A guide to careers in nursing: paths and progression 

Nurses are specially trained healthcare professionals who care for people and provide wellbeing support to those with illnesses, injuries, physical disabilities, and mental health conditions. They perform a wide range of duties including:

• Assessing, planning, implementing, and evaluating care for the needs of patients/clients
• Taking and recording patients’ observations, such as temperature, blood pressure, pulse rate and respiratory rate
• Administration of drugs, injections, and other treatments
• Documentation and updating records
• Working closely with other healthcare professionals, such as physiotherapists, doctors and occupational therapists, to determine the best course of action
• Communicating information regarding care and treatment to patients and if they wish to their families

There are many different careers in nursing available, where nurses can explore a variety of fulfilling roles. You could make a difference by starting your journey to specialise in nursing today.

The four areas of the nursing register

All nurses in the UK must be registered with the Nursing and Midwifery Council (NMC) to practice their chosen role. There are four parts of the nursing register that cover the different areas in the healthcare sector. They are:

• Adult nursing
• Children’s nursing
• Mental health nursing
• Learning disability nursing

How to become a registered nurse

The most common route to the different nursing career paths and getting on the NMC register is through completing a university degree training course. These can be completed through approved educational institutions (AEIs) or through employer-led apprenticeships. Degree courses typically take a minimum of three years to complete and include opportunities for nurses in training to gain practical experience. You could even join a nursing degree after starting an introductory degree course in a health-related subject, psychology, life sciences or social work.

To be able to join nursing degree courses, institutions typically ask that you have:

• 4 or 5 GCSEs at grades 9 to 4 (A* to C), or equivalent, including English, maths and science
• 2 or 3 A levels, including a science, or a level 3 diploma or access to higher education in health, science or nursing

Depending on your qualifications and learning needs, you could complete a Registered Nursing Degree Apprenticeship (RNDA) instead. A degree apprenticeship takes four years to complete and combines practice-based and academic learning. During this course, you will work in a variety of hospitals and primary care settings while attending lectures and studying for exams. You must be employed by an NHS trust or a private healthcare provider to be eligible for a degree apprenticeship. For example, you could undertake this whilst practising as a healthcare assistant (HCA).

Typical entry requirements to apply for a Registered Nurse Degree Apprenticeship are:

• 4 or 5 GCSEs at grades 9 to 4 (A* to C) and A levels, or equivalent

After qualification:

Certain nursing specialties may offer the opportunity for nurses to complete specialist nursing training courses to progress their careers. However, each NHS trust is different and doing specialist nursing training isn’t mandatory to progress in your role. Nurses can work towards their desired role instead.

Seven nursing career paths you can pursue

We’ve selected seven examples of nursing specialisms you could consider if you want to progress your career in nursing. Each one falls under different areas of the nursing register listed above and will have different entry requirements. We advise that you research what different trusts are looking for before pursuing your chosen specialism.

The seven nursing specialisms we have decided to focus on in this guide are:

• General nursing
• Community nursing
• Critical care nursing
• A&E nursing
• Mental health nursing
• Paediatric nursing
• Theatre nursing

General nursing

General nursing can open the doors to a variety of nursing career pathways. As a registered general nurse (RGN), you will work in a variety of locations, including hospitals, GP surgeries, community settings and nursing homes. RGNs will typically have completed their education and training in one of the four parts of the nursing register but most people who refer to them may only be referencing adult nurses.

Explore our general nursing jobs.

Community nursing

Community nurses offer care to patients outside of the hospital, for example, in their homes, clinics and nursing homes. They will carry out their regular nursing duties and offer additional support to patients and their families. The type of patients that community nurses will care for are often those who don’t need hospital care, those who find travelling to the hospital difficult and patients that require long-term care. They provide interventions outside of hospital settings, particularly for elderly and disabled individuals, and work to prevent unnecessary hospital admissions.

Here are a select number of roles associated with community nursing:

• District nurse
• Practice nurse
• Nursing home nurse

Note that nurses in this specialism may need to join different parts of the register throughout their career, depending on the roles they pursue. The only exception is if a nurse decides to pursue a community nursing sub- specialism that requires them to join the Specialist Community Public Health Nurses (SCPHN) register in addition to their initial registration.

