nurse

    Setting: in hospital

    Jimena is a staff nurse in a hospital. She enjoys her job immensely and has over the last few years been developing her professional knowledge and mentoring groups of student nurses as they gain practical experience. She’s enthusiastic about the nurse education and enjoys keeping on top of research and would like to take the step towards becoming a Nursing lecturer.

    Goals and Needs: She has a flair for teaching and loves passing on her knowledge to the student nurses that she mentors. She loves studying and has ambitions to go further.

    How do you make this change?

    • Send CV to Dean/Head of School at local HEI, become a lecturer/practitioner, assist with OSCEs and teaching of clinical skills; shadow lecturer for a day
    • Contact Trust or CCG Education Lead, offer to team teach, assist with simulation, OSCEs, clinical skills teaching, facilitation on mandatory study days and workshops

    What do you need to do to become a university lecturer?

    • Registration as nurse or midwife
    • Length of experience is dependent on the role you are applying for. There are opportunities for early careers in an education role so make enquiries locally
    • Nursing specific education preparation programmes no longer required for Mentor, Practice Educator and Lecturer role; look for interprofessional courses
    • Links with Allied Health Professionals, medical students, nursing associates
    • Mentorship/Practice Teacher experience helpful

    Education and training

    • Education and training: undertake Postgraduate Certificate in Education at local HEI, ensure accredited with Higher Education Authority
    • Master’s degree in specialist subject(full) or willing to undertake
    • PhD or be willing to undertake
    • PG Cert in Education or be willing to undertake

    Personal characteristics

    • Enthusiasm for patient care and teaching
    • Positive role model
    • Confidence
    • Leadership – been in a position of leadership
    • Teamwork, negotiation, collaboration capabilities
    • Communication and interpersonal skills

    Professional characteristics

    • Teaching and assessing in practice and in HEI
    • Digital literacy for workplace, teaching and assessing
    • Flexibility
    • Resilience
    • Management of change
    • Professionally aware
    • Awareness of changing landscape of nursing and nursing family, including nursing associates, HCA, assistant practitioner, apprenticeships
    • Experience teaching in HEI as visiting lecturer/clinical demonstrator e.g. supporting OSCEs.
    • Contemporary knowledge of delivering care to patients
    • Service improvement, audit, project management skills
    • Experience with student nurses as a mentor; practice teacher/educator
    • History of successful practice development/research projects
    • Research profile and publications
    • Conference presentations
    • Broad and advanced knowledge and skills. 

    Where can I find out more?


    Where can the role lead to?

    • Visiting/guest lecturer
    • Clinical demonstrator/assessor;
    • Joint university/NHS/Charity appointments
    • Lecturer-practitioner roles,
    • Secondments, internships, fellowships
    • Senior/Principal lecturer
    • Course leader
    • Associate/Professor
    • Head of Practice Development
    • Deputy/Head of Nursing – deputy post often the Lead for Education in NHS trusts
    • Lead for Midwifery Education (LME)
    • Nurse researcher, Clinical Academic
    • Strategic roles e.g Workforce development, Service/Quality Improvement, Patient safety

    Research

    This section is for nurses who are thinking about a career in nursing research from a clinical research role to a research role in a university setting.


    Introduction

    Caroline - Research nurse

    Name: Caroline

    Job title: Staff nurse

    Setting: in hospital

    Caroline loves nursing and learning and is really keen to improve the quality of patient care. She has good organisational skills and attention to detail and enjoys a role that is varied.

    Goals and Needs: She is keen to improve the quality of patient care, would like a role that stretches her both intellectually as well as retaining a clinical focus. She feels that a research post would allow her to manage her own casework and be developed.

    Claire Leader - Research Nurse video

    Charlotte Gordon - Research Nurse case study

    How do you make this change

    Clinical research nurses (CRNs) are professionals who help to develop new drugs, treatment regimens or care pathways for patients, through academic or pharmaceutical industry studies. CRNs are involved at every phase of study set up. They work to bring studies from paper protocol, through to study set up, recruitment, study visit and closure. Study recruitment and timely completion of research targets are a key performance indicator. CRNs are central to the process of timely selection and recruitment of trial participants. For some studies, CRNs can also be involved in protocol development, analysis and dissemination of study results.

