Maintain pressure on reforms to protect NHSDebate grows over who should be called a 'nurse'
Calls to protect the title “nurse” have sparked a debate over whether it would protect the public or simply act as a way for the nursing profession to raise its status.
The calls were made in draft recommendations by the Prime Minister’s Commission on the Future of Nursing and Midwifery, seen by Nursing Times.
It is understood the commission will call on the Nursing and Midwifery Council to take “urgent steps” to make sure the title “nurse” can only be used by those registered with the NMC.
A report by the Council for Healthcare Regulatory Excellence this month also reflects concerns. It points out that “registered dental nurses” have different levels of education from those registered by the NMC.
The report states: “The NMC believes that the public understanding of the role of a nurse is undermined by the use of a similar title in a different role.”
Nursing Times understands concerns also stem from the fact registered nurses make more autonomous decisions than some others who call themselves nurses. This has raised questions over whether people such as nursery nurses and veterinary nurses should be stripped of their titles.
CHRE chief executive Harry Cayton said: “A protected title is an important part of how we make regulation work but the danger is it becomes a totem for individual professions.
“My question always is where’s the evidence that the public are in any way put at risk by people calling themselves a nurse?
“I don’t think that people will assume that dental nurses have powers or qualifications or abilities that are the same as someone working in a hospital.”
The CHRE report, Protecting the Public from Unregistered Practitioners, sets out the huge array of protected titles registered by other professional regulators. For example, there are 33 on the Health Professions Council, including two different spellings of “dietician”.
Defining a “nurse” could prove difficult due to the “enormous range of talent and abilities” of people who work in the profession, Mr Cayton said.
The best way to increase public confidence in particular professions is by improving performance rather than protecting titles, he added.
A Unison spokeswoman said: “People don’t expect nursery nurses, dental nurses and veterinary nurses to have the same qualifications and experience that hospital nurses have.”
It was important patients were clear as to who was treating them, but this could be done by name tags, uniforms or by staff introducing themselves rather than “another layer of bureaucracy”, she said.
However Royal College of Nursing head of policy development and implementation Howard Catton said a protected title would help the public.
He said: “It’s about the public being assured of a level of training, capacity and skill and also that the person could be held to account for what they do.”
But he said it was important to ensure that such a move would not “undermine” healthcare support workers.
Nursing Times has recently highlighted differing views within the profession and among the Conservative Party over whether healthcare support workers carry out “nursing” or “caring” .
Association of Advanced Nursing Practice Educators chair Dave Barton said, while there needed to be clearer standards clarifying nurses’ qualifications, he did not think including healthcare support workers in the definition “demeans nursing”.
He said: “Healthcare assistants do the vast majority of hands on nursing care…that’s the fundamentals of nursing.
“We seem to waste a lot of time talking about what nursing is. We should be talking about care delivery. Whether we need to call them a nurse or not is semantics.”
A campaign in recent years by engineers to protect their title from use by lesser-skilled technicians gained significant support in the profession but was rejected by the government and the Engineering Council, which said it would not be “practical or appropriate” to attempt to legislate because the term had “been used so broadly and widely”.
| Some protected titles |
|---|
| Registered nurse |
| Midwife |
| Surgeon |
| Doctor of medicine |
| Dental nurse |
| Pharmacist |
| Osteopath |
| Sport and exercise psychologist |
| Art psychotherapist |
| Apothecary |
| Optometrist |
| Dietician/dietitian |
View results 10 per page | 20 per page | 50 per page |
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Readers' comments (76)
Anonymous | 24-Feb-2010 8:26 am
Pathetic! As always, wasting time on trivial matters instead of improving levels of service and quality of care. Does it really matter and haven't we got much better things to do with our time?! Grow up!
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Wilma Bichan | 24-Feb-2010 9:25 am
I agree with the previous author. This is bureaucracy at its very worst. I have long been an advocate for the term nurse being as broad as possible. Within hospitals people are now confused with HCA's and other titles. My father is in hospital just now and he is confused by the many titles. Infact he asked me what a certain person was and I clarified it by saying - just like a nursing auxilliary (which was meaningful to him). Nursing means to tend or care for someone. Nurses who are qualified should not have sole ownership of that meaning. In the past we had RGN's EN's and Auxilliaries. I didn't think there was any confusion over the roles each played. They knew what they could and couldn't do, but the patients just knew that they were all there to care for them in the best way possible. I don't think a title means better caring skills. We should be concentrating on raising care practice standards and building confidence back into our nursing services - not quibbling over a name.
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Anonymous | 24-Feb-2010 9:36 am
I have never heard of anything so ridiculous.Patients are always confused with uniforms anyway so its easier to call everyone nurse.So what will they call to the nurses not on the register when they need assistance "hey you".I advice a week in an NHS Hospital for these people who make all these decisions.Then they will really see how crap it is working in the NHS .They wouldnt last 2 minutes!
