The Castledine column
What is a registered nurse? George Castledine, University of Central England in Birmingham
mong the recent changes an nounced by the UKCC is one that has received little publicity: the use of the title of registered nurse. Previously when there was a change in title, such as when the abbrevi ation SRN was replaced by RGN, there was considerable resistance to the change. Are nurses nowadays becoming less concerned about such issues, or has the current proposal been overshadowed by the recent discussions and publicity surround ing the new Code o f Professional Conduct and the Scope o f Profes sional Practice documents (see BJN Vol 1 (6): 2%)? A
Registration Registering or licensing of practi tioners involves one of the oldest legal mechanisms for gaining credi bility to practise. Most professions control entry into their ranks through the process of licensing or registration, thereby demonstrating their accountability to clients and the public. The process represents control of a profession by society, which in turn grants autonomy for that profession to accomplish its particular mission (Moloney, 1986). Professor Castledine is Head of the Department of Nursing and Community Health at the University of Central England in Birmingham, Perry Barr, Birmingham B42 25U
404
Approved courses and examinations by the four National Boards provide a mechanism for determining mini mal safety of practitioners to prac tise nursing in the UK. Requirements for registration simply indicate that a minimum level of competent care has been achieved by candidates upon successful com pletion of practical competencies and written assessments or examin ations. The degree of competence that individual nurses may have ac quired beyond this minimum is not measured by the UKCC. It is mere ly the Council’s responsibility to register and place a particular nurse on the appropriate part of the regis ter upon recommendation by an ap proved college or nurse training es tablishment. Professional profiling, as recom mended in the UKCC PREP report could, however, start on entry into nurse education training and con tinue through it, so that a record would be kept of an individual nurse’s degree of competence. How ever, such an idea would need care ful administration and monitoring by colleges and designated learning institutions. There are 15 parts of the UKCC register: parts 1 to 11 are the established nurse, midwife and health visitor components, and 12, 13, 14 and 15 are the newly estab lished Project 2000 branches (Table 1).
The UKCC’s latest recommenda tions are shown in Table 2. The issues that surround these changes relate first of all to the single professional register which com prises the component parts mention ed above. Registration designation reflects the fact that the legal right to practise has been conferred on the practitioner. In the members’ room at the UKCC the old printed and bound register is shelved in a glass cabinet. On occasions I scan through one of its volumes just to see my mother’s name in print. So the old register comes alive! Today the whole process is hidden away on a computer.
Level of skill In terms of public interest, registra tion indicates that the practitioner has satisfied the Council that at least a safe level of skill has been achieved. The public is, therefore, restricted to noting the title that follows the nurse’s name. The part of the regis ter on which the nurse appears may now be hidden; yet in the public’s eye, whatever the patient’s problem, a registered nurse should be able to assume responsibility! Trying to ex plain to an anxious patient or rela tive the meaning of the various com ponent parts of the nurses’ register, and who is on what, may be more difficult than a simple indication in the nurse’s title.
Table I. Existing parts of the UKCC register fo r Project 2000. Part 12
Nurses qualified following a course of preparation in adult nursing.
Part 13
Nurses qualified following a course of preparation in mental health nursing.
Part 14
Nurses qualified following a course of preparation in mental handicap nursing.
Part 15
Nurses qualified following a course of preparation in children's nursing.
British Journal of Nursing, 1992, Vol l,N o 8
Downloaded from magonlinelibrary.com by 129.215.017.190 on January 14, 2019.
What is a registered nurse?
Table 2. Th e UKC C ’s recommendations fo r use of the title registered nurse. 1. The most appropriate descriptor to be used by all those registered on Parts 12, 13, 14 or 15 of the register should be that of registered nurse with the abbreviation RN. The branch of practice a nurse works in, i.e. adult nursing, mental health nursing, mental handicap nursing or nursing of the child, can be indicated elsewhere, such as in an individual’s curriculum vitae or professional profile. 2. The description of registered nurse with the abbreviation RN could be adopted by all those registered on Parts I, 3, 5 and 8 of the register should they elect to do so. 3. The description registered nurse, with the abbreviation RN, could be adopted by enrolled nurses whose names appear on Parts 2, 4, 6 or 7 of the register should they elect to do so.
With regard to employers being aware of an individual’s abilities and competence, the UKCC now feels that this should not be assumed from the designation or abbreviation nurses use after their names. It will be the employers’ responsibility to check with the Council’s confirma
tion service that practitioners do in deed hold the registration and quali fication they claim to hold. Al though the Council claims that this service is instant, there will be occa sions when access to confirmation will be difficult and some employers will probably not bother.
