The Level of Competence of Novice Registered Nurses

In stage one the novice nurse is typically a nursing student or a nurse that has been moved to a new discipline. They are unable to predict status changes and are unaware of interventions without an experienced nurse as a guide to practice. Stage two is known as the advanced beginner; this is the stage most new nurse graduates can be found at. Their knowledge is based on the components of recurrent situations and they are unable to comprehend the entire clinical picture. This stage is still reliant on being guided in their practice by more experienced nurses. The competent nurse is at stage three and is described as being able to recognize status changes more quickly and accurately than the preceding stage. This stage is distinct in that the nurse begins to have a feeling of patient responsibility, however it is typically a feeling of being overly responsible. This stage has both exhilaration with success and tension with knowing better choices could have been made. Organization and advanced planning become key components of care at this stage. Proficiency, the fourth stage, is marked with confidence in knowledge and abilities and the nurse is able is visualize the entire picture

The Differences in Competencies Between Nurses Prepared at the Associate-degree Level Versus the Baccalaureate-degree Level.

New Registered Nurses entering into the emergency department, are lacking experience to high acuity, and very sick patients with cardiac, stroke, trauma, sepsis, and pediatric emergencies. In the last few years the shortage of nurses with experience in specialty areas has become more evident. The vacancies of nurses retiring or moving out of the facility, is creating unsafe practices with high patient ratios. Thus, forcing managers to look at the need to hire new Registered Nurse graduates into a specialty area. In addition, this new trend is changing the hiring process, forcing the hospital and specialty units to look at all candidates equally, that is, new graduates or inexperienced nurses. This new trend is looking at the required two years of experience on a medical-surgical unit, therefore, causing other challenges and potential safety risks to both the patients and the new employees, because of the to the lack of experience and a lack of a good focused orientation process into the specialty area geared towards new graduates, or inexperienced nurses.

The 30 items of the nurse suitability scale were subjected to exploratory factor analysis using SPSS version 20. Firstly, the data set for factor analysis was assessed for suitability prior to the analysis. Tabachnick and Fidell (2001) suggest that it is comfortable to have at least 300 cases for factor analysis. The variables were visually inspected to determine whether there was evidence of coefficients above .3. The correlation matrix displayed presence of coefficients over .3 and below .9 which allowed factor analysis to be utilised. Barlett’s test of sphericity (Barlett, 1954) and the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was conducted on the data to help assess the factorability of the data. The minimum value recommended

The concept of interest is nurse competence in this article. Various studies mention nursing competence in the article. For example, as per the study of Benner (1982) nurse becomes competent with about two years of experience. The nurse has to go through stages like the novice, advanced beginner, competent, proficient, and then expert. The article also mentions about nurse’s self-assessment with the assessment completed by their managers, a study of Meretoja & Leino-Kilpi’s (2003). It was to check if nurses and managers agreed on the frequency competencies (Smith, 2012). Creation of an instrument called the Nurse Competence Scale (NCS) helps assess nurse competence (Smith, 2012). It’s a questionnaire consisting of different categories. This study showed that nurses in different environments rated themselves in a different manner on the test. These are just the nurse’s perspective on competency. The patients assume that the nurses are competent based on their caring skills.

Dr. Patricia Benner novice to expert theory (1984) has states that experienced nurses has more improved skills and comprehension of nursing care through by an excellent educational background and numerous clinical experiences. Benner described the levels of nursing into 5 stages: 1. Novice, 2. Advanced Beginner, 3. Competent, 4. Proficient, 5. Expert. Novice has no actual clinical experience at all, production and performance is limited. Advanced Beginner has gained some experience from actual situations, and now exhibits a more satisfactory performance. A competent nurse has at least 2-3 years of clinical exposure, can now identify the important from the less important components, and demonstrates organizational and planning abilities. Proficient

Hence, a national competency standards for nurses was developed during the early 1990’s by the Australian Nursing and Midwifery Council. These competency standards served several functions mainly as a framework for all nurses practicing the profession (Nursing and Midwifery Board of Australia, 2010). Furthermore, in Australia, the national competency standards function as an instrument to evaluate the nurses’ conduct and aptitude as a means to maintain the registration being a health care provider (NMBA, 2010). In view of that, as a guideline, according to Dugdale and Grealish (cited in Grealish, 2012) it has been used for curriculum design, student assessment and continuing education, as well as procedural competence. Nonetheless, as stated in Burns and Poster (2008) it is a reality that there is a difference between a new registered nurse graduate’s education for practice and actual practice requirements of new registered nurses. For that reason, Ironside (2008) suggested that to safeguard client’s safety, it is critical that nurses must assume a paradigm shift from demonstrating competency to continuing competency since that according to Axley(2008), competency in nursing has a direct effect on the health and safety of all clients. Without a doubt, the wellbeing of clients receiving medical care is noticeably related to the competency of the health

