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?
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.
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 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.
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.
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.
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"
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.
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 StateLast edit by Joe V on Jun 14, '18
Poll: Take this short true / false poll to test your knowledge. Select all that are TRUE.
331 Votes / Multiple Choice
Nursing Assistants are licensed
Medical Assistants are nurses because they can give injections
Office Staff who assist doctors in their practice are nurses
Graduates of approved nursing schools are nurses
All of the above are true
All of the above are false
About Nurse Beth, MSN, RN
Nurse Beth blogs at nursecode.com
Joined: Mar '07; Posts: 1,402; Likes: 4,205Dec 20, '16Great article. I think it is important to understand that to become a nurse you have to put in hard work to become one. Nursing is not for the faint of heart nor is it for the people who think they are nurses when they really are not. It is almost like me calling myself a doctor even though I am in nursing school. Nursing and medicine are two separate fields but work together to take care of the patient. That is how I see it.Dec 20, '16I do a set of bulletin boards at work. One has series of posters listing the prereqs, then classes in nursing school and the wide range of areas studied, then what the boards are, then all the mandatory certifications for our ER. Bottom line is "There is no such thing as just a nurse".Dec 20, '16I had a friend who was a tech (at the hospital where she worked this was equivalent to a nursing assistant)... She was not certified. She tried to pass as a nurse. She also was very contentious and used to make comments stating nursing assistants knew more than RNs... Uhhhhhhm, no, I don't think so!Dec 20, '16Quote from BSNbeDONEHaha. I hate when I do that with email.Oops! Goofed...realized it as soon as I clicked submit.Dec 20, '16Quote from al3x117I love thatNursing and medicine are two separate fields but work together to take care of the patient. That is how I see it.Dec 20, '16I used to work at a nursing home with this CRAZY, as in goofball crazy,
nursing educator/staff educator. For the most part, she was a wealth of
knowledge and I did respect her, but at the same time, some of the
things that she taught were flat out false. One of the things that she
taught was, she taught our nursing assistants that they were "nurses".
She would point at all of them and say "don't ever let anyone tell you
that you are not a nurse, you ARE a nurse, just like the RN, just
like the LPN, etc.".
I knew at the time that what she was telling them was false.
Why didn't I speak up? Not in my nature, I guess. Plus
I was starting my very first nurse management position,
and in my mind I guess I had bigger fish to fry.Dec 21, '16My 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.Dec 21, '16Legally, yes, there can be issues. Personally? No. I don't care if Raggles the Wino huddled in the parking lot calls themselves a nurse. It doesn't make my job any harder, nor does it affect compensation for doing my job, so I don't care. I did not become a nurse to satisfy any aspect of ego.Dec 21, '16I am a paramedic that works in an urgent care practice. I make it a point to correct anybody who addresses me as "the nurse". Our receptionist frequently says to patients on the phone, "I'll let you speak with the nurse…" And then transfers the call to me. I always correct them and introduce myself as the Paramedic.
I believe it's important that we make clear distinctions in our job titles.
But along those same lines, if you're an ER nurse, please don't refer to the paramedics as "ambulance drivers" or EMTs. While at times we do drive the ambulance and originally we were licensed as an EMT-P, the nomenclature for advanced life-support prehospital care providers is paramedic.
From one professional to another, thanks.Dec 21, '16I know someone who was a BSN but failed boards multiple times. She would sign her notes as NT (nurse tech) BSN.
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