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

[TruvyNurse]

I once went with my mom to a doctors appointment and we had an MA greet us as "I'll be your nurse today." You bet your butt I spoke up and said something!

[Glycerine82, LPN]

MAs, CNAs, PCTs, etc. all perform tasks delegated by nurses while nurses use critical thinking and a unique skill set to implement interventions and make recommendations independently. Anyone can learn to perform a task, but knowing what comes next is another story.

[moldyoldyrn]

Knowing WHY you are doing it is also another story.

[WanderingWilder, ASN]

In NH CNAs are licensed instead of certified and they are called LNAs. Still not nurses but just fyi.

[moldyoldyrn]

Not in every state though.

[LovingLife123]

I just saw a CMA tell a friend on Facebook that she was a nurse and started giving out medical advice. I happen to be privy to this friend's medical history and she has immune system issues and takes chemo as part of her treatment right now.

Another person says listen to the nurse. They know what they are talking about.

Do you call this person out? How do you handle it? Do you ignore it? It really bothers me when everybody throws around the term nurse so loosely. I feel it degrades our profession.

[moldyoldyrn]

Take what you know to the person in charge. Write it down and follow it up, keep a running record of it. It should be apparent to a supervisor that what that CMA is doing jeopardizes the entire facility.

[LovingLife123]

Take what you know to the person in charge. Write it down and follow it up, keep a running record of it. It should be apparent to a supervisor that what that CMA is doing jeopardizes the entire facility.

This is just a random person on Facebook. I have a friend on there with an extensive medical history. She was posting on there about how sick she was today. She's immuno-compromised so she picks up every little bug and it's hard on her.

This person just chimes in that she is a nurse and my friend is to listen to her advice. She is not a nurse. She is a CMA.

So many people throw the term nurse around because we are a trusted and respected profession and it sounds so much better than to say I'm a medical assistant. She probably feels it gives her more credibility to say she's a nurse. It bothers me because I worked hard for my degree and license and people who went to some commercial school for 6 months seem to think they are entitled to our title.

And maybe it's not a big deal to some people, but I guess I take a certain amount of pride in the work I do and the knowledge I have. We could teach a monkey to give injections. That's not what Nursing is about to me. It's an art we work our entire careers honing. And I know medical assistants work hard at their jobs. That's not my issue with it. It's the knowledge and training.

[moldyoldyrn]

Along with knowledge and training, how about responsibility? Who would be held responsible if a CMA made an error or told some one something in error and they said it was "the nurse" who told them.

[NotAllWhoWandeRN, ASN, RN]

I'm sorry, but I completely disagree. When Raggles the wino calls himself a nurse, it damages the reputation of your profession and the respect it demands. That not only makes your job harder, but it will affect your compensation when providers hire less qualified individuals because the patients can't tell the difference anyway.

I worked too hard to call myself a nurse.

Agreed. Words have meaning. In this case, words have legal meaning.

When we are denied the language to define our own profession, others are unable to understand what a nurse really is. What I've seen lumped together as UAP - unlicensed assistive personnel - do not have the education, experience, or judgment required of an LPN or RN. That's not talking down about other people, it's saying a licensed nurse has a specific role those other employees do not.

[chocoholic999]

I have a Master's in nursing, an NCLEX pass and a license to practice nursing in two states. I have to frequently remind my husband that I do not work "in the medical field". But when he referred to the vet tech as "the nurse" I did not come unhinged. I knew of whom he was speaking. He knows she is not an RN. She knows she is not an RN. The cat did not care. It was just the best way he could describe her job. I think most people do know who is a professional nurse (RN) and who isn't, they are just using a colloquialism for a job description. I don't think it demeans me or my profession. Military medics get called "doc" all the time and I have never heard a physician fall apart over it.

[Longleggedstar]

I just saw a CMA tell a friend on Facebook that she was a nurse and started giving out medical advice. I happen to be privy to this friend's medical history and she has immune system issues and takes chemo as part of her treatment right now.

Another person says listen to the nurse. They know what they are talking about.

Do you call this person out? How do you handle it? Do you ignore it? It really bothers me when everybody throws around the term nurse so loosely. I feel it degrades our profession.

On Facebook----I'd just ignore it