Modernising Nursing Careers: Setting the Direction

Modernising Nursing Careers

5 Nursing careers for tomorrow

Nurses are vital to achieving the health care reform programme. We need to make sure that nurses have a career structure which enables them to work in different care settings, to take on changed roles and responsibilities, develop a varied mix of skills, to pursue education and training when they need it, and to develop both generalist and specialist skills as they require them.

To highlight what will be different in the future we have compared traditional nursing careers with those we need to see in the future.

Modern nursing career
Anne started her career in nursing practice and became a ward sister. She moved to a corporate management post to manage complaints in the acute sector before pursuing an interest in telehealth and information technology with NHS Direct. This experience has taken her along a different path into national leadership helping to develop new IT systems for nursing.

Modern nursing career
Laura was a late entrant to nursing working on a temporary contact with her local trust for several years whilst her children were young. She then pursued a successful career in nurse teaching and research before establishing a small consultancy business. Now looking at retirement Laura has scaled down her business and restarted temporary work with NHS Professionals.

Nursing careers

Coming from

Going towards

Outdated image of nursing careers dominated by media stereotypes

An up-to-date picture of nursing careers characterised by opportunity and diversity

A nursing workforce focused on hospital based care

Care taking place in and outside hospital with the workforce moving between. Nurses starting their career in the community

A single point of entry to nursing

A career framework that allows nursing to 'grow its own' with multiple entry points for those taking up nursing as a second career or as mature entrants

Working for the NHS as a single employer

Plurality of provision offering alternative employers and employment models including NHS Foundation Trusts, self employment and social enterprises

An education system with a one size fits all approach, struggling to balance academic and practical learning and reflective of health care today not tomorrow

A flexible principle-based curriculum that is built around patient pathways, with a strong academic foundation and interdisciplinary learning

Linear careers characterised by increasing specialisation or promotion out of practice with penalties for those stepping off or changing pathway

A framework that supports movement between career pathways, practice, management and education, and that values and rewards different career types

Increasing specialisation and sub-specialisation

Better balance of generalists and specialists to provide integrated networks of urgent, specialist and continuing care

Careers defined by discipline or setting

Careers built around patient pathways using competence as the currency for greater movement and flexibility

Career structure with few opportunities for assistants

A career structure with increased number of assistants working as part of multidisciplinary teams

No standardisation of advanced level skills

Standardisation of advanced level skills

Organisation-based careers with a proliferation of titles

Patient pathway-based careers focusing on nursing roles rather than titles

Role dictated by title

Nursing roles defined according to patient need - to provide intervention that is timely, accurate and swift

Nursing teams hierarchically managed

Nursing teams more self-directed and professionally accountable

Nurses involved mainly in giving care

Nurses leading, co-ordinating and commissioning care, as well as giving care, to bring about change measured by health gain and health outcomes

Care dictated by custom and practice

Care based on evidence and critical thinking and assisted by new technology

These shifts in the direction of travel for modern nursing careers will promote greater movement and diversity than ever before. People will be able to move between clinical, management and academic careers and into different organisations and sectors. A nurse in care or service delivery might move between the health service ( NHS), independent and third sector 1, or increasingly into social services, housing and schools. As more services are delivered in or closer to home, there will be many opportunities for nurses in acute settings to follow patients and work wholly or partially outside hospital. Some nurses will start working in the community and will spend all or most of their careers there developing effective models of care.

Careers in education and research might take place in or between service and the university; leadership might take people into directorships or chief executive posts; into government, professional or employee organisations as well as regulation. All types of career can lead to social enterprise through self-employment, franchised services or small business operations.

Modernised nursing careers should encourage movement and progression but also provide rich opportunities for those who want to stay where they are and to work as locally as possible. They should also support more personalised career paths that meet the need and aspirations of individuals at different stages in life.

There are already examples of nurses who have developed careers that reflect the modern career structure that we want to see for all nurses.

Back to top