qualities of a nurse essay

30 Qualities Of A Good Nurse – Do You Have Them?

Are you a nurse or nursing student who wants to become the best nurse possible? Perhaps you have asked yourself, “What are the qualities of a good nurse?” Maybe you have wondered what you can do to develop attributes necessary for effective nursing practice. If this sounds like you, you will likely find the 30 essential qualities of a good nurse featured in this article helpful. As you continue reading, learn about these qualities, why they are important, and how to strengthen them in your professional role.

What Exactly Is The Definition Of A Good Nurse?

Why is it important to be a good nurse, what are the essential qualities of a good nurse, 1. excellent communication, what is it:, why is this quality important for a good nurse:, how to strengthen this quality:, 2. an attitude of advocacy, 4. compassion, 5. attention to detail, 6. clinical reasoning, • consider the patient situation:, • collect information/cues:, • process information:, • identify issues/problems:, • establish goals:, • evaluate:, 7. prioritization, 8. critical thinking, 9. flexibility, 10. perseverance, 11. confidence, 12. contextual perspective, 13. integrity, 14. clinical intuition, 15. emotional stability, 16. a willingness to learn, 17. versatility, 18. commitment to patients and the profession, 19. respectfulness, 20. assertiveness, 21. dependability, 22. resourcefulness, 23. leadership, 24. time management, 25. emotional intelligence, 26. mentorship, 27. goal-oriented, 28. veracity, 29. endurance, 30. practice self-care, what to do if you do not have the qualities that make a good nurse, bonus 10 bad qualities a good nurse can never have, 1. not taking ownership of oneself:, 2. job hopping:, 3. avoiding work assignments:, 4. lack of empathy:, 5. beware of a gossiper., 6. not being a “team player”:, 7. ignoring protocols:, 8. dishonesty:, 9. a sense of entitlement:, 10. disinterest in learning:, my final thoughts.

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The Exemplary Practice Life of the Nurse

Joan m. riley.

a Emmanuel College, Boston, MA 02115, United States of America

Judy A. Beal

b Simmons University, Boston, MA 02115, 27 Upton St. Unit 2, Boston, MA 02118, United States of America

Patricia Reid Ponte

c Boston College, Chestnut Hill, MA 02467, United States of America

Nurses consistently stand out in extraordinary ways especially during a global crisis, recently confirmed in the current Covid-19 pandemic. What is opportune this time is the call for clarity around what nurses do and what society can expect from them. Nurses, as members of a global profession, need a platform to build a contemporary practice life. This paper proposes the model: The Exemplary Practice Life of the Nurse . It provides a framework to explicate the essence of the role of the nurse. The model posits four inter-related essential components or pillars that ground a nurse's behavior and commitment: professionalism, leadership, scholarly practice, and stewardship. This uncomplicated, straightforward model is universally applicable for nurses to apply in whatever roles they hold and at any point in their careers. The use of a holistic model, as a guide across a full career trajectory, supports the nurse's ability to prioritize individual pillars while understanding the inter-relationship and influence among the four pillars. The authors pose assumptions that form the basis of the registered nurse role and provide the foundation for the exemplary practice life of the nurse. They make recommendations to nurses, the profession, the workplace, the academy, and the community.

Nurses have always been central to managing and abating health crises such as the recent COVID-19 pandemic health crisis. They will continue to be pivotal as the nation heals, all while the urgent need to reduce health disparities continues to soar. Nurses carried out their awe-inspiring and innovative work in hundreds of diverse roles and settings. They demonstrated true leadership in the most professional way ( Rushton & Thompson, 2020 ). This extraordinary contribution centers nurses in the midst of a “landmark” multi-year performance in every part of the globe. This truly was exemplary nursing practice at its best. This recognition amplifies the fact that nurses, as members of a global profession, require a common platform to build a contemporary exemplary practice life.

At the same time, the profession, while earning the designation as a major global workforce in the health care industry, continues to grapple with two key variables. The first is the slow transition within the United States for the BSN as the preferred degree for entry into the profession. The second is that practice roles are undergoing transformative changes in every part of the health care delivery system. As a result, nurses face extraordinary challenges to meet the emerging health care needs in a society that has experienced a long response to a global pandemic and faces significant health disparities. Nurses are positioned extraordinarily well to design innovative, and new models of care to respond to these challenges with a selfless commitment to remain true to the core work of the profession.

For eighteen years, the American public has acknowledged nursing as the most trusted profession in the United States ( Gallup, 2021 ; Reinhart, 2020 ). As the current COVID-19 pandemic has demonstrated, nursing is an essential profession whose members are highly valued, trusted, and respected. But the practice of nursing remains uneven – a reflection of wide variations in educational preparation, clinical expertise, and professional growth among its millions of individual clinicians. Nurses themselves often have difficulty articulating the essence of their practice. It is therefore not surprising that the public it serves has yet to fully grasp a consistent understanding of nursing's unique contributions to society much beyond nurses' uniform person-centered caring, comforting presence, reliable judgment, and technical expertise.

