Misleading job titles: 3 reasons we must protect the word ‘nurse’

‘Nurse’ title is widely misused in the NHS, so underplaying the importance of nurses and the skills and education they require to register and practise

When is a ‘nurse’ a registered nurse, or a registered medical practitioner a ‘doctor’?

The lines are becoming increasingly blurred by a proliferation of job titles for healthcare professionals. It is difficult enough for those working in the NHS to keep up, let alone the public. And our investigation into nursing titles lays bare the confusion and potential damage of this practice.

Why misleading job titles in nursing and healthcare matter

I recently saw firsthand how titles could lead to confusion, when I was seen by a physician associate (PA) at my GP practice. While they introduced themselves at the start of the consultation and I received good care, it only became clear that they were not a doctor when they explained their prescription would have to be signed off by a supervising GP. The British Medical Association argues that PAs could be mistaken for doctors by some members of the public. And there is concern over creep in scope of practice, just as nursing has seen with nursing associates.

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However, the situation our investigation has uncovered is murkier. We found that more than 8,000 roles featuring the word ‘nurse’ in the title were at Agenda for Change bands 1-4 (we excluded registered nursing associates from the total).

This matters for three reasons:

• The patient safety issues of assuming, based on a title, someone is a nurse and perhaps even one with advanced skills, such as the band 4 specialist nurse practitioner role we discovered via our Freedom of Information request to employers.
• If this is role substitution for what would have been registered nursing posts, and cost-cutting by employers.
• The devaluing of the profession of nursing and the skills, training and qualifications nurses require to fulfil their safety-critical roles.

Moves to protect the nurse title in law, supported by the NMC, must be made a priority to protect patients and the profession.

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