Nursing is changing rapidly, and today’s nurses are expected to take on an extended role – often performing tasks which were once the sole preserve of doctors, such as diagnosing, prescribing drugs and admitting and discharging patients.
There are four main branches of nursing: adult, child, mental health and learning disability. Student nurses qualify in one of these areas and then apply to go on the nursing register. This is held by nursing’s regulatory body, the Council for Nursing and Midwifery. Nurses are expected to abide by the Council’s Code of Professional Conduct. The organisation’s main role is protecting the public and it is responsible for monitoring standards and dealing with allegations of misconduct. There are more than 637,000 quali?ed nurses on the Council’s register, and this is the main pool from which the NHS and other employers recruit.
The criticisms about nurses’ education being too academic, and persisting problems of recruitment of nurses into the NHS, were among factors prompting a strategic government review of the status, training, pay and career opportunities for nurses and other health professionals. The new model emphasises the practical aspects of the education programme with a better response to the needs of patients and the NHS. It also o?ers nurses a more ?exible career path and education linked more closely with practice development and research, so as to provide greater scope for continuing professional education and development.
About 60 per cent of RNs work in NHS hospitals and community trusts. But an increasing number are choosing to work elsewhere, either in the private sector or in jobs such as school nursing, occupational health or for NHS Direct, the nurse-led telephone helpline. Others have dropped out of nursing altogether. The health service is facing a shortage of quali?ed nurses and many trust employers have resorted to overseas recruitment drives. The government has launched a major nurse recruitment and retention campaign and is promoting family-friendly employment practices to lure those with a nursing quali?cation currently working outside the NHS back into the workforce. Nursing is a mainly female profession and a third of nurses work part-time.
Nurses’ pay has for long compared unfavourably with other professional employment opportunities, despite being determined by an independent Pay Review Body. With the recruitment of nurses a perennial problem, the government’s strategy, Making a Di?erence, is to set up a new pay system o?ering greater ?exibility and opportunities for nurses and other health-service sta?. In 2005, a newly quali?ed sta? nurse earned around £16,000 a year, while one of the new grade of consultant nurses could command an annual salary of between £27,000 and £42,000. Nurse consultants were introduced in spring 2000 as a means of allowing nurses to progress up the career ladder while maintaining a clinical role.
The nurse of today is increasingly likely to be part of a multidisciplinary team, working alongside a range of other professionals from doctors and physiotherapists to social workers and teachers. A further sign of the times is that many registered nurses are being asked to act in a supervisory role, delegating tasks to nonregistered nurses working as health-care assistants and auxiliaries. In recognition of the latter’s increasing role, the Royal College of Nursing, the main professional association and trade union for nurses, has now agreed to extend membership to health-care assistants with a Scottish/National Vocational Quali?cation at level three.
Midwifery Midwives (see MIDWIFE) are practitioners who o?er advice and support to women before, during and after pregnancy. They are regulated by the Council for Nursing and Midwifery (formerly the UK Central Council for Nursing, Midwifery and Health Visiting). Registered nurses can take an 18month course to become a midwife, and there is also a three-year programme for those who wish to enter the profession directly. Midwifery courses lead to a diploma or degree-level quali?cation. Most midwives work for the NHS and, as with nursing, there are problems recruiting and retaining sta?.
Health visiting Health visitors are registered nurses who work in the community with a range of groups including families, the homeless and older people. They focus on preventing ill-health and o?er advice on a range of topics from diet to child behavioural problems. They are employed by health trusts, primary-care groups and primary-care trusts.
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