Children's nurse

Children's nurses look after patients from newborn to late teens, and the job differs from adult nursing in one basic way: the patient often cannot tell you what is wrong, and the family is part of the treatment. You are watching for change in someone who looked fine an hour ago and can go downhill quickly, while explaining what is happening to a parent who has not slept.

What the job actually involves

Take observations and read them as a set, because children hold normal numbers until quite suddenly they do not.
Work out and give medicines by weight, where a misplaced decimal point is the difference between a dose and an overdose.
Explain what is about to happen in words that match the child's age, and get their agreement wherever you can.
Support parents who are exhausted, frightened or angry, and keep them part of the care rather than outside it.
Hand over clearly at the end of a shift, including what you are worried about and what you have not resolved.
Spot deterioration, escalate it using the early warning score, and keep escalating until somebody comes.
Raise safeguarding concerns, including the ones that will make you unpopular on the ward.
Get families ready to go home, covering feeds, dressings, medicines and what would mean coming back.

On a normal day

A three year old will not take an antibiotic, you have four other patients, and the round is already late.
You repeat a set of observations you do not like, then ring the registrar before anyone tells you to.
A parent says their child is not themselves, and you treat that with the same weight as any number on the chart.
You crouch to bed height, because that is where a conversation with a six year old actually happens.
You hand over at seven in the morning and spend ten minutes on the one child you are still thinking about.

What it is actually like

Reading about a job only gets you so far. Career Lab drops you into one real situation from it: Assess Reuben after surgery. Reuben is two days into his recovery from appendix surgery. He hasn't moved since breakfast, his book is untouched, and he says he doesn't need anything.

You respond to the situation, then see what the work asked of you and what your choices changed.

Try being a children's nurse

Pay and hours

Starting: £32,000 a year
Typical: £40,000 a year
Experienced: £48,000 a year

Source: National Careers Service (children's nurse profile). The service publishes a starter and an experienced figure and no median, so the median here is the midpoint of that band., checked 2026-07-29.

Usually 37 to 45 hours a week, shift pattern. Weekend work is normal. Evenings are common.

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Skills that matter

Assessing without words. Babies and small children cannot describe pain, so you read breathing, colour, feeding and behaviour instead of waiting for an answer.
Drug calculation. Paediatric doses are worked out per kilogram and checked by two people, and there is no acceptable rate of error in it.
Being honest with children. A child who is lied to once will not believe you again, and you often need them to believe you next week.
Working with parents. The parent knows the child better than you do, and brushing that off is how deterioration gets missed.
Escalating. Telling a busy doctor you are worried, and then telling them again, is a skill people take years to get comfortable with.
Stamina. Twelve hour shifts, nights and weekends are the pattern, and the job does not become simpler when you are tired.
Recovering from bad days. Children die in this job, rarely but genuinely, and staying in it long term means knowing what you do afterwards.

How people get in

University (Degree). A three year nursing degree in the child field, roughly half of it spent on placement, leading to registration with the Nursing and Midwifery Council. Nursing students get a training grant that does not have to be repaid. Usually 3 years.
Apprenticeship (Level 6). The registered nurse degree apprenticeship is paid and usually taken by healthcare assistants or nursing associates already working for the employer. Usually 4 years.
Working towards this role (Level 5). A nursing associate foundation degree takes two years, is a job in its own right, and can then be topped up to registered nurse through a shorter apprenticeship. Usually 2 years.
Conversion (Postgraduate). Nurses already registered in the adult, mental health or learning disability fields can convert to the child field through a shorter university programme. Usually 18 months to 2 years.

Experience that helps

Nursing degrees are heavily oversubscribed and interviews turn on what you have actually seen. Care work, healthcare assistant posts, playwork, youth work and volunteering with disabled children all count, and any one of them gives you the examples an interview asks for. Being able to describe a time you noticed something changing in someone is worth more than a long list of interests.

Who employs children's nurses

NHS hospital trusts
Community children's nursing teams
Children's hospices
Special schools and residential services
Private hospitals and clinics
Nursing agencies

Where the work happens

Children's wards, emergency departments, neonatal and paediatric intensive care, outpatient clinics, community teams, schools and hospices. Most hospital posts are twelve hour shifts on a rota covering nights, weekends and Christmas. The wards are bright, noisy and full of families, which is nothing like an adult ward.

Where it leads

Band 6 senior staff nurse, then ward sister or charge nurse.
Specialist units such as neonatal intensive care, oncology, cardiac or community children's nursing.
Advanced clinical practitioner, which includes assessing, prescribing and running clinics.
Clinical nurse specialist in a condition such as diabetes, epilepsy or cystic fibrosis.
Education, research, or matron and senior management posts.

Common questions

How is children's nursing different from adult nursing?

You pick a field at the start of the degree rather than after it, so the child field is a separate course from the first week. Clinically, your patient may not be able to speak, doses are calculated by weight, and you are caring for a family rather than an individual. Children also compensate well for illness and then deteriorate quickly, which is why observation counts for so much.

Do I need A levels?

Universities usually ask for around three A levels or a BTEC at the same level, normally including biology or another science, plus GCSE English, maths and science. Access to Higher Education diplomas are widely accepted for people coming back to study, and the degree apprenticeship exists if you would rather be paid while you train.

Is it upsetting?

Sometimes, and nobody in the profession pretends otherwise. Most of the work is children who get better and go home, which is the part people never picture. The hard days are real, and hospitals run debriefs and staff support for them. What pushes people out is more often short staffing and tiredness than grief.

What does it pay?

You start at NHS Band 5 and move to Band 6 with experience or a specialism, with extra for nights, weekends and working in London. Pay is set nationally, so it does not depend on which hospital you join, and the pension is one of the stronger parts of the package.

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