Comment

Without a clear path, senior nurses are lost

Financial uncertainty and a lack of defined career pathways mean specialist staff get stuck in one place, says Nicola James.

Financial uncertainty and a lack of defined career pathways mean specialist staff get stuck in one place, says Nicola James.

I am now a long-in-the-tooth nurse consultant with my retirement date in sight. Having moved hospitals and jobs earlier in my career, I had intended to retire from my final job of nurse consultant in prostate cancer in 2017, complete with garden centre vouchers and a clutch of congratulations cards.

However, life has a funny way of throwing us curve balls. Unforeseen health circumstances led to my husband making a change of direction career wise at the grand old age of 56, and accepting a job in south Wales – four hours from our Derbyshire home.

We could have commuted and lived separate lives during the week but we felt we were too old for a weekend-only relationship. I could have left work early, moved with him and taken up gardening a couple of years earlier than intended.

However, that would have had a dramatic effect on my pension, leading to potential losses of many tens of thousands of pounds, if I am destined to live for more than 20 years in retirement, that is.

It seemed the only solution was for me to move to a nurse consultant post in my new area of work. The problem, of course, was that these sorts of jobs do not grow on trees.

This all led me to think about how difficult it is to move jobs as a nurse. The career path of a doctor is much more clearly defined. If a junior doctor leaves a team, an advertisement can be placed to recruit another at a similar stage in their career.

Doctors, wherever they are in their careers, use a common currency in terms of qualifications, experience and training. Nurses have no such currency. Often nursing jobs, particularly the more senior posts, are home grown and developed in an ad hoc way to fit the needs of the service for which they were conceived.

Movement in a profession can be a massive advantage in terms of exchange of ideas – ‘cross-pollination’, as it is known in business

Looking back over my career, this has been the case for many years. It is not just that as nurses we lack clear career pathways, there is also often a financial compromise associated with moving jobs in this profession.

Grading

When I first qualified in the early 1980s, it was quite reasonable to work for 12 months or so in one specialty before moving on to gain experience elsewhere – without financial penalty.

Then grading came in. It made it much more difficult for an F grade to move elsewhere without relinquishing that grading. The next development, Agenda for Change, did not help.

Because we have no clear pathway for senior nurses and because of financial penalties associated with moving posts, our profession has lost out on a fertile, mobile workforce. Movement in a profession can be a massive advantage in terms of exchange of ideas and culture – ‘cross-pollination’ as it is known in business.

What we need as a profession is the type of career pathway that is more clearly marked, with competencies and qualifications along the way, just as our medical colleagues have in their careers. There are ‘gateway’ points along the Agenda for Change pathways but these are often open to local rather than national interpretation.

Without attention to these career possibilities, we will become a profession in which an individual’s career starts and ends in the same place, without the rich benefits that come with mobility.

This is a problem that particularly affects specialist nurses. Because cancer nursing attracts a large number of specialist nurses, I would be keen to open a debate on this subject and understand if others have had similar experiences.

Can we as a workforce move positions, or are we destined to stay in the same place for 20 years?

About the author

Nicola James is a nurse consultant in prostate cancer at Morriston Hospital, Swansea and Cancer Nursing Practice editorial advisory board member.

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