Test Your Knowledge
Before reading the article, take the short true or false poll at the bottom of the article to test your knowledge.
Do you cringe when people use the word "nurse" loosely? Or worse, refer to themselves as a "nurse" when they are neither a Registered Nurse (RN) nor a Licensed Practical (or vocational) Nurse?
I do. I cringe. As an RN who worked hard to pass the National Council Licensure Examination (NCLEX) and just as hard to pass the pre-requisites of organic chemistry, anatomy and physiology, I support protecting the title of nurse and restricting its use to those who have done the same.
Nursing Assistants
Technically Certified Nursing Assistants (CNAs) are certified, not licensed, although the terms are often used interchangeably.
Certified means the person has received specialized training. Certification requirements vary state-to-state but usually the person has received 12-16 weeks of training and taken an exam.
Licensed means the person has passed a standardized nationwide exam (NCLEX) and may practice nursing under a scope of practice defined by state law.
Medical Assistants
Medical Assistants are trained to work in office settings, but they are not licensed and are not nurses. Medical Assistants may give injections, change dressings, and more because they perform under the direction and supervision of a doctor (or other licensed provider).
In other words, they cannot perform these functions independently.
Office Staff
The term "nurse" is often used to include anyone employed in a doctor's office.
The perception of nurses as handmaidens led to any female associated with a doctor in a helping capacity being called a "nurse".
Ironically, doctors rarely employ RNs because of the cost.
Receptionists in a doctor's office have been known to refer to themselves as "nurses" or allow patients to do so. They should politely correct people who refer to them as "nurse", the same as teacher's aides should correct those who call them teachers and paralegals should correct those who call them lawyers.
Graduates of approved nursing schools/programs
Persons who have completed an approved nursing school but have not passed the National Council Licensure Exam (NCLEX) are not nurses and may not refer to themselves as nurses.
Completing an approved nursing program of study is required in order to sit boards (NCLEX) but does not confer a nursing license. A nursing license is issued after successfully passing the NCLEX.
It's possible to hold a Bachelor's degree of Science in Nursing (BSN) and not be a nurse.
A BSN is an academic degree, but schools do not issue nursing licenses. States issue nursing licenses.
Licensure
Practitioners of nursing must have a license to practice nursing and to represent themselves as a nurse.
A license is a state's grant of legal authority to practice a profession within a designated scope of practice.
The only people that are licensed to practice nursing are:
- Licensed Practical Nurses (LPNs)
- Licensed Vocational Nurses (LVNs)
- Registered Nurses (RNs)
Nursing regulates its profession through licensing in that the NCLEX is uniform across all states.
A nursing license is like a driver's license in that it is:
- Issued by the state
- Granted to those who meet requirements
- Renewed at regular intervals
- Required to drive (practice)
"Restricting use of the title "nurse" to only those individuals who have fulfilled the requirements for licensure as outlined in each state's nurse practice act is a protection for the public against unethical, unscrupulous, and incompetent practitioners. Nurse practice acts describe entry-level qualifications such as education, practice standards and code of conduct for continued privilege to practice nursing." American Nurses Association 2013.
Public safety
Licensing is intended to protect the public.
Many do not realize that it is a punishable offense to represent one's self as an RN, LVN, LPN, if not licensed by the state. Impersonating a nurse is a crime.
For example, California Business & Professions Code states:
"In the interest of public safety and consumer awareness, it shall be unlawful for any person to use the title "nurse" in reference to himself or herself and in any capacity, except for an individual who is a registered nurse or a licensed vocational nurse"
Real Problem
Part of the problem is that the public does not know what nurses do. Even doctors do not always differentiate and refer to medical assistants as "my nurse".
The concept of what nurses do is vague, and so is the term "nurse".
We will never be fully respected as a profession as long as we are not successful at articulating to the public just what it is we do. Do you agree? I'd love to hear your thoughts because I think it's material for another post.
References
American Nurses Association. 2013. Title "Nurse" Protection. Accessed December 16, 2016. Title "Nurse" Protection
California Business & Professions Code. Division 2. Healing Arts. Chapter 1. General Provisions. Article 7.5. Health Care Practitioners Cal Bus & Prof Code 680 (2003). Accessed December 16, 2016. Title "Nurse" Protection: Summary of Language by State