The value of reviewing a nurse’s personal professional profile for a potential employer will be crucial. On the positive side there is no doubt that the adoption of a single designation for all nurses on the reg ister will encourage greater cohesion and commonality of registration. It is hoped that the various status bar riers between enrolled and registered nurses will disappear. The long lists of abbreviations fol lowing a nurse’s name will become obsolete and emphasis will be placed on each practitioner individually, justifying the fact that they are ac countable and worthy to practise in their chosen field. After all, titles are of little value if the practitioner us ing them is out of touch with current nursing practice. Moloney MM (1988) Professionalization o f Nursing. JB Lippincott, Philadelphia: 249-51
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SIGNED..............................................................................................DATE.
BJN SUBSCRIPTION RATES
Now post this form along with cheque to: Su e Duffin. Subscription Manager, BJN, Robiohna Farm, Finchingfield. E sse s CM1 4LJ.
(with effect from April 1992 — 22 issues
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British Journal of Nursing, 1992, Voi 1, No 8
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£10.00 £100 £120 £125 £140
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What is a registered nurse? George Castledine, University of Central England in Birmingham
mong the recent changes an nounced by the UKCC is one that has received little publicity: the use of the title of registered nurse. Previously when there was a change in title, such as when the abbrevi ation SRN was replaced by RGN, there was considerable resistance to the change. Are nurses nowadays becoming less concerned about such issues, or has the current proposal been overshadowed by the recent discussions and publicity surround ing the new Code o f Professional Conduct and the Scope o f Profes sional Practice documents (see BJN Vol 1 (6): 2%)? A
Registration Registering or licensing of practi tioners involves one of the oldest legal mechanisms for gaining credi bility to practise. Most professions control entry into their ranks through the process of licensing or registration, thereby demonstrating their accountability to clients and the public. The process represents control of a profession by society, which in turn grants autonomy for that profession to accomplish its particular mission (Moloney, 1986). Professor Castledine is Head of the Department of Nursing and Community Health at the University of Central England in Birmingham, Perry Barr, Birmingham B42 25U
404
Approved courses and examinations by the four National Boards provide a mechanism for determining mini mal safety of practitioners to prac tise nursing in the UK. Requirements for registration simply indicate that a minimum level of competent care has been achieved by candidates upon successful com pletion of practical competencies and written assessments or examin ations. The degree of competence that individual nurses may have ac quired beyond this minimum is not measured by the UKCC. It is mere ly the Council’s responsibility to register and place a particular nurse on the appropriate part of the regis ter upon recommendation by an ap proved college or nurse training es tablishment. Professional profiling, as recom mended in the UKCC PREP report could, however, start on entry into nurse education training and con tinue through it, so that a record would be kept of an individual nurse’s degree of competence. How ever, such an idea would need care ful administration and monitoring by colleges and designated learning institutions. There are 15 parts of the UKCC register: parts 1 to 11 are the established nurse, midwife and health visitor components, and 12, 13, 14 and 15 are the newly estab lished Project 2000 branches (Table 1).
The UKCC’s latest recommenda tions are shown in Table 2. The issues that surround these changes relate first of all to the single professional register which com prises the component parts mention ed above. Registration designation reflects the fact that the legal right to practise has been conferred on the practitioner. In the members’ room at the UKCC the old printed and bound register is shelved in a glass cabinet. On occasions I scan through one of its volumes just to see my mother’s name in print. So the old register comes alive! Today the whole process is hidden away on a computer.
Level of skill In terms of public interest, registra tion indicates that the practitioner has satisfied the Council that at least a safe level of skill has been achieved. The public is, therefore, restricted to noting the title that follows the nurse’s name. The part of the regis ter on which the nurse appears may now be hidden; yet in the public’s eye, whatever the patient’s problem, a registered nurse should be able to assume responsibility! Trying to ex plain to an anxious patient or rela tive the meaning of the various com ponent parts of the nurses’ register, and who is on what, may be more difficult than a simple indication in the nurse’s title.
Table I. Existing parts of the UKCC register fo r Project 2000. Part 12
Nurses qualified following a course of preparation in adult nursing.
Part 13
Nurses qualified following a course of preparation in mental health nursing.
Part 14
Nurses qualified following a course of preparation in mental handicap nursing.
Part 15
Nurses qualified following a course of preparation in children's nursing.
British Journal of Nursing, 1992, Vol l,N o 8
Downloaded from magonlinelibrary.com by 129.215.017.190 on January 14, 2019.
What is a registered nurse?
