The RN is responsible for the excellent delivery of care to a variety of patients including; pediatric, general surgical, general medical, stroke, orthopedics, and urology. Working within the model of “Safe Patient Family Centered Care”, the RN collaborates with the Health Care team to develop a plan of care, monitor the effectiveness of that plan, and meet the patient and families’ needs. The RN works under the direction of the designated leadership team.
Essential Job Responsibilities/Core Competencies
Nursing expertise and clinical knowledge develop over time and are acquired through experience and exposure to different practice situations. Nurses must utilize multiple ways of thinking in order to cultivate the essential skills of clinical reasoning, critical thinking and clinical judgment. These skills will continue to develop as they progress through the stages of a career on their journey from novice to expert. Competence in these areas develops over a continuum and can be measured throughout each of these stages. The evaluator considers the expected stage of competency when rating the degree to which the nurse is performing.
Stage 1: Novice Beginners, because they have no experience with the situations in which they are expected to perform, must depend on rules to guide their actions. Following rules, however, has its limits. No rule can tell novices which tasks are most relevant in real life situations. The novice will usually ask to be shown or told what to do.
Stage 2: Advanced Beginner An advanced beginner is one who has coped with enough real situations to note (or to have them pointed out by a mentor) the recurrent meaningful aspects of situations. An advanced beginner needs help setting priorities since she/he operates on general guidelines and is only beginning to perceive recurrent meaningful patterns. The advanced beginner cannot reliably sort out what is most important in complex situations and will require help to prioritize.
Stage 3: Competent Typically, the competent professional has been in practice two or three years. This person can rely on long-range goals and plans to determine which aspects of a situation are important and which can be ignored. The competent professional lacks the speed and flexibility of someone who has reached the proficient level, but competence is characterized by a feeling of mastery and the ability to cope with and manage contingencies of practice.
Stage 4: Proficient This is someone who perceives a situation as a whole rather than in terms of parts. With holistic understanding, decision-making is less labored since the professional has a perspective on which of the many attributes and aspects present are the important ones. The proficient performer considers fewer options and hones in on the accurate region of the problem.
Stage 5: Expert The expert professional is one who no longer relies on an analytical principle (rule, guideline, and maxim) to connect an understanding of the situation to an appropriate action. With an extensive background of experience, the expert has an intuitive grasp of the situation and focuses in on the accurate region of the problem without wasteful consideration of a larger range of unfruitful possibilities. (Adapted from Benner, 1984, pp. 13-34)
1. Demonstrates leadership in the professional practice setting through accountability, influence, change management, and collaboration with others in a way that will facilitate the establishment and achievement of shared goals.
2. Identifies, integrates, and evaluates current evidence and research findings coupled with clinical expertise and consideration of patients’ preferences, experience, and values to make practice decisions for quality outcomes.
3. Utilizes clinical reasoning and critical thinking skills, which drives a culture of safety to prevent risk of harm to healthcare consumers, families, colleagues, and the environment.