    Increasingly, roles are being created which cross specialities, focussing on a broad range of disease areas. It is good to begin to develop some insight into what the role is all about before making a change (as with any change of role!). Speaking to research nurses local to your area of practice will give you an idea of the local mechanisms for recruitment to posts. Every trust will have a Research and Development department with links to research nurses teams and leaders – contact them to get an idea of how research is organised in your local area.

    There are many opportunities to access research nurse roles and with the right preparation, this is a well-evaluated and rewarding career choice often offering flexibility and autonomy.

    What do you need to do to become a clinical research nurse

    This is often dependent on the local job description, however, sometimes, previous ward based or clinical experience is generally a requirement.

    Some trusts may have a central pool of research nurses on a rotational basis, others may appoint to specific posts within clinical directorates. There may also be a dedicated research facility in your area, often linked with a University and / or hospital who may fund their own research nurse posts. Posts are also available via local clinical research networks. Some areas may recruit nurses with no clinical or research experience into training posts, which enable the development of research abilities through work-based learning and training.

    It is beneficial to get some insight into the principles of good clinical research practice (GCP - see below), the phases of research trials and review NIHR websites to get an overview of the role. If research is happening in your area, speak to the team and find out more about the research process – often it is easier to transition to a research role within an area you are already familiar with, as you will have underpinning knowledge of the disease or area under investigation.

    Education and training

    • All CRNs must be qualified nurses who hold NMC registration
    • Junior roles may require a specific number of years’ experience post qualification
    • Senior clinical research nursing roles often require Masters level qualifications or progression towards this level of award
    • Before any research activity is commenced, nurses must complete Good Clinical Practice (GCP) training and hold certification of this – this training must be updated according to local policy
    • Clinical trials will often require study specific training according to the requirements of the protocol including but not limited to:
      • GCP and ethics
      • Study specific equipment / procedures – IV pumps, sensors, patient electronic diaries, spirometers, biopsies etc.
      • Data recording / reporting
      • Adverse event / safety reporting
      • Laboratory processing of blood samples and shipping / dispatch / storage
      • The investigational medicinal product (the trial medication)
      • Patient education 

    Personal characteristics

    The role of the Clinical Research Nurse requires someone with an enthusiasm and passion for high quality. The role suits those who are driven to deliver the highest standards of patient care throughout the research process, ever mindful of collaborative working towards the creation of a culture that is patient and public focused.

    An eye for detail and excellent organisational skills are key and, as the role is very autonomous, the confidence to make decisions which ensure that the patient/participant is safeguarded throughout their involvement with research, is a key function of these roles.

    A creative and innovative approach to patient care is required. A willingness to embrace technology as a means by which to increase opportunities for patients to become involved in research and to enhance the experience for patients, the public and NHS staff who take part in research studies.

    Outgoing, approachable and resilient with an ability to look critically at practice and to challenge and advocate for patients whenever necessary are all characteristics that will serve the research nurse well.

    You will need effective time management and organisational skills with an ability to work autonomously managing your own workload. Research studies can run for many months and even years. Whilst this allows you to gain in-depth insight into the research itself, often it can be hard to switch off, as the project does not stop until it is completed. You may be the only research nurse working on a study and this brings a great sense of responsibility – you are a core component in the life cycle of the clinical trial. This often allows a significant degree of autonomy in the role; facilitating a participant-centred approach that is often extremely rewarding.

    You need highly developed communication skills as you will need to communicate and engage effectively across multi-disciplinary teams, the pharmaceutical industry and academia. Research participation is only part of the picture in the holistic care of trial participants. 

    Enhanced nursing skills are often a requirement for some research studies, for example; venepuncture, cannulation, IV administration (including cytotoxic medications, monoclonal antibodies etc.), bone marrow aspirations, spirometry, arthroscopic procedures, DXA scanning, joint assessments, sample processing and dispatch to name just a few. Many of the required skills may be study specific and often training is provided to attain these skills. These often make the job more varied and can allow the CRN to coordinate many aspects of the studies.

