One thing I have learned over many years is that the best way to diminish a group of people is to first render them invisible. After all, if no one knows you exist then no one will miss you when you are gone. This can be so clearly seen in aged care.
Last week I was talking to a newly appointed person working in an aged care facility. Her new position title was that of ‘care coordinator’.
“Are you a nurse?” I asked, as I knew that this organisation lacked a registered nurse.
“Yes,” she replied.
“Are you registered or enrolled?”
“Registered,” she said.
“Are you required to be a registered nurse to hold this position?”
“Yes,” was the answer.
Why, then, was she given the title of care coordinator?
I also asked the same question of the ‘team leaders’ in the facility. It turned out they were enrolled nurses. So I guessed that all the remaining staff were personal care assistants – except that some of them turned out to be kitchen staff.
They all dress the same and no one wears a badge, so it is difficult to tell the difference. Indeed, so successfully has the identity of ‘nurse’ been erased from these institutions it is really unclear who is clinically in charge and what their professional status actually is. There seems to be a blurring of roles between the professionals and non-professionals.
The word ‘nurse’ has even been erased from the institution’s name – what used to be called a ‘nursing home’ is now a ‘residential aged care facility’.
So has anything else changed? Well… for one, it would appear that the acuity of the older adults in the residential aged care facility is higher than ever and there is no shortage of complex health issues that clearly require advanced professional nursing oversight from specialists in gerontic nursing care. Don’t be fooled by those who say that ‘care’ in this setting is not nursing care.
Yet not a nurse practitioner in sight.
Now back when I became a nurse it was very clear for all to see who was the senior nurse (not the ‘care coordinator’) in charge, who was the registered nurse, who was the enrolled nurse – and who were not.
The sisters wore navy blue, the staff nurses wore purple and the newly qualified nurses wore lavender. The enrolled nurses also wore lavender, but with a very different style of dress. The kitchen staff looked completely and unmistakably different. This was important to the patients and their relatives, who very quickly switched on to who was in charge and who was who. Advice would be sought from the best source. It also imbued a confidence that there was a hierarchy of knowledge and skill present in the unit.
So I asked the care coordinator, “What do you call the pharmacist? Is she a medicine provider?”
“No,” was the reply. “She’s a pharmacist.”
“What about the doctor? Do you call her a medical coordinator?”
“No, she’s called the doctor.”
“Well, what about the podiatrist? Is he called the foot carer?”
“No, he’s called the podiatrist.”
Hmmm … so it appears it is okay to be known by your profession unless you are a nurse.
As I said at the start, I have learned over my many years that one way to diminish a group of people is to first render them invisible. After all, if you never really existed – at least no one knew you did – then no one would miss you.
This is why we must all ensure that the word ‘nurse’ is never diminished and always appears somewhere in your title. After all, you worked hard to achieve this qualification and it is a title that is protected by law. The qualification you spent years acquiring puts you in the rank of an elite, highly-respected group of health professionals.
Therefore it is time to regain our visibility. Walk proud as a nurse and do not let your working title undermine who you are.
Educated as a registered nurse at the Royal London Hospital, England, Cynthea Wellings migrated to Australia in 1981. Her nursing experience, both in England and Australia, involved working in community and general hospital settings, as well as a short period in mental health nursing. She has co-authored several books including ‘Why The World Needs Nurses,’ a book that explored the importance of nurses outside of their direct care role. Cynthea is an entrepreneur who founded Ausmed Education in 1987 - a highly successful company - where she remains the present day CEO. In 2014, Cynthea was a Winner of Australia's ‘100 Women of Influence’ by The Australian Financial Review and Westpac Bank.