Careers resource for registered nurses

• Each employer will set requirements as to who is eligible for secondment onto a specialist practice programme.
• Many employers and Higher Education Institutions expect post registration experience within a community setting to apply. However, experience is other relevant settings may be considered.
• Taking on additional responsibility, such as being a link nurse or supervising new staff and students, will help you to prepare for this change.

Ideally you need some experience and insight into the management of complex patients in a community setting. You will need to manage your time effectively to create a work life balance that works for you. Having a supportive network of people is of benefit. The Specialist Practice Programme helps to develop in depth knowledge and skill providing insight into the community as a clinical area, an awareness of regional demographics, team management, advanced assessment skills and may include independent prescribing. 

For more information, see: Institute for Apprenticeships and Technical Education - District Nurse

• There are currently two different education pathways to becoming a District Nurse. 
• A one-year secondment to undertake a full time education programme (at either level 6 or 7) at a Higher Education Institution. This includes both theoretical learning and placement hours. 
• A level 7 (masters level) apprenticeship programme allowing you to work and undertake theoretical learning and placements, over approximately 24 months.
• Both education pathways are available, to check where each are running go to individual HEI websites.
• Having some recent study would be of benefit as studying at level 7 will require greater analysis and synthesis of research and information than you may be used to. 

The Specialist Practice Qualification is currently recordable with the Nursing and Midwifery Council (NMC).

District Nurses may be the only point of contact for a patient and, indeed, the final point of contact and the following qualities are required:

• resilience and resourcefulness
• sensitivity and understanding 
• excellent verbal communication skills 
• active listening skills 
• to be thorough and pay attention to detail 
• the ability to work well with others 
• knowledge of biology 
• patience and the ability to remain calm in stressful situations 
• the ability to understand people’s reactions 
• to be able to carry out basic tasks on a computer or hand-held device.

You can find information from:

• The workforce development/education teams within health and care organisations 
• Talking to your professional leads within your organisation 
• Higher education institutions who deliver specialist practice programmes
• Health Careers website.

A District Nurse is a highly skilled, autonomous practitioner and many who become one choose to stay in the role. If after gaining the Specialist Qualification and consolidating your knowledge and skills as a District Nurse you would like to consider other roles, it could lead to:

• specialising further in the community in roles such as palliative care, tissue viability, falls or dementia specialist nurse 
• progress to a more managerial role such as Community Matron or Head of Nursing
• undertake an Advanced Practice pathway to becoming an Advance Nurse Practitioner
• or consider a role in Education such as Lecturer Practitioner, Practice Teacher or Tutor. 

• Make professionally autonomous decisions, for which they are accountable
• Receive patients with undifferentiated and undiagnosed problems
• Assess health care needs, based on highly developed nursing knowledge and skills
• Refer and treat, including prescribing independently
• Make differential diagnoses using decision making and problem solving skills
• Order the necessary investigations and have the authority to admit or discharge patients from their caseload
• Acts on and interprets results.

• Show interest in undertaking a range of development opportunities to enhance your skills and knowledge 
• Shadow other Advanced Practitioners to ensure you find this role interesting and achievable
• Read widely about the opportunities of the role and what this means to nurses and patients
• Discuss your desire to develop with the General Practitioners at your practice, and identify what support may be available
• Consider the different educational routes to achieve this level of practice and choose the one to suit you.

• You must hold NMC registration and meet NMC revalidation requirements
• You will need to undertake education and development at level 7 (Masters level) which may include a level 7 Advanced Practice award (post graduate diploma/Masters degree)
• You will be required to evidence your ability to practice in all 4 pillars of Advanced Practice which are Clinical, research, education and leadership
• Develop the confidence to make decisions which ensure that the patient/participant is safe and provided with the best and most effective treatment
• Many Advanced Practice roles require that you are an independent prescriber
• Demonstrate autonomous practice
• Develop advanced physical assessment skills and have experience of managing people with long term conditions.

