Nurses are the largest single group of staff working in the health service. There are more than 686,000 qualified nurses registered with the Nursing & Midwifery Council (NMC) in the UK, of whom over half are employed in the National Health Service. Would-be registered nurses (RNs) do either a three-year diploma programme or a four-year degree. An increasing number of nurses are now acquiring degrees, either as their initial qualification or by studying part-time later in their career.
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. Of those on the register, by 2007 over 46,000 had a qualification in prescribing.
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 NMC register. 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. 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. Ninety percent of nurses (and all but 134 of the 35,000 midwives) are female. A third work part-time.
Nurses’ pay has for long compared unfavourably with other professional employment opportunities, despite being determined by an independent Pay Review Body. 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 non-registered 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 Qualification at level three.
Midwives (see MIDWIFE) are practitioners who offer advice and support to women before, during and after pregnancy. Like general nursese, they are regulated by the NMC. Registered nurses can take an 18-month 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 qualification. Most midwives work for the NHS and, as with nursing, there are problems recruiting and retaining staff.
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 offer 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. Other specialist community public health nurses include school nurses, and family health nurses.
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