nursing career job options and pathways

Nurses are the largest staff group in the NHS and work across a number of different settings. Embarking on a career as a nurse requires patience, determination and compassion. Nursing as a career option is an incredibly testing one, but will be an excellent choice if you have the confidence, stamina and adaptability required to succeed.

When you train as a nurse, your training will be in one of four fields – adult, child, learning disability or mental health. Once you’ve registered to become a nurse and gained employment, you’ll find there are numerous paths for you to go down in order to progress your career, and embark on further opportunities and specialise even further.


The Making a Difference Initiative

In 2000, the Making a Difference initiative was introduced to a number of universities and shaped the future of nursing education. The aim of this was to close the skill gap within nursing and create independent and efficient nurses. This project also ensures that nurses trained in one of four Standard of Competence fields required by the NMC. These are:

  • Adult Nursing
  • Children’s Nursing
  • Learning Disabilities Nursing
  • Mental Health Nursing

Whilst each of these are different fields of nursing, registered nurses are expected to meet the essential mental and physical health needs of people of all ages and conditions. This includes those requiring end-of-life care. If you choose nursing as a career, then you have to option to qualify in multiple fields and could therefore register in more than one field.


How Do I Become a Registered Nurse?

The first step to becoming a registered nurse is to complete a Nursing and Midwifery Council (NMC) approved course. This can be in the form of a full time or part time university degree teaching the theory and practical needed in order to qualify for the register, or a nursing apprenticeship.

In order to register with the NMC you must have:

  • Completed 2,300 hours of clinical practice and theory work
  • Good health and character
  • Passed all academic and practice assessments in the course


The UK Nurse Banding System

In 2004, the Agenda for Change was introduced, changing the grading structure of pay for Nurses and NHS staff.  Bands were used to define the knowledge and skills required to work at a specific pay level.

Bands 2 & 3: These bands identifies Health Care Assistants and unqualified support staff such as Nursing Auxiliaries. Band 2 & 3 nurses must have a minimum of 6 months experience of working in NHS hospital environments or the equivalent experience working collaboratively with others to meet the needs of patients and their families. Some Health Care assistants may have NVQ3 qualifications and train to become phlebotomists.

Bands 5 & 6: Bands 5 and 6 apply to staff nurses and registered nurses. All newly qualified staff are on Band 5, and Band 6 is awarded to nurses with greater knowledge and a better skillset.

Band 7: This band applies to Ward Sisters/Managers and Specialist Nurses in some areas.

Band 8 a-c: Band 8 and above applies to senior nurses including specialist nurses with advanced practice skills (normally at Masters Level) and Nurse Consultants (8b/c). Nurse Managers who cover more than one area are paid at this level, with Heads of Nursing normally on 8b/c.

You can find out more about different nursing careers in our in-depth guides:


What Type of Specialist Nurses Are There?

As mentioned earlier, there are four types of nursing roles you can choose to train in. These are:

Adult Nursing – Adult Nurses work with a range of health conditions in young and old adults. This includes caring, counseling, managing, teaching and utilising interpersonal skills in order to improve the patient’s quality of life.

Children’s Nursing – Children’s Nurses work with children and their families in a range of situations, from health to children protection issues. As well as helping to improve the child’s quality of life, they must ensure the child does not suffer from the stress of being ill, injured or in hospital.

Learning Disabilities Nursing – Learning disability nurses provide care for people with a range of learning disabilities and physical and mental health issues related to this. The main aim of this type of nursing is to support the social inclusion and well being of the patient, whilst maintaining or improving the patient’s physical and mental health.

Mental Health Nursing – Mental health nursing is a complex type of nursing that requires nurses to work with GPs, psychiatrists, psychologists and a range of other professionals, in order to improve the life of those with ill mental health.

Further Training and Specialisms are needed for the following nursing career options:

Neonatal Nurse – Neonatal nurses look after sick newborn or premature babies. In order to progress your career as a neonatal nurse, you will need to be registered in one of the following specialisms; adult, child or midwifery. Alongside this, some employers will ask for experience and/or knowledge required when it comes to neonatal nursing. This could range from issues handling bereavements to breast feeding. Once you have had six months of experience, you’ll be encouraged to undertake professional development involving specific training modules on different areas of neonatal nursing. These training modules will be delivered in partnership by your employer and local universities.

Accident and Emergency Nurse – To become an A&E nurse, you need stamina, patience and compassion. Attention to detail and critical thinking is essential when it comes to helping patients, as you will be faced with an array of cases in a busy facility. From crime related injuries to accidents and illnesses it is imperative that you work well in a team and can think outside of the box. Once you have completed your degree and registered, you will need to get experience from A&E.

Neurology Nurse – Neuroscience nurses or a neurology nurses help patients with neurological problems manage their lives and live with their disabilities.  Neuroscience nurses are crucial for assessing, identifying, diagnosing and treating patients who are suffering from a range of neurological problems. This is done through physical exams of patients, and studying the patient’s medical history and symptoms. A neurology nurse will learn how to read CT scans and MRI tests. In some cases, neurological nurses may administer medication or even assist during surgery. Once you have become a registered nurse, you should gain work experience on a neurological ward, where you can then further your training and obtain further qualifications.


How Will My Career in Nursing Progress?

Alongside the different specialisms to begin your nursing career path, there are many roles in which you can progress your nursing career. After taking a three year preparation course (university or apprenticeship), every nurse embarking on the next step of their career will become a qualified first level nurse. They can then move onto the following ranks;

Staff Nurses: The title Staff Nurse relates to anyone on the register with the career as a nurse, however, it does not differentiate additional qualifications.

Senior Staff Nurse: This title refers to nurses with considerable experience in a general setting, and any additional qualifications. In children’s services a senior staff nurse are expected to have a children’s nursing registration.

Children’s Nurse: This job role refers to a nurse registered on the children’s part of the register.

Theatre Staff Nurse: This job role refers to nurses who are deployed to work in theatre. Theatre staff nurses do not have to complete theatre nursing course to do so.

Anaesthetic Nurse: This speciality refers to a nurse who is deployed to assist the Anaesthetist. This nurse should complete an anaesthetic nursing course or may have undertaken a theatre course, further specialising in Anaesthetics.

Sister, Charge Nurse & Ward Manager: This role refers to experienced senior nurses responsible for a clinical area. This includes the management of staff and delivery of patient care. In specialist areas this may be one of a team of Sisters who ensure continuity for management of a clinical area under a Senior Sister/Ward Manager.

Nursing Officer, Clinical Nurse Manager, Matron, Modern Matron & Lead Nurse: These titles refer to nurses who are senior and working above ward level. They take operational responsibility for a service or a group of services. For example, a  Lead Nurse maybe responsible for renal services, or responsible for the ward and dialysis services.