There are several education routes to becoming an Advanced Nurse Practitioner. 

• One route is to undertake a level 7 Advanced Practice award (post graduate diploma/Masters degree) at a Higher Education Institution. This will include modules on advanced assessment skills, leadership, pathophysiology, quality improvement and may include prescribing. Assessment methods vary depending on the higher education institution delivering the programmes, but often include written assignments, portfolio development and objective structured clinical examination (OSCE). 
• An alternative route is to develop a portfolio which evidences your prior learning and ability to work at Advanced Practice level within the 4 pillars of Advanced Practice (Clinical; Education; Research and Leadership). 

• Enthusiasm and passion for improving care
• Interest and belief in self’s ability to develop knowledge and skills beyond first level registration
• Interest in developing solutions and teaching and educating staff and patients
• Drive to deliver the highest standards of patient care through a collaborative approach
• Excellent organisational skills 
• Creative and innovative, approachable and resilient with an ability to look critically at practice and to challenge and advocate for patients
• Interest in teaching.

• Develop an interest in a teaching and academic career and you may choose to pursue a PhD, or a Professional Doctorate
• Develop your research skills to develop your own research relevant to the field of nursing.

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. 

You will need to be educated to a minimum of degree level and to have undertaken further education and development within cancer, palliative care, or a clinically related subject. 

This role requires specialist knowledge and skills to assess, plan, treat and evaluate care for people with cancer. Therefore, having experience caring for people within an oncology setting is essential and some roles will require previous experience administering chemotherapy.   

You will need to be passionate about working with people with cancer and improving their experience of treatment and care.

You will be expected to undertake education to develop your knowledge and skills and your skills will be assessed in practice. 

The Career and education framework for cancer nursing provides guidance for pre-registration nursing students, support workers in health and social care, and registered nurses providing general or specialist cancer care. It sets out the knowledge and skills which you will be expected to develop to work as a cancer CNS. 

As a cancer CNS you will carry a patient case load which requires excellent time management, prioritisation and communications skills. A cancer CNS is a vital role for people with cancer, supporting them to navigate services, explaining treatment plans, listening to people’s needs and preferences and being their advocate. It would be beneficial to undertake a communication course, such as Sage and Thyme, to develop skills which enable you to hold and manage difficult conversations. 

You may undertake a Foundation in Cancer care course or similar, which enables greater understanding around the pathophysiology of Cancer. Macmillan have developed an EXPLORE programme, which is aimed at new CNSs to guide through challenges using reflective learning.

• Organised, able to prioritise and flexible
• Passionate about chosen speciality
• Excellent communication skills
• Acts as patient advocate
• Able to give psychological support and holistic care
• Compassionate
• Resilient.

• Macmillan. Excellence in Cancer Care: The Contribution of the Clinical Nurse Specialist 
• RCN. Career and education framework for cancer nursing. Guidance for pre-registration nursing students, support workers in health and social care, and registered nurses providing general or specialist cancer care

The role of the Cancer Clinical Nurse Specialist can be complex and varied. You will be organising treatment, providing care and communicating with an interdisciplinary team across services and settings. There are several possible career journeys which can be taken from this role, including: 

• A role in education; supporting education in practice or formally at a university
• Managing a team or service Management within a specific directorate
• Undertaking further development to become an Advanced Nurse Practitioner or Nurse Consultant.

Some organisations recruit nurses overseas and then support them through the NMC registration process while they earn a wage. For those coming to the UK independently, gaining experience in a health and care setting in the UK will enable understanding of the health and care system and how care is organised and managed. 

As a health care support worker in a care home Lily was able to learn about the culture, processes and systems of delivering safe care in the UK. She hadn’t worked with people living with dementia before and this experience helped her to further develop her knowledge and skills of working with this client group, her communication skills and to learn about personalised care. 

