Recently I saw the headline "Nurses will not lose their licenses" in my local newspaper; when I read the article, I wasn't surprised to discover that the "nurses" were actually nurse's aides. In another publication, I read about a woman who did volunteer work in her community by visiting homebound seniors; she was commended for her work as a "nurse." On a Web advertisement for a pediatric practice in Utah, medical assistants were referred to as nurses-a fact that triggered much debate on the discussion board of a nursing Web site, allnurses.com. Even in the popular reality television series Survivor, a certified nursing assistant was consistently referred to as a nurse.
Why is it so common for almost anyone who provides health related services-regardless of education or licensure-to be called a nurse? Are dental assistants "dentists," or physician assistants "physicians"?
The haphazard use of the title "nurse" implies that nursing isn't a profession, but something anyone is capable of doing. All state boards of nursing have passed legislation to prohibit the use of the titles "RN" or "LPN" by unlicensed personnel (and some states specifically protect the title "nurse")-meaning that those who incorrectly refer to themselves as nurses are subject to prosecution. 1, 2 But these measures have done little to halt the inappropriate use of the title.
Perhaps this lax attitude toward the title has to do with the fact that, unlike other professionals, nurses don't need a baccalaureate to practice. Having multiple routes to licensure creates confusion as to who is best prepared to be an RN and raises questions about the status of the profession. 3 In addition, the fact that one can complete the academic and clinical requirements for practice as an LPN while attending high school creates further misunderstanding regarding the education level of nurses. Still, despite the fractured state of nursing education, in order to be called a nurse, one should still successfully have completed an accredited nursing program and be licensed to practice.
People need to know that every person dressed in scrubs isn't a nurse. We should always introduce ourselves to our patients by name and professional status. Furthermore, when necessary, we should point out incorrect usage of the title "nurse." I e-mailed the author of that article about the erroneous reference to "nurses" in the headline, but to date haven't received a response; my next step may be a stronger statement in the form of an editorial. Former ANA president Mary Foley wrote a letter to the producers of Survivor to admonish them for their inappropriate use of the word "nurse." Likewise, the nurses who participated in the online discussion on allnurses.com informed the pediatrician of the misuse of the title "nurse" in his Web advertisement; he apologized, and the ad was changed.
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If the title "nurse" continues to be used in such a cavalier fashion, nursing will continue to be regarded as a health service requiring little or no formal education. We need to protect our profession's integrity, not only for our own sakes, but also to ensure that the public receives care from those who have earned the title and the right to practice as nurses.
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