Table 2. Th e UKC C ’s recommendations fo r use of the title registered nurse. 1. The most appropriate descriptor to be used by all those registered on Parts 12, 13, 14 or 15 of the register should be that of registered nurse with the abbreviation RN. The branch of practice a nurse works in, i.e. adult nursing, mental health nursing, mental handicap nursing or nursing of the child, can be indicated elsewhere, such as in an individual’s curriculum vitae or professional profile. 2. The description of registered nurse with the abbreviation RN could be adopted by all those registered on Parts I, 3, 5 and 8 of the register should they elect to do so. 3. The description registered nurse, with the abbreviation RN, could be adopted by enrolled nurses whose names appear on Parts 2, 4, 6 or 7 of the register should they elect to do so.
With regard to employers being aware of an individual’s abilities and competence, the UKCC now feels that this should not be assumed from the designation or abbreviation nurses use after their names. It will be the employers’ responsibility to check with the Council’s confirma
tion service that practitioners do in deed hold the registration and quali fication they claim to hold. Al though the Council claims that this service is instant, there will be occa sions when access to confirmation will be difficult and some employers will probably not bother.
The value of reviewing a nurse’s personal professional profile for a potential employer will be crucial. On the positive side there is no doubt that the adoption of a single designation for all nurses on the reg ister will encourage greater cohesion and commonality of registration. It is hoped that the various status bar riers between enrolled and registered nurses will disappear. The long lists of abbreviations fol lowing a nurse’s name will become obsolete and emphasis will be placed on each practitioner individually, justifying the fact that they are ac countable and worthy to practise in their chosen field. After all, titles are of little value if the practitioner us ing them is out of touch with current nursing practice. Moloney MM (1988) Professionalization o f Nursing. JB Lippincott, Philadelphia: 249-51
British Journal of Nursing SUBSCRIPTION FORM □ Yesl I would like to subscribe to the new fortnightly British Journal o f Nursing with effect from June 1992. I wish to pay by: □ Cheque Q Credit Card
□ Direct Debit
DIRECT DEBIT MANDATE Mark Allen Publishing Limited, Croxted Mews, 288 Croxted Road, London SE24 9DA To the Manager............................................................................................. Full Postal Address of Bank Branch.............
Please complete the details as required Signature............ ...................................................................... ...........Date. FULL NAME................................................................................................... ADDRESS...................................................................................................... ........................................................................................................TEL NOJOB GRADE................................................................................................... CLINICAL SPECIALITY.................................................................................... NHS OR INDEPENDENT?............................................................................... MONTH & YEAR OF REGISTRATION..............................................................
Reference Number l/We authorise you until further notice in writing to charge to my account with you, variable annual amounts which may be debited thereto at the instance of Mark Allen Publishing Ltd, by direct debit in respect of my/our subscription to the British Journal of Nursing Date of first payment on or within one month from .......................................... Name of account to be debited........................................................................ Account number | [ | | | 1 1 I ~1 Banks may decline to accept instructions to charge Direct Debits to certain types of account other than current accounts
SIGNED..............................................................................................DATE.
BJN SUBSCRIPTION RATES
Now post this form along with cheque to: Su e Duffin. Subscription Manager, BJN, Robiohna Farm, Finchingfield. E sse s CM1 4LJ.
(with effect from April 1992 — 22 issues
CREDIT CARD SUBSCRIBERS Please charge my Access, Barclaycard, Visa or American Express E.... My credit card number Is 1 I
I I I
1 I
1 I
I
H
UK:
Personal Annual Subscription (Direct Debit) Personal Annual Subscription (Cheque/Credit Card) Personal Quarterly Subscription (Direct Debit) Institutional Annual Subscription* Pre-Registration Annual Students (Direct Debit) Pre-Registration Annual Students (Cheque/Credit Card) Pre-Registration Quarterly (Direct Debit)
Expiry............................................................................................................
O V E R S EA S AND EIRE:
Signed................................................................................................. Date.
Personal Surface Mail Personal Airmail Institutional Surface Mail Institutional Airmail* *Hospital«/Librarias___________________________
Not«: If you w ant to m aka usa off our spacial FREEPHONE Sarvica, please phone 0800 220427 botwaan 0.30am and B.OOpm Mondays
-joFrktoyii--- --------------------------------------------------
British Journal of Nursing, 1992, Voi 1, No 8
£48.00 £49.50 £13.00 £80 00 £36 00 £38 00
£10.00 £100 £120 £125 £140
405 Downloaded from magonlinelibrary.com by 129.215.017.190 on January 14, 2019.