The protracted Covid-19 pandemic highlights the need to fully define what nurses do through the lens of what we, the authors, call the exemplary practice life for all nurses. Recently there have been calls that recognize the need to clearly describe the roles and expectations of nurses ( Godsey et al., 2020 ; Ulrich et al., 2020 ). We are proposing a universally applicable, compelling, straightforward conceptual model to explicate what nurses do. This model can guide nurses in their work, in whatever setting and in whatever the current stage of their careers. We believe that a universal holistic model is needed given the complexities of a global economy, the disparities embedded in the health care needs of society, the demand for expanded knowledge development, technological innovation, the pace of change in health care systems, and the public need to understand the work of nurses.

The aim of this paper is to describe a new holistic conceptual model that visually depicts what constitutes exemplary practice for a registered nurse formatively educated at the baccalaureate or master's entry level. To better understand exemplary professional nursing practice, we developed a model that describes such a person's essential attitude, behavior, and capability within the context of four independent, yet inter-related, pillars of: professionalism, scholarly practice, leadership, and stewardship. This model is named The Exemplary Practice Life of the Nurse . We define exemplary nursing practice as the best of the best of the art and science of nursing, and it represents the highest level of knowledge, expertise, and competence. While baccalaureate or master's entry graduates are prepared for an exemplary practice life, this evolves over a full career trajectory and is applicable across all professional nursing roles and practice settings.

Assumptions for an Exemplary Practice Life of the Nurse

The following are a set of assumptions that we believe underpin a framework for all nurse work, and as a result form the foundation of an exemplary practice life. These assumptions have been shaped by the history of the profession of nursing and are relevant to nurses in the present and for the future.

Assumption one

Society can expect that each nurse who has completed formative education at the baccalaureate or master ' s entry level will possess knowledge , attitude , behavior , and capability to care for all who need it regardless of setting .

The complexity of current practice environments requires critical thinking skills and a strong foundation in the art and science of nursing that are more completely developed during baccalaureate and master's entry level education. Society can expect that the knowledge, attitude, behavior, and the capability of a nurse will deepen over the course of a full career. Career advancement is tied to aspiration, experience, intent, formal education, and professional development. Optimal work settings support nurses throughout their careers to meet their developmental goals.

Assumption two

Society can expect each nurse to accept and value all persons as equal , worthy of respect and with intrinsic worth , regardless of all other considerations .

Nurses are formatively educated with a holistic and generalist framework that sets the background for a career that embraces diverse roles in diverse settings with and for diverse people, anywhere and in whatever roles to assure the public that healthcare is available for all. Furthermore, nurses are socialized to fulfill the expectation that a humanistic, individualized, person-centered approach to care uses social justice tenets as the foundation of interactions with others.

Assumption three

Society can uniformly expect each nurse to possess a set of role attributes and role functions that guide the scholarly work of all nurses .

Nurses use knowledge that prioritizes the ability to form therapeutic relationships; they appreciate the necessity to partner with people in their practice; they develop the capacity to teach; they are competent in the use of scientific knowledge and creativity to critically analyze phenomena and deliver evidence-based care. Nurses exert their capability to effectively collaborate with all stakeholders involved with the health and wellness of the public; they have been educated and socialized to be leaders in communities and within their practice settings. Nurses possess the ability to provide expert humanistic and holistic care to self and others that reflects kindness, compassion, respect, and mindfulness in their practice.

Assumption four

Society can expect that each nurse is adaptive to change and committed to the core tenets of professional practice regardless of the practice setting or role .

Working in complex environments that are constantly changing calls upon the nurse to understand the essence of the professional role. Leading change in formal and informal processes that result in improvements is a key role of the nurse and results in continuous learning by self and others. To best serve the health and wellness needs of society, the core of nursing's work centers on a strong collaboration with interdisciplinary partners and the people they serve. These collaborations often serve as natural laboratories for the design and implementation of dynamic innovations. Most importantly, nurses are committed to live and conduct practice with integrity, dignity and respect that includes a social, personal, and professional responsibility and accountability for one's actions as a member of the profession.

The model: The Exemplary Practice Life of the Nurse

In this model, the exemplary practice life of a nurse is illustrated as four essential pillars that provide a foundation for nurses as they evolve professionally. We envision this model as a holistic guide that affords the nurse the ability to prioritize individual pillars while always understanding the relationship and influence of pillars to each other and to the whole. There are four pillars in this model: professionalism, leadership, scholarly practice, and stewardship.

