Registered Nurses vs Enrolled Nurses: Which One Does Your Facility Need?
In the dynamic environment of healthcare, having the right mix of clinical professionals is critical. Facilities must often choose between hiring Registered Nurses (RNs) and Enrolled Nurses (ENs) based on the level of care required, regulatory compliance and budgetary considerations. Each nursing role brings unique strengths to the healthcare setting. Understanding their qualifications, responsibilities and ideal placement within a facility is essential for creating an effective staffing strategy. In this guide, we break down the roles of registered nurses vs enrolled nurses to help you determine which one your facility needs and how to build a team that balances skill, cost, and quality care.
Understanding the core roles
What is a Registered Nurse (RN)?
A Registered Nurse is a highly trained healthcare professional licensed to provide a wide range of medical services. Registered Nurses typically complete a four-year degree (Bachelor of Nursing Science) and pass national licensing exams.
Key responsibilities of a registered nurse
- Patient assessments and care planning
- Administration of complex medications and treatments
- Supervising Enrolled Nurses and other healthcare staff
- Leading emergency responses and clinical decision-making
- Collaborating with physicians for integrated care
Registered Nurses are critical in high-stakes environments such as ICUs, emergency departments, surgical theatres and specialist clinics.
What is an Enrolled Nurse (EN)?
An Enrolled Nurse usually completes a two-year diploma in nursing and registers with the South African Nursing Council (SANC). Enrolled Nurses work under the supervision of Registered Nurses and focus on delivering practical patient care.
Key responsibilities of an Enrolled Nurse
- Basic patient care (feeding, bathing, monitoring vitals)
- Wound care and dressing changes
- Medication administration (within the scope of practice)
- Assisting with mobility and rehabilitation
- Supporting RNs in daily clinical duties
Enrolled Nurses are ideal for general wards, elder care and facilities where supportive nursing services are crucial but less complex.
When to hire a Registered Nurse
Hiring a Registered Nurse (RN) is essential when your facility demands a high level of clinical expertise, decision-making autonomy and leadership. Below are the scenarios where a Registered Nurse is the best choice:
Managing critical or acute care patients
RNs possess in-depth medical knowledge and clinical training, making them indispensable in intensive care units, trauma centers, emergency rooms and surgical recovery wards. Their ability to react swiftly in emergencies, make independent assessments and implement urgent interventions can make a life-saving difference.
Developing and managing patient care plans
One of the hallmarks of an RN’s role is their ability to create comprehensive care strategies tailored to each patient. This includes evaluating patient conditions, coordinating multidisciplinary input, adjusting treatment protocols and ensuring the quality of care meets regulatory and professional standards.
Fulfilling clinical leadership roles
RNs often lead care teams, supervising Enrolled Nurses, care assistants and sometimes even other healthcare personnel. Their leadership ensures that protocols are followed, staff members are supported, and patient care is cohesive and efficient.
Administering complex medication regimens
RNs are qualified to handle advanced pharmacological responsibilities, such as administering intravenous therapies, high-risk medications, and titrated drugs. This is particularly critical in specialized units where patients require precision dosing and monitoring.
Meeting legal and accreditation standards
Regulatory bodies often mandate specific nurse-to-patient ratios and skill mixes in healthcare settings. Employing RNs helps facilities meet these standards, especially during inspections or when applying for accreditation. Having a sufficient number of RNs can also reduce legal liability and boost your institution’s credibility.
In summary, Registered Nurses are the backbone of high-quality clinical care. Their education, scope of practice and experience, position them as irreplaceable assets in facilities aiming to provide comprehensive, compliant and responsive patient services.
When to Hire an Enrolled Nurse
Hiring an Enrolled Nurse (EN) can be a strategic advantage for facilities that require consistent, compassionate care without the cost or complexity of employing a full roster of Registered Nurses. Here’s when hiring an Enrolled Nurse is the right move:
Delivering routine patient care
Enrolled Nurses are ideal for providing daily support such as bathing, feeding, dressing and assisting with hygiene. These tasks, though basic, are fundamental to patient comfort and recovery.
Supporting long-term and care settings
In environments like nursing homes, rehabilitation centers or chronic care wards, ENs offer steady and familiar care that promotes trust and emotional well-being in long-term patients.
Freeing Up RNs for critical tasks
ENs can handle routine nursing duties, allowing RNs to focus on complex patient cases and administrative responsibilities. This balance enhances efficiency and ensures critical care resources are allocated appropriately.
Reducing staffing costs without compromising quality
While ENs operate under the supervision of RNs, they can manage a significant portion of the patient workload. Their inclusion helps maintain high care standards at a lower cost, a crucial factor for facilities managing tight budgets.
Maintaining staff-to-patient ratios
Hiring more ENs improves the overall staff-to-patient ratio, ensuring each patient receives timely attention, which can reduce incidents of neglect and enhance satisfaction.
In conclusion, Enrolled Nurses bring practical, cost-effective and compassionate care to the table. Their presence is invaluable in environments where patient interaction, daily monitoring, and emotional support are as critical as medical interventions.
How to Build the Ideal Nurse Staffing Mix
Choosing between Registered Nurses vs Enrolled Nurses doesn’t always mean picking one over the other. In most cases, the right approach is blending both roles effectively.
Tips for an optimized nurse staffing strategy
- Assess patient acuity levels: High-dependency units require more RNs, while rehabilitation wards can function well with a mix.
- Create layered teams: Pair RNs with ENs to ensure both critical oversight and practical support are available at all times.
- Use data and metrics: Monitor patient outcomes, staff workload and feedback to adjust your staffing model.
- Train and upskill ENs: Ongoing education enhances the value ENs bring, especially in evolving clinical settings.
- Partner with expert recruiters: MASA offers customized staffing solutions tailored to your facility’s unique challenges.
By evaluating your needs with precision, you can achieve both clinical excellence and cost-efficiency.
Strategic staffing for superior patient outcomes
Selecting between Registered Nurses vs Enrolled Nurses is a pivotal decision that affects your facility’s overall performance and the quality of care delivered. Ultimately, the most successful facilities are those that create a well-structured, collaborative nursing team, one that draws on the distinct capabilities of both RNs and ENs. By aligning your staffing choices with your operational goals, patient needs, and regulatory requirements, you lay the foundation for excellence in care.
For tailored nurse staffing solutions that fit your unique needs, partner with MASA. Visit MASA’s homepage today and let us help you build a high-performing healthcare workforce that drives results and delivers exceptional patient experiences.
