Charlotteh12
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#1
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#1
Hi!
I'm half way through my Access to HE course and doing my research into nursing degrees. I have an interest in dermatology and during my research seen job posts for 'Nurse specialist' in dermatology.
Can anyone with nursing experience give me an insight into what the degree structure is like, how you choose what department you would want to work in and if nurse specialist requires further postgraduate qualifications?

Thanks in advance
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Emily_B
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#2
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So the first thing you actually need to do is decide which branch of nursing you want to do for your degree first - adult, mental health, children's or learning disability - and do that 3 year degree and then get a few years general experience before you go off and apply for/do extra training for specialist nurse roles. So the question is - do you want to look after adult physical health, children's physical health, all ages' mental health or learning disabilities. So if dermatology really interests you, then it's physical health you need to be looking at - and decide whether it's adult or children's dermatology to then decide whether it's adult or children's nursing you want to do. I would say, however, that focussing on one very specific area of nursing isn't great as you may not get exposure to that area, or it may not be as good as you think (many people think an area is the best thing ever, then get there and find they hate it... or the opposite and not want to go to an area and then love it - have seen both things happen).
So, you do 2300 hours of theory and 2300 hours of practice over 3 years at university to do a pre-registration nursing degree (ie passing it leads to registration with the NMC). Your time is spent 50:50 between theory and practice. Some universities split placements into 2x 10 week placements, others split them as 6-6-7 weeks and each block is between spells of theory in uni.
Sometimes you have placements the same as other people, some are different, some are at different times. For example, one of the placements I had in 1st year someone in my class had as 3rd year and vice versa - and we had different experiences of both places due to where in the degree we went to those places.

I'm an adult nurse/did BN Adult Nursing. You get field specific placements. The places I went to on placement (there is no choice bar final placement and elective if applicable):
1) School immunusations. This was in the height of flu jab season, so lots of flu jabs for 4-7 year olds, then a few meningitis jabs and the cervical cancer one for older children/girls. I'm not quite sure what I took away from this 6 week placement, but did visit practice nurses, district nurses, and school nurses in this time - lots of leg dressings, asthma/hypertension/diabetes reviews, and an insight into safeguarding.
2) Elderly medicine. This really helped me get my head around "being a HCA", which is actually the foundation of nursing. I spent a lot of time helping people washing and dressing, with eating and drinking, with toileting, with mobility, checking those who were incontinent for if they had passed urine/opened their bowels, doing obersvarions... ie meeting people's hydration/nutritional needs, making sure that they're not constipated or in urinary retention, checking skin integrity, making sure that their general condition isn't deteriorating. Then there's the dealing with Alzheimer's and further confusion thanks to a new environment/having some sort of infection.
3) Day surgery. It's all admit - send to theatre - take back from recovery - check OK - discharge home. The thing is here, some of it seems quite "major" surgery but people are safe to go home the same day - are they talking/eating/drinking/toileting ok, have they got up out of bed ok (they're pretty much all mobile and independent normally), is their condition improving and not deteriorating? If the answer to all of that is yes... send them home with a relative/friend and let them go to the GP to check any wounds.
4) Coronary Care. Basically all the patients here had a heart condition and needed cardiac monitoring. Some had had an NSTEMI (partial blockage of coronary artery/arteries) and were being monitored, waiting to go to the local specialist heart unit for surgery; some were having their heart rate monitored as they were fluid overloaded and on medication infusions to help get rid of extra fluid (needed to check their fluid intake/output to make sure they're getting rid of the fluid), others you're trying to control really high/really low heart rates.
5) A&E. What do I say? Everything from a headache to poorly kids to broken bones to heart attacks to car crashes and everything in between.
6a) Nursing home. Lots of basic care, and then, what do you do when a resident isn't well? It's either ring the on call GP or call an ambulance. If the on call GP prescribes something... you've then got to get hold of that medication - I did a fair few runs to & from the pharmacy in Morrison's round the corner!
6b) Elective placement - I organised going to a different hospital's surgical/theatres/ortho units.
6c) Stroke unit. All patients had had a stroke, some had been to the regional neuro unit to have clots removed, others hadn't. It was mostly rehabilitation - lots of personal care, with a bit of initial watching for deterioration.
7) Orthopaedics. A lot of the patients here were elderly people who had fallen over and broken a hip, so there was personal care here, and then learning about moving someone with a fractured bone and then aftercare including mobilisation post op. Some of these had quite interesting fractures, had external fixators (which you have to keep clean) or back braces to stop spinal fractures deteriorating. There's a lot of working alongside therapies here, making sure that skin is kept intact, and a lot of working with community services for discharge planning - a lot of people don't realise how much bending is involved in daily life until they break a hip, so may people's toilets are lower down than they can cope with bending to sit down on once their broken hip is fixed/replaced!
8) Vascular. Pretty much, most of these patients are at risk of losing a leg. A lot of it is trying to save that leg by trying to make sure that the blood flow is there or improved. Sometimes it works - the pain goes away, the swelling goes down, the leg/foot ulcer heals... sometimes it doesn't. There's also the patients whose main abdominal artery is weakened and may burst so it needs fixing, or the main arteries in their necks are getting clogged so need clearing before they have a stroke or die... there's a lot of wound management, skin integrity management, helping with personal care, mobilisation and toileting, giving IV antibiotics. A lot of these patients are also diabetic so there's that to manage, too.

