Nursing NZ - Registered Nurse

Competency 1.1 Accepts responsibility for ensuring that their nursing practice and conduct meet the standards of the professional, ethical, and relevant legislated requirements.

• Indicator: Practises nursing in accord with relevant legislation/codes/policies and upholds health consumers rights derived from that legislation.
• Indicator: Accepts responsibility for actions and decision making within scope of practice.
• Indicator: Identifies breaches of law that occur in practice and reports them to the appropriate person(s).
• Indicator: Demonstrates knowledge of, and accesses, policies and procedural guidelines that have implications for practice.
• Indicator: Uses professional standards of practice.

Competency 1.2 Demonstrates the ability to apply the principles of the Treaty of Waitangi / Te Tiriti o Waitangi to nursing practice.

• Indicator: Understands the Treaty of Waitangi/Te Tiriti o Waitangi and its relevance to the health of Māori in Aotearoa/New Zealand.
• Indicator: Demonstrates knowledge of differing health and socio-economic status of Māori and non-Māori.
• Indicator: Applies the Treaty of Waitangi/Te Tiriti o Waitangi to nursing practice.

Competency 1.3 Demonstrates accountability for directing, monitoring and evaluating nursing care that is provided by enrolled nurses and others.

• Indicator: Understands accountability for directing, monitoring and evaluating nursing care provided by enrolled nurses and others.
• Indicator: Seeks advice from a senior registered nurse if unsure about the role and competence of enrolled nurses and others when delegating work.
• Indicator: Takes into consideration the role and competence of staff when delegating work.
• Indicator: Makes appropriate decisions when assigning care, delegating activities and providing direction for enrolled nurses and others.

Competency 1.4 Promotes an environment that enables health consumer safety, independence, quality of life, and health.

• Indicator: Identifies and reports situations that affect health consumers or staff members’ health or safety.
• Indicator: Accesses, maintains and uses emergency equipment and supplies.
• Indicator: Maintains infection control principles. Indicator: Recognises and manages risks to provide care that best meets the needs and interests of health consumers and the public.

Competency 1.5 Practises nursing in a manner that the health consumer determines as being culturally safe.

• Indicator: Applies the principles of cultural safety in own nursing practice.
• Indicator: Recognises the impact of the culture of nursing on health consumers care and endeavours to protect the health consumer’s wellbeing within this culture.
• Indicator: Practises in a way that respects each health consumer’s identity and right to hold personal beliefs, values and goals.
• Indicator: Assists the health consumer to gain appropriate support and representation from those who understand the health consumer’s culture, needs and preferences.
• Indicator: Consults with members of cultural and other groups as requested and approved by the health consumers.
• Indicator: Reflects on their own practice and values that impact on nursing care in relation to the health consumer’s age, ethnicity, culture, beliefs, gender, sexual orientation and/or disability.
• Indicator: Avoids imposing prejudice on others and provides advocacy when prejudice is apparent.

Competency 2.1 Provides planned nursing care to achieve identified outcomes.

• Indicator: Contributes to care planning, involving health consumers and demonstrating an understanding of health consumers’ rights, to make informed decisions.
• Indicator: Demonstrates understanding of the processes and environments that support recovery. Indicator: Identifies examples of the use of evidence in planned nursing care.
• Indicator: Undertakes practice procedures and skills in a competent and safe way.
• Indicator: Administers interventions, treatments and medications, (for example: intravenous therapy, calming and restraint), within legislation, codes and scope of practice; and according to authorised prescription, established policy and guidelines.

Competency 2.2 Undertakes a comprehensive and accurate nursing assessment of health consumers in a variety of settings.

• Indicator: Undertakes assessment in an organised and systematic way.
• Indicator: Uses suitable assessment tools and methods to assist the collection of data.
• Indicator: Applies relevant research to underpin nursing assessment.

Competency 2.3 Ensures documentation is accurate and maintains confidentiality of information.