The NMC overseas registration process has three stages, including an English examination (such as International English Language Test System - IELTS), a computer-based test and a practical test known as an Objective Structured Clinical Examination- OSCE.  Additionally, it is necessary to evidence your identity, qualifications, health, character and confirm that you have professional indemnity cover to work in the UK. The process can take time and there is an associated cost; being prepared with your documentation in English is important. 

Lily found the English examination challenging, despite studying in English in Nigeria. She passed after the second attempt. The English examination is recognised as being challenging for overseas nurses and some organisations will support overseas nurses to gain their English examination whilst others may want evidence that this had already been achieved to recruit. 

The NMC requires you to have been registered in another country to practice as a nurse. There is no other requisite education or training required before undertaking the NMC registration process for overseas nurses.

Some organisations provide a programme of support which helps to acclimatise to the healthcare culture in the UK.

Coming to the UK to work can be daunting and it takes ambition and motivation to meet the requirements to become registered here as a nurse. Many overseas nurses have to leave their families behind in order to pursue a career the UK so will need support from their respective organisations to prepare as the English language test can be challenging, and it may be necessary to repeat this examination before being successful.

Many have immense determination, have curiosity to work in a different health and care system and learn quickly to understand and fully appreciate the health and care culture in the UK. 

Once you are a Registered Nurse in the UK, there are hundreds of career routes and opportunities.

Visit the Registered Nurse part of this careers resource to see some of the career journeys which might interest you. 

Name: Dawn

Job title: Community nurse

Setting: Integrated community team

Dawn qualified as a registered nurse and initially worked in a community nursing team, providing care to people in their homes. She is passionate about supporting people to stay in their own homes, preventing hospital admissions and promoting quality of life.

Goals and Needs: She would like to become a continuing healthcare nurse assessor. She has gained a good understanding of the local health and care system and would like to work in a role where she can develop her skills in coordinating care with people with long term health and care needs, and their families.

How do you make this change

This role focuses on performing comprehensive assessments to ascertain eligibility for NHS continuing healthcare funding. The continuing healthcare nurse assessor undertakes an assessment of the individual, collecting all information required to decide on whether they are eligible for funding. The assessment requires gathering and analysis of complex information from a variety of sources such as health and care records, from the person and their family.

Once eligibility has been determined, continuing healthcare nurse assessor is pivotal in developing a support plan with and for the individual, considering the desired health outcomes and then supporting the individual and their family to coordinate care provision using the personalised budget. The role does not involve the delivery of direct care, but the coordination of care to promote independence and empowerment.

They then follow up regularly with each person in their case load to ensure the package of care continues to be right for them and that they continue to be eligible for the funding.

It is possible to apply for a continuing healthcare nurse assessor from qualification.

What do you need to do to become a continuing healthcare nurse assessor

You need to have a good understanding of the health and care system in its entirety, and specifically your local services. It is necessary to build relationships with people in all parts of the system as part of the role.

The role requires excellent communication skills, developing an understanding of the person’s needs and then developing and evaluating a package of care to meet these needs.

Case management is a big part of the role and therefore getting some experience of managing a case load would be advisable, although not essential.

In many continuing healthcare nurse assessor roles, they follow the person from assessment all the way through to the end of their continuing healthcare journey. The people they assess are very varied and could be someone with a learning disability, an armed forces veteran with post traumatic stress and physical health needs, through to a person at end of life.

Education and training

This role is quite different from any other and therefore training would be given as part of an induction process.

You would expect to learn and develop skills in assessment, case management, care package development and evaluation, and advanced communication skills.

An online learning package has been developed to enhance and develop the knowledge and application of NHS Continuing Healthcare. This is for all practitioners involved continuing healthcare assessments, to enable a uniform approach. The learning package can be accessed here.

Personal characteristics

This role is for people who want to use their professional curiosity to its maximum. You need an attention to detail to enable you to identify the relevant information, it’s a bit like being a mini detective!. It’s a very analytical role and can be mentally taxing. It requires innovative and creative thinking and a little bit of risk taking.

