Call yourself a nurse…?

I’m a Nurse. I call myself a Nurse because I qualified through three years study and a final examination and was awarded the title of Registered Nurse, and most importantly, I am currently on the Register of the UK Nursing and Midwifery Council. I am a regulated and accountable Registered Nurse. That’s the reason I can call myself a Registered Nurse. Only when someone has undertaken the required education (a Bachelors or Masters degree today), has applied to and been accepted on to that register, can they call themselves a Registered Nurse. In order to continue to call themselves a Registered Nurse after that initial registration, a three yearly validation process is required and the annual payment of a substantial fee in order to stay ‘live’ on the Register. If someone’s registration lapses i.e. they stop practising, they don’t revalidate, they don’t pay their fee, or they are struck off for some serious disciplinary reason, then they can no longer call themselves a Registered Nurse. This is UK law. But, and here is the really important thing – in the UK anyone can call themselves a Nurse. And that’s a problem.

It’s a problem because we rarely go around workplaces or caring for patients proclaiming that we are Registered Nurses. We are called ‘Nurse’, and a host of other titles with ‘Nurse’ in them. We respond to being called ‘Nurse’. It is the title ‘Nurse’ that is in common usage, ‘Nurse’ that the general public use to attract our attention, or to describe us, ‘Nurse’ that is the shorthand for a safe, competent, accountable, and professional practitioner of nursing. It is generally interpreted as being the contraction for Registered Nurse. If you say you are a Nurse, then most people will assume that you have the required education and the correct validations to be a Registered Nurse – with all the trust and safety assumptions that go with that.

Unfortunately in those workplaces, we know that there are people in roles that have ‘Nurse’ in their title who aren’t actually nurses at all. They are probably a support worker or an associate or other helper role – all valuable within their own scope. They may have some specialist education, but they may have none, and they are not Registered Nurses yet their job title probably leads the public to believe they are. Hmmm. Apart from the ethics of such use of title, perhaps this is how we get the ‘50,000’ more nurses promised by Govt? (Note that it is ‘nurses’ that are promised and not Registered Nurses).

We also know that there are people who set out to deceive by calling themselves ‘Nurse’ – like the parliamentary candidate who referred to himself as a ‘Nurse’ in his campaigning, but was forced to admit that he wasn’t actually a nurse, but a health care assistant. I suppose he thought calling himself a Nurse would help him win votes. And he could do so, with impunity. We also know that there are people who have been struck off the NMC Register who can continue to call themselves a Nurse, again with impunity. It’s not against the law to say ‘I’m a Nurse’ when you are not. I think it should be.

I believe the title ‘Nurse’ should be legally protected for the sake of patient safety and patient trust. So that when someone needs a Nurse, that’s exactly what they get – a Registered Nurse – or at the very least, they are clearly told and made aware that the person in front of them is NOT a Registered Nurse. This could be done most simply by a job title that properly reflects what they are. It’s not a difficult thing to do, and it would be open, honest and transparent – who could possibly object?

I believe very strongly that the title ‘Nurse’, so long in common useage, has become synonymous with ‘Registered Nurse’ in the minds of the public. I believe because of that common and general interpretation that the title ‘Nurse’ should be protected and used only by those who are current Registered Nurses. To not do this is deceitful and potentially dangerous. Professor Alison Leary has set up a government petition to get the title ‘Nurse’ protected and used only by Registered Nurses. You can follow the campaign on Twitter on #ProtectNurse and #PatientSafety. You can find the petition here, it takes just two minutes to sign. I have signed it, and I hope you will too. Anyone can sign it, it is an issue for anyone who may come into contact with health care services now or in the future and who believes in safety and transparency. Do sign it if you think this is important too, and do share it via your own social media sites.

Thank you.

3 thoughts on “Call yourself a nurse…?”

  1. Hi June

    I certainly concur. You may not be aware, but the NMC legislation is synonymous with that of the HCPC – the regulator that replaced the Committee for Professions Supplementary to Medicine – the AHPs. As a podiatrist, I raised this concern with the regulator and the Health Secretary, Jeremy Hunt, in 2008 – and was duly ignored. Five years later, I was subjected to two private criminal prosecutions by the regulator for taking a stance on the issue.

