I can never understand why the health sector continues to remain so unstable and ‘volatile’. Nurses are at the center of it all. Their unique role makes the title ‘Nurse’ highly coveted and misused. I had thought this was a local problem, then i came across this piece written by a nurse, who is also a Professor.
Hopefully when you get to the end of this thought provoking write up, you would totally agree that the health sector and the ‘actors’ simply have to imbibe the ‘disruptive model/approach ‘ being put forward by a section of progressive healthcare workers and a model i have totally subscribe to.
If you walk into a hospital, care home or GP surgery in England today, you might see someone who calls themselves a nurse. But are they a nurse? What kind of qualifications, skills and experience do they have? Can you tell? The word “nurse” has become embedded over hundreds of years in society’s collective psyche – usually as a generic, female carer of some kind.
Whether in hospital, surgery or in their own home, the public has no way of knowing what kind of nurse is delivering their care. They could be seeing a registered nurse who has undergone three years of training, an assistant practitioner with a foundation degree, a healthcare assistant with a care certificate – or someone who, last week, was working in a completely different job and has had little or no training.
The title of nurse is used to describe all of these groups – and it causes confusion to the public, other professionals and even employers. To add to this confusion, a new group of nurses, called nursing associates, is being added to the workforce to address the shortage of registered nurses and bring down the wage bill.
In the UK anyone can call themselves a nurse. It is not a title protected by a regulatory framework or law – unlike other healthcare titles such as paramedic, radiographer and hearing aid dispenser. A protected title is a contract between a profession and the state: the public can be assured that anyone using protected titles will be appropriately trained.
The term registered nurse is protected, but is not in common use. To become a registered nurse entails three years of education and training, plus registration with the Nursing and Midwifery Council – a regulatory body that can call to account and ultimately strike off those not adhering to its code of conduct.
Many other groups who use the title nurse, such as healthcare support workers, are unregistered and unregulated – and therefore the regulator cannot offer the public protection from their practice. Recent research I did found support workers using titles that implied high level clinical qualifications, such as specialist nurse or associate advanced nurse practitioner.
The often recommended qualification for advanced practice nurses is registration and a master’s degree. However, those I came across were not registered nurses and did not have higher qualifications; in fact, some had no qualifications at all. These titles, which confound the public, are often granted by employers. The confusion is not helped by the fact that specialist nurses alone use around 600 job titles. Extend this to nursing overall and the number of specific titles probably runs into the thousands.
Support workers in health and social care are vital providers of care in their own right. They have a different set of qualifications specific to the role. Calling them nurses means their own specific contribution is diminished alongside that of registered nurses. Many groups of support workers want registration with a professional body so their work is formally recognized and the public is protected.
The work of registered nurses has been under scrutiny for many years. Everyone has an idea of what a nurse is, but very few experience the reality of the work. While most people appreciate the emotional burden of nursing, they do not recognize the enormous complexity of the work and the intellectual challenge the role brings. Registered nurses make a contribution not only to the quality of care, but also to survival.
There is also a growing body of evidence that suggests the government’s policy of diluting that expertise with increasing numbers of nursing associates and support workers is unwise – and likely to impact on patient care.
Nurses’ roles must be clarified and regulated, and their expertise valued. Nurses bring order to chaos, speak up for the vulnerable and work with people at times of suffering. It is still one of the most trusted professions, but if this confusion continues it may not remain so.
Source: Guardian UK
Written by Prof Alison Leary is chair of healthcare & workforce modelling at London South Bank University