Introduction
In this paper, attention will be paid to the concept of competence in nursing. Every facility offers high-quality services and prepares professional employees to cooperate with patients at different levels. Understanding the worth of competence in practice is a critical element. Sometimes, the concepts of competence and competency are confused because the former combines skills and knowledge that can be applied as capacities to perform a task, while the latter is a process. However, many dictionaries define them as synonyms that describe the concept that plays an important role in nursing due to advancing clinical experiences (Taylor et al., 2021). This concept analysis will cover competence attributes, antecedents, consequences, and empirical referents to clarify how hospitals and their employees may develop and improve their competence in different situations.
Analysis
Definition
Competence is usually related to positive achievements in the workplace because it implies the possibility of having the necessary skills and using knowledge properly. According to the American Heritage Dictionary (2022), competence is an ability or a specific range of skills and knowledge for being adequately qualified. It means a competent person who is able to do something well at the required level. Relying on the nursing perspective, competence is a skill of a nurse to cooperate with a patient and provide effective care under certain circumstances (Cabrera & Zabalegui, 2020). In Fukada’s (2018) study, competence (or competency) is defined as a two-fold concept, and, in addition to potential abilities, it is related to motivation that proves the usefulness of the offered abilities. In general, it is correct to define the concept of competence as a capacity for developing specific behavioral characteristics and skills for nursing practice.
Purpose
The professionalism of nurses may be assessed via a variety of tests and tools. In most cases, competence is a regular ability that should be present and constantly developed by any healthcare employee. This concept can be traced back to the middle of the 20th century when an American psychologist studied motivation (Salman et al., 2020). At the same time, Chinese and Indian impacts cannot be neglected because management and leadership also depend on understanding competence in its context. Following the historical development of the chosen concept, it is possible to say that competence is widely used in nursing, health care, social sciences, and politics to evaluate the quality of the work. Therefore, the selection of the competence concept for analysis is predetermined by the intention to achieve healthcare and nursing perfection in various directions.
Use
Competence is not a thing or a process that can be chosen or postponed in nursing practice. This concept is used in many research projects in the fields of nursing, healthcare, management, and social work. It is expected that all employees obtain some knowledge, exchange their experiences, and improve their understanding of the necessary topic. Taylor et al. (2021) used this concept to explain the essence of nursing as a profession where decisions are made by experts with a specific knowledge base and clinical competencies. However, competence standards and models are applicable not only in nursing but in other business spheres where individuals should work with resources and develop tactics for sufficient work.
Attributes
Learning the attributes of competencies allows defining characteristics of the chosen concept that may be repeatedly used and developed. From a historical perspective, competence was studied as a number of personality attributes that promote high performance and motivation (Salman et al., 2020). In other words, a person should be competent while completing a task, which reveals additional attributes like knowledge, skills, and even attitudes toward the situation (Cabrera & Zabalegui, 2020; Salman et al., 2020). Fukada (2018) also adds professional characteristics and values to fulfill the competent responsibility of a healthcare employee through practice. In nursing care, competence attributes are quality care, performance, effective interactions, and following work standards. The possession of all these attributes helps a person recognize nursing tasks and complete them properly for the patient’s good.
Model Case
A model case aims at showing the application of all attributes of competence within a situation. When a nurse enters the room, her task is to assess the patient’s condition and offer appropriate care services. B. B. is a 36-year-old male patient who reports headaches, dizziness, and blurred vision during the last 48 hours. The nurse who has a Bachelor’s in Nursing begins cooperation by introducing herself and her intentions. She listens to the patient’s complaints and asks questions to complete the health history assessment. The next step is physical examination (vital signs and a focused assessment of the head), which reveals some swelling on the back of the head. The nurse understands that a neurosurgeon’s counseling is required and calls an expert.