As shown in Fig. 1 , the four pillars in the model support the exemplary practice life of a nurse that, in turn, serves to advance the health and wellness of society. The placement of health and wellness of society represents the pinnacle to be achieved of in terms of exemplary practice. Its position as the highest point in the model serves to recognize the direct impact of an exemplary practice life of a nurse on society. The pillars link to a cross-directional arrow that represents the inter-related, yet independent, relationship among pillars. The model also illustrates the essential characteristics of each pillar. For example, the nurse exercises core responsibilities in professionalism when he or she invests in lifelong learning and self-care, accepts responsibility and accountability for the health and wellness of society, and comports with a strong professional identity. Each pillar of the model is subsequently explained in detail.

The Exemplary Practice Life of the Nurse .

In this model, the four core pillars rest on stakeholders. Stakeholders include individuals and groups who have an interest or an investment in supporting the exemplary practice life of the nurse and in turn the health and wellness of society. These include: the nursing profession (the body of individual nurses and professional associations/organizations, regulatory and credentialing bodies); education or the academy (colleges and universities that prepare nurses at the formative level); the workplaces (where nurses and inter-professional health care colleagues are employed); and the community (an essential part of society that shares common characteristics, aspirations, and challenges). These stakeholder groups are represented by the labels: Profession , Education , Workplace , and Community .

In the following sections, we describe each of the pillars and provide evidence for the choice of each in the model.

Professionalism

To understand professionalism as one of the pillars of an exemplary practice life of a nurse, we recognize the varied and rich history of nursing. Early historians noted that nursing's initial primary work centered on a sense of obligation to community through service of others ( Donahue, 1996 ). Over time, nurses, individually and collectively, engaged in societal struggle to address the need for equity ( Dock & Stewart, 1938 ). The term professionalism was rarely used in the literature prior to the 20th century. But what is informally described in the historical narratives are behaviors and characteristics used in the practice work of nurses during such times. The narratives connect the past to the present and offer guidance for the future.

Although controversial in the historical record, Florence Nightingale, with strong views about health and wellness and the unwillingness to accept the dictates of the politics of the day, brought professionalism into the lexicon of nurse work ( Donahue, 1996 ). She advocated for nurses to move beyond benevolence as the model of care to one where education preceded practice; where practice was a duty to society; where the character, values, passion for the care of the sick and their communities were frequently stated ideals for nurses. Nightingale recognized the importance of full nurse engagement, a positive approach to health promotion and informed decision making, and the pursuit of social justice as the bedrock of a professional life ( Beck, 2010 ; MacQueen, 2007 ; Wagner & Whaite, 2010 ;).

Two centuries later, the concept of professionalism continues as both multifaceted and complex.

Studies identify a wide range of dimensions, attributes and influences linked to the development of professionalism ( Ali et al., 2020 ; Garcia-Moyano et al., 2019 ; Ohlen & Segesten, 1998 ). The International Society for Professional Identity in Nursing (ISPIN) has committed its core work to developing the science to order to understand identity formation in nurses ( Godfrey, 2020 ; Joseph et al., 2021 ). Their work is grounded in a concept of professionalism that incorporates two distinct professional paradigms, social and psychological, into the nurse's professional identity ( Crigger & Godfrey, 2014 ).

Nurses often express the view that professionalism is easier for them to describe as situationally related actions than to define as a complete set of behaviors. There is no universally accepted definition of professionalism. This fact is not surprising given the complexity of the concept. Johnson (2015) reported counting sixty words or concepts in an informal review of the term professionalism. Regardless, professionalism remains a personally important concept for nurses. To explain its meaning, one needs to begin with the fact that no one is born a professional. Rather, it is an intentional process of development that begins in formative education, transitions into the workplace, and continues through the major stages of a nurse's career. “Developing and nurturing professionalism in nursing takes time, authentic presence of leaders, engagement of colleagues and somehow creating a feel of value in the contribution of each nurse, from the bedside to the boardroom” (p. 266, Leclerc, 2017 ). Professionalism is a purposively evolving mode of thinking and acting ( Johnson, 2015 ).

There is recognition that professionalism requires the individual nurse to act as the fully accountable agent of professional responsibility, throughout their career. Stakeholders, who are invested in the practice life of the nurse, are also recognized as important influencers because they support the development and promotion of conditions that are conducive to sustaining professionalism ( American Nurses Association, 2014 ). Professionalism offers a covenant with society as to what attitude, behavior, and process govern the work of nurses no matter where they practice and whatever their practice role.

