How to become a Nurse – A-Z of Specialties

Care for the elderly

Nurses who specialise in caring for the elderly utilise plans to meet their patient’s health care needs. The plan is designed specifically for their medical condition and assists the patient with hygiene, nutritional and toileting needs as well as providing safety information, such as whether or not the patient is mobile and how they are to be lifted if necessary. While they generally work in nursing homes and assisted living facilities, nurses who care for the elderly can also work with hospice patients.

Typical daily work activities include:

Administer the medications and intravenous fluids
Discuss the patient’s situation with the family members
Monitor the patient’s chart and remain in direct contact with the doctor
Making changes to the care plan as needed

Career Entry

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Cardiac

A cardiac nurse typically works alongside a cardiologist to deal with a range of heart-related illnesses such as angina, coronary heart disease and congestive heart failure. Their main work is carried out in hospitals, cardiology care units and coronary care units; they can also work with patients in their homes. There is the opportunity to work in a more senior role of cardiac nurse practitioner where the nurse will take on a more involved role and work in collaboration with physicians to diagnose heart conditions and decide treatment methods. Cardiac nurses can also be employed by medical institutes to carry out research and produce reports. Typical daily work activities include:

Assisting with monitoring and administrating drugs on the instruction of the cardiologist
Administering IV drips
Monitoring any abnormalities in heart function and other vital signs, consulting a physician for a detailed diagnosis if required
Using a defibrillator is the patient suffers heart failure
Dealing with any surgical infections that may occur after operations
Educating patients on rehabilitation though advice on leading healthier lifestyles
Provide emotional support to patient and family
Assisting other nurses with the feeding, washing, and dressing of patients when required

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Critical Care (ICU)

Critical care nurses are clinical specialists that focus on providing care for critically ill patients of all ages, dealing specifically with human responses to life-threatening problems. They practice in hospital critical care units and urgent care centres. Critical care nurses work bedside clinicians, nurse educators, nurse researchers, nurse managers, clinical nurse specialists, and nurse practitioners. Typical daily work activities include:

Using sophisticated equipment to provide care and treatment to the patient
Performing treatments and delivering medication
Closely monitoring the health of patients to ensure rapid and appropriate response to emergency’s
Being responsible for the emotional welfare of patients and their families

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Dermatology

Nurses in dermatology focus on the treatment and care for patients undergoing investigation for skin related conditions such as the treatment of wounds and skin disease. Career opportunities exist at a dermatology office, medical spa, cosmetic surgery clinic and other specialist medical facilities. Typical daily work activities include:

Perform diagnostic tests and certain types of treatments under the supervision of a doctor
Supporting a dermatologist or skin-care specialist
Educate patients about healthy skin-care habits
Treat certain wounds and diseases of the skin

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Diabetes

Nurses in this field specialise in the diagnosis, treatment and education of all types of diabetes, complications and illnesses related to diabetes. Treatment can occur in a home setting, in the hospital, or in a clinical or out-patient setting. Typical daily work activities include:

Performing all of the same functions as any other Registered Nurse involved with patient care
Assisting diabetic patients with their care
Educating patients on medications and how to control their blood sugar levels as well as the types and quantities of insulin they should receive, depending on their blood sugar level each day
Performing testing that helps to diagnose and manage diabetes

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Endocrinology

Nurses who work within the field of endocrinology are clinical specialists who are specifically concerned with hormones. They focus on the hormone producing glands that control functions related to growth, sexual health and metabolism and work with patients suffering from a variety of illnesses and conditions including diabetes, thyroid diseases, osteoporosis, hypertension, cholesterol disorders and cancer. Typical daily work activities include:

Diagnosing the illness, prescribing and administering treatment
Advising and counselling patients on diet, hygiene and care in dealing with their condition
Assisting endocrinologists in taking patient histories, ordering diagnostic tests, evaluating the results and monitoring treatment plans and medications
Educating patients about their condition and providing support

