Competency in practice: Are you fit for purpose?

As nurses we are bound by our code of practice as stated by our governing body – the Nursing and Midwifery Council (NMC). The Code (NMC, 2008) requires that all nurses should: 

• Make the care of people our first concern, treating them as individuals and respecting their dignity.
• Work with others to protect and promote the health and wellbeing of those in our care, their families and carers, and the wider community.
• Provide a high standard of practice and care at all times.
• Be open and honest, act with integrity and uphold the reputation of our profession.

The third statement can only be achieved by keeping up-to-date with emerging evidence and networking with the nursing fraternity. Nowadays, however, this is becoming increasingly difficult as training budgets are being squeezed and study-leave to attend external education events is becoming more difficult to obtain. This does fly in the face of the NHS Knowledge and Skills Framework (Department of Health, 2004) somewhat, which states that all NHS employees must:

• Have the knowledge and skills for safe and effective practice when working without direct supervision.
• Recognise and work within the limits of your competency.
• Keep your knowledge and skills up-to-date throughout your working life.
• Take part in appropriate learning and practice activities that maintain and develop your competency and performance.

It also alludes to the fact that it is the managers’ responsibility to ensure that educational opportunities are available.

Integrated career and competency framework
As a supplement to this edition of the journal, you will find the updated version of An Integrated Career and Competency Framework for Diabetes Nursing (TREND-UK, 2010; Figure 1). This document is the product of a collaboration between various professional bodies representing nurses who work in diabetes care, and was coordinated by the recently formed nursing group, TREND-UK (Training, Research and Education for Nurses in Diabetes-UK). The groups involved were the Royal College of Nursing Diabetes Nursing Forum, the Diabetes Nurse Consultant Group, the Paediatric Diabetes Special Interest Group, the National Diabetes Inpatient Specialist Nurse Group and the Practice Nursing Forum, as well as Diabetes UK Nurses Forum and with input from people with diabetes. 

Representatives from these groups have reviewed and further developed the original framework, published in 2005. This second edition was necessary to keep the document up-to-date with the developments in diabetes nursing roles and responsibilities over the past few years. It also discusses some of the challenges nurses are facing in such areas as commissioning, where services are being redesigned to fit with a political agenda.

The aim of the updated document is to support all nurses working in diabetes care, including healthcare assistants. The framework can be used in a number of ways to develop nurses’ knowledge and skills. For example, it will provide: 

• Help for individual nurses to plan their professional development in diabetes care.
• Guidance to employers about expectations of competency at different levels of diabetes nursing. 
• A reference point for planning educational programmes. 
• A framework for career progression in diabetes nursing.
• Information for commissioners in identifying appropriate staff to deliver services to meet local need. 

The clearly defined competency levels (Box 1) make it possible for nurses delivering diabetes care to identify their level of practice. The framework gives them the ability to plan their careers in a more structured way, and supports their continuing professional development by identifying individual development and training needs. So, are you fit for purpose?