    Knowledge of legal aspects of study management and ethical principles including the mental capacity act/adults with incapacity act, the human tissue act, and good clinical practice guidelines for clinical trials based on the Declaration of Helsinki, are a cornerstone of research nursing practice. The practical application of ethical principles is frequently a challenging and engaging process. Becoming a CRN can also be a great way for nurses to become members of local ethical committees. This facilitates further knowledge development and assists in enhancing CRNs expertise.

    Due to the innovative and uncertain nature of research, problems during the course of the research study often arise. Problem solving skills are essential therefore and demand an ability to be flexible, resilient and ‘think outside the box’ using the resources around you to effectively manage any difficulties the study may present. Every day is different and every day presents a new challenge.

    The CRN role demands a continuous need to undertake extensive training (mandatory and study specific) in order to meet the legal and operational requirements of research and development departments, and those of the pharmaceutical industry. The CRN role presents an unrivalled opportunity to gain and maintain education and training relative to the role, much of this being transferable to other nursing specialties.

    Data accuracy alongside data management skills are a fundamental element of the CRN role. Studies are subject to both internal and external audit (by trust R&D departments, pharmaceutical companies and the Medicines and Healthcare products Regulatory Agency). The CRN needs to ensure accuracy in data collection and demonstrate an ability to effectively manage regular inspection and audit, working collaboratively with the research team to ensure studies are conducted ethically and according to the specification of all research approvals.

    Where can I find out more

    Please find some links below on becoming a Clinical Research Nurse:

    Where the role can lead

    Increasingly, the role of the “clinical academic” is becoming more prevalent. Being a research nurse may lead you to become interested in an academic career and you may choose to pursue a PhD, or a Professional Doctorate, and become an independent nurse researcher. With an in-depth knowledge and understanding of the research process, you are well placed to use these skills to develop your own research relevant to the field of nursing.

    There is a growing workforce of clinical research nurses and this area is increasingly being viewed as a specialism. Opportunities for development may include senior roles, leading teams or research facilities (akin to the ward manager role), education or even being principal investigator on studies.

    There is also a growing number of Clinical Nurse Specialists who hold a joint clinical-research role. These roles are popular as they enable the nurse to remain involved in direct patient care, enhancing the experience for patients through an in-depth knowledge of the most recent innovations in their area.

    Lecturers in nursing in Higher Education Institutions are also actively involved in research. These roles provide the opportunity to develop the workforce of the future through high quality teaching, enhanced by academic credibility in nursing and health.

    Leadership

    This section is for nurses who are wishing to develop their leadership or managerial roles in the practice setting.


    Introduction

    Jasmine - Ward Manager

    Name: Jasmine

    Job title: Staff nurse

    Setting: in a hospital

    Jasmine is a staff nurse in an adult ward. She’s ambitious and organised and is looking into becoming a Ward manager. She’s married with a teenage daughter, her husband is a GP nurse.

    Goals and Needs: She has been thinking of this career move for a while. She is ready for the next step in her career, which will give her more responsibility and use the full potential of her experience.

    How do you make this change?

    • Speak with people in the role and fully understand the expectations, training or experience requirements - it’s more than just looking for a job with more money – they may lose money as there is no unsocial hours especially if she at top of band 6 which is 3 incremental points of band 7.
    • They need to understand the time commitment and consider the move from 100% clinical practice.
    • Speak with matrons manager or make an appointment with DoN to make sure they understand nursing strategy as well as the organisation's values etc.
    • Use opportunities for acting up shadowing, attending meetings and contributing, do further CPD in their speciality to develop expertise or consider gaining broader experience before specialising.
    • Actively support other staff across all professions.
    • Be a mentor practice assessor preceptor and enjoy it.
    • Get constructive feedback on their leadership skills, be able to show how they have learnt and developed from this.
    • Understand their organisations and directorate mission statement and business plan CQC reports and improvement action plan.

    What do you need to do to become a ward manager?

    Firstly, identify their current level of competence and then identify what the next leadership level of competence is for them to develop skills in. Thus, it becomes a developmental framework for individual leadership development plans

    Use appraisals, find a mentor, develop professional development plan using SMART objectives, shadow a ward manager from a different area to gain a view of the issues that face ward managers regardless of speciality.

    Apply for programmes such as the Edward Jenner NHS academy course,  Preceptorship  and first line management courses preferably interprofessional and orientated to your own organisation using experiential learning and development strategies.