As such, we posit that professionalism is a multidimensional lived experience that includes a combination of characteristics, values, conduct and actions. Professionalism includes identity formation, comportment, acceptance and accountability for professional responsibilities and expectations. Reflection, the need to form a therapeutic relationship integral to the caring relationship, passion for the work of a scholarly practice, as well as civic and social responsibility further define the understanding of professionalism. Nurses prioritize being available for others: for people, patients and families, colleagues, peers, workplace, and communities.

Professionalism informs the blueprint for educational programs, statements of workplace expectations and signposts for the nurse to incorporate into the other pillars of an exemplary practice life of the nurse. The newly approved AACN Essentials details the domain of Professionalism with its related descriptors, contextual statements, and competencies to be achieved during formative education ( AACN, 2021 ). Professionalism, in all its dimensions, clearly is an essential pillar of an exemplary practice life of the nurse.

Scholarly practice

Scholarly practice has consistently been part of the discussion surrounding the essential components of nursing practice. Since 1922, Sigma Theta Tau, the International Nursing Honor Society has recognized and promoted nursing scholarship as one of its major tenets ( Sigma Theta Tau, 2020 ). Carper's (1978) seminal work formulated what she coined “nurses' patterns of knowing” which set the foundation for scholarly practice. Benner's model From Novice to Expert further advanced this discussion as an explanation of how knowledge and skills are acquired and applied to nursing practice ( Benner, 1982 , Benner, 1984 ). While the dialogue on how to define scholarly practice continues to evolve, the message of its importance to the profession and to quality patient care outcomes remains consistently strong. Riley et al. (2002) , described a universal holistic model of scholarly nursing practice consisting of the scholarship of knowing teaching, practice, and service. This model evolved later to include the role attributes of “who I am” and “what I do” ( Riley et al., 2008 ). Participants ( N  = 36) in this qualitative study shared that they think of themselves as: 1) available for others, 2) active learners, 3) out of the box thinkers, 4) passionate about nursing, and 5) confident. They carry these values while leading, caring, sharing knowledge, and being self-reflective. We believe that scholarly practice includes the characteristics of developing new knowledge, improving practice, basing practice decisions on evidence, designing, and implementing innovative practices, using creative approaches to individualize the needs of the people we serve, and advancing system-wide priorities and initiatives.

There is professional consensus that formative nursing education programs have the responsibility to prepare their graduates for a scholarly practice. The competencies attained by baccalaureate and master's entry prepared nurses within their formative education are driven by the National League for Nursing (NLN) and the American Association of Colleges of Nursing (AACN). These competencies set the stage for a lifetime of scholarly practice. The National League for Nursing (2021) identifies four core competencies for all graduates of all formative educational programs, two of which support the expectation of scholarly practice. These include the spirit of inquiry and nursing judgment both of which prepare graduates for a “practice that is informed by a body of knowledge and ensures that all members of the public receive safe, quality care” ( NLN, 2021 ). The approved 2021 AACN Essentials ( AACN, 2021 ) labels this competency as ‘Scholarship for the Nursing Discipline’ and defines it as “the generation, synthesis, translation, application and dissemination of nursing knowledge to improve health and transform health care” p.11. The related sub-competencies include: advancing the scholarship of nursing; integrating best evidence and promoting the ethical conduct of scholarly activities.

After completing formative education at the baccalaureate or master's entry level, nurses, in partnership with the workplace and other stakeholders, assume responsibility for building on the foundation for scholarly practice competency attained in nursing education. As nurses transition into practice settings across a diverse and complex healthcare system, it is imperative that practice settings, in partnership with individual nurses and professional associations, fully support and help shape, evolve, and make a commitment to implementation of scholarly practice. Organizational credentialing bodies such as the American Nurses Credentialing Center (ANCC) and others promote the development of scholarly practice through a culture of individual and organizational scholarly practice. ANCC's include the ANCC Magnet Recognition Program, The ANCC Pathway to Excellence Program and The Practice Transition Accreditation Program (PTAP). While not all health care organizations are magnet designated, we believe that each individual nurse must commit to scholarly practice wherever they practice.

Scholarly practice is as much about attitude as it is about using a systematic approach to plan and deliver care and conduct other work of professional nurses. This attitude or mindset includes a commitment to systematic inquiry with the following questions in mind: How can we do this better? What does the evidence at all levels tell us? How can we do this in a way that meets the needs of this particular person or groups of people? How can what we learn be applied to broader groups of people within society served in a variety of contexts?

We believe that all nurses are capable of engaging in a scholarly practice. This capacity matures throughout a nurse's career. Nurses and the public have been socialized to think of scholars as educators and researchers employed by colleges and universities. According to Broome (2021) , “Despite our own internal conversations, the public does not think of us as scholars and scientists…” p. 250. Because of this prevailing belief, many nurses have been reluctant to embrace themselves as practice scholars and capable of scholarly practice. Nurses, however, do think of themselves as highly creative, resilient, and accountable for seeking information, and scientific and aesthetic evidence to help formulate their plans, decisions, and actions.

