the 4 fields of nursing in the UK: what you need to know as an overseas nurse

February 24, 2021

As an overseas nurse aiming to work in the UK, the first thing you’ll have to do is apply to join one of the four Nursing and Midwifery Council (NMC) registers. This can be a daunting task, especially when you are unfamiliar with the system. A good place to start is by understanding how nurses are and have been trained in the UK, what the 4 fields of nursing are, and what that might mean for you.

A Bit of Background

For much of the 20^th century, nurses in the UK were trained in many different fields of care to different standards in different hospitals. In 1983 the UKCC (United Kingdom Central Council for Nursing, Midwifery and Health Visiting) took over the responsibility for maintaining a professional register and at the same time consolidated a wide range of qualifications into the four fields in use today: adult, children’s, mental health, and learning disability. The current regulator, the NMC took charge in 2002. If you’re researching the process of joining the UK register, then you’re probably familiar with them.

In the UK, it only became necessary to have a degree in nursing in 2009. This, typically, is a three-year course. Students are required to choose their field at the beginning of their program, which, obviously is different from the US system with its single nursing degree. When registering with the NMC, you’ll have to consider the field of nursing, and corresponding register, you’d like to join.

*it’s helpful to note here that in the UK midwifery is its own 3 year degree which is completely separate from nursing.

The 4 fields of nursing

Adult

Adult nursing is the most generalized field and could potentially provide a wider range of roles to explore over the course of one’s career. From working in a general practice (doctor’s office) to accident and emergency (emergency department) and everything in between, being an adult nurse will get you there.

Children’s

Children’s healthcare may have some similarities to that of an adult, but it’s not as simple as adult nursing in miniature. Size certainly is a consideration, but so too are development, physiology, ability to communicate, increased compensation followed by rapid deterioration, and the care of the family unit as a whole.

Mental Health

Though all nurses are expected to have the skills to professionally manage interactions with those who use mental health services, mental health nurses are specialists in the field. Jobs in mental health are available in and out of the hospital where they form an important part of a multidisciplinary team which typically includes GPs, psychologists, social workers, psychiatrists, occupational therapists, arts therapists and healthcare assistants.

Learning Disability

Learning disability nurses focus on improving the quality of life of those identified as having a learning disability. This could include improving mental and physical health, increasing independence, removing barriers, safeguarding those considered vulnerable, and helping individuals and their families find fulfilment in life.

Working across the fields of nursing

Being on a specific register doesn’t necessarily mean you cannot work in one of the other fields, but it may reduce your options and make career progression more difficult.

Some positions, such as GP nurse, district nurse, and theatre nurse, are open to all nurses regardless of their registered fields. Others may accept applications from nurses in some but not all of the registered fields. For example, a neonatal nurse could be an adult nurse, children’s nurse or midwife.

Most job adverts will specify if they would like you to be registered in a certain field. It may be worth scrolling through NHS Jobs to see which registration is required for the positions that interest you. If you’re still unsure, there’s no harm sending an email to the contact person listed on the advert.

Switching fields of nursing

If at some point you set your sights on a job that requires registration in one of the other fields, there are ways to do this without having to undertake another degree. Many universities offer second registration courses which last 12-18 months. If you are interested in pursuing this, it may be something that your trust (hospital organization) would be willing to support by giving you protected, paid time for study while continuing to employ you. They may even fund your studies!

Switching to midwifery

Nursing degrees and midwifery degrees are completely separate programs in the UK so a US nursing degree would not directly transfer to a midwifery degree. However, if you are a certified nurse midwife in the States, then you would meet the requirements for applying to join the NMC midwifery register.

If you are a labor and delivery nurse like I was and want to continue working in obstetrics in the UK the process is slightly longer and more complicated, but it is possible. First, you must be registered as an adult nurse at which point you would be eligible to apply to a UK university’s shortened midwifery course which lasts 18 months. Sometimes hospitals will sponsor adult nurses for these courses, especially if there is a shortage of midwives. Again, often with protected, paid study time and funding for your course.

What you need to know as an overseas nurse

As an overseas nurse you will have to specify on your NMC application which register you would like to join. When I began my own journey, I remember this being the first of many confusing hurdles over which I had to jump.

If you are just starting to look into this transition read ‘6 steps American nurses must take to get a license in the UK‘.

It’s likely that you will have gained at least some experience as a nurse before considering the move abroad, so you may have a good idea of what you want your career to look like. If that’s the case, then your decision should be straightforward.

Now that the NMC does not require overseas nurses to have any post-qualification experience, you may still be new to the profession and feel uncertain of your career path. If that’s the case, there are a few things you should do/consider:

Explore the roles in nursing outlined by the NHS
Look through job adverts on NHS Jobs to become familiar with the positions available and which registration they require
Most support materials for going through the NMC registration process are geared toward registration as an adult nurses, though some hospitals are starting to support OSCE prep for the other fields
Your nursing degree from your home country can only be used for registration in one of the fields of nursing
If you’d like to be on more than one register, you will have to complete a second registration program from a UK university

Good luck as you embark on your nursing adventure and if you have any questions about my own journey, do get in touch via Instagram or the contact page.

the 4 fields of nursing in the UK: what you need to know as an overseas nurse

A Bit of Background