Are You Really a Nurse?

[Nurse Beth]

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

[smartnurse1982]

I hate when pt's or family members say "yeah I used to be a nurse" and they're clearly lying. Then I look them up and find nothing on the BON website. And my PCP's office used to refer to the MAs as the doctors nurses. I think the recording says assistants now. Drives me crazy! We worked so hard to get where we are and these people just throw the term around.

That is unreliable in some situations.

Maybe they were licensed in another state?

There are all sorts of situations were someone is a nurse in another state but for some reason is not licensed in the state they reside in now.

That is why I think we should have a national registry of nurses vs individual state boards.

[smartnurse1982]

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.

Not true.

What if you place your license on "Inactive" status?

Your name will still come up on the Bon website as "Inactive".

I am still licensed in South Carolina. My license is on Inactive status in that state,but I still practicing elsewhere.

[James W.]

The title 'Registered Nurse' is a meaningful matter IMO..

Patients & those properly concerned for their well-being,

are indeed entitled to know the bona fides ( credentials)

of the professional staff doing personally intrusive cares.

I find that a open, honest, 'nicely' put correction is best, if

should there be any role confusion.. & I have been called 'Dr'

( & not always sarcastically) since I was a teenage trainee nurse..

I also agree that ID badges ought to be worn up front, I find those worn

at belt level, or 'oops-wise' reversed on swinging lanyards to be improper.

[Iamthetruth]

Where I work as a Nurse. All the nurses Badges has the facility name, your name and "Nurse". It doesn't matter if you are a LPN,LVN,RN with a Diploma, Associates, BSN, MSN. If you are licensed as a nurse that's what you are. I think people want to be what they are not sometimes. Whatever you do be proud of it even if it's digging ditches.

[Avid reader]

Smart Nurse you have too much time on your hands! Does your title misadventures effect your paycheck? As a smart nurse, research the vagaries of being overly judgemental and its possible drawbacks.

[Avid reader]

JWG223, I have yet to meet an advanced degree nurse that can hold a candle to someone with oodles of experience and good judgement!

[kbrn2002, ADN, RN]

Regulations on who can call themselves a nurse are determined by the state's BON, and as we all know there's not a lot of continuity in rules in regulations. Wisconsin's nurse practice act is particularly strict, limiting the title of nurse to only Registered Nurses. I have yet however seen or heard of any disciplinary action by the BON against an LPN that dares to call themselves a nurse. Gee whiz, what a silly thing. Whoever decided to write that in the language had a real burr up their butt to decide an LPN somehow isn't entitled to use the term nurse, heck what are they supposed to call themselves then?

[Longleggedstar]

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?

Of course, you are still a nurse you are just a retired nurse now, I am almost certain that in some states you can even apply for a retired nurse status.

[Naya9600]

It's funny this is one of my biggest pet peeves within healthcare and I'm not even a nurse.

I am currently a ER Tech and have worked on the floor as an Aide. When I lived in OK I was certified as an Advanced Unlicensed Assistant, which meant I had more training then CNAs but not quite as much as an LPNs. I am also currently in nursing school. But I'm NOT a nurse.

I am ALWAYS correcting patients, family members, and doctors when they call me a nurse.

One thing I have learned is if someone makes a point to identify themselves as a nurse when they come into the ED they probably aren't a RN or LPN.

I actually find it funny and sad when they do this because if you are truly a nurse you don't need validation from other people about being a nurse. Even retired nurses don't broadcast that they were a nurse when they come into the ED.

[chacha82, ADN, BSN]

An RN is a nurse. LPN is a nurse. Nursing assistant or tech is NOT a nurse. I worked with some techs who would say "Let me just take the test" for RN....

[DeeAngel]

My current situation at the doctors office that I work at. Everyone is a "nurse." I feel so offended that I went through four years of nursing school and a brutal nclex only to end up in a place where you can just call yourself a nurse and actually believe that you are one.

So start calling them on it, asking where they graduated from, pinning down the details. File a complaint with the BON and write a letter of complaint to the doctor, send it certified mail. Your silence does nothing except to imply agreement.

[Footballnut]

I can see my earlier comment was taken differently than I intended. I would never argue or correct anyone. I listen and encourage.

Most of the people who care for me and my family know I am a nurse because they ask or I work with them. I like it, they like it. If it doesn't come up that I am a nurse it is not important in most cases. But if I need a further explanation I let them know that I have an interest in something they are telling me at a different level due to my background.