Role expectations of different levels of nurse on graduation: A mixed methods approach

Aim To explore graduating registered and enrolled nurses’ perceptions of what roles they were educationally prepared for and what their roles would include. Background Defining nursing roles can be challenging, with studies from many countries identifying role confusion and overlap as issues with employing two levels of nurse. Australia has two levels of nurse registered for entry to practice; registered and enrolled nurses. Recent changes to increase the educational level of enrolled nurses have resulted in increasing similarities in skills and knowledge being taught to these and degree-prepared registered nurses, causing role ambiguity and confusion between the two levels of nurse. Design Mixed methods research. Method The research utilised a cross-sectional survey of completing nursing students (n = 57) from both levels of nursing programme in Australia in 2012. Analysis involved Mann–Whitney U tests and content analysis. Results Similarities were expected by students between the levels of nurse in basic patient care skills. Registered nurse graduates were expected to care for patients of higher acuity and take on increased levels of responsibility. Conclusion Despite similarities in graduate role expectations, differences remain in the expected level of practice with graduate registered nurses expected to be prepared to care for patients of higher acuity and undertake higher levels of responsibility than graduate enrolled nurses. Nurse managers need to take into account the differences in educational preparation and role expectations when allocating patients for nursing care and determining skill mix for patient care.