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Debate 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
Doctor of medicine
Dental nurse
Sport and exercise psychologist
Art psychotherapist

Readers' comments (76)

  • 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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  • 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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  • 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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  • 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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  • 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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  • 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 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!

    Nurse (don’t care which type, as we are all important)

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  • 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 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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  • A real Nurse shows whatever, wherever, she is!

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  • Or indeed he!

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  • 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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