The role can be challenging, and you will see and need to manage distressing situations, challenges from families and other health and care practitioners.

There is a huge sense of reward when you are able to support people to have the best quality of life possible, preventing hospital admissions.

Where can I find out more

I would really encourage anybody interested in the role to contact their local CHC lead for a conversation. Every Integrated Care Board has a CHC lead which can be found by doing an internet search. 

Joanne Cesarano - General practice nurse case study       

Prior to applying for a position of a general practice nurse:

• Gain a good understanding of how Primary Care is organised in the country you are looking to work in and how General Practice is financed and managed. This may include:
  • Clinical Commissioning Groups (CCG) in England
  • Local Commissioning Groups (LCG) in Northern Ireland
  • GP networks and federations, as an increasing number of General Practices are entering into collaborative arrangements with other practices.

• 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 in your country that influences the future of Primary Care
• Before completing a CV devise a list of the transferable skills you can bring to the role, ensuring 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 
• 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.

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. GPNs need a sharp eye to see when gentle probing is needed, to uncover the really concerning issues taking place 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.

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.

• 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.

Please find some links below on becoming a GPN:

• Take the lead in a clinical area e.g. 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.

Michela Littlewood - Telehealth nurse case study              

• 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. 

• 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.

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 nurse’s 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 Continuous Professional Development is also important due to the fast changing nature of the queries received. 

• 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 and families to navigate the NHS and Social care system 
• 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. 

• NHS Choices explains what NHS 111 is as a service
• NHS Jobs will advise on the types of telehealth roles available. Review job descriptions to assess your skills
• Calling NHS 111 - a career of choice
• Integrated urgent care/NHS 111 roles

• Nurses have the opportunity to be clinical advisors and senior clinical advisors, who 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. 

This video has been provided by Health Education England.

• Contact school nursing services in your area and ask if there is a possibility of shadowing/meeting a Specialist Community Public Health Nursing (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 SCPHN course in School Nursing – how you apply/requirements/financial and time implications.

• 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.

• The SCPHN qualification is usually essential 
• There are different education routes to undertake the SCPHN. 
• The course can be undertaken full time over 1 calendar year or part time over 2. You will usually need to be seconded from your organisation onto a SCPHN programme.Theis full time course is 50% theory and 50% practice - you will be supported in the practice area by a qualified Practice Teacher. 
• Another route is the Specialist Community Public Health Nurse apprenticeship, which enables you to study whilst working, over an 18 month period. 
• 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.

• This is not exhaustive but should include being: friendly, approachable, an 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.

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.

See also: Institute for Apprenticeships and Technical Education: Specialist Community and Public Health Nurse

• 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.

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 his current skills, knowledge and experience to identify a specific role and speaking to nurses who are already working in this role to gain a clearer insight and understanding.

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 is 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 organisations, 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. You do not have to volunteer as a nurse - for example, you may wish to volunteer for a homeless or young person’s charity instead.

• The SCPHN qualification is essential for a health visiting, school nursing or occupational health nursing role, and is registered with the NMC.
• There are 2 education routes to getting this qualification. The first is to undertake a full time SCPHN programme over 1 calendar year or part time over 2. You will usually need to be seconded from your organisation onto this type of programme. 
• The second is to undetake a Specialist Community Public Health Nurse apprenticeship, which would involve working while you study, over an 18 month period. 
• For other public health nursing roles (such as HIV nurse and sexual health nurse) you may start as a staff nurse and gain experience and be offered in-house training or a university course. 
• There are a range of free online learning opportunities that are available on the topic of public health that may help you get your first job in a specialty or give you a wider understanding and insight into public health nursing. 
• The key thing to remember over your career is to continue consolidating your learning and experience alongside developing future learning opportunities.

The ability to work in a team as well as managing 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 colleagues from different career groups.

Search for SCHPN courses at your local University.

See: Institute for Apprenticeships and Technical Education - Specialist Community and Public Health Nurse

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.

