Career advice

What is competency and how can I maintain it?

Competency is a key principle of the NMC code and without it, patient safety is at risk

Competency is a key principle of the NMC code and without it, patient safety is at risk

Every professional who joins the Nursing and Midwifery Council (NMC) register has the right level of knowledge and skills – or competency – to start practising, says Anne Trotter, the regulator’s assistant director of education and standards.

‘From the moment a nurse begins their first role, they’ll further develop their competency within a particular scope of practice through formal and informal education and training. This normally reflects the needs of people in their care and the setting that they are working in,’ she says.

Recognising and working within the limits of your competence is a key principle of the NMC code. Given the significance of its

Competency is a key principle of the NMC code and without it, patient safety is at risk

Picture: iStock

Every professional who joins the Nursing and Midwifery Council (NMC) register has the right level of knowledge and skills – or competency – to start practising, says Anne Trotter, the regulator’s assistant director of education and standards.

‘From the moment a nurse begins their first role, they’ll further develop their competency within a particular scope of practice through formal and informal education and training. This normally reflects the needs of people in their care and the setting that they are working in,’ she says.

Recognising and working within the limits of your competence is a key principle of the NMC code. Given the significance of its impact on public protection, this principle should be upheld at all times, the NMC says in its introduction to the Code.

What are the risks of working outside of my competence?

The NMC’s standards for competence for registered nurses set out what nurses must achieve before they can be registered.

In reference to professional values, it says that all nurses must ‘practise independently, recognising the limits of their competence and knowledge. They must reflect on these limits and seek advice from, or refer to, other professionals where necessary’.

Nurses must maintain these standards throughout their careers to remain on the register, says the NMC. Failing to meet them consistently may result in a fitness to practise investigation, with the potential for sanctions, including suspension or being struck off the register.

How do I make sure I’m working within the scope of my competence?

Being asked to take on a task or work in a clinical area outside your usual practice can be challenging. To ensure you are practising safely, Mandy Day-Calder, who runs a healthcare training company and has a nursing background, suggests using this checklist:

  • Situation: Do you understand what is being asked of you and why? Nursing is no longer a task-orientated profession and to practise safely you must be able to explain the rationale behind your actions, omissions and delegations.
  • Environment: Do you know where to find everything you need, such as equipment and paperwork? Do you know which team you are working with and who the nurse in charge is?
  • Level of care: What level of care will you be expected to provide? Do you have any experience caring for patients with these types of conditions?
  • Knowledge and experience: Have you been adequately trained and assessed as competent to carry out the tasks you are being asked to perform, or to work in this particular area of practice? For example, you may have witnessed colleagues undertaking elements of advanced practice, but you are not competent to do so unless you have passed competency-based training programmes in these areas.
New staff should have a supernumerary period, the RCN advises Picture: iStock

How do you maintain competency when moving to a new specialty?

‘Any employment role change will involve a change in a nurse’s scope of practice, knowledge and competence to some degree,’ says Ms Trotter.

‘If a nurse is considering a role with a big change in scope – for example, from mental health to A&E – they might have additional learning needs or require additional support to become more confident in the new setting. They should discuss this with their manager and speak up when they need additional support.’

In its Nursing Workforce Standards, published in May 2021, the RCN says there should be a period of supernumerary induction or preceptorship for newly appointed staff, including those in management roles.

‘Individuals with no previous experience should have a preceptorship period, which includes structured induction and close supervision, until specialty competence and confidence are achieved,’ the standards say.

‘For more senior/experienced staff taking on additional or different roles, a preceptorship period is still needed until competence and confidence are achieved.’

I’ve been asked to do something that I believe is outside my competence. What should I do?

If you are asked to carry out any action or procedure that is beyond the limits of your competence, you should seek help from a suitably qualified and experienced professional, says the NMC code, in the section on preserving safety.

The Code also says that you should raise concerns immediately if you are asked to practise beyond your role, experience and training.

What about emergency situations?

While you should always offer to help in an emergency, you must also make sure you continue to act only within the limits of your knowledge and competence, says the NMC code.

I’m working with someone who I don’t think is working within their competence. What should I do?

‘If anyone is concerned that a nurse may be working outside their scope of competence, it’s important to raise this to ensure the right support and training can be put in place to support the nurse,’ says Ms Trotter.

‘It may be that nurses feel anxious about starting the conversation, but it’s so important that they do. Speak up to managers and leaders, who share a responsibility to ensure people receive care that is safe and effective.’


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