Entry-Level Competencies for the Practice of Registered Nurses
Background
In 2017 the Canadian Council of Registered Nurse Regulators (CCRNR) initiated the revisions of the Entry-Level Competencies of Registered Nurses in Canada (the “ELCs”). This initiative was led by a working group comprised of 11 jurisdictions representing registered nurse (RN) regulators in Canada. The ELCs are revised every five years to ensure inter-jurisdictional consistency and practice relevance. Consistency between jurisdictions supports the workforce mobility requirements of the Canadian Free Trade Agreement. Revisions are based on the results of an environmental scan, literature reviews and stakeholder consultation. The regulatory body in each jurisdiction validates and approves the ELCs and confirms they are consistent with Provincial/Territorial legislation.
Each ELC in this context is defined as “an observable ability of a registered nurse at entry-level that integrates the knowledge, skills, abilities, and judgment required to practice nursing safely and ethically.”
ELCs are used by regulatory bodies for a number of purposes including but not limited to:
- Academic program approval/recognition
- Assessment of internationally educated applicants
- Assessment of applicants for the purpose of re-entry into the profession
- Input into the content and scope of entry-to-practice exams
- Practice advice/guidance to clinicians
- Reference for professional conduct matters
- Public and employer awareness of the practice expectations of registered nurses
The Context of Entry-Level Registered Nursing Practice
The design and application of the listed competencies is at entry-to-practice. Entry-level RNs are at the point of initial registration or licensure, following graduation from an approved nursing education program. Their beginning practice draws on a theoretical and experiential knowledge base that has been shaped by specific experiences during their education program. They are health care team members who are expected to accept responsibility and demonstrate accountability for their practice. They will recognize their limitations, ask questions, exercise professional judgment, and determine when they require consultation. Entry-level RNs realize the importance of identifying what they know and do not know, what their learning gaps may be, and how and where to access available resources. They display initiative, a beginning confidence, and self-awareness in taking responsibility for their decisions in the care they provide.
RN practice is dynamic and evolving; the ELCs establish the foundation for nursing practice. Entry-to-practice represents the time when learners become clinicians. Further development of RN practice is facilitated through education, collaboration, and mentorship. All groups involved in the provision of health care have a shared responsibility to create and maintain practice environments that support RNs in providing safe, ethical, and quality health care. The practice environment influences the transition and consolidation of RN practice and the development of further competence.
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