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – ENT/Maxillofacial

Maxillofacial nurses are clinical specialists who focus on the ear, nose and throat. They assist physicians and dentists with the care and treatment of patients. Typical daily work activities include:

Administering treatment and medication as requested
Providing the patient and their families with emotional support

Regulator: Nursing and Midwifery Council (NMC)

Useful links

ENT Nursing

Clinical Specialists – Gastro and Stoma Care

Gastroenterological nurses work with patients who are undergoing diagnosis and treatment for disorders affecting the digestive system, including reflux, abdominal pain, bleeding and cancer. They assist in the treatment and prevention of diseases and conditions and provide essential care to patients undergoing procedures for diagnosis and treatment. Typical daily work activities involve:

Assisting healthcare providers with the treatment and prevention of diseases and conditions in patients
Educating patients about the proper way to live with their condition
Supporting gastroenterologists with their daily duties, such as prescribing and administering treatment to patients

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Gynaecology

Nurses working in the gynaecology field are clinical specialists who provide care and support for women with dysfunction or disorder associated with the reproductive organs in the lower pelvic and abdominal areas. This field of nursing can be further specialised into perinatal nursing and labour and delivery nursing. Typical daily work activities involve:

Educating patients regarding the appropriate self-care for conditions
Carrying out post-operative observational assessment
Providing emotional support for patients who may be suffering from what they see to be an embarrassing condition or who may be experiencing peri-natal grief or emotional labour
Assisting with physiological tests, pain management or wound care

Clinical Specialists – Haema & IV Therapy

Haematology & IV therapy nurses are clinical specialists who assist in the treatment, prevention and education of conditions related to blood and blood producing organs. They provide care for people with haemophilia, sickle cell, leukaemia and other blood related diseases. Haematology nurses work closely with the oncology department due to the relation between some diseases of the blood being cancer. Due to this, there is the opportunity for the nurse to advance their career into cancer research.
The specific role of the IV therapy nurses is to provide an advanced level of care for physically and mentally ill people through intravenous delivery of medication and health promoting fluids. Typical daily work activities involve:

Taking blood samples from patients as requested by the physician
Delivering treatment and medication using IV therapy (directly into the vein)
Providing emotional support to patients and their families, particularly when delivering the news that the patient has a blood disease
Educating patients and families about the disease or condition and possible treatments

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Nephrology

Nephrology nurses are clinical specialists who focus on the care for patients who are experiencing, or at risk of, kidney related diseases. They work with people of all ages, including the patient’s family, preventing, assessing and treating the disease. These nurses also deal with every organ system in the body, and deal with patients with numerous conditions including cardiovascular disease and diabetes. There is the opportunity to become a specialist, for example, in the field of peritoneal dialysis, transplantation and continuous renal replacement therapy. Typical daily work activities involve:

Helping patients manage their lives, enabling them to succeed in school or work, maintain relationships and enjoy hobbies whilst effectively deal with their health issues by promoting the maximum level of patient-desired independence
When working in a multidisciplinary team the nurse functions as advocate, educator, consultant, care coordinator, direct caregiver and oversees long-term care of chronically ill patients
A primary role is to educate patients about their diseases, prognoses and treatments

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Neuroscience

Nurses working within the field of neurology are clinical specialists who assist with the diagnosis and care of conditions relating to the brain and nervous system. They work with patients with dysfunctions of the nervous system, spinal cord injuries, head trauma and seizures. Their typical work settings are hospitals and the doctor’s office. Typical daily work activities involve:

Answering patient questions and explaining physical exam procedures such as brain scans
Evaluating patient health and tracking vital signs, ensuring concerns are raised when necessary
Provide appropriate assistance to neurology doctors
Performing delicate and precise manoeuvres to ensure there is no further harm to the patient
Administering medication
Coordinating follow-up care, such as ensuring all relevant tests are done and results received

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Occupational Health

An occupational health nurse (OHNs) practises within the workplace and contributes to the health and wellbeing of employees. Occupational health nursing practice is an important part of a public health strategy and is influenced by a range of health and safety legislation. OHNs work in large businesses, for private consultancies, as part of an environmental health and safety team or alone, as there is the opportunity to set up individual consultancies. Typical daily work activities involve:

Assessing the work environment for health and safety problems by conducting a range of risk and health assessments
Ensuring employers know how they can achieve compliance with legislation by developing policies and new health promotion initiatives
Delivering health and safety related training programmes
Monitoring employee exposure to hazardous chemicals and undertaking health surveillance
Developing return to work strategies following serious injury or a period of prolonged ill-health

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Oncology

An oncology nurse is a clinical specialist who provides care for cancer patients. Their work consists of the roles of direct caregiver, educator, consultant, administrator and researcher. The oncology nurse functions as a coordinator of care working expertly with the multidisciplinary team to provide required care as effectively as possible.
The nature of oncology care spans the spectrum, from prevention to acute supportive care. Due to the diversity oncology nurses can focus on chemotherapy, breast oncology, radiation, bone marrow transplant and prevention and early detection. Typical daily work activities involve:

Carrying out patient education activities to ensure the patient is fully aware and educated about their disease and treatments
Advising the patient and their families regarding the importance of diet, nutrition and exercise
Creating environments which promote health and recovery
Providing emotional support to patients and their families in what will be a very difficult time in their lives
Designing and implementing care plans that comprise administering treatments like chemotherapy
Determining the necessity of intravenous (IV) lines
Recording patient progress, consulting a physician if necessary

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Ophthalmology

Ophthalmology nurses are clinical specialists who provide care and support for patients diagnosed with disorders of the eyes such as blindness, glaucoma and eye trauma. Typical daily work activities involve:

General assistance in the treatment and prevention of conditions
Assistance in surgery
Making pre and post-operative home visits to ensure full recovery and management of the condition
Using equipment to diagnose, monitor and treat patients conditions
Educating the patient about their condition
Providing emotional support to patients, especially those who will develop physical and emotional disorders that some conditions can result in

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Ortho and Trauma

Trauma nursing involves responding quickly with minimal information to a wide variety of unexpected events that might range from broken limbs to poisoning by assessing, intervening and stabilising patients. Their work involves different patient needs, ages, cultures and severity of symptoms. These nurses maintain vital signs and prevent complications and death in their patients. Orthopaedic nurses assist in the care, treatment and prevention of conditions related to the bones and joints. They are clinical specialists whose assessment of musculoskeletal conditions relies on a holistic approach. As well as treating and preventing the conditions, orthopaedic nurses also educate patients and families of the patient about self-care and support systems. Typical daily work activities involve:

The orthopaedic nurse will assist with administering medications and inserting IVs
Assessing patients environments and advising self-care accordingly
Checking the site of surgery or injury and changing dressings
Trauma nurses will stabilise the patient’s condition until the doctor arrives, they will then assist with any further treatment required
Advising doctors and surgeons on any information that may be life saving
A trauma nurse must deal with patients under severe stress, coping with a variety of emotions including grief, anger and confusion

Clinical Specialists – Paediatrics

Paediatric nurses care for and support children and young people suffering from many different conditions in conjunction with other health care professionals. They play a key role in assessing children’s needs taking into account a variety of situations such as medical circumstances, family and culture. Paediatric nurses then plan and deliver care in a variety of settings, such as hospitals, homes and in the community, as well as during transfers between these settings. It is important that a paediatric nurse can appropriately communicate with children of all ages and understand the needs of the patient will change depending on the developmental stage. Typical daily work activities involve:

Assessing, observing and reporting on the condition of patients and preparing patients for operations and procedures
Administering drugs and injections and assisting with tests and evaluations
Explaining treatment and procedures whilst supporting and advising parents and carers to enable them to give consent to treatment
Writing reports and keeping accurate records of patient observations

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Palliative Care

A palliative care nurse is a clinical specialist who works in a multidisciplinary team providing holistic care to patients with advanced progressive illnesses. Palliative care is part of supportive care and its goal is to achieve the best quality of life for patients and their families. These nurses are specialists and work closely with palliative medicine consultants and a range of other experts including, physiotherapists, occupational therapists, dieticians, pharmacists and social workers. They carry out treatment and care within hospitals, hospices, care homes and the patient’s home. Typical daily work activities involve:

Provide relief from pain and other distressing symptoms
Offer a support system to help patients live as actively as possible until death
Intensive co-ordinated home support for patients with complex needs who wish to stay at home
Bereavement support services which provide support for the people involved in a patient’s care following the patient’s death
Education and training in palliative care

Regulator: Nursing and Midwifery Council (NMC)

Useful links

The National Council for Palliative Care

Clinical Specialists – Respiratory

Respiratory nurses assist with the practice of treatment and prevention of disorders relating to the lungs and respiration. This field of nursing can be preventive, acute or critical, and rehabilitative. These nurses promote health for individuals and communities throughout the lifespan. Typical daily work activities involve:

Consulting with patients and developing treatment plans that include medications, medical procedures and lifestyle changes to meet the patient’s needs
Obtains and records patient medical histories
Administers medication, performs diagnostic tests and observes the condition of patients
Provides education to patients and families on how to manage respiratory conditions and the necessary follow-up care
Promoting good pulmonary health and preventing respiratory conditions within public education

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Rheumatology

Rheumatologic nurses are clinical specialists who, along with other healthcare providers, assist the treatment of conditions in the very complex field of rheumatic diseases including rheumatoid arthritis, lupus, fibromyalgia, myositis, spondylitis, and Lyme disease. Typical daily work activities involve:

Monitoring patient’s blood work and pain response
Ordering diagnostic tests and assist in developing treatment plans for a variety of conditions and illnesses
Recognising and treating symptoms
Evaluating and managing the effectiveness of medication
Counselling the patient if seen necessary

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Theatres

Theatre nurses assist surgeons and other surgical specialists during procedures performed in the operating theatre. They play multiple roles before, during and after the surgery. Theatre Nurses have two major roles within the operating theatre. They can either be a scrub nurse or a circulation nurse.

Scrub nurses focus on the patient and equipment that will be used in the operating theatre. Although the scrub nurse will not be using the equipment it is important that they know their uses to ensure a calm and immediate response to a surgeons request.

The role of the circulation nurse is to fetch and open packs that need to be used. Most of the time, the packs that need to be opened contain sensitive contents that should remain sterile and immaculate. There is the opportunity to move up and become a senior theatre nurse and also train, teach and supervise new staff. A theatre nurse can also have various specialisations, such as orthopaedics, ophthalmology, obstetrics, cosmetic, and other fields that require operations. Typical daily work activities involve:

Anaesthetic duties
Being responsible for the patient’s well-being during the recovery phase ensuring all further treatments are carried out
The scrub nurse is responsible for passing equipment to the surgeon as requested and accounting for all equipment used after the surgery
The circulating nurse should make sure that the operating room is not contaminated in any way and ensure the correct packs are opened and remain sterile. They can also be trained to provide post-operative consultation

Regulator: Nursing and Midwifery Council (NMC)

Clinical Specialists – Urology

Urologic nurses are clinical specialists who focus their work on a range of urologic disease and concerns. They care for patients of all ages in a variety of health care settings, providing guidance on management and treatment of the care of the urinary tract, bladder, prostate gland, kidneys and their related conditions. Typical daily work activities involve:

Performing exams on the patient
Undertaking and interpreting diagnostic studies (such as urodynamics)
Treating bladder dysfunction and incontinence
Provide patient education, such as, teaching preventing care

Regulator: Nursing and Midwifery Council (NMC)

Educating Nurses

An educating nurse works in the classroom and practice setting, preparing and mentoring future nurses. They are responsible for designing, implementing and evaluating academic and CPD education programs for nurses, ensuring quality and educational experiences that prepare the workforce for an ever-changing health care environment. In most cases, educating nurses teach clinical courses that correspond with their clinical expertise and work part-time in the health care setting, giving them the opportunity to maintain a high degree of clinical competence. Typical daily work activities involve:

Designing curricula and developing courses/programs of study
Teaching, guiding and evaluating learners
Documenting the outcomes of the educational process
Advising students
Engaging in research
Speaking/presenting at nursing conferences
Maintaining clinical competence

Career Entry: Educating nurses are trained / educated to master’s or doctoral level

Regulator: Nursing and Midwifery Council (NMC)

General Nursing

General nursing is varied and diverse depending on the area of practice. Generally, the nurse is assigned to an individual or group of patients and works as an autonomous professional within a multidisciplinary team which may include, for example, other nurses, doctors and physiotherapists amongst others. Nurses focus on the needs of the individual rather than on illness or conditions. They help individuals and their families to live more comfortable lives by providing care, advice and counselling. Irrespective of the practice area, the nurse continuously assesses, plans, implements and evaluates patient-centred care throughout the day. Typical daily work activities include:

The role of the nurse in providing information and education, it is important in helping patients understand their health status and empowers the patient to become self-reliant and self-determined in controlling of her own health
Advising patients of ways of optimising their lives
Decide on treatment options where appropriate and how best to manage their specific situations
Assessing, planning and implementing care
Meeting the psychological and emotional needs of the patients and their families

Regulator: Nursing and Midwifery Council (NMC)

General Nursing – Advanced Nurse Practitioner

Advanced nurse practitioners are registered nurses with advanced academic and clinical expertise who provide primary and acute care, and are qualified to meet the majority of patient’s health care needs, working independently or as part of the health care team. They focus mainly on health maintenance, disease prevention, counselling and patient education. With a strong emphasis in primary care, advanced nurse practitioners are employed in several specialities, including neonatology, nurse-midwifery, paediatrics, women’s health and mental health and more. Many nurse practitioners also work as educators and research scientists at schools of nursing, and are actively involved in legislative activities and health care policy to promote quality health care delivery for the nation. Typical daily work activities include:

Taking patient histories
Performing physical exams and diagnosing and treating common acute illnesses and injuries
Providing immunization
Managing high blood pressure, diabetes, and other chronic health problems
Ordering and interpreting lab tests
Prescribing medication and non-pharmacological therapies
Counselling patients on healthy lifestyles and health care options

Career Entry: Must obtain a Master’s degree in nursing

Regulator: Nursing and Midwifery Council (NMC)

General Nursing – Matron

Matrons often oversee just one department, although in larger hospitals it is likely that some will have groups of wards to manage. A hospital may have many matrons, one for surgery, one for medicine, one for accident and emergency etc. Their managerial powers are limited and they spend most of their time on administrative work rather than direct patient care.
Community matrons are now widely employed in the UK. The role of this group is clinical; therefore these matrons have a caseload of patients they are clinically responsible for. Many of these patients have chronic health conditions. It is the aim of this staff group to treat the patient within the community thereby limiting hospital admissions. Typical daily work activities involve:

Administrative duties
Overseeing management of ward, for example, ensuring cleanliness and patient catering are managed effectively
Community matrons work within the patients’ homes and community areas to limit hospital admissions by providing care and advise outside of the healthcare setting

Regulator: Nursing and Midwifery Council (NMC)

General Nursing – Ward Sister

A ward sister is required to work within a team of staff including qualified nurses, health care assistants and clerical staff, providing the highest standards of nursing care to a caseload of patients. They are in charge of the ward, and must demonstrate leadership skills and professionalism. Typical daily work activities involve:

Ensuring the environment is safe for the well-being of patient care
Provide leadership and supervision for all health care assistants within the team
Participate in unit meetings
Be aware of budgetary constraints and work in a cost effective manner
Assisting with the maintenance of appropriate stock levels within the ward and department

Regulator: Nursing and Midwifery Council (NMC)

