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Difference between a Registered Nurse and an Enrolled Nurse
Make sure to sign up to The Nurse Break quickly before reading on. Click here. It is NOT a RN versus EN situation…that was merely the title of this post. It is also not an easy comparison of apples vs apples. There is no BIG difference. Read on to learn what we mean.
If you’re thinking of pursuing a career in nursing, then understanding the difference between an Enrolled Nurse and a Registered Nurse is very important. There are various factors that differentiate the two from one another, with the primary difference being the level of education that has been completed.
However, it is important to begin with the premise that EN and RN’s work together to provide patient care, they are both healthcare professionals and are valuable members of the healthcare team.
|Complete a Diploma in Nursing at a certified TAFE or vocational institution. These courses normally take 2 years of full time study (each) to complete.
|Complete a Bachelor of Nursing. This qualification is offered at almost all universities and will take approximately 3 years of full-time study to complete.
If you have a degree already in a different field, you can study a 2 year Graduate Entry to Practice Nursing course. Such as the Monash University Masters of Nursing Practice or Bachelor of Nursing – Graduate Entry at QUT. Many universities now offer graduate entry nursing.
Many Enrolled Nurses end up transitioning to become Registered Nurses. However, many also do not and have great fulfilling careers in all areas of nursing. It is a personal choice, we are all a team, all health professionals and all work together.
What are the differences?
We asked a group of Registered Nurses and Enrolled Nurses what the differences were. This is the list we came up with.
- An enrolled nurse, while working a significant role, has less authority in a hospital.
- Registered Nurses have more career opportunities and diverse roles. Ie: Rural & Remote, Amy/Airforce/Navy Nursing, Flight Nursing/Midwifery, Humanitarian roles, clinically advanced roles ie: nurse specialist, nurse practitioner, leadership positions such as ANUM and NUM and higher up.
- Enrolled Nurses work under the supervision of a Registered Nurse (in practice, they are quite independent). For example, while an enrolled nurse will have learned how to administer and monitor medicines and intravenous therapy, they will typically not be able to create and oversee these management plans of a patient.
- Registered nurses will have more functions in the development and creation of patient management and care plans. It is the next professional stage from being an enrolled nurse, where nurses have a greater overview of all facets of the role.
- Registered Nurses will have a more in-depth knowledge of patient conditions, how to assess more comprehensively, and more critical thinking skills. The time difference in study does result in the development of more in-depth critical thinking skills and start to ask ‘WHY’ we do the things we do and draw deeper links between patient conditions and underlying pathophysiology.
- Registered Nurses should be able to look at a patient and determine not only their current but potential needs and plan appropriate care that is within their scope of practice.
The blurring of Scope of Practice
The blurring of the scope of practice does exist. Enrolled Nurses can expand their scope of practice to undertake traditionally Registered Nurse skills. This is often according to their workplaces, such as extra training and education such as suturing, more complex medications etc.
For example, some nurses in The Nurse Break Facebook Group said….(join here)
Generally speaking, it depends on what hospital/health service you work for and which state in Australia. RNs & ENs can expand their scope of practice to allow them to perform certain tasks beyond the base level of competency. For example: (RNs performing ECMO & ENs managing a PICC line).
At a basic level ENs can:
- Administer medication
- Perform basic patient care
- Perform basic wound care
- Manage IVCs.
- Hang premade IV fluids (including IVABx they have mixed)
- Be the second checker for s4, s8, bloods/ blood products.
RNs can & should be doing all of the above + (However, some EN’s in the group stated they can / are doing these things also – SO it depends on the state/employer and if you have the appropriate further training.
The following things listed under RN, can be extended practise roles for an EN but as an EN undertaking extended practise roles you are still working under the supervision of an RN.
- Handling the S8/S4 keys.
- Mixing drugs for subcutaneous/IV infusions such as syringe drivers, ketamine infusions…
- Managing blood products and transfusions
- Managing tracheostomy/laryngectomy patients
- Administering chemotherapy
- Working solo in community health settings
- Managing PEG/PEJ fed patients.
- Catheterising men and women
- Using PICCS/CVADs
- Administering warfarin & insulin.
- These are just some limited examples…
As you can tell, it really depends which clinical area you are employed and what your exployer will let you upskill to do. Your depth of knowledge will be different though as a TAFE course doesn’t have as much anatomy & physiology & pharmacology.
Where can you work as an Enrolled Nurse?
Enrolled Nurses in the group here said they have worked in:
- Clinical speciality areas such as ED, ICU, HDU, Anaesthetics, Paediatrics and so on in public and private hospitals.
- GP clinics
- Mental health public and private
- Theatres, OR, PACU
- Defence (not as Nursing Officer)
- Medical/Surgical wards
- CCU/Cardiac speciality
- Rural & Remote
Pretty much every clinical area. There will be hospital and state differences and you should consider getting a resume & cover letter review from TNB to ensure you are actually competitive, as there are not often as many EN roles.
RN’s generally get
- Better pay
- More responsibility both clinically and in leadership roles
- Better job prospects
- Opportunities for career advancements and career growth both in management and clinically
- RN’s have more opportunities to transition into managerial roles or other roles such as government departments. Become a Nurse Manager, Operations Coordinator, CEO of a Health Service, and so on…
- You can become clinical leaders such as Nurse Educators, University Lecturers & Researchers, Senior Nursing Clinicians such as Clinical Nurse Consultants, Critical Care Nurses, Nurse Practitioners and so on…
- Ability to work in speciality areas more often and more opportunities for study and research.
- More opportunities to get shifts as a casual
- More chances of getting overseas jobs
Some things to do to get a better understanding
- Ask universities and tafe’s about their courses and offers
- Ask hundreds of Registered Nurses and Enrolled nurses on a private Facebook Group called: Australian Nursing – The Nurse Break
- Watch live Q&A’s / listen to podcasts from Australian health professionals and get some inspiration from a range of nursing professionals here
- Read from EN’s and RN’s here
Should I become a Registered Nurse or an Enrolled nurse?
This is really personal choice. What I can do for you is tell you some questions that you need to ask yourself!
- Are you academically or financially in a position to study a 3-year Bachelor’s full time or 6 years part-time? If you need to enter the industry quicker, then becoming an Enrolled Nurse might be a valid option! You can also do further study to become a Registered Nurse later on once you are working.
- The Enrolled Nurse course is vocational study which is very different to the academic study required to be a Registered Nurse.
- What kind of nursing do you want to do or what options do you want to have? If your goal is to work in specialist areas to the full scope of practice you can achieve then becoming a Registered Nurse is the best option for you.
- You should also look and consider the differences in salary. A Registered Nurse salary will be higher with more career progression.
- There are many job vacancies for both Registered and Enrolled Nurses, so you shouldn’t have a problem getting a job.
- Ask other nurses! Go here
What is your view? Anything to add? Head to the Facebook page and post a question.