Protect the title Nurse

[Cuck00soup]

Arbella2 has been doing sterling work over on petitions and activism to promote the current petition to protect the title Nurse in law so that it can only be used by those who are qualified and registered with the appropriate organisation.

This isn’t a TAAT, I thought it was worth discussing the feminist aspects of this. The nursing workforce is predominantly female and I can’t help thinking that is part of the issue.

As explained by prof Alison Leary in the blog linked below Although the term Registered Nurse is protected under the 1997 Nurses Midwives and Health Visiting Act, the term “nurse” is not protected in the UK. It’s an issue because the term nurse is the term in common usage. Other professional titles such as physiotherapist, hearing aid dispenser, dental nurse or paramedic are protected in law.

This means anyone can use the term nurse to offer services, advice or be employed as a “nurse”. The use of the term nurse is not restricted to use by Registered Nurses and can be used by many different types of worker. This includes assistive roles such as healthcare support workers or other professionals taking on “nursing” work.

richmondgroupofcharities.org.uk/news/guest-blog-protecting-title-nurse-uk-law

It is women who are most affected by this. If the title Nurse isn’t protected in law, the option to employ unqualified workers becomes tempting to companies looking to save money. This means nursing assistants being placed in positions they shouldn’t be, and patients and the public being at risk of receiving the wrong care. It will also, in all likelihood, exert a downward pressure on the salaries of qualified nurses.

I can’t help wondering if this would even be an issue in professions with more males.

If you would like to sign the petition, please see Arbella2’s thread

www.mumsnet.com/Talk/petitions_noticeboard/4368136-protect-the-title-nurse-in-uk-law-petition-the-title-nurse-can-be-used-by-anyone-in-the-uk-petition-created-by-professor-alison-leary-rn?reverse=1

@CovidCorvid

We have nursery nurses working on the paed wards at my local hospital, name badge says nursery nurse. I’d wager the parents of the sick kids they’re looking after think it’s a medically qualified nurse looking after their kid.

I think you’re right @CovidCorvid.

I don't think it's a feminist issue myself, since it applies to some male dominated jobs as well, but this definitely needs addressing. We should not be using terms like "nursery nurse" in hospitals or childcare centres, or "maternity nurse" for infant nannies. It creates a false impression of the role and qualifications involved. It's also out of step with the rest of the English speaking world, which doesn't use terms like this. It's also quite frankly bizarre- why would a nurse be working in a childcare centre?! I'd prefer that a qualified early years practitioner look after my children, thanks.

I’m not sure. I’m in a different country where there is a difference between someone who calls themselves a nurse (anyone with a nursing role can do this eg carer in an aged care facility) and registered nurse (this requires a degree). Registered nurses have specific things only they can do eg must have an RN to dispense restricted drugs.

In hospital we distinguish between registered nurses and ‘enrolled nurses’ or ‘assistants in nursing’. The last two don’t have degrees but provide essential elements of nursing care. When they help elderly patients to eat they are providing absolutely essential nursing care that is one of the few things that may actually help that person to recover and return to their previous level of independence.

I think it would really demean the contribution of (again mostly women) those who perform a role involving elements of nursing care but who are paid much less and who have much less autonomy if they were not able to call themselves nurses. There are women who’ve devoted their whole lives to the care of the sick and elderly who would be affected by this simply because they don’t have a degree.

I do agree that the issue of pay is related to being a female-dominated industry; I don’t agree that it is related to the title of nurse being more widely used.

Where I am chiropractors without doctorate-level education merrily call themselves ‘dr’. Recently had a naturopath tell me his qualifications were the ‘same or better’ than mine (I’m an actual doctor and he was quite some way off being correct) and so he was ‘comfortable’ with his customers calling him ‘dr’……lol I bet.

@CovidCorvid I have had a baby on NICU and then make our way down to low dependancy where a nursery nurse was looking after us. Not for one minute did I think they were a registered nurse. I knew they were there as a HCP to look after our baby and while able to do some medical things that they were not a registered nurse. I am forever grateful to them for their excellent care.

@MissTrip82 I just don’t understand why anyone would call themselves a nurse when they aren’t unless they are being deliberately deceptive. To me there is nothing wrong with identifying yourself as a carer or support worker or whatever your title is. I’ve proudly been both and in my nhs trust you just don’t hear people using the title if it’s not actually theirs

[quote 3cats4poniesandababy]@CovidCorvid I have had a baby on NICU and then make our way down to low dependancy where a nursery nurse was looking after us. Not for one minute did I think they were a registered nurse. I knew they were there as a HCP to look after our baby and while able to do some medical things that they were not a registered nurse. I am forever grateful to them for their excellent care.[/quote]
I’m not in any way disparaging them or insinuating that they don’t give great care. The experienced ones are worth their weight in gold and know an awful lot. That wasn’t the point…..it was more about whether there is the risk of some people not realising that actually they’re not a qualified nurse/health care professional.

