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Nursing job titles: what's in a name?

Marilyn Eveleigh

I have been watching the growing variety of nursing job titles over the past years, and what I've come to realise is how necessary it is to closely scrutinise the additional information in an advert to determine the meaning of the title. You may think this close consideration should be an integral process of considering a post - and you would be right. But what is amazing is that it's not just the titles that are diverse - the roles, responsibilities and remunerations differ vastly for the same job titles. This does not only apply to acute hospital units, but is also rife in the community, primary care and independent sectors.
In one copy of the Nursing Times in spring 2002, the job vacancies listed 24 different nurse titles that appeared to denote the individuality of the organisation that was advertising. This did not include the formally recognised titles on the NMC Register, such as health visitor, occupational health nurse and other qualifications.
One interesting anomaly was the advertising for nurse practitioners (D-I grade) and for advanced nurse practitioners (G-H grade). I was confused by the plethora of terms - clinical lead, lead nurse, specialist nurse, nurse specialist, nurse advisor, lead practitioner and team leader. I was becoming really concerned by others, such as care programme approach facilitator, nurse specialist practitioner, a senior staff nurse and sister post being paid across exactly the same salary range at F grade, and practice development nurses ranging from E to H grades. I was smiling incredulously at some titles within NHS organisations - the modern matron, the trainee advanced neonatal nurse practitioner, and the scrub practitioner - would these look right on an identification badge?
Do other professional groups have this same issue over job titles? I am not aware of it happening elsewhere within healthcare, although I admit to occasionally being muddled over the titles of staff working for the pharmaceutical industry. They change titles after specialist profiling and review, often following a merger of another company. But who dreams up nursing titles?
If I, a member of the nursing profession, am not clear about the role and responsibility invested in a title, how much more difficult will it be for other colleagues? And more importantly, for the general public? What can be expected of a nurse with a specific title - patients and carers need to have some clarity and continuity, regardless of which organisation provides their healthcare. Are we likely to see a greater array of titles as the nursing role expands and diversifies with government directives and support? The use of healthcare assistants and support workers for nursing teams will no doubt extend this trend of interesting job titles.
We need to stop and ask ourselves whether these imaginative and descriptive job titles are helping or hindering the nursing profession? Rumour tells me that the NMC are reviewing nurse titles, and I look forward to their report when it is published. Meanwhile, the editorial team here would be very keen to hear from readers on this issue. What has been the most confusing or amusing nurse title you have seen - or been?
If you have not recently browsed the situations vacant pages of leading nursing publications, do so. It's an experience that will make you smile - how far can we go to describe our skills and potential?
The NiP team would like to wish you all a happy, sunny summer to recharge your batteries - flu immunisation schedules will be upon us soon enough!