Are you competent? Have you demonstrated competence in an area? How do you maintain your competence...or is it competency? What's the difference and why does it really matter? As an educator, I find myself frequently scrutinizing tough decisions I have to make in the learning environment. One of my seasoned mentors always reminds me, "It's about the patient in the bed!" No matter the area I have practiced (hospital, outpatient clinic, research clinic, academia), it is caring for our current and future patients that makes us nurses. With that in mind, the opening question takes on a deeper importance. Our patients trust that we have graduated from nursing school and taken a licensure examination. The education and examination demonstrated that we were at some point competent as registered nurses. Does that mean today we remain competent?
Part of the mission of the Orthopaedic Nurses Certification Board is to promote professional development and advance the practice of orthopaedic nursing. The bottom line is that we cannot advance the practice of orthopaedic nursing without incorporating the idea of continuing competence. To further convince us that action was needed, the Accreditation Board for Specialty Nursing Certification, which accredits our orthopaedic credentials, has incorporated continuing competence into the accreditation standards. Standard 13 reads, "The certifying organization has a recertification program in place that requires certificants to maintain current knowledge and to provide documentation showing how competence in the specialty is maintained and/or measured over time" (Accreditation Board for Specialty Nursing Certification, 2014, p. 29). In other words, not only is it important to us as professionals, it is required to maintain our accreditation!
In my opinion, it is quite hard to provide evidence that the continuing competence standard has been met. However, to maintain our prestigious accreditation, we must demonstrate that nurses who hold orthopaedic certifications can document how they have maintained their competence in the specialty. The board discussed the concept and made decisions around the topic at our meeting in spring 2012. The intense face-to-face meeting concluded with two actions. First, the board endorsed The Statement of Continuing Competence for Nursing: A Call to Action developed by the National Board of Certification of Hospice and Palliative Nurses (2011). Second, the board determined that in 2014, all recertifying orthopaedic nurses would complete a learning needs self-assessment and an evaluation of their learning plans before obtaining recertification.
The board believes that requiring an activity, such as the learning needs assessment, is one way of documenting continuing competence. We believe that only the certified nurse can know what continued education is needed to maintain competence in his or her specific role. Other certifying bodies have required lengthy examinations and used the results to prescribe specific areas for continuing education to maintain certification. Your certification board believes that we can meet the accreditation standards with a less prescriptive needs assessment and evaluation.
When you complete the learning needs assessment on our learning management system (LearningBuilder), the board is simply asking you to think of some topical areas where you believe you need to obtain more continuing education over the next 5 years. As the certified nurse, you take control of the topics that will help you maintain your competence. We would also like to know why you chose those topics. Whether it is because you have a new surgeon using the anterior approach or you are just curious, it is all welcome in your learning needs assessment! Most importantly, no action will be taken if you have not been able to obtain continuing education in that area. The idea is to think about your certification as part of the big picture, continuing your competence in orthopaedic nursing for the benefit of the patient in the bed!
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