Maintaining clinical competency is your responsibility

Healthcare consumers expect competency from the nurses who care for them—and registered nurses (RNs) have an ethical and legal responsibility to maintain their competency. The scope of the professional nurse evolves continuously to adjust to the dynamic healthcare landscape, society’s changing needs, the political climate, and the expanding knowledge base of theory and scientific domains.

Competencies defined

The American Nurses Association (ANA) states that “assurance of competence is the responsibility of the profession, individual nurses, professional organizations, credentialing and certification entities, regulatory agencies, employers, and other key stakeholders.” ANA has 17 standards of practice and professional performance; each standard has two parts—a description of the standard itself and multiple competency statements for that standard.

Standards reflect philosophical values; they remain stable.

Competency statements, on the other hand, are revised as needed to incorporate advances in scientific knowledge and expectations for nursing practice. To demonstrate competency, the RN must meet all competencies for the given standard.

A general scope and standards apply to all nurses; additional scopes and standards apply to nurses in specialties. General standards are presented in nursing school; novice nurses should be establishing competency in these areas as they enter practice.

All nurses should be familiar with the scope and standards that drive their clinical practice. You’re responsible for ensuring that you meet the competencies for each standard. To find the standards, see Nursing: Scope and Standards of Practice (3rd edition) or your specialty organization’s website.


Maintaining your competency

You can maintain and enhance your competency through education, professional organizations, networking, conferences, webinars, continuing nursing education (CNE) modules, and certification.

Continue your formal education to give yourself new perspectives and keep up-to-date on society’s changing healthcare needs, the expanding knowledge base, and political currents affecting health care. The 2011 Institute of Medicine’s report The Future of Nursing: Leading Change, Advancing Health recommends that 80% of practicing nurses should have a bachelor’s of science degree in nursing by 2020.

Belong to a professional organization to stay current on changes that affect your practice. ANA’s website also offers valuable information to keep you informed of these changes.

Attend conferences and meetings where you can network with other nurses, learn from researchers, gain new information to take back to your workplace, and learn about new procedures your employer can implement to improve patient care.

Complete webinar courses and CNE modules. But make sure the information presented comes from a reputable source. For instance, Sigma Theta Tau (International Honor Society of Nursing) offers webinar courses that members can access for free. Another reputable website is that of the Institute for Healthcare Improvement’s Open School. It offers free courses in five categories that dovetail with competencies from the American Organization of Nurse Executives (AONE) and Quality and Safety Education for Nurses (QSEN). (See AONE and QSEN competencies.)

Read peer-reviewed nursing journals and take the CNEs they offer.

Become certified in your practice area. The American Nurses Credentialing Center (ANCC) states that its certification program “enables nurses to demonstrate their specialty expertise and validate their knowledge to employers and patients. Through targeted exams that incorporate the latest nursing-practice standards, ANCC certification empowers nurses with pride and professional satisfaction.” If you’re a specialty nurse, being certified in that specialty shows the public you’re competent and committed to lifelong learning.

Nurses at all levels should be actively involved in determining the competencies they need to stay current. Remember—you have an ethical and legal responsibility to the public, yourself, and the nursing profession to provide safe, timely, efficient, effective, equitable, and patient-centered care.

Margaret Strong is an associate professor of nursing at Baptist College of Health Sciences in Memphis, Tennessee.

Selected references

American Nurses Association. Nursing: Scope and Standards of Practice. 3rd edition. Silver Spring, MD: Nursebooks.org; 2015.

American Nurses Association. Nursing’s Social Policy Statement: The Essence of the Profession. Silver Spring, MD: Nursebooks.org; 2010.

American Nurses Credentialing Center. About ANCC. (n.d.)

American Organization of Nurse Executives. AONE guiding principles for the role of the nurse in future patient care delivery. 2010.

Institute for Healthcare Improvement. IHI Open School. (n.d.)

Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2011.

Institute of Medicine. Health Professions Education: A Bridge to Quality. Washington, DC: The National Academies Press; 2003.

QSEN Institute. QSEN: Quality and Safety Education for Nurses.

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