It’s That Time of Year Again: Hospital Competencies


I’m not sure how other hospitals do it, because I have only worked in one; but every year we have this thing called competencies.

What are competencies?

Basically all the nurses in the hospital are corralled into a room over a series of a week or so and have to “check off” at various stations. Not that it takes a whole week to do it, you just have several days over that week in which you can attend. The stations have a nurse or member of administration staffing them and cover various topics related to practice on the floor. These stations include categories such as: Foley catheter irrigation, PICC line care, safe transfer, hospital beds, med reconciliation, and others. So you go around this room, hurry up and wait, because likely there is a group already there, already listening, and you can’t start halfway through. Half your time at these competencies are spent waiting for the different stations. Once your turn finally arrives, the instructor tells you everything you already know, and adds any additional information or changes that are taking place in the procedure.

By the way, none of these nurses actually practice on the floor.

This is also the time where they inform you that you’ve been doing something wrong for years, even though you know they hadn’t mentioned this at any of the competencies before. Yep, a lot of these new standards are passed off as if you should have magically known they were the standard. I HATE this part of competencies. If standards of care change, I am more than willing to grow and adapt, but don’t tell me I have been doing something wrong for YEARS and act as if everyone else was doing it the right way. Don’t make a policy, tell me about it after the fact, and then belittle me for not knowing this new policy.

I’m a good nurse. I do my very best to follow the standards, rules, and guidelines set forth. I try my very best to perform to the best of my abilities and do the right thing. My goal is to do what any prudent nurse would do given the same situation. So it’s incredibly frustrating and discouraging to hear I’m unknowingly not meeting the standard. What’s worse, when everyone around you smiles and nods and acts as if nothing is new and of course they knew to do it a certain way… especially when you work side by side with them and know they didn’t (or at least don’t practice it).

So  I had two and half hours of standing, waiting, signing, and being discouraged, only to determine that now we have addition work to do, likely because of the recent layoffs.

What did I get out of the competencies? 

Well now we have to be “Secret shoppers” to other nurses, spy on them and make sure they are performing patient safety, and document this 3 times in a month. Yep, stealing our autonomy right away from us. Because we don’t trust you, or because we want to sell our statistics (a reason the educator gave a coworker of mine) we need to “beef up” our numbers, so that we can “show” we are performing patient safety.

I really think this is just going to be another one of those annoyances that people don’t actually do, but just tab through and go through the motions. Just checking boxes and going through the forms as quickly as possible.

I should just embrace the change, I know, but right now I am a little more than annoyed. Take my bonus, make me park further away (an entry for another day), force me to wear uniforms, and then have my coworkers check up on me? I feel like a red-head step child, and I don’t like it.

Does your hospital have competencies?

3 thoughts on “It’s That Time of Year Again: Hospital Competencies”

  1. We have competencies too, taught by our own unit educators and co nurses. They are mostly encouraging, unjudging, not belittling(is that right, the word?). Anytime there is something new, we get notified or inserviced before it gets put into use…There is no waiting in ours. We simply move from table to table and I get done with my competencies in one hour this way (around 6 competencies on chest tubes, epidural, PCA, handheld machines, mock codes…).

  2. I definitely think anyone in the healthcare profession should have to officially demonstrate their skills at least on an annual basis (from EMT’s right up to doctors) but you are soooo right that AS SOON AS THERE IS A POLICY CHANGE, they need to inform everyone involved immediately. It should be in newsletters, on bulletin boards in the staff lounge and you should have an inservice meeting to learn of the new changes as soon as possible! The only people to blame for anyone not following protocols/policies are the ones who never passed the info along!!

    1. Agreed we need refreshers. Problem is we are never actually asked to demonstrate anything. I wouldn’t mind so much if half of the time wasn’t spent standing and waiting. But I hate waiting, especially when I cant just pull my iPhone out and play games, since I am pretty sure it would be frowned upon.

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