Considerations in determining scope: competence
In determining their scope of practice, nurses and midwives must make judgements about their competency to carry out a role or activity.
Competent nurses and midwives not only fulfil certain roles or complete specific activities. They also possess many additional attributes; including knowledge, technical and practical skills, interpersonal skills, the ability to think critically and to practise safely and effectively based on evidence. Competence also involves being able to work collaboratively with other health care professionals, demonstrating a professional attitude and accepting responsibility for their practice.
Competence is understood as:
The attainment of knowledge, intellectual capacities, practice skills, integrity, and professional and ethical values required for safe, accountable and effective practice as a registered nurse or registered midwife.
Competence relates to the nurse’s or midwife’s role or practice within the relevant division of the Register, and competence is maintained through continuing professional development and is adaptive to the needs of a changing population profile.
Competence changes and develops over time. A nurse’s or midwife’s level of competence is influenced by their educational preparation, frequency of clinical exposure and the duration of their experience, in particular, clinical settings.
Since competence is not constant, the individual practitioner is expected to continually re-evaluate their competence when faced with new practice situations. Each nurse and midwife is accountable for their professional actions and, as such, they should refuse delegated or assigned roles or activities if they judge their competence to be limited. If they identify a competence deficit, they should take appropriate measures to gain competence.
Each nurse or midwife is responsible for identifying concerns about their competence and, under the Nurses and Midwives Act 2011; they must maintain their “professional competence on an ongoing basis” (yet to be enacted as at date of publication of September 2015). Competence can be achieved by engaging in continuing professional development.
Scope of Nursing and Midwifery Practice Framework
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