Are You Really a Nurse?

Who should be allowed to call themselves a nurse? Is it important to protect the title or is it no big deal? Nurses Announcements Archive Article

  1. Take this short true / false poll to test your knowledge. Select all that are TRUE.

    • 39
      Nursing Assistants are licensed
    • 0
      Medical Assistants are nurses because they can give injections
    • 0
      Office Staff who assist doctors in their practice are nurses
    • 107
      Graduates of approved nursing schools are nurses
    • 3
      All of the above are true
    • 279
      All of the above are false

407 members have participated

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

Here in Washington, nursing assistants are licensed by our DOH to practice as nursing assistants.

Firstly, I want to clarify something. As a CNA, I actually am state licensed. I was certified when I finished my CNA classes, but had to pass the state practical & written exam to receive my license.

Secondly, I am not a nurse & do not refer to myself as one. I call myself a "nurse aide" to residents and their families.

I have a bachelor's in psychology & am applying to several accelerated BSN programs, and I can't wait to use the title "nurse" once I have earned it!

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

This issue has nothing to do with our egos or how hard we worked to become nurses. It is a matter of professional credibility and public safety. The public has a legal right to know who is providing any aspect of their care. They should not be allowed to believe a nurse is providing them anything unless an actual nurse is doing the providing. Whoever misrepresents him or herself as a nurse is committing an act of fraud.

Think about it this way: you go to your doctor's office and a nice man in a white coat comes in, examines you and makes some recommendations. Then you find out he is the janitor. So? He works in a doctor's office, so he must know as much as a doctor by now, right? But you're not buying it, because he isn't a doctor.

The second issue is professional credibility. When I am providing health information, it is based on my education, experience and expertise. The recipient knows the information is being provided by a registered nurse. Suppose they are given erroneous information by someone who isn't a nurse, but they were led to believe the person was a nurse. That makes it much harder to trust nurses, so anyone who pretends to be a nurse hurts the credibility of the entire profession.

The law exists to protect our integrity as a profession. Nothing to do with anyone's ego or personal preference.

Specializes in ICU/Management/Holistic Health.

Precisely!! Very well expressed!

Specializes in Wound care; CMSRN.

Right wrong or indifferent, your license is what defines you as a nurse. Every state has a BON that administers licensure under rules codified by that states legislative body. That's it. Nurses in every state need to meet qualifications set out by the BON of that state, and you must pass the NCLEX.

This discussion is not really about that, and quibbling over attitudes and misunderstandings by both the lay public and members of allied professions (yep, I just called med teching and nurse aiding and ward clerking professions because thats how many of us feed our families) serves no one well; especially those of us who have gone to the trouble to jump through the hoops necessary to be able to make our living working at registered nursing.

I am also not laboring under the misapprehension that my skill level is the same as that of another RN who has been doing this since the NCLEX was a 3 day paper test you didn't get an answer to for 6 months. The school I went to ( yes, it was a real "brick and mortar" school) was very clear with us that making it through school and sitting for and PASSING the NCLEX was only the beginning of our chance to practice a VOCATION (look it up) and that our education would never stop if we intended to practice that vocation on behalf of our patients (remember them?).

Personally, I think you should have to practice the art of nursing (as in being directly involved in the nursing care of actual human beings) to be called a nurse. I also think that people who pass themselves off as something they're not are either stupid or dangerous or both.

I take great pride in telling people who mistake me for a Doc (I'm older and male and society in general is pretty sex and role bound) that I am in fact an RN. If they then proceed to ask me a question that requires the expertise of a Physician, I, as I have been trained to do, tell them they need to talk to an actual Physician and offer to help them contact one.

Otherwise, I ask them how I can be of service to them, cuz that's what this is about. Call me crazy.

A friend of mine calls herself a nurse, although she hasn't practiced or kept up her license for more that 20 years. Once a nurse, always a nurse? Or do you forfeit the title when you give up your license?

I agree with this and in the grand scheme of things, think that this line of thinking will help us keep our sanity more than fighting the truly good fight of who can/does call themselves a nurse. It doesn't affect anything about my job on a day to day basis but there are many, many things that do that management and healthcare regulatory bodies don't seem to care at all about.

We need more non-nurse staff such as Aides, Transport, Dietary, Phlebotomists who are actually held accountable to do their jobs and have their job descriptions re-written to be more helpful to the nurses. I work at an urban, Level I Trauma Center with 800+ beds on a very busy med-surg (with more post-ops usually) unit with the typical ratio of 5:1 during the day and 6:1 at night. The lack of this type of help is what is causing huge turnover- including me! I'll be leaving as soon as I find something that's a good fit.

Exactly. I read stuff like this on this board, and it helps me understand why it's so easy for me to view this as a job instead of a lifestyle. I simply cannot relate to a lot of the things that many people in this field get worked up over. When they retire, I half expect to see them come back through the ER as an SI because they discovered they have NOTHING ELSE IN THEIR LIVES to live for except this job, should I take the things they say at face value.

