Clinical

This category boasts the widest and most varied range of nursing roles, placing an emphasis on providing direct patient care. Opportunities and choices are numerous, often leading to careers within specialist or advanced practice.

The majority of nursing roles fall within the category of clinical practice, characterised by delivering direct care to patients, clients or service users, and boasting the widest choice of roles at a variety of different settings and levels.

In terms of career progression, most individuals will gain a few years post-qualifying experience before going on to senior, specialist or advanced roles.

However it's not all about “moving up the ranks,” and you may instead want to explore a sideways or lateral move. This could be to change setting, gain experience in a different clinical area, enjoy new challenges, work with a different client group, facilitate a lifestyle choice, or indeed act as a stepping stone for future plans.

If you’ve been working at band 5 level or equivalent, but feel you’d like more responsibility or autonomy, you may want to consider a senior nursing role.

Senior nursing roles are usually characterised by working at a higher and more autonomous level, utilising enhanced skills and competencies, and often dealing with more complex patients or cases. Providing clinical leadership and mentoring/teaching often form a key part of these roles.

Senior nursing roles usually sit at a band 6 or equivalent and require a few years’ worth of post-registration experience. (There are some exceptions: more junior practice nurse posts can sit at band 5, and training programmes can be available at entry level. Midwives enter on band 5, but go up to band 6 after a year or two due to a special transfer mechanism.)  

Senior nursing roles can often act as a good stepping stone, leading to roles in advanced or specialist practice, teaching, research or leadership roles.

Examples of senior clinical roles

• Team leader
• Junior sister
• Lead nurse
• Senior nurse / Senior staff nurse
• Nurse practitioner
• Practice nurse
• Triage nurse
• Nurse adviser (e.g. NHS 111)
• Midwife / Community midwife

If you're interested in senior roles...

• Volunteer and show enthusiasm to take on more responsibility, (e.g. taking charge of shifts, taking the lead on projects, getting more involved in training new staff, putting yourself forward for training, etc.)
• Build up a network of senior nurses. Network at events or meetings, use your colleagues and friends to seek new contacts, and reach out on social media, LinkedIn, forums, and professional networks.
• Shadow senior nurses within your organisation to gain insight into the role and build your contacts.
• Contact third party employers or organisations to set up informal visits and shadowing opportunities.
• If you see a relevant job advert, call the hiring manager or employer to find out more about the role or ask for advice. 
• Examine relevant job vacancies at the level you want (e.g. band 6 / band 7) to identify the type of experience or skills generally required
• Speak to your employer for support, and make sure any goals or aspirations are documented in your 121s and appraisals.
• See if your employer offers mentoring schemes, internal coaches, or recognised career frameworks.

Many nurses are drawn towards specialist roles because they have a particular interest or passion within a certain area of nursing, and prefer the idea of being a clinical expert within that area. You could specialise:

• Within a clinical remit or area (e.g. school nursing, occupational health, sexual health, etc.), or 
• In relation to a clinical condition (e.g. substance misuse, dementia, lung cancer, diabetes, etc.)

Nurses working within specialist roles will have specialist skills, competencies and experience, and practice at an advanced level. They will also usually have completed or will be working towards post-registration qualifications relevant to their specialist area such as modules towards a degree pathway, SCPHN courses, or Masters programme. Although they work within a multidisciplinary team, they have a greater deal of autonomy, and will be responsible for a caseload or group of patients. 

Some examples of specialist roles:

• Occupational Health Nurse
• School Nurse 
• Health Visitor
• Public Health Nurse 
• District Nurse
• Clinical Nurse Specialist / Nurse Specialist / Specialist Nurse
• Specialist Mental Health Therapist
• Specialist Midwife

If you're interested in specialist roles...

• Take it upon yourself to become an expert in your chosen subject in your own time.
• Swot up on your area or subject by reading journals, articles, books, attending conferences, joining professional networks, and getting involved with relative initiatives, pilots or projects that are relevant.
• Volunteer to become the "link nurse" for your chosen subject within your unit. (e.g. infection control, diabetes, nutrition, tissue viability, etc.)
• Contact relevant employers and organisations to arrange informal visits.
• If you see a relevant job advert, look to find the relevant manager's contact details. Call them to find out more about the role or ask for advice. 
• Try to shadow specialist nurses. This could be through your networking, informal visits or through your current employer.
• Use your contacts, colleagues, and friends to get in touch with specialist nurses and build up a list of contacts. 
• Try and network with specialist nurses or with employers, organisations or charities who employ or engage with specialist nurses
• Volunteer with a charity relevant to your chosen specialty for experience and to gain contacts. 
• Examine relevant job vacancies at the level you want (e.g. band 6 / band 7) to identify the type of experience or skills generally required
• Speak to your manager for support, and make sure any goals or aspirations are documented in your 121s and appraisals.
• See if your employer offers mentoring schemes, internal coaches, or recognised career frameworks.

RCN Nursing Career Resource

For more information about the desired qualifications, education, skills and experience needed to transition into specialist practice, see the RCN's Nursing Career Resource, which includes videos, case studies and loads of further resources.

If the idea of developing and using advanced skills, dealing with more complex patients and having more freedom to act appeals to you, you may want to consider an advanced nursing role.

Such roles are characterised by advanced clinical skills and competences, a higher degree of autonomous decision-making, along with the remit to diagnose, treat and prescribe. They require an education to Master’s level, as well as prescribing qualifications. 3 years post registration experience is often required.

Nurses in advanced roles practice across primary, secondary and tertiary care, from general practice, to emergency care, to specialties like paediatrics, neonatal care, cancer care, ophthalmology and orthopaedics.

Examples of Advanced roles:

• Advanced Nurse Practitioner 
• Emergency Nurse Practitioner
• Nurse consultant
• Consultant midwife

If you're interested in advanced roles...

If you think you might be suited to an advanced role, you'll probably want to do some further research before you start applying. Here's some things you can do: 

• Ask your manager about development opportunities such as learning new skills, completing new competencies, doing courses, etc.
• Keep your eye out for “trainee advanced nurse practitioner” vacancies. (You may want to contact your local trusts or health board for info)
• Shadow nurses in advanced roles. This could be through your networking, informal visits or through your current employer.
• Enquire with universities about any programmes they are running in Advanced Clinical Practice and career prospects
• Contact relevant employers and organisations to arrange informal visits. Be specific about which roles interest you.
• Contact the named person/manager listed within relevant job adverts for advice and further discussion.
• Use your contacts, colleagues, etc. to get in touch with advanced nurses.
• Do your research - study all the job vacancies at the level you want (e.g. band 6 / band 7 / band 8) - what experience and skills do employers want?
• If appropriate, speak to your manager for support, and make sure any goals or aspirations are documented in your 121s and appraisals
• Check if your employer offers mentoring or coaching, or has any career frameworks.
• Check if your employer has an education lead, practice facilitator and/or RCN Learning rep.
• Join the RCN's Advanced Nurse Practitioner forum and the RCN Advanced Nurse Practitioner facebook group.

RCN Nursing Career Resource

For more information about the desired qualifications, education, skills and experience needed to transition into specialist practice, see the RCN's Nursing Career Resource, which includes videos, case studies and loads of further resources.