Ready to explore community nursing jobs? Browse our vacancies and apply today.

Critical care nursing

The critical care nurse (ICU nurse) career path could be the perfect nursing role for you if you thrive on challenges. Every day is different for an ICU nurse, plus there are multiple roles that come under this pathway, including:

• High dependency nurse (HDU)
• Intensive therapy nurse (ITU)
• Clinical educator
• Critical care outreach

Apart from the typical route into intensive care nursing, you can also get experience in a paediatric intensive care unit (PICU) or complete a paediatric nursing degree. But remember, you need to belong to relevant parts of the register for this role.

View our latest ICU nursing roles to find out where your career could take you.

A&E nursing

A&E nursing is a great pathway to consider if you work well in high- pressure environments. A&E nurses are typically the first point of contact for patients as they enter the hospital setting and are trained to provide acute, urgent, and emergency care to lots of patients. Although you may work in other healthcare settings, such as:

• A minor injury unit
• Walk-in centres
• Primary care centres
• GP out-of-hours
• Emergency departments in a hospital
• Ambulance services

Some specific examples of A&E nursing roles you could pursue include:

• A&E nurse
• Emergency nurse practitioner (ENP)
• Advanced nurse practitioner (ANP)

To become an ANP, you need to complete a master’s degree. Remember, the time it will take will vary depending on the specific role you wish to work towards. Once you’re a nurse practitioner, you will be able to apply for different nursing practitioner specialism roles. View our emergency and acute services jobs and apply today.

Mental health nursing

Mental health nurses play a fundamental role in the treatment of patients with mental health conditions. The role of a mental health nurse takes a comprehensive approach to treating patients as part of multidisciplinary teams, helping them recover whilst offering advice. You’ll assist patients in how to self-manage their conditions. There are many settings a mental health nurse can work in, such as hospitals, psychiatry units, community settings (including prisons), and residential or nursing homes.

Roles in mental health nursing include:

• Registered mental health nurse (RMN)
• Learning disabilities nurse (RNLD)
• Community psychiatric nurse (CPN)
• Elderly mental illness nurse (EMI)

Want to know where a career in mental health nursing can take you? Read our guide to learn how you can progress as a mental health nurse.

Paediatric nursing

Paediatric nurses cover a range of responsibilities to help and support children ‘s health, from newborns to adolescents. Offering care and support to their families alongside their treatment is vital in this role.

There are different roles in paediatric nursing, including:

• General paediatric nursing
• Neonatal intensive care unit nursing (NICU)
• Special care baby unit nursing (SCBU)
• Paediatric intensive care unit nursing (PICU)

View our pediatric nurse job listings to search and apply for a role today.

Theatre nursing

Theatre nursing could be the perfect role if you excel in high-pressure environments. As a theatre nurse, you’ll be assisting throughout distinct stages of operations on people of all ages.

A handful of specific theatre nursing roles include:

• Scrub nurse
• Anaesthetic nurse
• Recovery nurse

Explore theatre nursing jobs and take your nursing career to the next level with Pulse.

How do I progress my career in nursing?

There are several nursing opportunities you can explore if you’re looking to advance your career, including:

• Networking with senior staff or nurses from different specialisms
• Going back into education to gain certifications and/or master’s degrees
• Specialising in a field to follow the career progression pathway
• Taking on extra responsibilities
• Looking for a new role in a different specialism

If you decide to look for a new role to advance your nursing career, view our guide to common nursing interview questions and how to best answer them.

What qualities make a good nurse?

Having all the right qualifications is a must for nursing, but having the right qualities will help you progress your nursing career and make you stand out from the crowd.

The most successful nurses have:

• Excellent communication skills
• Compassion
• Empathy
• Motivation
• Problem-solving skills
• Outstanding interpersonal skills
• A keen attention to detail
• Systematic organisational skills

Find nursing career opportunities with Pulse

Whether you’re looking for permanent or flexible roles, we can help you enhance your career in nursing in a variety of specialisms.

Pulse has been working with nursing professionals for over 30 years. We’ve partnered with a range of NHS and private clients, many of whom we are the sole provider for. You’ll benefit from our strong relationships with leading healthcare providers. This is because you’ll gain access to exclusive and exciting roles.

Register your interest to speak to a team member or browse our current nursing job listings to apply today.