Nursing jobs in homes, prisons and the armed forces

The environment you work in can have a huge effect on your job satisfaction. You might want to work in Accident and Emergency departments or acute wards within the National Health Service (NHS), for example. You could specialise in community nursing, work in a GP surgery, or be attached to a community team as a district nurse, midwife or health visitor. Less obvious places of work include occupational health practitioners in the independent sector. Nurses may also work in the private and care home sector, hospices and nursing agencies. Some nurses even work abroad with the armed forces or work in prisons, universities or higher education colleges.

The options are anything but limited so it can be difficult to know which one is right for you. Take a look at the information below to see what working in a nursing home, voluntary organisation, the armed forces or the prison service will be like. Whatever your preference, there is likely to be something to suit you – the key is to investigate thoroughly before you make a decision.

Nursing homes

A nursing home provides a place of residence for people who require constant nursing care. Usually the residents are elderly but nursing homes also provide palliative care or intermediate care for people recovering from an illness or injury. Nursing comes can vary from the small, friendly, privately-owned home to larger homes owned by independent healthcare organisations. The smaller homes in particular often offer flexible working hours, allowing many nurses to work part time. there are also independent hospitals providing acute care. 

The work
As a registered nurse (RN) in a nursing home, your role will involve taking charge of shifts and working with care assistants and other colleagues, including visiting therapists and medical staff, to provide high quality care. Senior RNs can work as sisters or charge nurses who may be responsible for a unit or floor in a larger home and who may take charge of a home in the absence of more senior staff. Where a group of nursing homes is owned by an independent healthcare organisation, there are further opportunities to work as a regional manager or to manage a group of homes.

Armed forces

The Royal Navy, the Army and the Royal Air Force employ over 1,000 nurses between them, the majority of whom are in the Army. The majority of roles will be in primary healthcare as nursing teams will be based wherever Britain’s military forces are stationed. Nursing in the armed forces is a varied career that could involve anything from teaching diabetes control to Kosovan teenagers to rehabilitating Iraqi amputees in Basra.

The work
Nurses support the services in everything from primary care to dealing with battlefield casualties. Treating and empowering civilian populations in areas affected by conflict is also very much part of the job. However, service abroad, on ships or planes, forms only a small part of the modern military nurse’s career and a lot of time can be spent in the UK in more traditional roles within the UK’s Defence Medical Services (DMS). The DMS is responsible for secondary care wherever the forces are deployed which means nurses might work with colleagues from the Air Force or the Navy on active service or at one of the Ministry of Defence hospitals units (MDHUs) attached to an NHS trust. There are opportunities to specialise in areas such as orthopaedics or opthalmics, to build specialist careers or become an accomplished generalist. You will also be able to learn unique skills such as aeromedical evacuation and advanced trauma.

Voluntary organisations

Aid agencies recruit nurses to work in conflict areas or areas struck by natural disasters. Locations are variable and you could find yourself working anywhere from Afghanistan to Liberia. Nurses working for voluntary organisations will have the opportunity to experience a wide range of different cultures and can live in places that you may have never even heard of. Most aid agencies will recruit nurses on a fixed-term paid contract of six to twelve months, so between assignments a lot of nurses will register with an agency or do bank work to continue earning a salary. 
The work
Nurses will work in public health roles in hospital or community settings. Hospital-based roles are normally for surgical ward nurses or operating theatre nurses. You will also work with local nurses managing a number of patients and provide both on-the-job and formalised training for them. Community public health nurses will work with leaders of local communities setting up health programmes, managing budgets and providing technical expertise. Their work might focus on HIV and AIDS or mother-and-child healthcare. It can be frustrating working with limited resources but helping people whose lives have been turned upside down by war, conflict and disaster can be very rewarding. However, this type of work is more suitable for experienced nurses as the majority of roles expect F grade nurses who have managed and trained staff before.

Prison service

The prison service is a fast-paced and challenging environment in which to deliver care. The work of prison nurses differs from the role of nurses working in other healthcare situations as it is controlled by environmental factors associated with regimes, security and the prison culture. Prison nursing is not easy, but it can be rewarding and it does provide a source of opportunities for experienced nurses to work in an environment and culture that is different from their previous areas of practice.
The work
Prison nurses can be employed either directly by the prison service or by the NHS depending on the particular prison. Increasingly, they are employed by the NHS and their work is overseen by the local NHS primary care trust (PCT). This has enabled some nurses to choose to spend part of their week working in the community and part of their working week in prison healthcare. Nursing in prisons is comparable to working as a practice nurse in a GP surgery but it is arguably more challenging, with higher concentrations of patients needing help for mental health and substance misuse problems. Depending upon the size of the prison, you could expect to find a pharmacy lead nurse, a nurse practitioner, forensic psychiatric nurses and staff nurses. To work as a nurse in prison, you willneed to have qualified as a registered nurse and will preferably have registered in either adult, mental health or learning disabilities.

With thanks to Linda Thomas, editor in chief at RCN Publishing for her kind help with this article.

Take your pick from these places of work

• The NHS – trusts, commissioning authorities, GPs/primary care
• Nursing agencies
• Private hospitals
• Private nursing homes and residential care homes
• Schools
• Local authorities
• Occupational health departments
• Trade unions and professional organisations
• Pharmaceutical/medical supplies companies
• The Blood Transfusion Service
• The armed forces
• Prisons
• Universities and colleges
• The Nursing and Midwifery Council
• The Department of Health/NHS Executive and their equivalents in Scotland, Wales and Northern Ireland
• Overseas development organisations
• Religious orders.