Clinical Competence and Coaching, Term Paper Example

Introduction

Various studies acknowledge that the transition between academic and clinical environments is a critical stage in a professional nursing career (West, 2007; Horton-Deutsch & Sherwood, 2008). That is, a nurse must be able to adjust from the relatively risk-free classroom and laboratory settings to the fast-paced, high-risk scenario, where his or her actions can truly mean the difference between a patient’s life and death. This review of current literature focuses on a significant element of this transition, which is that of including coaching and other preventive measures to help nurses in transitioning to clinical competence. In particular, the following sections will discuss what are clinically competent nurses, what are the components of being clinically competent, what are the barriers and risks to clinical competence and how can they be overcome, and what are the disciplines or coaching opportunities that are available to prevent clinical incompetence during actual healthcare operations.

Clinically Competent Nurses

According to a study by Linberg (2006), the concept of competence varies from one individual to another. However, the study was able to cull various themes that form the idea of the clinically competent nurse particularly in the high-risk intensive care setting. This idea is that the clinically competent nurse is one who is able to determine within a limited amount of time, the best way to care for a specific patient, and carry out that identified way effectively while following all of the relevant, applicable protocols of the work environment (Linberg, 2006). On the other hand, both West (2007) and Horton-Deutsch & Sherwood (2008) describe the clinically competent nurse under the context of the student-to-practitioner transition. As discussed by West (2007), the competent nurse is one who is able to get over all of the distractions and hindrances in the contemporary work environment and effectively put the knowledge, skills, and abilities that they developed during their training and education into correct application during appropriate moments of operations. Chin (2008) gives a contrast between the clinically competent nurses and the clinically incompetent nurse by explaining that while both nurses may basically have the same training and may have developed the same knowledge and skills throughout their education, the clinically competent nurse is emotionally and emphatically prepared to deliver care to patients and does so, while the clinically incompetent nurse does not have the necessary emotional capacity to be able to carry out his or her duties effectively.

Components of Clinical Nursing Competence

Based on the definitions and descriptions of the clinically competent nurse discussed above, several components of clinical competence can be inferred. First, it can be said that a primary component of clinical competence is the ability to cooperate with others in a multidisciplinary environment (Linberg, 2006). While student nurses can survive in their studies without help from their peers, they must realize the as professional nurses, they are not supposed to tackle their responsibilities on their own and in a vacuum, but rather cooperate synergistically with doctors, aides, and even patients and patients’ families in order to provide the best care (Deutsch & Sherwood, 2008). Another component of clinical competence is perceptiveness, which is the ability to be aware of all of the details pertaining to the patient and the interconnectedness of these details in relation to the care that the patient receives (Linberg, 2006). As implied from the work of West (2007), this is more than the academic exercise of reading a case and then determining the best course of action arising from it, but the ability to do so in the pressures caused by understaffing, poor patient cooperation, and various other sources of stress and ethical distress. The third component of clinical competence is described by Linberg (2006) as the ability to give respect to the role of the institution and heed the rules and regulations nuanced to the institution and the entities within it. This implies a sense of malleability on the part of the nurse to not be close-minded in attempting to come to terms with the difference between the actual clinical setting and the envisioned setting that he or she had. Deutsch & Sherwood (2008) emphasized that an effective nurse is one who will not get caught up with thinking why things are not the way he or she was taught them to be, but instead work with the situation and employ his or her abilities within the boundaries set.

Preventing Clinical Incompetence

Vital to preventing clinical incompetence in the workplace is the understanding of the dilemma faced by student nurses as they enter the clinical setting. As discussed by Chin (2008), there are various reasons why a nurse would come to exhibit “poor behaviour and performance” (p. 18). However, Chin (2008) argues that at the root of the problem is the student nurse’s lack of proper emotional orientation on the differences between academic and clinical settings of the profession. This is supported by Linber (2006), which discussed how “personal maturity and the right kind of attitude” (p. 77) were pivotal in the ability of a nurse to become competent in the clinical environment. Thus, there is a strong need to elevate the perception of nurses of their responsibilities to the fast-paced, high-risk setting that is the norm in order for them to avoid the pitfalls of incompetence.

Coaching to Increase Clinical Competence

Several studies point out the importance of placing neophyte nurses under the wing of more experienced preceptors, mentors, and coaches. According to West (2007), an effective coaching program is very important in ensuring the proper orientation of a new nurse into the clinical setting. Also, establishing a strong professional relationship with an experienced mentor may play a critical role in preventing a nurse from allowing minor problems encountered at work to spiral into a serious ethical dilemmas (p. 7). The importance of coaching is likewise acknowledged by Chin (2008), which identified the process as being crucial to the continuous development of clinically competent nurses. According to Chin (2008), coaching allows for the formal, internally organized development of nurses by seasoned practitioners with both authority and personal power, leading to the refinement of perspectives on nursing responsibilities as nuanced to the particular clinical setting that the nurse is a part of (p. 18).

Conclusion

Based on this review of literature, it can be inferred that the concept of the clinically competent nurse is well-defined, and is focused on the nurse’s ability to successfully breach the barriers that separate academic and clinical settings. It was also found that having more senior nurses serve as coaches of new nurses is recommended as a means to help nurses make the transition to the clinical setting competently.

References

Chin, H. (2008). Making a fresh start. Nursing Management, 15(2): 18-20.

Deutsch, S., and Sherwood, G. (2008). Reflection: an educational strategy to develop emotionally competent nurse leaders. Journal of Nursing Management, 16, 946–954.

Lindberg, E. (2006). Competence in Critical Care. Dimens Crit Care Nurs, 25(2):77-81.

West, J. (2007). Ethical Issues and New Nurses: Preventing Ethical Distress in the Work Environment. The Kansas Nurse, 82(4): 5-8.