- Nursing Competency - Judgement, Knowledge, and Skill in Nursing Practice
A nursing competency describes skill, knowledge, or other characteristics required for nursing practice.
The Canadian Registered Nurse Exam tests the identified competencies required for entry level nursing practice.
Competencies can be categorized as behavioural or technical. A technical competency describes a technical skill. A
behavioural competency describes a certain behaviour.
Both technical and behavioural competencies are based on knowledge and may
require professional judgement and clinical decision making.
Technical nursing competencies tested on the nursing entrance test for registered nurses in Canada (Canadian Registered Nurse Exam) include:
administers and manages parenteral and enteral nutrition (e.g.TPN, nasogastric tube)
calculates medication dosage
manages drainage tubes and collection devices (e.g.chest tubes and vacuum drainages)
inserts, maintains, and removes naso-gastric tubes
practises in a manner consistent with the ethical code for Registered Nurses
articulates the nursing scope of practice to others
(eg. the client, health-care team members, the public,community leaders, politicians)
uses evidence and critical enquiry to challenge,change or support nursing practice (eg. questioning accepted practice, participating in research).
seeks appropriate assistance when unsafe workload is identified.
Examples of nursing competency statements that combine both behavioural and technical components:
collaborates with the client in identifying strategies to accommodate or modify health practices (integrating traditional food into a diabetic diet, modifying built environments,
promoting healthy choices in schools)
collaborates with other health-care providers to respond to rapidly changing complex health risks (eg SARS outbreak, Norwalk virus, antibiotic-resistant organisms, pandemic)
What does entry level mean?
The What's and the How's of Nursing Practice in Canada
A nursing competency is what the nurse does as part of nursing practice.
A nursing competency set is held by the individual and changes over time.
Nursing standards are absolute and must be maintained in all nursing practice regardless of the type of
client, years of experience, or setting in which the nursing practice takes place.
It cannot be expected that an entry level set of competencies are maintained
throughout your nursing career. Entry level competencies describe only what is expected of a nurse entering the nursing profession.
It is not expected that the entry level competencies are maintained.
Entry level competencies are identified in order
to provide a framework for education programs and licensing.
Nurse education programs are required to prepare graduates to meet entry level competencies so there
is a good chance of success on the Canadian Registered Nurse exam.
As your nursing career proceeds, a personal set of competencies is developed that
reflects the experience and area of specialization acquired through your work and continuing education.
Here is How it Works
A personal competency set is always changing.
If you never work with a client with chest tubes you will forget how to do it and you may lose that skill. You will however, gain other skills through the nature of your work and the types of
clients that you care for.
There is nothing in professional nursing practice standards that suggest you must maintain
the entry level competency set.
However, if at some time in the future you were assigned to care for patient with chest tube drainage
and your own competency set no longer included care of chest tubes, your professional nursing standards require
you to engage in only those activities in which you are competent.
Therefore in this chest tube
scenario you would have to accept the care of the patient and tell your nursing colleagues or supervisor that you
were not up to date on caring for a patient with chest tubes and that you will need some help.
You would then have to
work closely with another more experienced nurse who could help you to regain your skill at caring for a patient with
chest tubes.
Here is the breakdown of the nursing competencies tested on the Canadian Registered Nurse exam.
behavioural
61
technical
58
combination
29
To my knowledge www.registered-nurse-canada.com is the only website that classifies the
nursing competencies tested on the CRNE in this way.
This breakdown shows that the majority of competencies do have a behavioural aspect to them and clearly indicates
the importance of the behavioural aspect of nursing in Canada as opposed to the technical aspect.
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Read about the Substantially Equivalent Nursing
Competency Evaluation being used to assess competencies for internationally educated nurses.