Other places people got placements were district nurses, health visitors, community continence team, Macmillan nurses, other medical/surgical wards, ICU, theatres, the local hospice.
It's a great way of finding out what you enjoy - and being sent sometimes to places you'd otherwise never think of going (I thought I wanted to work on a surgical ward not medical and my placements proved me right, however I also found medical wards better than community and know I absolutely will not be going back to A&E although other people loved it). You may or may not get the placement you want - I got the surgical I wanted, other people didn't get A&E that they were desperate to try.
Last edited by Emily_B; 1 year ago
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Charlotteh12
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#3
Report Thread starter 1 year ago
#3
(Original post by Emily_B)
So the first thing you actually need to do is decide which branch of nursing you want to do for your degree first - adult, mental health, children's or learning disability - and do that 3 year degree and then get a few years general experience before you go off and apply for/do extra training for specialist nurse roles. So the question is - do you want to look after adult physical health, children's physical health, all ages' mental health or learning disabilities. So if dermatology really interests you, then it's physical health you need to be looking at - and decide whether it's adult or children's dermatology to then decide whether it's adult or children's nursing you want to do. I would say, however, that focussing on one very specific area of nursing isn't great as you may not get exposure to that area, or it may not be as good as you think (many people think an area is the best thing ever, then get there and find they hate it... or the opposite and not want to go to an area and then love it - have seen both things happen).
So, you do 2300 hours of theory and 2300 hours of practice over 3 years at university to do a pre-registration nursing degree (ie passing it leads to registration with the NMC). Your time is spent 50:50 between theory and practice. Some universities split placements into 2x 10 week placements, others split them as 6-6-7 weeks and each block is between spells of theory in uni.
Sometimes you have placements the same as other people, some are different, some are at different times. For example, one of the placements I had in 1st year someone in my class had as 3rd year and vice versa - and we had different experiences of both places due to where in the degree we went to those places.