Public health nurses can also progress to being public health consultants, through a period of education and training. 

Sharon Spain - Mental health nurse case study                  

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.

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). He would then need to keep this registration current and revalidated alongside his existing qualification.

The field of mental health care 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.

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. However, this varies greatly across universities and across the UK countries. He will therefore need to explore this in his area.

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 a successful career takes someone who has (or who can learn and develop) the skills to look after themselves and their colleagues both physically and emotionally.

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.

Julie Auger - Learning disability nurse case study              

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. This may provide him with an opportunity to undertake additional education and training so that he is skilled and up to date. 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.

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!

If Andreas wishes to undertake a programme that will provide him with the second registration of a learning disability nurse he will need to find an NMC approved programme delivering LDN. This may be a shortened programme which will allow him to be dually registered as an adult and learning disability nurse, however this varies across universities and across countries. 

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.

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.

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.

Theiba Khan - Practice educator & mental health nurse case study             

• Shadow educators and plan to commence further training if required.
• 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 health care assistant (HCA)) with the care certificate so they can see how to assess defined learning programme in practice.
• Support to develop coaching and education 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.

• Broad and advanced knowledge.
• Enthusiasm for high quality patient care and teaching.
• Professionally aware of changing landscape of nursing and nursing family.
• Experience with student nurses as a supervisor and assessor.
• 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.

• Be willing to undertake masters level education. A Post Graduate Certificate in Education (PGCE) would be helpful in this role and its development due to changes taking place in nurse and health care education.
• Involvement in Interprofessional Education (IPE), so links with allied health professionals, medical students, nursing associates. Practice educators are involved with the educational delivery to a multitude of learners including post-registration, pre-registration and apprenticeships.
• Some Trusts may have a programme for clinical educators supporting the transition into being a practice educator or action learning facilitator training.

• Good communication and interpersonal skills.
• Flexibility.
• Resilience.
• Confidence.
• Understand the importance of making students feel welcome and setting clear objectives for their learning. 
• Understand how best to learn in a clinical setting.
• Kind and supportive manner when talking to students.
• Enjoys linking theory to practice and keen to develop self.

• Management of change.
• Professionally aware of changing landscape of nursing and nursing family.
• Experience with student nurses as a supervisor and an assessor.
• Research Skills: Research profile and publications is desirable and something to work 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.

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

• Send CV to Dean/Head of School at local Higher Education Institution (HEI), become a lecturer/practitioner, assist with Objective Structured Clinical Examinations (OSCE) and teaching of clinical skills; shadow lecturer for a day.
• Contact Trust or Clinical Commissioning Group (CCG) Education Lead, offer to team teach, assist with simulation, OSCEs, clinical skills teaching, facilitation on mandatory study days and workshops.

• 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 Assessor, Practice Educator and Lecturer role; look for interprofessional courses.
• Links with Allied Health Professionals, medical students, nursing associates.
• Assessor/Practice Teacher experience helpful.

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

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

• Teaching and assessing in practice and in an 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, health care assistant or support worker, assistant practitioner and 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 practice supervisor / assessor; practice teacher/educator
• History of successful practice development/research projects
• Research profile and publications
• Conference presentations
• Broad and advanced knowledge and skills

• 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

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.

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.

• 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 

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.

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

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.

How do you make this change

Nursing in the UK is very different to nursing practice in Kenya. The training in Kenya is longer compared to the UK and once qualified a nurse can work in any speciality from paediatrics to labour suites to mental health units. Arriving in the UK and seeing the difference was quite interesting. It also took some time to settle into the different systems and ways of working in the UK but I found that nursing roles and responsibilities are more or less the same apart from advance practice roles which have yet to be introduced in Kenya.

Kenya is a developing country and hence a lot of challenges in the health care system due to low resources. Coming to the UK and working for the NHS was different given that it is accessible to all and offering a high-quality level of care. At times it felt challenging, fitting in with new colleagues, understanding different English accents as English is not my first language and settling into a new way of life. Personally, I struggled with the weather.

