Defining
nursing
Members of the Steering Group
Project Leader:
Contents
Professor Dame June Clark DBE FRCN (RCN Past President) Introduction 1
Steering Group: A definition of nursing 2
Sylvia Denton OBE FRCN (RCN President)
Jackie Burns (Council Member,Chair RCN North-West Board) Why ‘defining nursing’ has become an issue 4
Diane Rawstorne (Vice-Chair RCN Council) What others have said 6
Eirlys Warrington (Council Member,Chair RCN Welsh Board)
How the RCN definition of nursing
RCN Staff Support: was developed 10
Professor Alison Kitson FRCN(Executive Director, Nursing)
Colin Beacock (Nurse Adviser) Defining nursing illustration 14
Lynda Kenison (Executive Assistant) Conclusion 15
Cherill Scott (Research Fellow, RCNI)
Jasmine Belgrave (Secretary) References 15
Research Assistant: Glossary 17
Andrew Salmon, RCN Member Appendix 1.
Andrew Salmon became a member of the Defining Survey of members of the International
Nursing Workgroup in April 2002 when he took on the role Council of Nurses 19
of Research Assistant, in a voluntary capacity. Appendix 2.
Thinking ahead: key issues for the
Tragically, after a short illness,Andrew Salmon died on 2
definition of nursing in the UK 20
February 2003.Andrew's professionalism and friendship
were greatly valued by the other members of the
workgroup. Thanks to Andrew's skills, vision and
determination, the values of today's nurses have been
successfully integrated into our report.Andrew Salmon
made an enormous contribution to our work. He will be
fondly remembered and greatly missed by us all.
Acknowledgements
The Steering Group acknowledges the contribution of all
those – RCN members and others – who have participated
in the Defining Nursing project and have contributed to
this document.We acknowledge in particular the seminal
work undertaken in this field by the American Nurses
Association, the Canadian Nurses Association, and the
Queensland Nursing Council (Australia) from which we
have drawn heavily in this document.
Further information
To obtain a summary copy of Defining Nursing you can
call RCN Direct on 0845 772 6100 and quote publication
code 001 983 or you can down load a copy from the RCN
website at www.rcn.org.uk
,1
Introduction
This document is written for nurses and others to help implicit, sometimes explicit, of codes of ethics,
them to describe what nursing is. It incorporates a specifications of the scope of nursing practice, and
definition of nursing that can be used in developing educational curricula. Most countries have a legal
policy and legislation, determining skill-mix, and definition of the title ‘nurse’ and some also have a legal
resource management. Defining Nursing describes why definition of ‘nursing’. In the UK there is no legal
and how this definition was developed, and explains its definition of ‘nursing’ but ‘registered nursing care’ has
key concepts. It is published as a policy statement by the been defined by the Health and Social Care Act 2001 in
Royal College of Nursing, the professional association such a way that it can be distinguished from ‘social care’
that acts as the collective voice of nursing in the UK. or ‘personal care’ for the purpose of defining
responsibility for its provision and eligibility for
The document has been prepared by a small steering funding. This legislative definition, however, does not
group and incorporates the results of wide consultation relate in any way to professional definitions or to
and participation by RCN members and others.A specifications of the nurse’s scope of practice.
review of published literature both from the UK and
from other countries was carried out, and a survey was Definitions can help to put key concepts into words, but
undertaken of all the members of the International a definition of nursing, however sophisticated, cannot
Council of Nurses to identify definitions of nursing that be expected to overcome all of the misunderstandings
have been developed in other countries. To ensure that and stereotypes of nursing that exist.Although it is a
the statement reflects the views of British nurses, and in useful tool, its usefulness, like that of any tool, depends
particular RCN members, a Values Clarification on the way it is used.A definition cannot alone
Exercise1 was undertaken, the findings of which were accomplish what only political processes can achieve.
used as a framework for developing the definition.A For example, a definition alone cannot determine the
draft document was the subject of a web-based relationships between nurses and patients, nurses and
consultation, and this final version has been amended to other health professionals, or between nursing and the
take account of the responses received. agencies that determine how health care is to be
delivered.
