This chapter explores changing career patterns and report on trends in nurses' career satisfaction and career progression. In particular, the shift towards a primary health care led service and transformations in the delivery of care mean that nursing careers are becoming less predictable, less linear and more complex. Future nursing careers are likely to be more diverse, with entry from education into a number of sectors, to be characterised by short-term contracts and multiple moves between sectors, and with nurses having shorter and later career breaks. In response to rising concern the Management and Staff sides of Nursing and Midwifery Staff Negotiating Council set up a joint working group on pay and clinical grading in 1985. The Briggs report found that nurses were very cautious about career progression. The requirement for language capabilities to communicate with clients and patients is likely to act as a barrier to many nurses who might be considering working abroad.