What do you need to do to become a registered nurse/pre-doctoral clinical academic fellow

To embark on the clinical academic pathway you need to a registered nurse, registered midwife or an allied healthcare practitioner e.g., physiotherapy, occupational therapist, pharmacist etc you need to:

• be passionate about clinical research and its impact on healthcare
• have some research experience and/or training. This could be either be through workshops, seminar and university courses or quality improvement projects within your department.

Education and training

My training is in nursing. I have an undergraduate degree in nursing in Kenya.

I needed to register with the Nursing and Midwifery Council (NMC)to practice as a registered nurse in the UK. I undertook some of the registration process including the IELTS English language test and the CBT on my own in Kenya but needed to come to the UK before sitting the OSCE to complete the registration process with the NMC.

I was very particular about the NHS trust that I wanted to work in I as it was recommended to me by my mentor who had studied at a university in the same locality. After successfully completing the first part of the NMCs registration process, I reached out to the agency that was recruiting for my chosen NHS Trust who arranged an interview for me and facilitated the rest of the process for me to get to the UK.

After coming to the UK as an international nurse, I was supported by my trust to prepare for the OSCE exam to complete the NMCs registration process and allow me to practice as a registered nurse in the UK. I received support from the Education Team within the Trust which was very beneficial and included tips and pointers not only to pass the exam but alleviate the anxiety associated with the exam. The process from landing to in the UK to getting registered took about three months.

When I became registered, I got a mentor from my trust’s Institute of Care Excellence who trained and guided not only myself but other like-minded nurses and allied health professionals in research proposals and applications for funded opportunities on the clinical academic pathway. The training, mentorship and preparation for funding applications over the period of a year improved my ability to successfully apply for research funding which can be very competitive. I have fortunate to be awarded funding for the Pre-doctoral Clinical Academic Fellowship (PCAF) by the National Institute for Health Research and Health Education England. The award offers research training in preparation for a Ph.D.

Personal characteristics

One must have the characteristics of a good nurse, one has to be caring, empathetic, have good communication skills, great attention to detail and be a good advocate for their patients.

The clinical academic pathway can be challenging but also very rewarding. I found passion to be a great motivator in my journey so far.

One must be resilient and have the heart to try again and again. There are many awards, grants and funding opportunities but they are all very competitive.

One must be curious and eager to learn. Once I started, I found out that this pathway prepares you to be a lifelong learner. There is so much to be learnt but you can’t learn it all, so you always have to be ready to learn something new at every point in your career.

One must be innovative. With many problems in healthcare and generally in life one must be a creative thinker and think of ideas that may address these problems. You may not be able to solve the issues but you contribute to their solutions or add on to their body of knowledge.

Where can I find out more

• The NMC website has help and advice on gaining NMC registration for nurses from outside the UK
• Register as a nurse or midwife if you trained outside the UK - The Nursing and Midwifery Council.

To find out more about research:

• Social media - There are a lot of resources shared on Twitter and a lot of clinical academics have a Twitter presence and are always sharing any opportunities from within their networks
• Enquire within your trust’s research/innovation department
• From the professional bodies and networks such as: East Midlands Clinical Academic Networks, Royal College of Nursing
• Funding bodies such as the National Institute of Health Research and Health Education England.

• 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 need to understand the time commitment and consider the move from 100% clinical practice.
• Speak with or make an appointment with the Director of Nursing to make sure you understand nursing strategy as well as the organisation's values.
• Use opportunities for acting up, shadowing, attending and contributing in meetings, do further professional development in your speciality to develop expertise or consider gaining broader experience before specialising.
• Actively support other staff across all professions.
• Be a practice supervisor, practice assessor, preceptor and enjoy it.
• Get constructive feedback on your leadership skills, be able to show how you have learnt and developed from this.
• Understand your organisations mission statement, business plan, Care Quality Commission reports and improvement action plan.