Definitions of nursing, like nursing itself, are dynamic;
nursing is constantly evolving to meet new needs and The RCN expects that nurses will be able to use this
take account of new knowledge. This document is only a document to:
beginning. Later in 2003 the RCN will undertake a ✦ describe nursing to people who do not understand it
survey, based on the work of the Queensland Nursing
Council2, to validate the document and the definition. ✦ clarify their role in the multidisciplinary health care
team
The uses and limitations of definitions ✦ influence the policy agenda at local and national
In 1999 the UKCC reported that it was sceptical about level
the usefulness of trying to arrive at a definition of ✦ develop educational curricula
nursing and concluded that:
✦ identify areas where research is needed to
“a definition of nursing would be too restrictive for the strengthen the knowledge base of nursing
profession.” 3 ✦ inform decisions about whether and how nursing
In practice, however, some specification is necessary for work should be delegated to other personnel
purposes such as the formulation of policy, the ✦ support negotiations at local and national level on
specification of services, and the development of issues such as nurse staffing, skill mix and nurses’
educational curricula.As Lang has pointed out: pay.
“If we cannot name it, we cannot control it, finance it,
research it, teach it, or put it into public policy.” 4
Different kinds of definitions are needed for different
purposes. Definitions of nursing are a part, sometimes
1
, Defining nursing
1 2
A definition of nursing
A word about words The definition of nursing that is presented in this
We have tried wherever possible to use simple language document is expressed in the form of a core supported
and to avoid jargon. However, some concepts require the by six defining characteristics (see Glossary). It is
use of technical terms with which some readers may be important to recognise that nursing is the totality: while
unfamiliar.We have defined these, and other contested some parts of the definition are shared with other
or ambiguous terms, in the Glossary on page 17. Some health care professions, the uniqueness of nursing lies
words have broader meanings than their most common in their combination. The definition takes account of the
usage sometimes suggests. For example, although there great diversity of nursing, which includes the care of
are many definitions of the word health, our use of the people who are healthy as well as those who are sick,
term always includes mental as well as physical health - and of groups of people as well as individuals. The
similarly we use the terms ‘diagnosis’,‘prescription’, and definition expresses the common core of nursing which
‘treatment’ in their generic sense which is not limited to remains constant.
medicine.
In the UK the family of nursing includes nurses,
midwives and health visitors. Since the Royal College of
Nursing includes all three groups among its members,
in this document the word ‘nursing’ includes the work of
all three.
The recipients of nursing services include individuals,
families and communities, and are called ‘patients’,
‘clients’,‘service users’,‘customers’ or ‘consumers’. These
terms are not synonymous, however, because the
relationship between provider and recipient is different
in each case. In this document we use, wherever
possible, the inclusive term ‘people’.Where this is not
appropriate we use the term ‘patient’.
2
nursing
Members of the Steering Group
Project Leader:
Contents
Professor Dame June Clark DBE FRCN (RCN Past President) Introduction 1
Steering Group: A definition of nursing 2
Sylvia Denton OBE FRCN (RCN President)
Jackie Burns (Council Member,Chair RCN North-West Board) Why ‘defining nursing’ has become an issue 4
Diane Rawstorne (Vice-Chair RCN Council) What others have said 6
Eirlys Warrington (Council Member,Chair RCN Welsh Board)
How the RCN definition of nursing
RCN Staff Support: was developed 10
Professor Alison Kitson FRCN(Executive Director, Nursing)
Colin Beacock (Nurse Adviser) Defining nursing illustration 14
Lynda Kenison (Executive Assistant) Conclusion 15
Cherill Scott (Research Fellow, RCNI)
Jasmine Belgrave (Secretary) References 15
Research Assistant: Glossary 17
Andrew Salmon, RCN Member Appendix 1.
Andrew Salmon became a member of the Defining Survey of members of the International
Nursing Workgroup in April 2002 when he took on the role Council of Nurses 19
of Research Assistant, in a voluntary capacity. Appendix 2.
Thinking ahead: key issues for the
Tragically, after a short illness,Andrew Salmon died on 2
definition of nursing in the UK 20
February 2003.Andrew's professionalism and friendship
were greatly valued by the other members of the
workgroup. Thanks to Andrew's skills, vision and
determination, the values of today's nurses have been
successfully integrated into our report.Andrew Salmon
made an enormous contribution to our work. He will be
fondly remembered and greatly missed by us all.
Acknowledgements
The Steering Group acknowledges the contribution of all
those – RCN members and others – who have participated
in the Defining Nursing project and have contributed to
this document.We acknowledge in particular the seminal
work undertaken in this field by the American Nurses
Association, the Canadian Nurses Association, and the
Queensland Nursing Council (Australia) from which we
have drawn heavily in this document.
