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If your job title says 'nurse', you should be a nurse

Hospitals are urged to review staff job titles because some call unregistered support staff 'nurses'.

Hospitals have been urged to review staff job titles because some call unregistered support staff 'nurses'.


Job titles appearing to claim nurse status can mislead patients. Picture: Nathan Clarke

Two nursing leaders have written to NHS trusts stating: 'Our preferred position is that only a registered nurse should have the word "nurse" in their job title'.

A study found that unregistered support workers are practising in the NHS with job titles that describe them as nurses with advanced skills.

Qualifications or experience

The study found that thousands of nursing jobs across the NHS actually have titles that have little or no link to a nurse's education or level of experience.

In many cases, NHS employers or staff themselves create their own job titles.

London South Bank University professor and chair of healthcare and workforce modelling Alison Leary, who led the study, warned that the practice could undermine public confidence in the profession and puts patients at risk.

Following publication of the research, NHS Improvement executive nursing director Ruth May and England's chief nursing officer Jane Cummings wrote to NHS trusts.

Registered status

They urged the employers to ensure job titles reflect an employee's registered and regulated status.

The letter, first seen by the Health Service Journal, states Nursing and Midwifery Council chief executive Jackie Smith 'has reinforced that employers should not mislead patients into thinking the person in front of them is a registered nurse (RN) when they are not and that employers have a duty to make that clear to patients.

'We would certainly support that and do accept that this issue is not occurring as a deliberate act of deception.

'However, our preferred position is that only a RN should have the word 'nurse' in their job title or in their job description.'

Description of roles

The letter states that further discussion is required on job titles and how they are linked to roles and qualifications.

It also instructs NHS trusts to ensure all staff titles recognised as denoting the delivery of nursing or midwifery care clearly reflect the holder's registered/regulated status, and to consider whether the word 'nurse' is used appropriately.

RCN general secretary Janet Davies said: 'Support workers play an extremely important role but there must always be a clear distinction between them and trained nurses.

'As the shortage of nurses begins to bite, the NHS is increasingly filling shifts with unregistered care staff. They do not have the qualifications and training of registered nurses and it is unfair on the all sides, not least patients, when they replace more qualified staff.

'"Nursing" on the cheap'

'The government must not allow nursing on the cheap. When the number of registered nurses on shift falls, patient outcomes and mortality rates that are adversely affected.'

The NMC's Jackie Smith added: 'If individuals are calling themselves nurses and they are not on our register then, from a patient perspective, that is quite worrying.

'If they are describing someone as an advanced nurse practitioner, I would think that person was a nurse and on the NMC register.

'Employers should not mislead patients into thinking the person in front of them is a registered nurse when they are not. They have a duty to make that clear to patients.'


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