The Royal College of Nursing is calling for an to end the growing practice of employing those without registered nurse qualifications into registered nursing posts, warning that this risks compromising patient safety.
There is substantial evidence that registered nurses improve patient safety, including outcomes and mortality. This practice appears to disregard that academic evidence, and the years of education and the specialist skill set of nurses who are registered with the Nursing and Midwifery Council (NMC).
The RCN is committed to multidisciplinary working in health and social care and recognises the knowledge, skill and expertise of the many professions involved. Many inquiries and reviews, however, including the Francis report into the catastrophic events at Mid Staffordshire, have highlighted the risk of not having the right nursing care available for patients and stressed the importance of nursing leadership. The common theme has been that patient safety and need must drive the shape of the workforce.
The RCN has found instances where employers have formally opened registered nurse vacancies to people without registered nursing qualifications, or from different professional backgrounds, including physiotherapy and occupational therapy.
The adverts often carry a caveat that post holders need to be registered either with the NMC or Health and Care Professionals Council (HCPC).
A recent advert for a matron post responsible for older people’s mental health and learning disability services was open to ‘registered professional clinician with demonstrable evidence of working at senior level’ but did not say it required NMC registration.
Other adverts included:
- A Band 5 Staff Nurse required the post holder to be ‘RGN/RN or equivalent Allied Health Professional Qualification’
- A Matron (nursing leadership role) in Acute Medicine open to those without a nursing qualification
- A post where a Registered Nurse and Registered Nursing Associate were seen as interchangeable despite different education requirements and standards for the two roles
Royal College of Nursing Acting General Secretary and Chief Executive, Pat Cullen said: “Filling registered nurse vacancies with those who are not registered nurses is not filling those vacancies. Acting in this way not only leads to vacancies elsewhere but also carries a risk to patient care.
“The very fact that employers are needing to fill nursing posts in this way should set alarm bells ringing with ministers that cannot be ignored and spur them into a proper investment in the long-term future of the nursing workforce.”
Chair of the Professional Nursing Committee of the RCN, Rachel Hollis, said: “We need to see all employers in health and social care ensure that where a vacancy exists for a registered nurse, this is open to registered nurse applicants only.
“We respect and value the role of all healthcare professionals in the multidisciplinary team but we believe that only registered nurses, and our nursing support worker colleagues, can deliver safe and effective nursing care.
“Strong nurse leadership not only improves patient outcomes but also helps in developing the skills of the whole nursing workforce.”