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Sharon Nutting | 24-Feb-2010 9:55 am
Dental nurses in my area have band 5 pay the same as a staff nurse. I really am angry at this, as they do not have any where near the responsibilities as a trained NMC nurse!!
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Anonymous | 24-Feb-2010 10:33 am
i think it is disgusting that several HCAs i have met think and call themselves NURSES the title should be protected to the NURSE we nusrses work damned hard at university and on placment for 3 years to earn that title it should be protected. it should not be used litely. we have a broader knowledge base including drugs so yes we nurses should be proud to have the title nurse and unless you have earned it dont call yourself a nurse.
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Anonymous | 24-Feb-2010 11:43 am
Hmmmm....
Dear Ms. 'litely',
You have suggested that your professional title should be based on the education you have acquired and how hard you have worked...do you know what is involved in the other disciplines work and training? Everyone should walk a mile in someone else's shoes before we criticize them!
Also I am sure that you would be the exact individual that would correct someone if they referred to you as a nurse and not an RGN, something I hear all of the time! RGN sets you apart; use it as that denotes your profession and alignment with a registering body! Stop wasting time complaining over something so silly, when we can already be set apart by RGN!
By the way… ‘litely’ is spelt ‘lightly’, maybe a MA in English could help you’re your spelling and adding a few more letters after your name, as this is obviously important to you!
Sincerely,
Nurse (don’t care which type, as we are all important)
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nuha amer | 24-Feb-2010 12:04 pm
well..
it's lovely to have a name that has a meaning connected to it...but when you spend time looking for one meaning it becomes confusing.
on the other hand...in my country,when people doesn't know a staff name or title (whatever is her profession), they just call her "Nurse!" Everyone is a nurse here!!this of course upsets many who don't like being a nurse!!
the subject has double sides!!
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nuha amer | 24-Feb-2010 12:09 pm
A real Nurse shows whatever, wherever, she is!
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Anonymous | 24-Feb-2010 1:45 pm
Or indeed he!
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Anonymous | 24-Feb-2010 2:33 pm
When is a nurse not a nurse? when she worries more about the title and who might wear it.
As a nurse yes I like the recognition the title brings me, but I am happy to be known as the person who gave a patient the best care they could get. I have been nursing for over 25 yrs and as such I have gone from nursing Auxilliary, to State Enrolled nurse to Registered nurse, now I am proud to be a nurse clinician and I didnt attend university. But it seems in this day and age of nursing if you didnt attend university you know nothing, no one seems to care about the long years of service and experience. There are many Auxilliary nurses and Enrolled nurses out there who can run rings around a lot of the new university Grads .In each of my roles I was a valued member of the team, because nursing is not an individual job but a team job. I hope I provided the best care possible and I still have patient thank you letters addressed to me that show that at that particular time and for that particular patient I did.
Lets not make the title of nurse become another political forum that will eventually become more important than the work we actually do.
The patient should always come first and not the pride of those who care for them. remember pride comes before a fall.
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Anonymous | 24-Feb-2010 4:33 pm
Heeee, finally it has caught up with the UK. When I first came to the UK, I was disgusted by the fact that anyone can call themselves a nurse. The uniforms confuse patients because they are just too many, every Trust has it own uniform, Why???? I thought Registered general nurses were on the national NMC, so why do we have different uniforms? I don't get it one bit. No wonder, every Tom and Harry call themselves nurses. There should be a stark contrast between Registered nurses, and a nurse at the counter in Boots pharmacy. Where I trained, Registered Nurses had one colour of uniform nationally, and they wore epilletes and a badge to show that they are registered. There was no confusion between the people in the saloon and the nurse in a walk-in center. I will support the protection of the title. If its so trivial, why don't those people who want to call themselves nurses call themselves doctors, teachers or anything else but nurse. They know very well that it is illegal to call themselves by those titles because of the level of their education and responsibility. So what makes them think they are good enough to be addressed as nurses. Be happy with what you do, don't grab what is not rightfully yours. So if you want to be called a nurse, go get the right training and take the responsibility that come with it. Now, in some Trusts I have seen HCA level 2-3 being given the same uniforms as staff nurses but with yellow epilletes. I was confused initially, but when I realised what was going on, I laughed. I laughed at the confusion it was going to cause if this goes nationwide. I am glad I will be out of this unrespected profession. I think that the entry requirements and training standards should be raised. Having a caring heart only does not qualify anyone to be a 'nurse'. My nan has a very caring heart and she is not qualified to call herself a nurse. If this cannot be solved, a new title should be adopted soon.
