1. Ngozi has found out that there are four fields of nursing and wants to know exactly what the differences are between them. 

As Ngozi is aware, within the UK there are four fields of nursing, each being named after the patients which nurses in these fields care for most frequently. These four fields are referred to as mental health, child, learning disability and adult. Whilst there are many aspects of care within each field that reflect the speciality, there are also core elements which underpin the profession of nursing as a whole. So, no matter which field of nursing you work in, it is likely that you will undertake activities such as:

• assisting patients with physical needs
• counselling a patient or group of patients
• supporting patients to recover or to cope with their needs more effectively
• helping children and young people to manage their health by developing partnerships in care with families
• delivering educational programmes to promote the health of a community
• supporting an individual with a long-term condition, such as diabetes, to live independently.
• It can be seen that nurses from all fields care for individuals of all ages and cultural backgrounds, who do not have to be sick. However, in considering the differences between the fields, there are certain elements to consider.
• Learning disability nurses work in partnership with people with learning disabilities, their families and carers in a range of community, residential, and healthcare settings. Learning disability nurses require a range of knowledge and skills, which include good communication skills (including use of alternative communication approaches), assessment skills, person-centred planning skills and values grounded in equality, inclusion and human rights. The central roles include identifying and meeting health needs, reducing health inequalities and promoting better health outcomes which can be achieved through working as a community learning disability nurse, or within an assessment and treatment unit, a secure unit, a nurse therapist, or an acute care hospital liaison nurse.
• Mental health nurses practise with people of all ages with mental health problems. They care for patients with a wide range of mental disorders using supportive methods to promote positive and therapeutic relationships, which focus on social inclusion, human rights and recovery. This aims to enable a patient to develop the ability to live a self-directed life, with or without symptoms, which the patient feels is personally meaningful and satisfying. The rates of mental health problems in prisons or in other secure services are much higher than the general population, so mental health nurses are often employed to provide direct care or to advise prison officers or other staff on how to respond to mental distress.
• Children’s nurses care for individuals usually between the ages of birth and nineteen, and their families in range of different settings. They care for well children, promoting their health in the role of a school nurse for example, and for children with special physical or learning needs, mental health concerns or physical illnesses. Children’s nursing occurs in many settings, in a hospital, community, or in the child’s home and children’s nurses can work shifts, including nights and weekends or a more usual working week. Maintaining the normal daily routine is important, because children find being away from their usual environment distressing and disruptive to the life of their entire family. So, working in partnership with a family, empowering them to care for their child is central, as this enables independence and a return to normal routines.
• Adult nurses normally work with patients from the age of 16–19 upwards, aiming to promote good health by treating patients who have may have acute or long-term health issues. With an ageing population adult nurses are finding their patient population is increasingly the elderly with complex multiple health problems along with the added challenge of dementia. Adult nurses need to be able to prioritise the care they deliver, using a range of skills to achieve this whilst working in partnership with the patient, the patient’s family, carer or friends and other healthcare professionals. Adult nurses provide a wide range of care to improve the quality of patients’ lives, sometimes in difficult situations.

2. Although Ngozi feels he has a wide range of life experiences, he does wonder whether he would be able to cope with the demands of being a nurse.

It is really good that Ngozi realises that both becoming and being a Registered Nurse is challenging, but most nurses will say that their choice to join the nursing profession is one of the best decisions they have ever made. Studying on a nursing course is not easy, nursing is both physically and emotionally demanding. In real life nursing isn’t often what is shown in popular television programmes, plus a student nurse has to spend many hours gaining the knowledge and skills they will require to deliver effective patient care. Ngozi should talk to as many nurses as he can, from different fields, to hear their views and experiences. It would also be a good idea for him to become a volunteer at his local hospital or at a nursing home, as this would increase his knowledge about exactly what nursing is and what nurses do, before he decides whether it really is for him.

3. Ngozi is unsure what the opportunities for him would be once he had completed his nursing course, as he is not certain he would want to work within a hospital environment.

Nursing today is far more challenging than ever, with patients presenting with far more complex healthcare needs. Healthcare reforms have aimed to put patients at the heart of the health service, there is a move away from all care being delivered in hospitals; patients are hospitalised for shorter periods, more care is delivered within the community and some care services are delivered by non-NHS organisations. Such changes have resulted in developments within the nurses’ role, as they now provide care previously delivered by a doctor, or can choose to specialise in a particular area of nursing practice, or become a researcher or lecturer. So, for Ngozi, no matter which field he decides he wishes to care for patients in, if he does not want to work within a hospital setting, there are numerous other settings where patient care is delivered, both in the UK or other countries. Ngozi would have the opportunity to decide whether he wanted to become active in nursing research, as a clinical research nurse or, after gaining experience in patient care and further education, he could become a nursing researcher within a university setting or a nurse lecturer.