Nurses with a scholarly practice prioritize learning; they know the people they care for; they believe that knowledge is ever evolving. Nurses recognize that, for them to be at their best, they need to continually learn in formal and informal ways. They collaborate and partner with others including the people they serve to find solutions to healthcare and societal challenges. This is scholarly practice!

As such, nurses with a scholarly practice accept responsibility for implementing and disseminating new knowledge for the advancement of the health and wellness of society. This important process occurs in the clinical care setting, in the classroom, in the conduct of research, in whatever setting and role the nurse holds. Scholarly practice with its direct connection to the health and wellness of society is an essential pillar of an exemplary practice life of the nurse.

The early literature on leadership was primarily driven by leaders and scholars from the world of business ( Kouzes and Posner, 2003 ). More recently, other professional disciplines including nursing have joined in the development and analysis of the theories and practice of leadership. There remains considerable debate about what leadership really is and how it differs from management. As a result, there is a plethora of definitions of leadership from both within and outside nursing. Diers (2004) , in one of her classic editorials, wrote that leadership is viewed as multi-dimensional, encompassing the wise use of power, managerial functions, and human relations processes. We believe that leadership is a set of actions and behaviors used by individuals or groups of individuals within their environment that facilitates the establishment and acquisition/achievement of shared goals ( MA Department of Higher Education, 2016 ).

The following review of the literature centers on understanding leadership and its expected behaviors. From the world of business, Kouzes and Posner have been writing about exemplary leadership since 2003. In their seminal work, they define essential leadership practices that are important to promoting growth of an individual and an organization. This definition includes engaging and empowering all members in the organization to establish sustainable outcomes intentionally and collaboratively. They describe five leadership practices: 1) ‘modeling the way’, 2) ‘inspiring a shared vision’, 3) ‘challenging the process’, 4) ‘enabling others to act’, and 5) ‘encouraging the heart’. While ‘encouraging the heart’ has not typically been viewed as a leadership competency, executive coach Daskell (2017) wrote that love is a leadership competency. By leading with compassion, commitment, kindness, and competence one can motivate others toward achieving greatness.

The long running and highly effective Robert Wood Johnson Executive Nurse Fellows Program (1997–2017) identified core competencies for nurse leaders ( Bellack & Morjikian, 2005 ). These include:

• • Self - knowledge , or self - awareness is the ability to understand and develop oneself in the context of organizational challenges, interpersonal demands, and individual motivation.
• • Strategic Visioning is the ability to connect broad social, economic, and political changes to the strategic direction of organizations. Strategic nurse leaders are always thinking about the next step.
• • Risk - taking and Creativity is the ability to transform both oneself and the organization by moving outside the traditional and patterned ways of success. A leader who is a risk taker often feels uncomfortable and learns to accept this discomfort.
• • Interpersonal and Communication Effectiveness is the ability to translate a strategic vision into compelling and motivating messages. Great leaders care about people with whom they work. They stay on mission but are always listening to divergent voices.
• • Inspiring and Leading Change is the ability to inspire, structure, lead and effectively implement organizational change in an inclusive way. Great nurse leaders lead from their values. Their personal integrity and moral courage are the cornerstones of their legacies.

While the RWJ program was a formal program directed toward nurses aspiring to advance in their leadership roles, we believe that these five constructs are applicable to leadership development of all nurses, regardless of title or work setting.

Leadership identity has typically been associated with a hierarchical, authoritative, and formal position ( deZuleuta, 2015 ; Van de Mieroop et al., 2020 ). However, there is support in the nursing literature for the importance of informal leadership where the leader may not have a formal titular position or authority over a group of individuals. Informal leadership roles are exercised by those individuals who are situationally willing to step up and take actions; they are the “go-to nurses” ( Clifton, 2014 , p. 68). Within the culture of workplace organizations, an informal leader has been described as anyone who directs/guides a group toward accomplishing desired outcomes ( Ross, 2014 ). Nurses, who engage in scholarly practice throughout the healthcare enterprise, assume informal leadership roles in acknowledged and unacknowledged ways.

Riley et al. (2008) in their study that explored perspectives of thirty- six experienced nurses' descriptions of their scholarly nursing practice, found that participants' perspectives of leadership differed from more traditional views of formal leadership. Participants spoke to a non-hierarchical approach to leadership that they repeatedly called “stepping up the plate over and over again to guarantee the highest level of care…to develop others and to advance practice” (pg. 431). Informal leadership was their expectation for their exemplary practice life. We believe that informal leadership needs to not only be further developed and supported but included in the performance expectations for every nurse in every workplace.