Further information
To obtain a summary copy of Defining Nursing you can
call RCN Direct on 0845 772 6100 and quote publication
code 001 983 or you can down load a copy from the RCN
website at www.rcn.org.uk
,1
Introduction
This document is written for nurses and others to help implicit, sometimes explicit, of codes of ethics,
them to describe what nursing is. It incorporates a specifications of the scope of nursing practice, and
definition of nursing that can be used in developing educational curricula. Most countries have a legal
policy and legislation, determining skill-mix, and definition of the title ‘nurse’ and some also have a legal
resource management. Defining Nursing describes why definition of ‘nursing’. In the UK there is no legal
and how this definition was developed, and explains its definition of ‘nursing’ but ‘registered nursing care’ has
key concepts. It is published as a policy statement by the been defined by the Health and Social Care Act 2001 in
Royal College of Nursing, the professional association such a way that it can be distinguished from ‘social care’
that acts as the collective voice of nursing in the UK. or ‘personal care’ for the purpose of defining
responsibility for its provision and eligibility for
The document has been prepared by a small steering funding. This legislative definition, however, does not
group and incorporates the results of wide consultation relate in any way to professional definitions or to
and participation by RCN members and others.A specifications of the nurse’s scope of practice.
review of published literature both from the UK and
from other countries was carried out, and a survey was Definitions can help to put key concepts into words, but
undertaken of all the members of the International a definition of nursing, however sophisticated, cannot
Council of Nurses to identify definitions of nursing that be expected to overcome all of the misunderstandings
have been developed in other countries. To ensure that and stereotypes of nursing that exist.Although it is a
the statement reflects the views of British nurses, and in useful tool, its usefulness, like that of any tool, depends
particular RCN members, a Values Clarification on the way it is used.A definition cannot alone
Exercise1 was undertaken, the findings of which were accomplish what only political processes can achieve.
used as a framework for developing the definition.A For example, a definition alone cannot determine the
draft document was the subject of a web-based relationships between nurses and patients, nurses and
consultation, and this final version has been amended to other health professionals, or between nursing and the
take account of the responses received. agencies that determine how health care is to be
delivered.
Definitions of nursing, like nursing itself, are dynamic;
nursing is constantly evolving to meet new needs and The RCN expects that nurses will be able to use this
take account of new knowledge. This document is only a document to:
beginning. Later in 2003 the RCN will undertake a ✦ describe nursing to people who do not understand it
survey, based on the work of the Queensland Nursing
Council2, to validate the document and the definition. ✦ clarify their role in the multidisciplinary health care
team
The uses and limitations of definitions ✦ influence the policy agenda at local and national
In 1999 the UKCC reported that it was sceptical about level
the usefulness of trying to arrive at a definition of ✦ develop educational curricula
nursing and concluded that:
✦ identify areas where research is needed to
“a definition of nursing would be too restrictive for the strengthen the knowledge base of nursing
profession.” 3 ✦ inform decisions about whether and how nursing
In practice, however, some specification is necessary for work should be delegated to other personnel
purposes such as the formulation of policy, the ✦ support negotiations at local and national level on
specification of services, and the development of issues such as nurse staffing, skill mix and nurses’
educational curricula.As Lang has pointed out: pay.
“If we cannot name it, we cannot control it, finance it,
research it, teach it, or put it into public policy.” 4
Different kinds of definitions are needed for different
purposes. Definitions of nursing are a part, sometimes
1
, Defining nursing
1 2
A definition of nursing
A word about words The definition of nursing that is presented in this
We have tried wherever possible to use simple language document is expressed in the form of a core supported
and to avoid jargon. However, some concepts require the by six defining characteristics (see Glossary). It is
use of technical terms with which some readers may be important to recognise that nursing is the totality: while
unfamiliar.We have defined these, and other contested some parts of the definition are shared with other
or ambiguous terms, in the Glossary on page 17. Some health care professions, the uniqueness of nursing lies
words have broader meanings than their most common in their combination. The definition takes account of the
usage sometimes suggests. For example, although there great diversity of nursing, which includes the care of
are many definitions of the word health, our use of the people who are healthy as well as those who are sick,
term always includes mental as well as physical health - and of groups of people as well as individuals. The
similarly we use the terms ‘diagnosis’,‘prescription’, and definition expresses the common core of nursing which
‘treatment’ in their generic sense which is not limited to remains constant.
medicine.
In the UK the family of nursing includes nurses,
midwives and health visitors. Since the Royal College of
Nursing includes all three groups among its members,
in this document the word ‘nursing’ includes the work of
all three.
The recipients of nursing services include individuals,
families and communities, and are called ‘patients’,
‘clients’,‘service users’,‘customers’ or ‘consumers’. These
terms are not synonymous, however, because the
relationship between provider and recipient is different
in each case. In this document we use, wherever
possible, the inclusive term ‘people’.Where this is not
appropriate we use the term ‘patient’.
2