I'd also quite like to know the proportion of registered nurses who actually have a degree and post graduate qualifications (as we are so often told is the case) compared to who converted from SEN several years ago. Not that those SEN nurses who may now be advanced practitioners aren't a zillion times better than some of the more recently qualified graduate nurses and may have been better educated in the late 70s than their contemporary graduate nurse counterparts.

I'd also quite like to know the proportion of registered nurses who actually have a degree and post graduate qualifications (as we are so often told is the case) compared to who converted from SEN several years ago. Not that those SEN nurses who may now be advanced practitioners aren't a zillion times better than some of the more recently qualified graduate nurses and may have been better educated in the late 70s than their contemporary graduate nurse counterparts.

To me this isn't the point. Regardless of whether they have a degree, these two groups of RNs have the same scope of practice and perform the same clinical roles on a ward. A nursery nurse doesn't have the same scope of practice (nor would they have the same level of training as either of the above groups). They perform a vital role, but it's a different role. What's wrong with Nursery Assistant / Nursing Assistant?

Again happy to be told I’m missing the point but I don’t see this a feminist issue. To me it’s one of honesty and making sure patients and families are well informed

@ChocolateDeficitDisorder

*A lack of Protection of the title Nurse in UK law has led to •Employers including the NHS to be able to employ those without registered nurse qualifications into registered nursing roles ie Staff Nurse and District Nurse.*

Where have you seen this happen? As an ex- reg nurse myself and married to a Band 7 District Nurse, our Scottish NHS does not employ unregistered individuals into nursing roles. Registration is required to be shown before the interview and will be checked with the NMC.

Sources Royal College of Nursing press release June 2021 re the growing practice of employing those without registered nurse qualifications into registered nursing roles. https://www.rcn.org.uk/news-and-events/press-releases/nursing-workforce-crisis-leads-to-risky-recruitment-practice

Also Professor Alison Leary September 2021
https://richmondgroupofcharities.org.uk/news

@FlorenceNightshade

Again happy to be told I’m missing the point but I don’t see this a feminist issue. To me it’s one of honesty and making sure patients and families are well informed

You realise something could be a feminist issue and one of honesty and making sure patients and families are well informed?

@NumberTheory of course I do! But all I’ve seen on this thread and in my own scope of practice comes down to honesty

[quote FlorenceNightshade]@NumberTheory of course I do! But all I’ve seen on this thread and in my own scope of practice comes down to honesty[/quote]
So the fact the issue is of significant consequence to a large number of women doesn't register at all for you when it comes to feminism?

That raising the status of registered nurses might lead to greater respect for women as professionals or give them greater sway over health care policy?

Or, from the opposite side, that removing the right to use "nurse" as a title from the many women who do but are not RNs might devalue their status as professionals and lower their working status?

Feminism isn't simply about discrimination. Anything that has an impact on a lot of women is a feminist issue.

@NumberTheory my view is that only registered nurses should be titled as nurses. As a previous hca, carer etc I wouldn’t allow myself to be titled as such. But this has never been an issue in my part of the uk. I’ve canvassed my colleagues in case I’ve been oblivious to this but no one I spoke to has been aware of non registered nurses either calling themselves nurses or being titled as such by employers.
In Scotland uniforms and job titles are standardised in every nhs trust, we don’t have matrons or sisters. Our nursing roles contain the word nurse. Support roles for unregistered staff do not.

Andrea Sutcliffe Chief Executive NMC (Nursing and Midwifery Council) writing in the Nursing Times September 2021
"One aspect we really want to pursue is that the title nurse is currently not protected"
"I believe it is essential we have the right protected titles and associated enforcement powers to take effective action to protect the public"

BMJ (British Medical Journal) article
The Healthcare Quality and Safety Conference October 2021
"A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages"
https://qualitysafety.bmj.com/content/26/7/559

I wouldn't really support this. There are specific designations for nurses with specific qualifications, like RN, as others have noted. But the word nurse has all kinds of other traditional uses and I don't think you should just declare a word like that as being "owned" by one specific group.

Patients not recognizing different roles in hospitals is an issue, but I would note that it wasn't back when uniforms were less casual and differentiated different roles more clearly.

I think even the term doctor isn’t? Hence chiropractors calling themselves Dr x when they aren’t medically trained. Which I think is very wrong.
Obviously there are many many legitimate doctors with no medical training whatsoever

What about instead an information campaign that registered nurse is the qualified role? Isnt that easier than trying to force this word limit through to distinguish nursing from all of the other professions that are also not protected? Nurse on its own is as others say quite a multi use word, nursery, nurse as in care for, nurse as in breastfeed.

@RosesAndHellebores

I think it is a very important issue in relation to honesty and disingenuous representations rather than a feminist issue.