• Indicator: Maintains clear, concise, timely, accurate and current health consumer records within a legal and ethical framework.
• Indicator: Demonstrates literacy and computer skills necessary to record, enter, store, retrieve and organise data essential for care delivery.

Competency 2.4 Ensures the health consumer has adequate explanation of the effects, consequences and alternatives of proposed treatment options.

• Indicator: Provides appropriate information to health consumers to protect their rights and to allow informed decisions.
• Indicator: Assesses the readiness of the health consumers to participate in health education.
• Indicator: Makes appropriate professional judgement regarding the extent to which the health consumer is capable of participating in decisions related to their care.
• Indicator: Discusses ethical issues related to health care/nursing practice, (for example: informed consent, privacy, refusal of treatment and rights of formal and informal health consumers).
• Indicator: Facilitates the health consumer’s access to appropriate therapies or interventions and respects the health consumer’s right to choose amongst alternatives.
• Indicator: Seeks clarification from relevant members of the health care team regarding the individual’s request to change and/or refuse care.
• Indicator: Takes the health consumer’s preferences into consideration when providing care.

Competency 2.5 Acts appropriately to protect oneself and others when faced with unexpected health consumer responses, confrontation, personal threat or other crisis situations.

• Indicator: Understands emergency procedures and plans and lines of communication to maximise effectiveness in a crisis situation.
• Indicator: Takes action in situations that compromise health consumer safety and wellbeing.
• Indicator: Implements nursing responses, procedures and protocols for managing threats to safety within the practice environment.

Competency 2.6 Evaluates health consumer’s progress toward expected outcomes in partnership with health consumers.

• Indicator: Identifies criteria for evaluation of expected outcomes of care.
• Indicator: Evaluates the effectiveness of the health consumer’s response to prescribed treatments, interventions and health education in collaboration with the health consumer and other health care team members. (Beginning registered nurses would seek guidance and advice from experienced registered nurses).
• Indicator: Reflects on health consumer feedback on the evaluation of nursing care and health service delivery.

Competency 2.7 Provides health education appropriate to the needs of the health consumer within a nursing framework.

• Indicator: Checks health consumers’ level of understanding of health care when answering their questions and providing information.
• Indicator: Uses informal and formal methods of teaching that are appropriate to the health consumer’s or group’s abilities.
• Indicator: Participates in health education, and ensures that the health consumer understands relevant information related to their health care.
• Indicator: Educates health consumer to maintain and promote health.

Competency 2.8 Reflects upon, and evaluates with peers and experienced nurses, the effectiveness of nursing care.

• Indicator: Identifies one’s own level of competence and seeks assistance and knowledge as necessary.
• Indicator: Determines the level of care required by individual health consumers.
• Indicator: Accesses advice, assistance, debriefing and direction as necessary.

Competency 2.9 Maintains professional development.

• Indicator: Contributes to the support, direction and teaching of colleagues to enhance professional development.
• Indicator: Updates knowledge related to administration of interventions, treatments, medications and best practice guidelines within area of practice.
• Indicator: Takes responsibility for one’s own professional development and for sharing knowledge with others.

Although nurses involved in management, education, research and policy making are exempt from being assessed against the above competencies in domain two, they are required to provide evidence of how they contribute to the management of care.

Competencies for nurses involved in management:

• Competency Promotes an environment that contributes to ongoing demonstration and evaluation of competencies.
• Competency Promotes a quality practice environment that supports nurses’ abilities to provide safe, effective and ethical nursing practice.
• Competency Promotes a practice environment that encourages learning and evidence-based practice.
• Competency Participates in professional activities to keep abreast of current trends and issues in nursing.

Competencies for nurses involved in education:

• Competency Promotes an environment that contributes to ongoing demonstration and evaluation of competencies.
• Competency Integrates evidence-based theory and best practice into education activities.
• Competency Participates in professional activities to keep abreast of current trends and issues in nursing.