Similar Case
A similar or borderline case is used to demonstrate how the concept can be applied, with some attributes being purposefully excluded. The patient is a 45-year-old Japanese female who presents to the emergency room with a burn on her hand. The woman does not speak English, and the nurse does not understand her language. The nurse begins physical examination and explains what she is doing to the patient. She neglects the possibility of finding an interpreter for this case or at least a person who knows Japanese. Her actions are correct, and her help is appropriate to relieve pain. However, the decision not to find a negotiator results in no trauma history from the patient.
Opposite Case
In opposite or contrary cases, competence attributes are absent intentionally or unintentionally. There is a nurse whose experience is more than 15 years at the same hospital. She knows most of the staff and prefers to delegate her responsibilities from time to time. The patient, a 46-year-old K. L., is delivered to the emergency department with the same high blood pressure complaint for the third time. The nurse does not spend much time on physical examination and communication but checks his blood pressure, gives hydralazine injection, and begins her paperwork. In this case, the nurse does not demonstrate competence in performing regular assessments and cooperating with the patient, relying on her experience and observations.
Antecedents
There are many ways to find additional insights about the attributes of competence, and one of them is learning antecedents. This characteristic illustrates the context in which the offered concept may be used or, in other words, the requirements under which competent work is possible (Salman et al., 2020). In the nursing context, competence will be promoted if a person has appropriate educational preparation and obtains enough knowledge to understand why competence is important. The level of nursing competence also depends on how well theories and responsibilities are identified to promote accountability and appropriateness of services. It is not enough for nurses to cooperate or assist patients in following their care plan. Nurses should be competent with any task, either assessing a person or supporting family members.
Consequences
When competence is implemented in nursing practice, it is important to identify and analyze consequences and find out if new ideas can be appropriate for the concept. The outcomes of competence, if it is properly applied, vary from patient safety to the possibility of increasing care standards (Taylor et al., 2021). When nurses neglect the concept of competence, the number of medical errors and misunderstandings between the staff and the patient increases. Many poor patient outcomes are reported, and the staff cannot make solid decisions. Therefore, competence is integral in nursing to see what strengthens the practice and prevents the successful completion of tasks.
Empirical Referents
Competent nurses should understand that their work can be assessed and measured, and defining empirical referents to prove the occurrence of competence is an obligatory step of concept analysis. Objective measurement of competence is rare, and many nurses address the results of self-assessments and the assessments offered by other stakeholders (Salman et al., 2020). There are many online questionnaires and surveys to evaluate personal competence in the desired field. Organizations create special inventory tools to help healthcare workers use a rating system and assess their knowledge at different periods. The level of competence may also be measured by the number of negative experiences, patients’ complaints, task execution, or achievement. In all cases, one should remember that competence assessment is always subjective.
Conclusion
In general, the analysis of the concept of competence reveals a number of crucial aspects in nursing. This choice is explained by the necessity to understand the level of professionalism among nurses. Sometimes, it seems enough to get a degree and make observations to become a good healthcare practitioner. In other cases, the process of becoming a high-quality nurse takes time and effort. However, competent nurses should meet certain standards, develop skills, and improve knowledge constantly, relying on personal characteristics, antecedents, and consequences of this concept. This analysis helps improve the quality of nursing care and achieve sufficient satisfaction levels in all nursing directions.
References
The American heritage dictionary of English language (5th ed.). (2022). Houghton Mifflin Company.
Cabrera, E., & Zabalegui, A. (2020). Nurses workforce and competencies. A challenge for health systems more than ever. Nurse Education in Practice, 48. Web.
Fukada, M. (2018). Nursing competency: Definition, structure and development. Yonago Acta Medica, 61(1), 1-7. Web.
Salman, M., Ganie, S. A., & Saleem, I. (2020). The concept of competence: A thematic review and discussion. European Journal of Training and Development. Web.
Taylor, I., Bing-Jonsson, P. C., Finnbakk, E., Wangensteen, S., Sandvik, L., & Fagerström, L. (2021). Development of clinical competence – A longitudinal survey of nurse practitioner students. BMC Nursing, 20(1). Web.