    Look at the management competencies relevant to the role e.g. Chartered Management Institute.

    Education and training

    As a minimum, a degree. You are also likely to need a masters and be knowledgeable about leadership and management behaviour, styles and skills. Be aware of and use professional nursing forums, and the bodies that generate the thought leadership e.g. institute of leadership and management. Develop competence in and use coaching and clinical supervision.

    Personal characteristics

    • Be ambitious, focused, driven, person focused, and strives for excellence approachability, powerful communication skills, empathetic, compassionate and caring, respectful, holistic and transformational. It is important to have resilience and - a true respect for the role.  
    • Resilience honesty emotional intelligence high standards of clinical.
    • Continuously develop effective communication and interpersonal skills.
    • Demonstrate integrity.
    • Enjoy and promote interprofessional working.
    • Walk the walk, don't just talk the talk.
    • Be prepared for Risk taking, change the status quo using your political skills.       
    • Have vision of where nursing can go and share this vision.
    • Caring and compassionate leadership - kind on the people, tough on the problem. 

    Professional skills

    • Likely be to be qualified for a minimum of 5 years.
    • To have been a mentor and preceptor and completed formal courses.
    • Have experience of taking charge on a frequent basis, perhaps working as seconded deputy.
    • Experience of front line leadership, operational leadership and strategic leadership.

    Where can I find out more?

    NHS leadership framework and academy, RCN career guidance, RCN management and leadership forum, current employers leadership pathways. Look at job descriptions, skills and person specifications health, professional forums, talk to others, speak to your organisation practice development team. 

    Where can the role lead to?

    The role can lead anywhere and everywhere its foundation for the next steps. Clinical services manager, assistant director, director of nursing, specialist nurse led services, policy roles, different settings e.g. community, independent.

    Introduction

    Name: Fatima

    Job title:
    Registered Nurse

    Setting:
    in a care home with Nursing

    Fatima
     is a care home nurse. She is experienced and organised and aspires to be a Registered Manager of a Care Home with Nursing. She’s married with a family.

    Goals and Needs: She's ready for the next step in her career, which will give her more responsibility and use her organisational skills. She is also very keen on improving standards of care in carehomes.

    Cheryl Henderson - Care Home Manager video

    How do you make this change?

    • Discuss with the current Registered Manager in supervision/1:1 meetings.
    • Consider a Clinical lead or Deputy Manager post.
    • Take lead responsibility for a clinical area that includes a management component.

    What do you need to do to become a Registered Manager?

    • To continue practicing as a registered nurse whilst progressing to be a Registered Manager you will need to seek a post in a Care Home with Nursing. Working as a Registered Manager in a care home without nursing would mean that you were not providing nursing services as part of your role, even though you may be drawing on your knowledge and background.
    • It is recommended that you undertake a level 5 (or equivalent) qualification in health and social care management. Your experience should be commensurate with the type of service within which you are seeking to be a registered manager.
    • You will need to evidence how you have been developing your management knowledge and skills. This will be relevant to your application to CQC.

    Education and training

    You will need to:

    • Maintain and keep up to date all mandatory training.
    • Maintain a CPD portfolio for re-validation with the NMC.
    • Have a professional development plan.

    Personal characteristics

    • Experience of leading and managing people
    • Values driven
    • Demonstrate adherence to the NMC code
    • Excellent communicator (verbal and non-verbal)
    • Resilient
    • Organised
    • Assertive and confident
    • Has integrity and is authentic

    Professional skills

    • Assessment, care planning and review
    • Knowledge of regulation and legislation
    • Networking and communicating
    • Management of people
    • Management of finance and property

    Where can I found out more?

    Where the role can lead

    • If you are a Clinical Lead it could lead to a Deputy or Registered Manager’s post.
    • If a Deputy it could lead to a Registered Manager’s post.
    • A Registered Manager could develop into area and regional positions in clinical and quality roles as well as director roles.
    • There are national positions in policy and in other organisations and sectors such as regulation, education and business.

    The skills and knowledge developed in this role are transferable to a range of settings across social care, health and housing.

    Return to work

    This section is for those who are thinking about returning to nursing following a period of absence.


    Page last updated - 18/04/2019