Choosing A Specialism
Published: 03 Dec 2015
If you have decided to study for a Pre-Registration Nursing degree, then you must pick a specialism from four areas - Adult, Paediatric (Children’s), Mental Health, and Learning Disabilities. There are some universities that allow you to pick two specialisms, but the usual practice is to focus on one.
Adult Nursing involves treating patients both on a long and short-term basis, so the care given is wide ranging and the role can be very challenging at times. Adult Nurses must focus on developing observational and assessment skills, in order to: monitor all patients; check if they need immediate intervention; ensure a continuing high standard of care; and to observe vital signs for any changes. Therefore it is important that you are be able to juggle priorities and multiple patients, whilst ensuring each one receives the same level of excellent care.
A career in adult nursing will require you to have the skills to build long term, trusting relationships with your patients, who will come from a variety of demographic backgrounds. You must develop the ability to apply sensitivity and care to each individual, and be aware of any cultural implications. You must be able to improve quality of life for all your patients, no matter how long you are treating them for.
Healthcare is a constantly changing and evolving practice, and therefore a commitment to learning is vital if you want to go into nursing. For example, you will need to stay up-to-date with the latest treatments and be aware of the NHS Constitution, which sets out how nurses and other healthcare professionals should conduct themselves.
There are many options available in adult nursing: care for the elderly, theatre nursing, or oncology are just a few of the paths open to you. Your career could be based in a number of settings, such as the community, hospitals, prisons, and other institutions. All areas require you to be organised and flexible - two qualities vital for any nurse.
In addition to patients, Nurses also come into contact with families and carers, and may be required to educate them about the care needed in the future and to provide reassurance. You will also come into contact with a multidisciplinary team including doctors, occupational therapists, and radiographers; therefore you must be able to work with others efficiently to produce the best results for all patients.
Mental Health Nursing
Mental Health Nursing is a challenging but ultimately rewarding choice. Treating patients with a mental health difficulty requires a great deal of patience, but you will ultimately improve someone’s quality of life, and help them manage distressing situations.
You will need to build effective relationships with your patients, who will be under your care long-term. This requires a warm and engaging personality, but you must also be able to show assertive skills when needed. A good Mental Health Nurse is required to be on the ball at all times, and able to diffuse potentially difficult situations. For example, a patient may be at risk of harming himself or herself and it is vitally important to intervene early to ensure the best outcome.
A Mental Health Nurse should be able to encourage independence in their patients, and be confident in helping them take control of their own care; for example being able to dispense their own medication, or attend other appointments with minimal assistance.
Mental health care requires you to have a deep understanding of the theories applicable to each type of care, and to keep up to date with the latest research and types of treatment.
There are many opportunities within Mental Health Care, for example you may wish to work in a psychiatric inpatient setting, the community, or a university.
Families and carers of those who are receiving Mental Health Care often need reassurance, and you will work alongside various parties to help them understand the situation, how they can help, and what may happen in the future. You will also come into contact with other Mental Health Professionals, such as Psychiatrists and Occupational Health Therapists, and it is important that you convey information about the patient to them clearly, and maintain a strong working relationship to ensure the best outcome for the patient.
Paediatric (Children’s Nursing)
Paediatric Nursing can be frustrating and challenging, but entails a great sense of job satisfaction. A wide range of ages is covered under Paediatric Nursing, so you may find yourself caring for a new-born, and then a teenage patient directly afterwards.
You will be required to have highly tuned communication skills (especially non-verbal) as children can sometimes have difficulty expressing their pain and distress or may be too young to do so. This makes understanding body language and other forms of communication a vital skill. As well as being able to assess pain or distress levels within your patients, you will need to have the skills to spot when vital signs change, or when intervention might be necessary in order to secure the best outcome for your patient.
Health Care Professionals are vital tools in aiding a child’s development. You will need to understand theories and research, and be aware of any factors that might hinder your patient's development and act on them as necessary.
Paediatric Nursing involves a wide range of working environments, such as schools, homes, or hospital settings; in addition there are opportunities for further specialisation such as neonatal care or caring for children in accident and emergency departments, making paediatric nursing a field with a lot to offer in the way of further training and development of your skills.
Learning Difficulties Nursing
Working with people who have a learning difficulty is broad and challenging, but highly rewarding. Around 1 in 50 people have a learning difficulty, and the spectrum is very wide, bringing with it varying abilities and different challenges.
As with Paediatric Nursing, working with people who have a learning difficulty requires excellent communication skills, as you must be able to interpret non-verbal communication such as body language in order to assess your patient’s condition. You will need to ensure you are sensitive whilst maintaining a calm and clear attitude.
There are sometimes other health complications that come with learning difficulties, and you must be aware of how these will impact your patient’s condition. Acting fast is vital to maintaining the health and happiness of your patient.
A Learning Difficulties Nurse will be aware of local activities and other groups that encourage independence within their patients. This will help patients to become self-aware and help boost their confidence. There can unfortunately be a stigma surrounding learning difficulties and therefore you must be understanding and assertive.
There are many fields that you can specialise in, for example you may decide to work with people who are on the autism spectrum, or people who have Down’s Syndrome. Alternatively you may also choose to work in a specialist residential home, a school, or to provide care in the community.
There are other professionals you will come into contact with whilst working with learning difficulties, for example Speech and Language Therapists (SLTs) and General Practitioners (GPs). Working closely with the various professionals involved with your patients' care will improve the life of the patient and potentially help to stop further health issues in the future. You will also spend time with parents, carers, and/or friends of the patient and must be able to reassure them of the current situation, the likely outcomes, and what they can do in the future to help the patient.
Although there are many similarities across all the specialities (such as the need to be aware of research and treatment) each has its own set of requirements and challenges.
It is important to be confident in the speciality you choose as you will be studying this in depth and working in this field; however there will be opportunities to change if you decide that it is not the right path for you. All of the options will bring with them excellent options for progression and will ultimately result in a strong career. Nursing teaches you valuable skills that can be applied to many situations outside of work, and brings with it a great sense of job satisfaction.