Modernising Nursing Careers: Setting the Direction

3 What will this mean for the way nurses work?

The success of the health care reforms depends on the contribution of nurses: they are responsible for delivering the care that patients want. Nurses know that if they are to meet patients' needs in a variety of care settings, the values of their profession must remain.

Wherever nurses work, there are four elements to the nurse's role. Across the UK these elements link to the core and specific dimensions of the generic NHS Knowledge and Skills Framework and so provide a sound structure for future developments.

Elements for all nurses
Practice
Education, training and development
Quality and service development
Leadership, management and supervision.

Nurses will continue to care for people who cannot care for themselves, support and empower people with long term health care problems to care for themselves, and to help people to promote their own health. This will apply to children, young people, adults and older people.

Nurses' roles and responsibilities will continue to change in line with the health reforms that are improving care for patients. The nursing workforce will need to:

• organise care around the needs of patients
• ensure patients have a good experience of nursing as reputations of organisations and patient choice will rest on the quality of nursing
• work in a range of settings, crossing hospital and community care, and use telemedicine
• have the skills and competencies to care for older people and people with long term conditions, who may have both physical and mental health needs
• be able to use preventative and health promotion interventions
• work for diverse employers, and take opportunities for self-employment where appropriate
• have sufficient numbers of nurses with advanced level skills to meet demand
• work as leaders and members of multidisciplinary teams inside and outside hospital, and across health and social care teams
• work with new forms of practitioners, for example assistant practitioners and anaesthesia practitioners
• deliver high productivity and best value for money.

Individual nurses' stories have been used to illustrate how modern nursing careers can develop.

Modern nursing career
Sag trained and worked as an enrolled nurse before leaving to work for a bank for four years. Returning to nursing she worked in care of the elderly then moved to the community rehabilitation team. After qualifying as a first level nurse she moved to the independent sector for two years before returning to the NHS as ward manager. She worked as a nurse consultant then became associate director of integrated services and now manages 200 staff and a budget of £6.2 million. Her experience of all parts of the career pathway has driven her ambition to improve patient care.