How many times on here have we seen a Dr state the terms HCA and nurse are interchangeable?

How often are we tended in hospital thinking it's by a nurse who also dispenses advice authoritatively? How often do we realise that person, in what most of us would call a nurse's uniform, is an HCA?

The title is important so to is absolute clarity about who is who in our hospitals. The colour uniforms need to become uniform and instantly recognisable re the role in every single hospital and practice

The thing is, all this is entirely possible within the NHS without any recourse to a law that applies to everyone else in the country.

If we aren't prepared to do it within the NHS - why should we make a law that makes everyone else do it too?

But the law already does apply to "everyone else in the country" The false use of a protected title is illegal for everyone in the UK. Hearing aid dispenser and physiotherapist are examples of protected titles. Notice the lack of the prefix 'registered'. To falsely claim to be a hearing aid dispenser or a physiotherapist is illegal. To falsely claim to be a nurse is not illegal. The campaign for protection of the nurse title is to bring it into line with the other titles , not to try to create something at odds with existing protected titles.

Below is an example of falsely claiming to be a nurse. Not illegal for anyone to do.
If this person had falsely claimed to be a hearing aid dispenser or a physiotherapist , this would have been illegal.
https://nursingnotes.co.uk/news/politics/newly-elected-mp-falsely-claims-mental-health-nurse/

*Sources
Royal College of Nursing press release June 2021 re the growing practice of employing those without registered nurse qualifications into registered nursing roles.
www.rcn.org.uk/news-and-events/press-releases/nursing-workforce-crisis-leads-to-risky-recruitment-practice

Also Professor Alison Leary September 2021
richmondgroupofcharities.org.uk/news*

I've read the links...

'A post where a Registered Nurse and Registered Nursing Associate were seen as interchangeable despite different education requirements and standards for the two roles'

Presumably the role that they wanted to fill would have matched either RN or RNA? They weren't asking an unqualified person to do more than they were trained to do.

'A Matron (nursing leadership role) in Acute Medicine open to those without a nursing qualification';
'A recent advert for a matron post responsible for older people’s mental health and learning disability services was open to ‘registered professional clinician with demonstrable evidence of working at senior level’ but did not say it required NMC registration'

Both senior posts which are to manage staff, not patients. You don't need a nursing registration to be a good personnel manager (not saying that I agree), I imagine that they're not doing direct patient care as that what the registered nurses are there to do.

'A Band 5 Staff Nurse required the post holder to be ‘RGN/RN or equivalent Allied Health Professional Qualification’

They're not looking for an unqualified person, they're asking for a reg. nurse or someone with an 'equivalent Allied Health Professional Qualification'. Again, I presume that is a particular role that can be carried out by others - maybe an OT?

You haven't proved your point. There are still plenty of roles that will required registered nurses and those will be quite clearly advertised as such.

@Arbella2

But the law already does apply to "everyone else in the country" The false use of a protected title is illegal for everyone in the UK. Hearing aid dispenser and physiotherapist are examples of protected titles. Notice the lack of the prefix 'registered'. To falsely claim to be a hearing aid dispenser or a physiotherapist is illegal. To falsely claim to be a nurse is not illegal. The campaign for protection of the nurse title is to bring it into line with the other titles , not to try to create something at odds with existing protected titles.

It's hardly at odds to have a prefix like that - Licensed boatmaster, Registered Gas Engineer, Registered Dental Nurse, Chartered Marine Engineer, Chartered Physicist, Registered Trademark Agent, Practitioner Psychologist, Chartered Builder, Registered Meteorologist, etc.

Where nursing is more similar to some of these titles than the healthcare ones you mention is that there are broad areas of practice that have traditionally used the titles nurse (like a personal nurse, nursery nurse) whose jobs do not require RN skills. Even in NHS their is a long tradition of tiered nursing levels and hospitals, though they have been increasing the coverage by RNs they do not have to have nurses who are registered in a lot of posts. So to require registration for every post that uses the title "nurse" would potentially pull it away from its common usage. (And it may backfire as a tactic, especially given the skills shortage, forcing hospitals to, instead, rename every nursing role that doesn't currently absolutely require an RN. A move like that would probably speed up the hiring of non-RN staff, lowering of the status and pay for many women in the NHS).

(apologies for typos. Don't hav emy glasses so typing semi blind!

@Arbella2

Below is an example of falsely claiming to be a nurse. Not illegal for anyone to do. If this person had falsely claimed to be a hearing aid dispenser or a physiotherapist , this would have been illegal. [[https://nursingnotes.co.uk/news/politics/newly-elected-mp-falsely-claims-mental-health-nurse/]]

Politicians lies about their past experience are legion. It's not the appropriate basis for deciding on legal protections that would impact people currently legally doing their jobs well who happen to use the title "Nurse" but not be RNs.