Adult nurse

What do adult nurses do?

Adult nurses provide care for adults of all ages. 

They provide person-centered care - this means building good relationships with patients as well as their families.

Adult nurses assess, plan, coordinate and manage care for their patients, while working closely with other health and social care professionals plus members of the care team. 

They can work in a range of place including hospitals and in local community services (like GP practices). There are also opportunities to work in a wide range of specialist services, as well as residential and care homes.

Meet Michele, an adult nurse in the NHS

This Is Modern Nursing

Christie Watson at RCN Congress 2018

Useful information

How I became an A&E nurse - John's story

Where did you study?

I studied at City University London and I now work in the A&E department at Homerton Hospital

What's your job like?

It's a big transition from being a student to working but the guys I work with are all very supportive and helpful. If I ever I have a question they'll always be willing to answer it for me.

What do you enjoy the most about your job?

Especially in A&E no day is the same. You never know what could come in the door. It could go from quiet to busy. You just have to be prepared for everything.

What do you find most challenging about it?

Now I'm not a student, the buck stops with me. You have to explain and justify why I made a specific decision. The transition from a student takes time but I think we're getting there slowly.

How's the preceptorship?

At Homerton we have a nine-month preceptorship. One of the nurses I work with a lot is my preceptor and she's good if I have any problems I go to her. But the rest of the staff, the doctors as well, are really helpful. They know that you're newly qualified, so no question is a dumb question.

Why did you decide to work in A&E?

I did my last 12-week placement there and it was one of the areas I liked. It's always changing and nothing's ever the same. It's not a routine. You get to see so many different things. It's a broad spectrum of conditions that you deal with which is good for me because I get to see a lot to broaden my knowledge and understanding.

What do you think about staying in London after you qualify?

There are probably more opportunities in London but then again you need to consider the cost. It has good and bad sides. There's so many hospitals recruiting. There's so many specialities in the hospitals in London so if you want to work in a specific area you get the opportunity to.

If you could go back in time and give some advice to yourself when you were a student and applying for jobs, what would you say?

Don't let people put you off. Older nurses say that you should go to the wards first but I think if there's an area if you specifically want to do, then you should go for it.

Take into consideration the distance when you're travelling. If your house is far away from where you're working after a 12-hour shift you're going to be knackered. So you need to remember that if you have a two-hour journey, think about early mornings as well. If you're applying for somewhere go for a visit to get to know the area. Learn as much about the hospital that you're applying to that you can, what their values are, if they are working on anything new - that shows that you've done your homework in the interview.

How I became a Nurse Educator - Sally's story

Sally Barbrook is passionate about rotational nursing. The benefits are that it gives nurses wide experience and improves their practice making it more holistic, but she says nurses need to be adaptable and great communicators to thrive through the changes.

She studied at London Southbank University and chose to do the rotation scheme when she first qualified as a nurse in 2014. She now works as a clinical facilitator at North East London NHS Foundation Trust (NELFT).

What did you do when you first qualified as a nurse?

When I was newly qualified I went straight on to rotation in adult nursing. I would recommend it. You have to be adaptable because you are moving around every six months. You have to be a good communicator and generally good with people to get the best out of it, to be able to adapt to different work environments and different types of nursing.

The Trust that I worked with are very supportive. You have your preceptorship which was six months when I did it but is now 12 months, so that supports you from growing from a student nurse to becoming a qualified nurse. I was on a mental health acute ward for six months as part of the rotation. It was a fast learning. I'm the clinical facilitator now in NELFT and I support rotation programmes for nurses.

What did you get out of the rotation programme?

I'm now a much more holistic practitioner. When I look at a person I don't just see a respiratory disease or anxiety, I think that they are intrinsically linked. So for me the rotation embedded that in me. Nursing can be very separate in the way that we are taught at university. Rotation has enabled me to be a much more holistic practitioner.

Would you recommend working in London after you qualify?

Because of the diversity of cultures and the variety in demographics and epidemiology, I think it makes it a very interesting place to work. I personally live out in the countryside and I travel in every day. For someone that doesn't live in London, I prefer working in the city because I feel you have a lot more scope in your practice. For me that's important. There's also more opportunity. And you can get the training to support the practice. So there's a lot of education opportunities being more in London. I don't love the commute - I don't think anyone does. But I don't mind commuting because my job enables me to use a big skillset.

What do you enjoy about your job?

What I like about my current job is that I am able to support the nurses I manage from a position of knowing what it's like being in their role. Sometimes managers don't know how it feels to be in the role that you're managing, whereas because I've had the rotational experience I understand the practice. I feel like this role uses a lot of my skills.

What do you find challenging about it?