Competencies for nurses involved in research:

• Competency Promotes a research environment that supports and facilitates research mindedness and research utilisation.
• Competency Supports and evaluates practice through research activities and application of evidencebased knowledge.
• Competency Participates in professional activities to keep abreast of current trends and issues in nursing.

Competencies for nurses involved in policy:

• Competency Utilises research and nursing data to contribute to policy development, implementation and evaluation.
• Competency Participates in professional activities to keep abreast of current trends and issues in nursing

Competency 3.1 Establishes, maintains and concludes therapeutic interpersonal relationships with health consumers.

1. Indicator: Initiates, maintains and concludes therapeutic interpersonal interactions with health consumers.
2. Indicator: Incorporates therapeutic use of self and psychotherapeutic communication skills as the basis for nursing care for health consumers with mental health needs.
3. Indicator: Utilises effective interviewing and counselling skills in interactions with health consumers.
4. Indicator: Demonstrates respect, empathy and interest in health consumer.
5. Indicator: Establishes rapport and trust with the health consumers.

Competency 3.2 Practises nursing in a negotiated partnership with the health consumer where and when possible.

1. Indicator: Undertakes nursing care that ensures health consumers receive and understand relevant and current information concerning their health care that contributes to informed choice.
2. Indicator: Implements nursing care in a manner that facilitates the independence, self-esteem and safety of the health consumer and an understanding of therapeutic and partnership principles.
3. Indicator: Recognises and supports the personal resourcefulness of people with mental and/or physical illness.
4. Indicator: Acknowledges family/whānau perspectives and supports their participation in services.

Competency 3.3 Communicates effectively with health consumers and members of the health care team.

• Indicator: Uses a variety of effective communication techniques.
• Indicator: Employs appropriate language to context.
• Indicator: Provides adequate time for discussion.
• Indicator: Endeavours to establish alternative communication methods when health consumers are unable to verbalise.
• Indicator: Accesses an interpreter when appropriate.
• Indicator: Discussions concerning health consumers are restricted to settings, learning situations and or relevant members of the health care team.

Although nurses involved in management, education, research and policy making are exempted from being assessed against the above competencies in domain three, they are required to provide evidence of how they contribute to interpersonal relationships.

Competencies for nurses involved in management, education, policy and research:

• Competency: Establishes and maintains effective interpersonal relationships with others, including utilising effective interviewing and counselling skills and establishing rapport and trust.
• Competency: Communicates effectively with members of the health care team, including using a variety of effective communication techniques, employing appropriate language to context and providing adequate time for discussion.

Competency 4.1 Collaborates and participates with colleagues and members of the health care team to facilitate and coordinate care.

• Indicator: Promotes a nursing perspective and contribution within the interprofessional activities of the health care team.
• Indicator: Provides guidance and support to those entering as students, beginning practitioners and those who are transferring into a new clinical area.
• Indicator: Collaborates with the health consumer and other health team members to develop plan of care.
• Indicator: Maintains and documents information necessary for continuity of care and recovery.
• Indicator: Develops a discharge plan and follow up care in consultation with the health consumer and other members of the health care team.
• Indicator: Makes appropriate formal referrals to other health care team members and other health related sectors for health consumers who require consultation.

Competency 4.2 Recognises and values the roles and skills of all members of the health care team in the delivery of care.

• Indicator: Contributes to the co-ordination of care to maximise health outcomes for the health consumer.
• Indicator: Collaborates, consults with and provides accurate information to the health consumer and other health professionals about the prescribed interventions or treatments.
• Indicator: Demonstrates a comprehensive knowledge of community services and resources and actively supports service users to use them.

Competency 4.3 Participates in quality improvement activities to monitor and improve standards of nursing.

• Indicator: Reviews policies, processes, procedures based on relevant research.
• Indicator: Recognises and identifies researchable practice issues and refers them to appropriate people.
• Indicator: Distributes research findings that indicate changes to practice to colleagues