The Royal College of Nursing (RCN) has unveiled a revised definition of nursing, a landmark moment for nurses in the UK, which could not be more timely. In the decades since the International Council of Nurses (ICN) published its definition of nursing, nurses have adapted to contemporary medical technologies, demographic changes and evolving healthcare policies.
2002 definition
- Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people
- Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles (ICN, 2002).
2023 definition
- Nursing is a safety critical profession founded on four pillars: clinical practice, education, research, and leadership
- Registered nurses use evidence-based knowledge, professional and clinical judgement to assess, plan, implement and evaluate high-quality person-centred nursing care
- The work of registered nurses consists of many specialised and complex interventions. Their vigilance is critical to the safety of people, the prevention of avoidable harm and the management of risks regardless of the location or situation
- Compassionate leadership is central to the provision and co-ordination of nursing care and informed by its values, integrity and professional knowledge. Responsibility includes leading the integration of emotional, physical, organisational, and cognitive nursing work to meet the needs of people, organisations, systems, and populations (RCN, 2023).
Both definitions aim to describe the role and scope of nursing, but highlight different aspects of the profession.
The ICN (2002) definition is broad and inclusive, emphasising the autonomy and collaborative nature of nursing across age groups and settings. It covers the promotion of health and prevention of illness, in addition to caring for the sick and disabled. The definition identifies advocacy, research, education and participation in shaping health policy. The RCN (2023) definition organises the role around the four pillars cited above. It puts strong emphasis on evidence-based practice and professional judgement, highlights the complexity and specialisation of nursing interventions, and the importance of ‘compassionate leadership’. It stresses nurses' responsibility in managing risks and ensuring patient safety. Consequently, although the ICN definition provides a more general view of nursing that includes a variety of roles, the new version identifies the critical aspects of contemporary nursing evidence-based practices, specialised interventions and leadership roles.
Today, registered nurses are far more than the traditional caregivers many imagine. They use clinical judgement and problem-solving expertise, playing a part in co-ordinating complex health and social care systems. With a high level of autonomy within both nursing and multiprofessional teams, nurses are empowered to delegate tasks in line with the nursing Code (Nursing and Midwifery Council, 2018). Their decisions are instrumental in aiding people and their families to improve, maintain or recover health, or face a dignified end of life when recovery is not possible.
A gap of two decades in any professional field is considerable. In health care, it marks a crucial period of transformation: advancements have equipped nurses with state-of-the-art diagnostic tools and new treatment options. Concurrently, there has been a shift in patient needs, notably an increase in those with long-term conditions such as diabetes and arthritis. Nurses are therefore integral members of long-term healthcare management teams. These shifts clearly demonstrate the urgency for an updated definition that captures contemporary roles and responsibilities.
The new definition captures the multifaceted roles of nurses today. Beyond patient care, they are leaders, educators and decision-makers. They focus on holistic patient care work within interdisciplinary teams and are pivotal in applying research and evidence-based practice in clinical settings.