Based on experience, research, and a synthesis of the literature, we believe that all nurses educated at the baccalaureate or master's entry level are prepared to be leaders. Whether in informal or formal leadership positions, nurses are held to the following expectations: developing oneself and others; embracing cultural humility, inclusivity, and diversity; modeling professional practice and behavior with a non-hierarchical approach; communicating with colleagues and others with clarity and purpose; managing resources effectively; and collaborating with others to advance the practice and profession of nursing and health care for the benefit of society. Nurses as leaders are reflective, visionary, and strategic thinkers who feel comfortable taking risks and innovating in even the most challenging situations ( Bellack & Morjikian, 2005 ).

We believe that both the formal and informal nurse leader is obligated to advance oneself, others, and the profession with humility, inclusivity, and generosity of spirit. Whatever the role, a nurse leader has the ability to influence others and build consensus toward a mutually shared goal or decision on both the micro and macro level. For example, the nurse leader has the responsibility to advocate for advancing health equity for all by removing practice barriers and supporting nurses in their efforts to understand the impact of the social determinants of health ( NASEM, 2021 ). For these many reasons, leadership is one of the four pillars that supports the exemplary practice life of the nurse.

Stewardship

Identifying stewardship as one of the four pillars supporting the exemplary practice life of the nurse is both timely and necessary. Nursing is charged with preparing for its future while living in the present. All nurses are called upon to assume a stewardship responsibility for the conservation of the ideals of nursing while leading consequential changes in health care environments that impact the health and wellness of society.

The concept of stewardship, outside the boundaries of a profession, has a long history. When the word stewardship first appeared in the English language during the Middle Ages, it functioned as a job description, denoting the office of a steward , or manager of a large household ( Merriam-Webster, 2020 ). Over the centuries, the understanding of stewardship expanded to include the oversight by the courts and many organizations. In recent years, the long-established “management” sense of stewardship has evolved into a positive meaning emphasizing “careful and responsible management” ( Merriam-Webster, 2020 ). The historical evolution of stewardship carries forward a set of ideals that include duties, shared responsibilities, oversight, resource preservation, prudence, and advocacy into a modern era.

Twenty first century stewardship ideals are addressed in business as integrated leader behaviors that place long term best interests of the business entity and stakeholders over self-interest ( Hernandez, 2008 ; Hernandez, 2012 ). Leaders, committed to their role as steward, see the benefit of this scope of social responsibility to their workforce and to society. Hernandez (2012) calls stewardship behaviors a “type of prosocial action” that carries with it a positive effect on people. Although primarily associated within a formal leadership role, there is current recognition that stewardship can and should live in all levels of organizations, adopted by all individuals, regardless of positional power ( Dalcher, 2019 ).

In a traditional view of stewardship, nurse leaders and scholars are entrusted to preserve and hold in trust the value priorities of stakeholders ( Milton, 2014 ). According to Haase-Herrick (2005) the simple essence of the diversity of stewardship actions for nurse leaders is grounded in the imperative to leave a profession, discipline, and scholarly practice in a better place than where it was found. This imperative does not apply only to nurses who are in formal leadership or scholar roles.

In broadening the responsibility of stewardship to include all nurses, the exercise of stewardship actions becomes a transformative experience that assures transparency and accountability for conserving what is essential in the profession and beneficial to society. With a more inclusive view of stewardship, all nurses, as stewards of the profession, exercise their responsibility to preserve what is intrinsically good and valuable in the profession, while promoting what knowledge and practice benefits the health of society ( Murphy, 2009 ; Murphy & Roberts, 2008 ).

Stewardship is not a one size fits all paradigm. Nurses are advocates at the point of practice or wherever they do their work. The consistent outcome of their advocacy is to preserve the core values of a practice profession while embracing practice changes that improve experience and outcomes of care. For educators, curricular learning opportunities that reinforce the expectations and responsibilities of being a steward of the profession begin to emerge at the point of formation of future nurses. For leaders of the profession, opportunities emerge at the nexus of transforming practice environments to meet society's current and future health needs. For researchers, stewardship implies a commitment to use their requisite abilities and curiosity to delve into the study of core nursing phenomena that address health issues that burden society. Being a steward of the profession stems from a nurse's passion and a sense of responsibility to advance the profession's work.

In a national study of chief academic nursing officers ( Beal & Riley, 2015 ), participants shared that they believed that every nurse, regardless of role or practice setting, is a steward of the nursing profession and of scholarly practice. Participants' collective vision for the future of baccalaureate education was that educational programs would place more focus on “helping students think about themselves as members and future stewards of the profession” ( Beal & Riley, 2015 , p. 382). In a recent national study, senior nurse leaders in magnet hospitals confirmed that “nursing culture is both significant and consequential to the nursing milieu as well as the overall organization” ( Beal & Riley, 2019 , p.192). Embedding expectations of stewardship for all nurses, not just leaders, into the nursing culture of health systems adds potential for significant influence within the organization.