Dr. Benner has categorized nursing into five levels of stages; novice, advanced beginner, competent, proficient, and expert (Petiprin, A, 2015). According to Dr. Benner’s stages of clinical competence, I view myself as in competent stage. I have been a nurse in the surgical floor for nine months, but I started as a certified nurse assistant in the same surgical floor for two years, which helped me to raise my career into a competent stage. According to Dr. Benner, “competency nurses recognize patterns and nature of clinical situation more quickly and accurately” (Petiprin, A, 2015). I believe myself that my first career certified nurse assistant helped me to become a better nurse, by providing a basic foundation for my professional nursing.

Many people think when they see nurses that they are experts in their fields, however, that is not always the case. As a matter of fact, that is rarely the case. Many factors contribute to the expertise of nurses to include their education, how they were trained, their experience and where they were trained or currently work. Coworkers also play a part in the expertise of the nurses. The level of expertise was broken down according to Benner’s (1984) five levels which include levels such as expert, proficient, competent, beginner, and novice. Becoming an experienced nurse allows for reflection and growth leading to a better outcome for patients and possibly expertise of the nurse.

Clinical training is considered as an indispensable part of professional nursing education. The evaluation of clinical competence is an integrated form of evaluation seeking to combine knowledge, understanding, problem solving, technical skills, attitudes, and ethics in evaluation (Rafiee, Moattari, Nikbakht, Kojuri, & Mousavinasab, 2014)

Healthcare sector plays a critical role as noted in many societies in the world. Both governments and non-governmental organizations have placed enormous resources to improve access and quality of healthcare. They have also equally invested in health care providers, and nursing is no exemption. Institutions, thus, train the various professionals in the health care sector and have to develop curriculum. They ensure that graduates from the different institutions are competent enough to address the requirements and duties related to their

Adequate levels of nurses who are suitably educated and equipped are needed to address the challenging quality and protection issues persistent in health care. Nursing deficiency is not only viewed as workforce issue, but also as an issue of eminence care. In the health care systems, 80% of registered nurses comprise the professions in place of 2.6 million jobs. This lays a base under which their significance and impacts on health delivery to patients is underscored. Among the common roles expected of a registered nurse is: providing patients in hospital with direct care, setting emergencies, providing care in community health arenas, home health and other places of care (Joint Commission, 2010). As indicated by (Delamaire&

It was found that 41.0% of the nurses held a certificate or diploma in nursing, while another 14.8% possessed a post-basic or advanced diploma in nursing. The percentage of nurses with a bachelor’s or master’s degree in nursing was 41.4% and 2.3%, respectively. A majority (47.2%) of the nurses were working in inpatient wards, 21% in intensive care wards (ICUs), and 7.1% in outpatient units. The percentage of nurses working in operating theaters and emergency departments was 12.1% and 2.5%, respectively. Some 51.1% of the nurses had up to 5 years’ experience of working as registered nurses. The percentage of nurses with 6– 10 years’ of nursing experience was 21.9%, while another 27.0% of them reported having more

While living in the United States there is no denying that the fact of a shortage of nurses throughout the country. The role of a nurse cannot be filled by just anyone, the nurse needs has to put in countless hours of hardwork and dedication to be able to provide safe and quality care to a patient. This fact alone is enough to make a person feel as if the career of a nurse is not for them. The purpose of this paper is to inform the reader of possible factors causing the shortage of nurses. The sections of this paper is broken up into three sections: scientific, professional research, and a position paper. There are multiple conditions that factor into the idea of why there is a shortage of nurses spanning across the United States, some of these conditions include: economic levels, retiring nurses, limited experience of newly graduated nursing students, and the demand of nurses being more than the supply that is available within America. With a large percentage of all health related services being provided by nurses, the shortage can play a role on how effective the service is being provided to the patients.

Competent nurses have been working about two to three years. They are able to recognize a situation, interpret and response to the situation more quickly and accurately. However, they are lack of efficiency and adaptability as proficient nurses are.