I'm an adult nurse/did BN Adult Nursing. You get field specific placements. The places I went to on placement (there is no choice bar final placement and elective if applicable):
1) School immunusations. This was in the height of flu jab season, so lots of flu jabs for 4-7 year olds, then a few meningitis jabs and the cervical cancer one for older children/girls. I'm not quite sure what I took away from this 6 week placement, but did visit practice nurses, district nurses, and school nurses in this time - lots of leg dressings, asthma/hypertension/diabetes reviews, and an insight into safeguarding.
2) Elderly medicine. This really helped me get my head around "being a HCA", which is actually the foundation of nursing. I spent a lot of time helping people washing and dressing, with eating and drinking, with toileting, with mobility, checking those who were incontinent for if they had passed urine/opened their bowels, doing obersvarions... ie meeting people's hydration/nutritional needs, making sure that they're not constipated or in urinary retention, checking skin integrity, making sure that their general condition isn't deteriorating. Then there's the dealing with Alzheimer's and further confusion thanks to a new environment/having some sort of infection.
3) Day surgery. It's all admit - send to theatre - take back from recovery - check OK - discharge home. The thing is here, some of it seems quite "major" surgery but people are safe to go home the same day - are they talking/eating/drinking/toileting ok, have they got up out of bed ok (they're pretty much all mobile and independent normally), is their condition improving and not deteriorating? If the answer to all of that is yes... send them home with a relative/friend and let them go to the GP to check any wounds.
4) Coronary Care. Basically all the patients here had a heart condition and needed cardiac monitoring. Some had had an NSTEMI (partial blockage of coronary artery/arteries) and were being monitored, waiting to go to the local specialist heart unit for surgery; some were having their heart rate monitored as they were fluid overloaded and on medication infusions to help get rid of extra fluid (needed to check their fluid intake/output to make sure they're getting rid of the fluid), others you're trying to control really high/really low heart rates.
5) A&E. What do I say? Everything from a headache to poorly kids to broken bones to heart attacks to car crashes and everything in between.
6a) Nursing home. Lots of basic care, and then, what do you do when a resident isn't well? It's either ring the on call GP or call an ambulance. If the on call GP prescribes something... you've then got to get hold of that medication - I did a fair few runs to & from the pharmacy in Morrison's round the corner!
6b) Elective placement - I organised going to a different hospital's surgical/theatres/ortho units.
6c) Stroke unit. All patients had had a stroke, some had been to the regional neuro unit to have clots removed, others hadn't. It was mostly rehabilitation - lots of personal care, with a bit of initial watching for deterioration.
7) Orthopaedics. A lot of the patients here were elderly people who had fallen over and broken a hip, so there was personal care here, and then learning about moving someone with a fractured bone and then aftercare including mobilisation post op. Some of these had quite interesting fractures, had external fixators (which you have to keep clean) or back braces to stop spinal fractures deteriorating. There's a lot of working alongside therapies here, making sure that skin is kept intact, and a lot of working with community services for discharge planning - a lot of people don't realise how much bending is involved in daily life until they break a hip, so may people's toilets are lower down than they can cope with bending to sit down on once their broken hip is fixed/replaced!
8) Vascular. Pretty much, most of these patients are at risk of losing a leg. A lot of it is trying to save that leg by trying to make sure that the blood flow is there or improved. Sometimes it works - the pain goes away, the swelling goes down, the leg/foot ulcer heals... sometimes it doesn't. There's also the patients whose main abdominal artery is weakened and may burst so it needs fixing, or the main arteries in their necks are getting clogged so need clearing before they have a stroke or die... there's a lot of wound management, skin integrity management, helping with personal care, mobilisation and toileting, giving IV antibiotics. A lot of these patients are also diabetic so there's that to manage, too.

Other places people got placements were district nurses, health visitors, community continence team, Macmillan nurses, other medical/surgical wards, ICU, theatres, the local hospice.
It's a great way of finding out what you enjoy - and being sent sometimes to places you'd otherwise never think of going (I thought I wanted to work on a surgical ward not medical and my placements proved me right, however I also found medical wards better than community and know I absolutely will not be going back to A&E although other people loved it). You may or may not get the placement you want - I got the surgical I wanted, other people didn't get A&E that they were desperate to try.
Hi Emily,

Thank you so so much for your in-depth response.