The key question then becomes: Who is responsible for stewardship of the profession? We believe the expectation for stewardship must be expanded to include a responsibility for all nurses, operationalized in different ways, across the lifetime of a career. This expectation broadens meaningful actions to include sharing knowledge with others, mentoring, and teaching, using knowledge of the business of healthcare to specifically impact health policy, regulation, ethical and financial decisions. These are actions that support the essence of the profession. As a touchstone for both preservation and change, stewardship in today's health care enterprise, leads to a wide range of critical opportunities for all nurses. We therefore believe that this expanded stewardship paradigm earns its placement as a supporting pillar for the exemplary practice life of a nurse. The legacy of stewardship is a future workforce that is comfortable with their professional heritage yet sensitively responsive to the changing healthcare needs of society.

Summary of the model

The holistic model The Exemplary Practice Life of the Nurse calls for nurses to commit to developing an exemplary practice throughout one's career. Table 1 : Core Commitments with the Holistic Model: Exemplary Practice Life of the Nurse summarizes the essential attitudes, behaviors, and capabilities within the context of the four independent but inter-related pillars.

Core commitments with the holistic model: exemplary practice life of the nurse.

The proposed model emanates from nursing's historical roots, respectful of its past while positing perspectives to guide the profession to meet current and future societal needs. Understanding the relationship between and among pillars represents the essence of an exemplary practice life. A holistic model adds equipoise in the components of nurse work. The model allows for counterbalancing the essential components while offering guidance to nurses in the whatever the situation that they confront in meeting the universally stated goal of health and wellness of all members of society. Because of the nature of their work, nurses need a holistic model to serve as foundational to their practice life. Such a model transcends all roles and work-settings and offers stability within an ever-changing health care environment. An unexpected benefit could be that the society will more clearly understand the essential elements of a nurse's practice life.

Each of the four pillars of this model has been separately described in the literature. What was not discussed in the literature was the inter-relationship of these four essential pillars to each other and how, as independent but inter-related entities, they holistically support the exemplary practice life of the nurse. The importance and value of informal leadership has also been overlooked. Three pillars (Professionalism, Leadership, and Scholarly Practice) are incorporated into competencies that drive formative education, advanced education, and workplace norms. Their relationship to each other, within these systems, however, is not well articulated within the competencies. Historically, stewardship, the fourth pillar, has been assigned and well-described for executive levels of leadership but not addressed as a responsibility for all nurses. There has been a recent call to make stewardship an explicit component of PhD education programs ( Morris et al., 2021 ). While important, the call must be expanded to include educating all students to be stewards of the profession.

We fully acknowledge the significant contributions of the academy and professional organizations over decades of dedication to the advancement of nursing education ( AACN, 2021 ; NLN, 2021 ). We recognize that they have a long-standing commitment to the development of specific essential competencies and principles for educating nurses. Faculty have developed curricula guided by the professional educational standards of these organizations. The complexity of today's nursing curricula calls for a simple, concise, and holistic translation the nursing competencies for each student and nurse to internalize what it means to have an exemplary practice life. We believe that this is the ultimate goal of nursing education at the baccalaureate and master's entry levels. To accomplish this translation, and at the same time provide a seamless transition to practice, faculty should integrate and emphasize the four pillars of this proposed model into teaching/learning experiences throughout the curriculum. The model offers a pragmatic framework to guide and support a nurse's practice life. Currently we know of no model or framework that captures the essence of exemplary practice life in a simple, concise, and holistic manner.

We introduced this paper with the important recognition that society once again acknowledges nursing as the most trusted profession in the United States ( Gallup, 2021 ; Reinhart, 2020 ). Globally, the International Year of the Nurse and Midwife continues to link the exemplary life of the nurse with stories of contemporary exemplary practice. At the same time, there are reports in recent literature about three distinct but related calls for nurses and the profession that are discussed in the following paragraphs: 1. The need to claim an authoritative role as leaders in health care services; 2. The need to claim a complete and accurate professional image for nurses; 3. The need to reclaim values foundational to the profession.

While nurses are clearly viewed as trustworthy, we are not perceived by the public as leaders, scholars, or innovators who make major contributions to healthcare delivery ( American Nurses Association, American Organization of Nurse Leaders, Johnson and Johnson, 2020 ; Broome, 2021 ; Prybil et al., 2019 ). The study findings of Godsey et al. (2020) address the need for change in the brand image of the nurse. These findings report factors contributing to the inconsistent and often negative image of nursing. They posit that variability in educational preparation, lack of visionary leadership, lack of leadership development, and an inconsistent professional image are significant contributors to the inability of the profession to demonstrate full leadership throughout the healthcare system.

