Competency in Entry-Level Nurses Competency In Entry Level Nurses

Competency in entry-level nurses: Implications for practice

Given the responsibilities shouldered by nurses, it is essential that all new nurses are competent to practice their profession when they graduate. The increased emphasis upon evidence-based practice in healthcare means that integrating this component of modern medicine into the framework of nursing education is required to produce graduates ready to face the future. Evidence-based practice is the assumption that "to affect better patient outcomes, new knowledge must be transformed into clinically useful forms, effectively implemented across the entire care team within a systems context, and measured in terms of meaningful impact on performance and health outcomes" (Stevens 2013). Evidence-based practice means bridging the gap between academics and actual research. It is designed to "reduce illogical variation in care, which is known to produce unpredictable health outcomes" (Stevens 2013).

As well as being technically competent, nurses must be able to be strong critical thinkers. They must be able to evaluate different alternatives and select the best possible option. There is often no clear solution: rather the nurse must weigh a variety of alternatives. "The Health Professions Education report (IOM, 2003) declared that current educational programs do not adequately prepare nurses, physicians, pharmacists or other health professionals to provide the highest quality and safest health care possible. The conclusion was that education for all health professions were in need of 'a major overhaul' to prepare health professions with new skills to assume new roles" (Stevens 2013). Many healthcare professionals struggle to operate as part of an interdisciplinary team and put the principles of evidence-based research into action.

The report suggested that five core competencies become integrated into every future healthcare professional's education, including: providing patient-centered care; the collaborative and communication skills to work in an interdisciplinary team; the...

None of these skills are traditionally associated with nursing education specifically -- they are not nursing-specific technical competencies but imply a more general education in the worldview required by healthcare professionals in the future. They reflect the fact that nurses will be given more and more autonomy in making vital decisions that could have a permanent impact on their patients' lives. As well as making suggestions to change the ways in which nurses think about and perform the skills related to their practice, a measurement instrument to assess the nurses' ability to perform these techniques, the ACE EBP Readiness Inventory (ACE-ERI) was also developed to enable institutions to better measure such competencies and behaviors (Stevens 2013).
Nursing education must become more uniform as well as more comprehensive in its overview. "Programs for basic preparation of health professionals were to undergo curriculum revision in order to focus on evidence-based quality improvement processes. Also, professional development programs would need to become widely available to update skills of those professionals who were already in practice" (Stevens 2013). Without changing the way that education is provided to nurses, who are on the front lines of patient care, substantive improvements in quality and efficiency of care cannot be realized.

Nursing has thus grown more 'patient-centric' in its emphasis on quality control, adopting much of the language and standard assumptions commonly used in business, not just healthcare. Nurses are increasingly asked to make decisions about what works and what does not work and graduates must be prepared for this level of autonomy. Greater demands are also placed upon nurses passing through the educational system because of the increased demand for places at nursing schools. Despite the nursing shortage, entering into the profession remains difficult because of a lack of faculty to teach all would-be candidates. According to Holmes (2011), the passage of the Affordable Care Act and the heightened standards for entry into the nursing profession provide a unique opportunity for nursing…