I have a job. My job has a very big impact on the clients I work with. My job is keeping them alive, keeping them comfortable, and improving their situation on the continuum of health---not always mutually exclusive or together.

In turn, I get my bills payed, I get an air-conditioned/heated place to work, and I have job-stability within an industry that is unlikely to ever run out of need for me, and will never introduce "a model I don't work on", since people are evolving slower than my lifespan can appreciate, lol.

What I do NOT get compensated for is pseudo-outrage over things like The View, someone assuming a title that is not theirs to bolster self-esteem or social standing. Bragging about the job I chose. Or any other number of crazy things I see people doing that make me wish I didn't have to associate myself with them even in a passing sense, lol!

People forget that this is a JOB. Not a lifestyle. Not a political statement. Not a whatever else it is they are trying to turn it into.

Make your job as easy as you can (lobby for help if you need more staff, don't go out of your way to correct people who could become offended over things that don't matter in the workplace, you get the drift), and strive for the best results that you can (take good care of your patients/clients/customers, manage their care effectively and with an eye to cost to your hospital, ie. don't go using a bunch of 10cc flushes when you can just as easily pull NS from the running IVF, or however you want to do it), and you will go VERY far in any career.

If you want a pointed reminder of the fact that yes indeed, you have a job/career, and not a lifestyle or political ideology or whatever you're pretending your job as a healthcare provider is, your HR office will gladly remind you at any given time, should you become too involved with trying to turn your job into a lifestyle. Post about it on Facebook for an expedited reminder (at most facilities) ;)

I agree with your statement but I really hated when I was an LPN and people would ask are you an RN? when I said LPN they acted like that title was " Not" a real nurse still irks me.

Blame that partly on the ANA.

The ANA only believe that Bsn holding Rn's are real nurses....shame.

A friend of mine calls herself a nurse, although she hasn't practiced or kept up her license for more that 20 years. Once a nurse, always a nurse? Or do you forfeit the title when you give up your license?

When you retire from being a police officer...are you still a police officer?

When you sold cars in college, and now you nurse...are you still an auto-sales rep?

When you played football in college, and you're now 60, are you still a football player?

If you are not an active practitioner of something...you ain't that thing.

Blame that partly on the ANA.

The ANA only believe that Bsn holding Rn's are real nurses....shame.

Oh, and don't you believe for a second that the nursing schools that offer BSN programs do NOT waste ANY time in telling us BSN holders just how superior we are to every other kind of nurse out there (except NP and MSN and so forth if they ALSO offer those programs). My program even taught me that I was vastly superior to the MD "because they treat the disease, and you take care of the patient, and you are around the patient more". Yes. They literally said this. Those words. To us students. Then they turned around and told us how the BSN was so much more highly educated and skilled than the ASN. At this point, I decided that I had done messed up and gotten myself involved in a bunch of petty stupid, but there I was, so I made the best.

Specializes in CAPA RN, ED RN.

I am clearly labeled as an RN where I work. The hospital has all the disciplines wear a badge with bold letters 3/4 inch tall and mine says "RN." And there is no one more handy in managing the patient's ongoing care than "the nurse." I feel a lot of respect for my profession.

I come across a lot of family and patients that tell me they are nurses. I smile warmly and ask them what their area of expertise is. Much of the time they are not nurses but current or past caregivers or involved in delivering medical services in some way. Sometimes I am little uneasy listening to how these "nurses" present themselves although it is a high compliment that many people want to be a nurse.

I suspect most of the RNs don't say a word about their profession in my presence unless I ask. I am wondering if it would change things to have more of us who are professionals speak up and be known for what and who we are.

I am clearly labeled as an RN where I work. The hospital has all the disciplines wear a badge with bold letters 3/4 inch tall and mine says "RN." And there is no one more handy in managing the patient's ongoing care than "the nurse." I feel a lot of respect for my profession.

I come across a lot of family and patients that tell me they are nurses. I smile warmly and ask them what their area of expertise is. Much of the time they are not nurses but current or past caregivers or involved in delivering medical services in some way. Sometimes I am little uneasy listening to how these "nurses" present themselves although it is a high compliment that many people want to be a nurse.

I suspect most of the RNs don't say a word about their profession in my presence unless I ask. I am wondering if it would change things to have more of us who are professionals speak up and be known for what and who we are.

I think it would just rub people the wrong way.

*patient family member at bedside* "I'm a nurse"

*Actual nurse*

"Cool, what do you do?"

"I deliver sandwiches from Jimmy John's to the staff on 4W."

You could say: "Awesome! I love Jimmy Johns"

---or---

"You're not a nurse. You're a catering service."

*smug look on patient's face* "I'd like a turkey sandwich and I believe it's time for my morphine, please. My toe is a 10/10."

But seriously though, why argue? I once had a patient that told me her grandson was a wonderful doctor. Turns out, I knew the guy. He was a good tech. Who am I to care what she thinks about her grandson, though? I am there for MEDICAL CARE. Not to introduce her to some sort of caste system.