• Firstly, identify your current level of competence and then identify what the next leadership level of competence is for you to develop skills in. This then becomes a developmental framework for individual leadership development plans.

• Use appraisals, find a coach, develop a 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.

• As a minimum, you will need 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. the Institute of Leadership & Management. Develop competence in coaching and clinical supervision.

• Be ambitious, focused, driven, person focused, and strive 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 care.
• 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 and strategic skills.
• Have a vision of where nursing can go and share this vision.
• Caring and compassionate leadership - kind on the people, tough on the problem.

• Likely be to be qualified for a minimum of 5 years.
• To have been a practice assessor 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.

• NHS leadership framework and academy, RCN career guidance, RCN management and leadership forum, current employer’s leadership pathways.

• Look at job descriptions, skills and person specifications, professional forums, talk to others, speak to your organisation's practice development team.

The role can lead anywhere and everywhere - it is a 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.

• 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.

• 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.

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.

• 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

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

• 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.

Introduction

Name: Chelsea

Job title: Graduate entry student nurse

Setting: University based, with placements across health and social care settings

Chelsea did a degree in biology, which was a mixture of animal biology and molecular biology. She thought she wanted to become a scientist or work in a laboratory after completing her degree, but quickly realised that she wanted a role with more interaction and variation. 

She worked for a year as a recruitment consultant, and then got a role in Tissue and Eye Services, a branch of NHS Blood and Transplant. The role involved retrieving tissues from deceased patients to be used for transplant purposes. She absolutely loved this job and found it really rewarding but wanted a role with more opportunities for career progression. She enjoyed working with people, meeting, and interacting with other health care professionals and decided she wanted to become a registered nurse. 

Having a first degree in biology, she realised that she could undertake a post graduate programme in Nursing. 

Find out more about nursing programmes, including the post graduate nursing programme. 

There is also information on the government website about finances available to support post graduate students.  

You may be able to apply directly through your university’s online system. You may be required to fill in an application form, write a personal statement and provide references. However, each university has its own application process, some may require application via UCAS.

If you have a first degree, then it may be possible for you to take the post graduate route into nursing. Your first degree doesn’t have to be in a science or health related subject. Each university has its own entry criteria, so it is worth looking at individual university websites for more information. 

Financial support is available to undertake post graduate study. More information can be found here:

• GOV.UK. Funding for postgraduate study 
• GOV.UK. NHS bursaries 

The post graduate nursing programme is a master level (level 7) programme which combines academic study with clinical placement experience. There are also blended learning post graduate nursing programmes, which have a greater proportion of online and virtual learning, as well as an apprenticeship option. Studying at level 7 requires high level critical thinking and analysis. Support is given by universities to prepare and guide students to work at this level, such as how to write at level 7. 

Due to the COVID-19 pandemic, many lectures are online, and students find the recordings useful, allowing them to revisit the lecture content whenever they need to. Students receive feedback on each assignment which helps them to develop their academic writing skills. 

Placements are a big part of the programme, as students must achieve the required number of hours, specified by the Nursing and Midwifery Council, to become a registered nurse. A degree programme is usually a minimum of 3 years; however, the post graduate programmes are shorter, enabling students to achieve both theoretical and placement hours within a shorter time period. 

People come to post graduate nursing programmes from different backgrounds, with different first degrees and life experience. These experiences really help with undertaking a post graduate nursing programme, where confidence, strong communication and interpersonal skills are required. 

Being adaptable and flexible is important. The programme has both theoretical and practical components, requiring the application of knowledge in practice. To get the most out of these, it is necessary to actively question, seek out opportunities to learn in practice and have excellent time management skills. 

Successfully completing a post graduate nursing programme leads to being an NMC Registered Nurse. Being a registered nurse brings many career opportunities. Browse this careers resource for some examples. 

Someone successfully completing a post graduate nursing programme will be awarded 120 academic credits at level 7, meaning they can go on to achieve a full level 7 master’s degree with some further level 7 study.