Competencies and nursing: A critical exploration
Rachel Ardern
Weber State University, USA
: J Nurs Patient Care
Abstract
Nurses are perceived as a profession that elicits safe and competent care. This perception has been developed through decades of disciplined standards and practice in the delivery of care. Traditional nursing education made way for an emphasis on theoretically informed practice through tertiary nursing education. This move coincided with the appearance of the competency movement across industries as flexibility was sought through the development of frameworks aimed at reducing work to discrete and transferable skills. Within the clinical environment, competency frameworks have been structured around minimum standards of practice. The introduction of competencies and the focus on creating generic and mobile skills has given rise to questions over the blurring of nursing roles. The purpose of this study was to explore the social and political function of competencies as they have been adopted in clinical nursing. The study was informed by the theoretical work of Jürgen Habermas with a focus on forms of knowledge and associated interests. Data were generated through 16 individual semi-structured interviews with Registered Nurses (RNs) and Enrolled Nurses (ENS) and five focus group interviews three with RNs and two with ENs. The data analysis was organized by three levels of interests; technical, practical and political. The focus was on the social and political functions of competencies at each level. Through the lens of critical theory, this research has shown that the competency framework has been used as a means of increasing flexibility within the clinical environment through the expansion of the traditional function of the EN. This expansion has created a blurring of lines between the RN/EN roles forming an environment where neither role is fully aware of disciplinary boundaries. Organizational control has provided financial rewards while increasing the workload of the EN and limiting the function of the RN.
Biography
E-mail: rachelardern@weber.edu
