Which of the four disciplines are you going to go for? Adult, children’s, mental health or learning disabilities? Let us help you decide …
Nursing is all about making decisions for the patient, regarding treatment and intervention.
But before you even start day one of your nursing degree, you have a pretty big decision for yourself regarding your own career - which of the four discipline to go into: learning disabilities, adult, mental health or children’s.
According to University of Manchester director of undergraduate education Philip Keeley, you have to get it right first time. He says: “Gone are the days of moving from one of the four disciplines to another,” he says.
He stresses the importance of nurses doing their homework when considering becoming a nurse. Mr Keeley says children’s nursing is oversubscribed. If a student chooses adult nursing and wants to change to children’s nursing, it is almost impossible.
So, perhaps the best way to ensure that you make an informed decision is to get some experience in the field you want to work in first. Rosie Paget is due to start her children’s nursing degree at London South Bank University in September. She says it wasn’t difficult for her to make a decision due to her previous experiences. Ms Paget has been working at The Princess Royal Hospital in Telford, Shropshire on the rehabilitation ward since last September and also works with Girlguilding UK as a unit leader helper.
“The Guides are aged between 10 and 14. I feel that this helped me choose child nursing due to the relationships you create with the girls and their parents or carers.”
She chose to study at South Bank because it offers placement at Great Ormond Street Children’s hospital. “It is my dream to work there,” she says.
So, if you can, try and help on a ward or in the community doing something with the type of patients or service users you intend to care for. That will give you some idea of what you are letting yourself in for - and whether or not it is for you. Elizabeth, associate dean of Nursing at Bournemouth University, thinks it’s not just nice to have a taste of what nursing care is all about, it’s essential.
Once you’ve picked your course, the decisions don’t end there. You have to think about a specialty within adult nursing, for example.
University of Sheffield nursing lecturer Mark Limb says that on the pre-registration postgraduate diploma, students cover primary and secondary care. Before unit three, students decide which sector they want to go into. “We do presentations and they talk to their mentors,” Mr Limb says.
“During unit three, they do half primary and half secondary care. Their choice for unit four will be reflected in the last half of unit three and during unit four they are placed in an area of their choice. Effectively, the programme is designed around them making a choice of their area of interest. Students can talk to personal tutors, programme leaders, placement co-ordinators and mentors” says Limb.
So, use the first few clinical placements to really decide what will suit you. Alwin Puthenpurakal decided on a nursing field during his elective placement on an intensive care unit at Manchester Royal Infirmary. “I endeavoured to learn, practise and finely tune the basics in nursing and care provision whilst being in different practice placements,” he says.
Mr Puthenpurakal gathered advice and feedback from work colleagues, tutors at the University of Manchester, friends and family to make his decision. He says he chose critical care because he enjoys dealing with patients who have complex problems and need medical care.
“It was important for me to choose a specialty that I was interested in and most of all to enjoy it day in and day out,” he says.
Mr Puthenpurakal has been working as a cardiothoracic Intensive Care nurse at Papworth Hospital NHS Foundation Trust in Cambridge since September.
For many students, the attraction of nursing in the community is great. However, community placements that will help you to work out if this is for you are in shorter supply than those in acute environments, so it is much harder for community nursing situations to take students on placement. However, Philip Keeley believes that the Health Visitor Implementation Plan, which will enable the government to recruit 4,200 more health visitors by 2015, will make it easier for students to graduate into this community role.
Psychiatric nurse Sarah Jones works in the community in a treatment home, which involves looking after people in their own homes as an alternative to hospital admission. Ms Jones had a different route into mental health nursing. She was forced to give up her general nurse training when she failed one practical assessment. She then worked as a care assistant at her local psychiatric hospital. She then trained to be a mental health nurse.
“I immediately felt that this was the right career path for me, as the atmosphere was so much more relaxed than it had been in the general hospital.”
In fact Sarah’s daughter, Emma Jones chose to follow in the footsteps of her mother with a career in nursing but opted for adult nursing rather than mental health. Currently, Ms Jones is working on a clinical decisions unit at the Queen Elizabeth Hospital in Birmingham. She says she would eventually like to specialise in caring for critically ill adults, either as part of a critical care outreach team or on an intensive care unit.
“Working on CDU has helped me to reach this decision as I get to look after patients who have been transferred from resus in A&E,” she says.
She’s not alone in preferring the hospital environment. Natalie Wraw is studying adult nursing at Southampton University. She aims to specialise in surgery or critical care, such as A&E.
But unlike choosing a degree course, nursing does offer some flexibility and just because you select one specialty doesn’t mean you have to stay with it forever. Many nurses move from children’s nursing to midwifery, and from acute to district nursing or health visiting.
That is one of the attractions for Emma Jones. “I feel that as a nurse you can specialise in many fields throughout your career - it’s just a matter of knowing which one is right for you at that time in your life and career.”