The Enrolled Nurse (EN) role started in 1943 due to a period of staff shortages and financial pressures, the great depression, in the 1930’s that led to more unregulated nursing assistants being employed. (RCN) In 1986 the UKCC (now NMC) said that the role was no longer fit for purpose and training for ENs was phased out.
Many recent reports have criticised nurses for not getting fundamental care right and even Prime Minister David Cameron identified recently that the standards of nursing need to be raised. So is there a place for EN’s in modern nursing? Do we need a two tier nursing system ? Should the NMC use part two of the register to re- introduce the EN? Or is the role of the practical EN now defunct in our highly educated nursing workforce?
Thanks goes to @cherylwilson2 for this discussion suggestion
Thanks goes to @cherylwilson2 for this discussion suggestion
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Below are some links to some background reading – please feel free to add to this, via the comment box, if you find something useful to share.
State Enrolled Nursing - RCN
Second level registered nurses scope of practice - NMC
Different grades of nurses should be re-introduced to improve care - Nursing Times
Two levels of practice: meeting professional or workforce needs - Nursing Standard
Second level registered nurses scope of practice - NMC
Different grades of nurses should be re-introduced to improve care - Nursing Times
Two levels of practice: meeting professional or workforce needs - Nursing Standard
Summary by Teresa Chinn RN
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Post Chat Summary
View the Nursing Times blog for this chat
Summary by Teresa Chinn RN
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Chat Transcript (via storify.com)
Post Chat Summary
View the Nursing Times blog for this chat
“Should we bring back the EN?” was a discussion subject suggested by @cherylwilson2 and it is a subject that has been touched upon in a few NurChat discussions, but never really discussed in full. The chat started by asking if anyone remembered the role of the EN? There were a few nurses who had trained as ENs and had either converted or were still on Part 2 of the register. Many participants remembered ENs as having good hands on skills and being experienced and committed.
One participant suggested that it was a sad day for nursing when the EN went and many agreed it was pointed out that RNs delegate fundamental care often to unskilled/ untrained HCAs and ENs were needed to bridge that gap. Another participant mentioned that we should not bring back the EN as this would lead to a 2 tier system and patients often get confused over who is who with RNs and HCAs.
The role of the Assistant Practitioner was discussed and one of the participants was an AP. It was discussed that some trusts are bridging the gap between RN and HCA with the use of APs. However it was pointed out that APs are unregulated. Why AP’s cant be registered was discussed and most chatters agreed that there would be room on Part 2 of the register. Some stated that we do need to give new professionals a means to register.
Some NurChatters were unsure of what the role of the EN was so this was discussed: NurChatters stated that the EN was a hands on nurse who was not trained in management but for good hands on care. It was explained that there were several routes to be coming an EN – some had 2 years of pupil training, some had failed their RN final exams and some were long service Nursing Auxiliaries.
Finaly NurChat asked if we should bring back ENs? Answers ranged from a resounding yes to we have to move with the times and maybe the AP role could be adapted and put on Part 2 of the register.
Summary by Teresa Chinn RN
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Chat Transcript (via storify.com)
1 comment:
I was Enrolled Nurse in the UK for 14 years inclusive of my training at Manchester Royal Infirmary. I had a lot of experience including from my various posts. Ranging from Neurological , Gastro- Enterological, Community . Moved to Yorkshire did Agency work in the Leeds central hospitals. Then worked at Pinderfields General Hospital and finally at Pontefract. In these hospitalsI gained experience medicine, CCU and some ICU.
I then went to live in Western Australia,who still train Enrolled Nurses and have worked as a Clinical Community Nurse for the past 23 years.
I would of liked to come back to the UK and worked but now the EN has been phased out I would not be able to get a job.
I probably should of done the conversion course before I left. I must admit I liked being a practical bedside nurse and the patients were looked after well. I do think the EN had it tough though . One minute you were capable of doing a certain task, then they were not , again it boiled down to finance. It also allowed the RN to concentrate on the management side of the job. I think the EN did have a role to play under the supervision of the RN and a valuable one . I never went into nursing to be a pen pusher or a IT specialist. I went in to be a bedside nurse. I know we have to evolve as but most of my time is spent on documentation rather than direct care and the shear volume of patients who require visits makes me feel the patients deserve better. Lorraine Emsley
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