    Your post reminds me of my own on the subject in 2012:

    This was the outcome:

    Both regulators have been dishonest with their registrants, the professions and the public concerning “protected titles”. They had a vested financial interest. If you remember the statements in 2004 when the NMC and HCPC came into being – you were told you had to be registered to use a “protected” title. It isn’t true – obviously. The “intent to deceive” has never been more appropriate.

    Compelling professionals to register with a regulator on threat of prosecution, when that isn’t legally so, is fraudulent misrepresentation. Both regulators should repay your professional fees from their inception in 2004 – but that would total some £1.27 billion and counting.

    For me it was always about public safeguarding and standards of practice. But with government and their institutions – it’s always about the money.

    Good luck to Alison and you all with the petition.


  2. Hello June
    I am a recently retired RN. What has got me thinking is the confusion caused by care home workers wearing nurse-style uniforms. None of these carers have nurse training as a requirement for their jobs, but I believe their uniforms may create unrealistic expectations in clients and their families for the care they are able to deliver.
    My mother just died after 18 months in an excellent care home, but as her Alzheimer’s worsened and her needs became more complex, I found I had to take a lead to get her the care she needed – as well as to fend off interventions that would have caused her unnecessary discomfort and distress.
    If I had left it to the carers, who unquestioningly followed GP instructions that were seemingly based on computer algorithms rather than patient choice, my poor mum would have been dragged to hospital on countless occasions – and would have suffered even more pain than she sadly did at the end of her life.
    This is not the carers’ fault. They are neither trained nor paid enough to take any other action. I used my years of nursing experience and knowledge of the healthcare system to protect my mum. I worry for the families who do not have this support.
    I wonder if the carers’ nurse-style uniforms mean clients and families expect a greater level of skill and understanding from them than their training can ever deliver?
    I would love to hear your thoughts on this.

    Liked by 1 person

    1. Hi Alison,
      I’m really sorry to hear about your mom, but I am pleased that she was in a good care home, even if you did have to intervene sometimes.
      I was interested in your comments about uniform. I think it’s difficult today to find alternatives that would clearly differentiate between care workers – first, there are so many different roles that it is already some kind of chaotic scrubs rainbow army out there, and secondly, I don’t believe that many of the general public pay much attention to uniform – they make assumptions, as we know from long experience.
      I am sure you are right that this means that patients and relatives make assumptions about knowledge and potential for treatment, that’s why our petition wants to stop the use of the term ‘Nurse’ by anyone who isn’t an RN. Protection of title is one step towards making differences clearer.
      I share your views, and came to my strong feelings on this matter, in much the same way as you – I realised through experience with myself and my loved ones in hospital, that I knew the differences and could make appropriate interventions, but those without my expertise may not be able to do that, and where does that leave the patient/relatives who trust the person they see in front of them to do the ‘right’ thing? It’s a tricky issue – made worse by the rise of the acceptance of a ‘nursing family’ – a term I strongly disagree with – and by the dilution of the Registered workforce caused by short-term thinking and financial expediency.
      Many years ago, when I was first qualified, the hospital I worked in had a good system that I think has some merit now. All Registered Nurses, whatever their title or grade, wore white uniforms. There were slight differences – sleeve length, collar etc, but it was absolutely clear that anyone in white was a Registered Nurse. Something like that could work now – providing there wasn’t a clamour for every single RN role to have an obviously differentiating uniform. It would take confidence on behalf of the RN workforce and a will to have a uniform that made a clear statement to the public, rather than to each other.
      More important, I think, is the reliance on protocols and guidelines that lead to the inappropriate interventions that your mother may have experienced. Developed with good intentions to help ensure best practice, because of their use by those without the appropriate education to apply them critically or to amend them, they can result in rote interventions that may not be necessary, or indeed do harm. This is a workforce issue and a financial issue. Until the risks of a diluted workforce are accepted by those in power as being more important than financial issues, then I fear not much will change – in any health care environment. The #ProtectNurse campaign is part of that wider patient safety work.
      All the best


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