Nursing is going through a lot of changes at the moment. Working through and making it more integrated is a challenge. People's mindsets are changing. It might be a challenge but I'm focused on making the changes that we can to fit the government agenda.

If you could go back in time and give some advice to yourself when you were a student and applying for jobs, what would you say?

If you stay in the Trust that you trained in that can be positive because it's quite daunting when you first qualify and get that first job. For me, staying in the same Trust has really helped. They’ve been very supportive.

I'd also say to believe in yourself when you first qualify because you feel like you're starting afresh, but we have gained a lot of skills over those three years of training. We probably are a lot further on than we think.

If you build relationships when you're a student, the chances are you're going to be working with those people. It's very important to maintain professional relationships when you're newly qualified. Having a mentor, someone who's willing to look out for you, is really helpful.

I'd say just put yourself out there and open yourself up to opportunities, because they're there. And if you come across the right attitude you will be invested in. I've been invested in a lot and I'm putting back into the system because I've stayed with the same Trust. They've given to me so I think it's important for me to give back. I was given a lot of support and training and a lot of educational programmes supported the rotation while I did it. For me, that was really important as a newly qualified. Having that continuation of the adult nursing skills training. So I'd say to be open to possibilities.

How I started working in an Acute Medical Unit - Sarah's story

Where did you study?

I studied at Middlesex University and I now work in the Acute Medical Unit (AMU) at North Middlesex University Hospital NHS Trust

What's your experience of working as a newly qualified nurse?

I didn't do a placement on the AMU as a student so I wasn't sure what to expect. I soon learnt that it was very busy. None of my placements had been acute, so I wasn't used to the fast pace of it. I spent six months learning my time management, I had to zone in and focus on it. After six to eight months I felt like I understood the ward.

Then after 10/11 months I started to be in charge. You have to look after all 39 beds and coordinate care on a shift. It's hectic. It's a different type of time management. It's a different type of stress. You have to look at the whole ward instead of your six to eight patients. You're responsible for making sure things are done when they are meant to be.

But it's enjoyable. It's something that I feel like I can do now because I took my time, I pushed myself in the first six to eight months I didn't do extracurricular activities. I solely focused on getting my nursing skills up to a place where I felt they were good. I feel like that assisted me to be able to be in charge. I am now able to see the bigger picture of what is happening on the ward.

Why did you decide to work on the Acute Medical Unit?

I wanted a bit more patient care than in urgent and emergency care, so the next thing was AMU. We assess patients. I thought it would be a great place to learn because of various things coming through the door. They have a large area of cardiology patients. I thought that that would again be a great learning opportunity. There are various pathways to specialising from here. It can teach you a lot.

What do you enjoy about your job?

I like the fact that it's a fast-changing environment, but not as fast as A&E. I like that there's more patient care than A&E, even if it's just for one or two days. You get to know a patient a bit. You get to understand their diagnosis. I like that it changes every day.

What do you find most challenging about your job?

The most challenging thing sometimes is the cut between time management and prioritising. Sometimes you might have two sick patients in two separate bays and they both need the same amount of attention. That can be quite difficult. But the good thing is that we have a great team. We have good sisters, deputy ward managers, and they step in and assist which makes AMU all the better. There is a good sense of solidarity within the unit, so you don't feel like you're alone.

How did you find the preceptorship?

My preceptor was very good. She made time to answer questions. If we were on shift together she would always ask how I found it. What I found good, what I found bad, and she’d ask if I needed help. Even though she's a sister on the ward, it never felt like going to her would stop her from doing her job. She was just very helpful. And I think working with her assisted in things like the time management, she would give me hints and tips and helped me progress.

Why did you decide to stay in London after you qualified?

I'm a Londoner. I don't know where I would go that would give me the same busy-ness that London does. I thought North Mid would be a great place to start. I did training at North Mid hospital and I've not come across a staff member who's been unhelpful. Everybody's happy. Everybody's welcoming. Everybody's helpful.

If you could go back in time and give some advice to yourself when you were a student and applying for jobs, what would you say?

I would say don't rush into it. Go to various hospital open days. Get an understanding of the different wards that are out there and what they can bring to you, what the learning opportunities are, what the career development opportunities are, if there's career progression and how good would the career progression be. I would say to look at rotations. And think about your commute to and from the hospital to ensure that's manageable.

Ensure you have people to talk to, whether that be the educational link, your preceptor, your manager. If anything is bothering you at the start, managers, student links, work links, educational links can be really helpful. The educational link is the team within the hospital who do the preceptorship and various courses and study days. They are good people to talk to and they could be a good advocate if there's something you want to say and don't know how to talk to your manager.

Once you do start your job take it in stages. There's no need to rush. You have the rest of your career to do various things. Get the basics underway first.

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