Whilst doing my research I have picked up on quite a few areas that would interest me as well as dermatology such as; women health, gynaecology and obstetrics so I was interested to know how you come about working in these areas to gain an insight of it is what you would want to specialise in.
You mentioned a few years experience after the degree before going into specialised area - what happens straight after the degree, do you apply for a job post in a particular department of interest or is it rotated work on different wards? (Sorry, this probably sounds like a stupid question, I literally have no idea what happens after the degree)

'Your time is spent 50:50 between theory and practice. Some universities split placements into 2x 10 week placements, others split them as 6-6-7 weeks and each block is between spells of theory in uni.' - This is interesting to know as I would wondering what the timetable would be like.. what did your university do and what can I expect a weekly time table be like? Also, did you work alongside your degree?

Again, apologies for all the questions and I appreciate your help!!

Thanks x
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Emily_B
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#4
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(Original post by Charlotteh12)
Hi Emily,

Thank you so so much for your in-depth response.

Whilst doing my research I have picked up on quite a few areas that would interest me as well as dermatology such as; women health, gynaecology and obstetrics so I was interested to know how you come about working in these areas to gain an insight of it is what you would want to specialise in.
You mentioned a few years experience after the degree before going into specialised area - what happens straight after the degree, do you apply for a job post in a particular department of interest or is it rotated work on different wards? (Sorry, this probably sounds like a stupid question, I literally have no idea what happens after the degree)

'Your time is spent 50:50 between theory and practice. Some universities split placements into 2x 10 week placements, others split them as 6-6-7 weeks and each block is between spells of theory in uni.' - This is interesting to know as I would wondering what the timetable would be like.. what did your university do and what can I expect a weekly time table be like? Also, did you work alongside your degree?

Again, apologies for all the questions and I appreciate your help!!

Thanks x
So jobs depend on the trust. Some have rotational posts for newly qualified nurses, others you apply for either a generic post (where you can put a preference but be realistically put into any vacancy) or a post on a particular ward. Where I work, you either apply for a job on a particular ward if it's available or a corporate job (one where they can place you anywhere) - I applied for a corporate job and asked for vascular. Placements are the best ways to gain insight into different areas/what you'd like to specialise in but this depends on whether you get given what you'd like - although you can go for a job in these areas. Women's health/gynae departments are common and many will take newly qualified nurses.

Theory/practice... you have x number weeks in uni then y number weeks on placement then go back to theory. You tend to spend more time of theory blocks in uni in 1st year than 2nd and in 2nd than 3rd. I had 4-5 days a week in 1st year, 3-4 days in 2nd, 2-3 in 3rd. You do 37.5 hours a week on placement. Yes I did work alongside it - I was a bank HCA. Depending on what was going on with uni and placements I worked anything up to 24 hours a week.
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Charlotteh12
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#5
Report Thread starter 1 year ago
#5
(Original post by Emily_B)
So jobs depend on the trust. Some have rotational posts for newly qualified nurses, others you apply for either a generic post (where you can put a preference but be realistically put into any vacancy) or a post on a particular ward. Where I work, you either apply for a job on a particular ward if it's available or a corporate job (one where they can place you anywhere) - I applied for a corporate job and asked for vascular. Placements are the best ways to gain insight into different areas/what you'd like to specialise in but this depends on whether you get given what you'd like - although you can go for a job in these areas. Women's health/gynae departments are common and many will take newly qualified nurses.

Theory/practice... you have x number weeks in uni then y number weeks on placement then go back to theory. You tend to spend more time of theory blocks in uni in 1st year than 2nd and in 2nd than 3rd. I had 4-5 days a week in 1st year, 3-4 days in 2nd, 2-3 in 3rd. You do 37.5 hours a week on placement. Yes I did work alongside it - I was a bank HCA. Depending on what was going on with uni and placements I worked anything up to 24 hours a week.
Thank you for your time Emily.
I've added adult nursing to my UCAS application for Jan 2021 start... fingers crossed!! X
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