Qualification for practice is assured by licensing laws and by professional standards. Laws and rules are generally considered to uphold the lowest minimum standard for practice. Licensing laws for example, protect patients from harm, but do not hold professionals accountable to a skill level that promotes quality. As a profession, nursing does not want to rely on self-reflection on competence as the sole method to assure the public and ourselves that nurses are competent. Nor should we be satisfied that external measures such as licensing laws, CE, or competency-based evaluations will provide the absolute assurance of competency.
Competency is a complex construct that requires numerous measures.
To practice competently requires us to comply with external competence measures and to reflect ethically about competence. As professionals, nurses must individually and collectively raise questions related to competency measurement. The answers to these questions require thought, reflection and discussion. Processes that are difficult under the best of circumstances may seem more elusive when health care restructuring, reallocation of resources, shifting client populations, new ways of delivering health care, and new and different technology are challenging us. It is, however, in times of turbulence when nurses need to examine competence collectively and individually , or outside regulatory forces will step in and mandate how competence will be measured.