Mental Health & Learning Disabilities

Mental health and learning disability nurses work with children, adults and older people, usually in a multidisciplinary team, and are concerned with their clients health in the widest context. The work involves helping people to come to terms with, or recover from, their illness allowing the patient to maximise their life potential while respecting their rights and dignity. They work closely with clients, their families and carers to assess their needs and draw up care plans, monitoring the implementation of recommendations. As a registered mental health nurse (RMN) and learning disability nurse, you may work with patients in their own homes, in a community health care centre, a hospital outpatients department or specialist unit, or a secure residential unit. Typical daily work activities involve:

Using expert communication skills to engage with vulnerable people, building trusting relationships whilst assessing conditions and discussing the best way to deliver care
Interpreting and understanding behaviour and evidence-based outcomes to develop individual care for the patient whilst liaising with other hospital staff
Using group and one-to-one therapy sessions with other health professionals or individually
Organising social events which are aimed at developing the patients social skills
Working closely with patients families and carers
Focusing on a ‘recovery’ based approach to care

Regulator: Nursing and Midwifery Council (NMC)

Practice Nursing

Practice nurses work in general practitioner (GP) practices and provide assessment, treatment and care to patients of all ages and from a wide section of the community. They also play a key role in educating patients on treatment and care of common illnesses. Typical daily work activities involve:

Giving patients consultations, specialist information and advice in areas such as blood pressure, weight control, giving up smoking, heart conditions and a range of other health conditions, referring to other members of the practice team as necessary
Performing minor operations
Conducting clinics for conditions such as asthma, diabetes and skin disorders as well as well-woman/man clinics where they can administer contraceptive advice and devices and offer cervical smear and pregnancy tests
Taking blood and urine samples, performing routine procedures, such as ear syringing, eye washing, treating and dressing wounds and administering immunisations and vaccinations
Taking accurate notes and updating computer records regarding all consultations and treatments
Liaising with other practice nurses, GPs, reception and office staff

Regulator: Nursing and Midwifery Council (NMC)

Primary Care and Community

Primary care nurses work in doctor’s offices and walk-in clinics, diagnosing and prescribing medications for common illness.
Community nurses work in Government agencies, clinics and other private settings. They focus on improving the overall health of populations, individuals, groups and families. They educate patients on health issues, disease prevention, nutrition and childcare. Community nurses also work with community leaders, teachers, parents, and physicians in community health education. Typical daily work activities involve:

Educating patients on self-care, health issues and prevention of common illnesses
Being responsible for coordinating all aspects of care for the same group of patients throughout their stay in the health care setting
Dividing duties by patient and not function (e.g. medications and treatments) providing patient focused care
Diagnosing and treating patients illnesses and injuries
Conducting physical exams, interpreting X-rays and other tests

Regulator: Nursing and Midwifery Council (NMC)

Research

The research nurse role is a relatively new occupation, yet they are essential to the pharmaceutical industry as they liaise with research scientists involved with developing treatment and therapy.

Research nurses work for hospitals and drug developers in scientific/clinical experiments on patients. They use advanced research-focused assessment skills to determine potential patient care issues and devise plans for care for patient’s trialling a new drug. They also assist in developing treatment protocols and methods for the drug or therapies by incorporating their own research data with that of other investigators. Typical daily work activities involve:

Clinical data coordinator
Clinical research assistant
Clinical research monitor
Research assistant
Assisting physicians and scientists in monitoring the health and responses of a patient during a new drug or therapy trial
Recording physical assessments and vital signs
Administering the investigated compounds or therapies and coordinating research activities
Collecting patient samples, such as blood, urine or tissue biopsies

Regulator: Nursing and Midwifery Council (NMC)

Sexual Health

Nurses working in sexual health give advice by providing HIV, family planning and sexually transmitted disease services. Their role is mainly educational and some clinics specialise in support and advice for young people (under the age of 26). The treatment centres are operated on an out-patients basis. Typical daily work activities involve:

Carrying out health assessments and diagnostic tests
Providing pre and post-test counselling, information and advice regarding treatment
Educating clients through health promotion initiatives
Undertaking work within the education setting and in youth projects and hostels

Regulator: Nursing and Midwifery Council (NMC)