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amanda searle | 24-Feb-2010 5:24 pm
As a Registered Nurse who has been an NA and a HCA I am happy to be called nurse. We have a protected title registered Nurse do we really need to add Nurse to it? I think not!
Instead of being concerned what the pt or public is calling me I concentrate on the standard of care I provide.
This bureaucracy is silly, this paper pushers could do with employing a few more nurses instead of worrying if they can call them nurse.
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Roger Hodgson | 24-Feb-2010 7:11 pm
Why change what isn't broken? This government is again meddling where there is no need for amateurish politicos to put their sticky and corrupt fingers. In their ignorance they have already destroyed our economy, armed services, sold off our assets and have now turned their attention to the instiution which once was the envy of the world, the NHS.
Politicians should never be involved with the caring profession, except perhaps as patients....... even then?
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Anonymous | 24-Feb-2010 7:34 pm
I believe we should protect the title of Nurse and who uses it.
Whilst I agree that these days HCA or Auxillary's do many nursing tasks when caring for patients, they do that because we are doing things they can not. We can do their job without them, they cannot do their job without us.
I am not against non-registered nurses, I have learned a lot from them in the past and believe they are a vital part of the system that cares for patients.
However, its about patients knowing and understanding about who is who.
Patients have a right to know the "title" and capabilities of those caring for them.
Then they can make an informed choice about who they talk to and about what. Some patients find it easier to talk to HCA's etc others feel they only want to share their information with a Nurse or a Doctor. They can only make this choice if we have a clear distinction of roles/responsiblities etc.
I can't imagine Consultants being too pleased if for example a patient sees one of the SHO's or Registras in a clinic but think they have seen someone more senior/experienced/qualifed because of a lack of clarity about "titles".
I remember a patient in outpatients going missing. When the Doctor called for her, she was no where to be found.
When telephoned the patient, she said, she had seen the Doctor and then left. She had not, she had seen the auxillary nurse who should have just done pre-lims. The Auxillary overstepped the boundaries of her role.
This was dangerous and a dis-service to the patient.
If we do not stand up and protect our "title" of nurse, who will? It just undermines the need for Registered Nurses.
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sandra dilks | 24-Feb-2010 7:54 pm
I would support any move to protect the title 'nurse'. Why should it be possible for an untrained and unregistered individual call themselves a nurse? Nobody would say they are a police officer or doctor.
Whilst this is being debated I also feel there should be a move to ensure the uniform is not used by other individuals either. It is a criminal offence to portray oneself as a police officer.
We train a long time and are governed by numerous regulations to protect the public so where is the protection for our professional role.
On many occassions I have had patients state 'the other nurse told me so or the other nurse did this form me'. When in fact there is no other nurse it is a phlebotomist!! This is even when wearing an identity badge.
I work hard to deliver the best care to my patients and I am proud to be a nurse and this has nothing to do protesting against HCA's, dental nurses and carers in nursing homes, who work very hard too. For the record I began my career as a home help then HCA then student etc.
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Zena ZENA | 24-Feb-2010 8:06 pm
I am a Senior Sister but before getting were i am i have gone through all stages from HCA, Student Nurse and different stages as a registered nurse but have always been called a nurse. It should not matter what qualifications we hold but simply what we do for our patients. We are carers at different levels who delivery care to our patients as a team no matter the qualifications that we hold. There are more important issues in the NHS that we should be worring about rather than who should be called a nurse.
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Anonymous | 24-Feb-2010 11:02 pm
Still a student nurse, i have witnessed more aggrevating and outrageous behaviour that some "nurses" practice while caring for their patients. This leaves me wondering whether i really want to be a "nurse" or someone who really cares about her patients and aim to get them better health and regain their utmost level of ability. Wateva u want to call me, am proud to be one of the team members dedicated to helping patients get better, never mind the tittle as i, myself, sometimes i fail to figure out who is who on the ward, so feel sorry for the patients who can never differentiate their caring personnels. Some HCAs are more worthy nurses than "actual nurse".
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Anonymous | 25-Feb-2010 8:20 am
The fact that this "debate" is being conducted form the Prime Minister's commision which spawned the "Pledge" means money is being spent on it.
Tax payers pound notes!!
Money from the NHS coffers!!
Come on really does it matter if an HCA is called a nurse, I remember they used to be called Auxialliary Nurses!
Anyway, I have a title by which all my patients know me and it is my first name, oh and they know that I am a nurse!!
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Anonymous | 25-Feb-2010 8:21 am
Ooops also forgot to say that I am an RGN, with MSc. and BSc. if it makes a difference?
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Anonymous | 25-Feb-2010 9:12 am
How do 'nurses' working in admin. posts such as those at the NMC and RCN manage to fulfil the NMC criteria to maintain registration? Would they still be entitled to call themselves nurses when others working outside the clinical bedside area are clearly not?
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