Recently I read an article in the New Jersey Nurse newsletter that there is proposed legislation to protect the title ‘nurse.’ This articles is seeking to prohibit the use of the title ‘nurse’ by anyone who is not licensed as a Registered Professional Nurse or a License Practical Nurse in that state. The author, Kathleen Mullen, DNP, MA, RN, CNE stresses that the public expects the individual to have the knowledge and expertise of a nurse; and that knowledge and expertise distinguishes the nurse from others who have not acquired the necessary qualifications.
Texas nurses, you can be proud. The Texas Nurse Title Protection has been in effect since 2003. A bill in Texas defeated a 1999 bill that authorized veterinary technicians to call themselves nurses. Nurse aides were also able to call themselves nurse aides without working with a nurse. Currently in Texas only individuals who are qualified, have taken and successfully passed the licensure exam for their licensure level may use the title ‘nurse’-this is the standard for the Licensed Vocational Nurse (LVN), Registered Nurse (RN), Advanced Practice Registered Nurse (APRN).
The Board of Nursing (BON) looks strongly on people who try to pass for nurses. However they have limited power, jurisdiction and authority to take action against that person since the BON can only discipline LVNs, RNs, and APRNs. One group of unlicensed health care personnel that continues to use the title nurse is the certified medical assistant (apparently this is not just a Texas problem). The BON wants nurses to be aware that they should clarify that the person in the physician’s office or clinic is appropriately licensed as a nurse when nursing responsibilities are being addressed. The person who is in school to become a nurse, and the Unlicensed Assistive Personnel (UAP) who might be a CNA, nursing assistant, provider, etc., cannot call themselves nurses. As I have talked with faculty from programs teaching these courses, they shared that they tell the students that they are not nurses and should not use the title. The New Jersey Nurse Newsletter article acknowledges that individuals may have worked hard to earn their certification but that it is easier to say they are nurses. It may also be easier than using their long and or unfamiliar title.
Though they are committing a crime, these individuals do not come under the jurisdiction of the BON. If a person is reported as a nurse imposter (one who seeks and obtains employment using illegal means), which is more serious than misidentifying oneself as a nurse, the BON, after completing its investigation, can then pass the case over to the law enforcement authority in the jurisdiction where the individual was engaging in this behavior.
In looking into this issue a little more, there are several other states with actual laws on the books prohibiting non-nurses from using the title ‘nurse’. These states in their Nursing Practice Act (NPA) may use different language, but the one thing that is clear, it that the intent is to assure the public that those individuals licensed as nurses have the education and qualifications to practice nursing at their level of licensure. These laws speak to the mission statement and the importance of assuring the public that the state boards of nursing are focused on rules that will keep the public safe.
The problem is more than an expectation that only persons licensed as nurses can present themselves to the public as nurses. So what can be done about the problem? At a minimum, we as nurses can correct, challenge, and educate anyone who calls themselves a nurse if we believe it to be otherwise. Educate those who believe it is OK to use the title nurse for non-nurses, such as physicians and administrators. We can inform them that they are encouraging misinformation to be passed to their patients and as such a level of care that may be expected, cannot be provided. Being a nurse means having a body of knowledge and skills that are substantial. It is more than performing a series of tasks.
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