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Does your job title act as a barrier to patients?

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Who, in the UK health system, can honestly say that they have a clear understanding of the different job titles used in the nursing professions? Surely no more than a handful of people. 

Nurses’ titles seem to multiply following obscure rules of self-generation, like mushrooms after the rain. It seems that each trust, each department, each unit is left to grow its own crops of more or less intricate and unfathomable work denominations.

I suspect that shiny new job titles are sometimes used to assuage nurses’ legitimate thirst for recognition, whether that be of their hard work, dedication, experience, skills, training or specialisation – or a mix thereof. A way of glossing over the absence of other types of rewards, such as a pay rise.

It is true that nursing practice is increasingly complex. Nurses are venturing into new territories, new roles are created to support them, and new branches of healthcare are emerging at an unprecedented speed.

“While these job titles may be meaningful to those who bear them, they are often not understood by others”

In the eyes of its advocates and actors, every emerging specialty and subspecialty probably warrants new, ad hoc job titles.

However, while this specialisation and complexity are to be acknowledged for their positive aspects, do they really need to translate into a plethora of enigmatic and protracted job titles?

The problem with such job titles is that, while they may be meaningful to those who bear them, they are often not understood by others – particularly patients and families. What might a lay person think a ‘safety thermometer co-ordinator (all sites)’ does? Or a ‘surgical care practitioner and robotics specialist nurse’? Or a ‘live donor co-ordinator’? Or a ‘clinical nurse specialist new entrant/community’?

I am French and, when I arrived in this country almost 11 years ago, I was unfamiliar with NHS and medical jargon, so I can imagine the confusion in people’s minds when they come across job titles of this kind.

“The main concern here should be patients: if they understand who they are talking to, they will have more confidence”

The examples above are job titles that used to exist at Imperial College Healthcare Trust, before it conducted a courageous project to narrow down, simplify and clarify the titles of its nurses, midwives and support staff (an article on the project appears in the January issue of Nursing Times and on the website next week).

I say ‘courageous’ because I suspect the move required perseverance and determination in the face of opposition from staff keen to protect their status and rank.

But surely there must be ways of recognising knowledge, skills and experience that do not involve name badges no one can decipher because they are too long and too complicated.

The main concern here should be patients: if they understand who they are talking to, they will have more confidence in them and be more willing to engage, develop a relationship and take charge of their own health and wellbeing.

And that can only be a good thing.

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Readers' comments (1)

  • Neither of the examples used are particularly patient facing roles, or at least roles that patients will regularly have contact with. . Both examples accurately describe their jobs, so other clinicians know what they do, and know when to refer and defer to them. Its our job ensure our patients and colleagues know what we do, but narrowing down titles for the sake of clarity could have the inverse effect. The role of a Clinical Nurse Specialist could probably fall under a number of other titles already used, but when you want a clinical nurse specialist, the fact they have their own title ensures that you will get one, not someone who's job might also be described in that way.

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