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Staff nurses facing reassignment-are you competent?

Staff Development Coordinator, HEC Trinity Regional Medical Center, Fort Dodge Issues have arisen when nursing staff have been reassigned to a clinical specialty area in which they are unfamiliar with the skills that are needed to provide safe patient care. Picture yourself reporting to duty on your surgical unit only to be reassigned by the nursing staff coordinator to a telemetry unit. You have not worked with cardiac monitors since your clinical rotation in school, but are expected to care for four patients on cardiac monitors.

Each clinical area has a degree of specialty in today's nursing practice. Nursing practice is "knowledge based." We perform tasks from knowledge obtained through educational programs. An individual nursing license ensures that the basic and minimum competencies and standards have been met by the educational program. Ongoing education and working experience will provide the needed knowledge to care for patients in specialty areas in today's healthcare settings. If a nurse concludes that he or she lacks competence or is inadequately prepared to carry out a specific nursing function to provide safe care they should have the right to refuse that assignment.

Then how can we ensure that staff is competent to provide the needed care? That they are qualified and capable of performing the job of caring for patients? ANA through the Code of Ethics for Nurses and Standards of Clinical Nursing Practice have stated that it is the nurse's responsibility to maintain competence in practice. The American Hospital Association states that hospitals have the ethical and legal responsibility to make certain that the healthcare provided by their personnel meet acceptable standards. Then there is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and other accrediting bodies that have requirements to ensure the ongoing competencies of personnel. It is a joint effort by an individual person and the organization to provide and maintain the competencies that support the ability to perform the skills needed to do the job.

It is not just a matter of having adequate staff but that of providing adequate staffing of competent nurses, able to complete the assignment while providing safe patient care. Employers need to provide the time, resources and educational support necessary for safe nursing care. Staff needs to be willing to learn new competencies and expand their nursing knowledge in anticipation for role expansion.

To learn new competencies staff may transition into new roles by shadowing experienced staff as they provide nursing care. Cross-training between specialty areas is another way to ensure competency. Educational departments could assess educational needs and provide competencies as needed. Nurse leaders have the responsibility to ensure that the care provided meets the standards and that staff are educated and competent.

Be an advocate for safe patient care thorough the practice of continuing education to remain competent in the ever-changing healthcare arena.


American Nurses Association. (2005). Utilization Guide for the ANA Principles for Nurse Staffing (Brochure).

Brunt, B.A. (2002). Identifying Performance Criteria for Staff Development Competencies. Journal of Nurses in Staff Development, 18(6), 314-321.

American Nurses Association. (1995). The Right to Accept or Reject an Assignment (Position Statement).

LaDuke, S. (2000). Competency Assessments: A Case for the Nursing Interventions Classification and the Observation of Daily Work. Journal of Nursing Administration, 30(7/8), 339-340.

Giordano, B.P. (1996). American Nurses Association Centennial Celebrates Nursing's Past and Addresses Current Issues: Friday, June 14, to Wednesday, June 19, 1996. AORN, 64(3), 354-358.

By Diane Anderson, RN, BSN
COPYRIGHT 2007 Iowa Nurses Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2007 Gale, Cengage Learning. All rights reserved.

Article Details
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Author:Anderson, Diane
Publication:Iowa Nurse Reporter
Article Type:Brief article
Geographic Code:1U4IA
Date:Mar 1, 2007
Next Article:Capture, exchange and use data, information and knowledge within electronic health records.

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