The 2020–21 Covid-19 pandemic exposed fractures and vulnerabilities in our health care delivery system ( Ulrich et al., 2020 ) that include oppressive and discriminatory structures that are embedded in the organizations in which nurses work ( NASEM, 2021 ). These papers call for the need for nurses to step forward to lead substantive institutional reform. This will require an increased emphasis on supporting nurses in these endeavors ( NASEM, 2021 ). This call is an urgent message to see, as one endpoint in the pandemic, an opportunity to reclaim “values foundational to our profession and to establish new norms of communication and teamwork, intentionally address [ing] disparities” (p. 843, Ulrich et al., 2020 ).

These calls offer some insights that are germane to the proposed model. The Exemplary Practice Life of the Nurse is a simple yet compelling description of the essential work of every nurse integrated into four inter-related pillars. The model answers the calls for a strong professional image and compelling leadership that embrace the foundational values of the profession. It is consequential for formative education at the baccalaureate and master's entry level education. Most importantly the model acknowledges a consistent universal recognition of what nurses do in all roles, in all work-settings and within our global society. This model can be part of the solution of clearly describing the important work of nurses.

Recommendations

Proposing the model.

The Exemplary Practice Life of the Nurse , in conjunction with the greatest public health crisis since the 1918 flu epidemic, provided an opportunity to reflect on the rich past, the present, and the emerging future or our profession. Guided by this perspective we provide recommendations for the use of this model for individual nurses, the workplace, the academy, the profession, and the community. Specifically;

• • We ask all nurses to consider re-framing their practice life to include the inter-related pillars of professionalism, scholarly practice, leadership, and stewardship. We recognize that the implementation of this model may look different at specific stages of a nurse's career.
• • We ask that workplace leaders commit to examining and integrating this model as a mechanism to support all nurses throughout early, mid, and late career phases. We ask them to consider the integration of the model in systematic performance evaluation matrices that foster an exemplary practice environment.
• • For the academy, we ask that leaders commit to conducting a systematic curricular appraisal to ensure that the model components are equally integrated throughout educational formation. Formative clinical learning needs to shift from a predominately skill acquisition model to a model that recognizes a more equitable distribution of the four essential pillars as the foundation for developing an exemplary nurse. Accomplishing the integration of this model into the curriculum is the first step in preparing the nurse of the future.
• • We ask the leaders of professional associations to use their collective voice to advocate for the privilege of all nurses to have an exemplary practice life. The right of all members of society to have their health and wellness needs met equally requires no less than all nurses having an exemplary practice life. Furthermore, we ask that professional associations work collaboratively with certification, accreditation, legislative and regulatory bodies to commit to advancing the BSN as the preferred professional nursing degree. While efforts have been made in the past, there is a greater sense of urgency as the complexity of care continues to increase.
• • For communities, we recognize their position as a guardian and supporter of society's health and wellness needs. We ask for continued support in new and emerging ways that reflect the conditions, commitments, changes, and requirements that must be confronted.

In conclusion, we ask service and academic leaders, and individual nurses, as partners, to review, implement and evaluate this model to seamlessly support career transition and the development of an exemplary practice life for all nurses.

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NursingTroop

Accessories for Nursing Students & Working Nurses.

28 Essential Qualities & Attributes of a Good Nurse

Nursing is a demanding profession that requires more than technical skills and knowledge to be successful. Being a practical nurse also takes certain qualities, characteristics, and values. These essential qualities of the best nurse are necessary for providing quality care and creating positive patient outcomes. From being compassionate and having excellent communication skills to staying organized and flexible, these 28 essential qualities of successful nurses can help you become an exemplary healthcare provider.

Table of Contents

Essential Qualities of a Good Nurse

Being a good nurse requires many qualities and skills, such as the ability to think quickly and act decisively in moments of medical crisis. Compassion, empathy, and patience are also essential because they help nurses build relationships with individual patients and their families. Let’s conclude it with the following points:

1 . Compassion :

Being compassionate is one of the essential qualities a nurse can possess. A good nurse will show empathy and understanding for their patients to create an environment that promotes healing and support.

2. Respect :

Treating all patients with respect, regardless of their background or culture, demonstrates professionalism and creates positive outcomes in the long run.

3. Strong Communication Skills :

Communicating effectively is critical for nurses to succeed. A great nurse can listen, understand and respond appropriately to patient needs.

4. Attention to Detail :

Nurses need to pay close attention to detail when taking patient information, assessing symptoms, recording data and administering medication.

5. Organization :

Staying organized is essential for nurses as they juggle multiple tasks and care for many patients simultaneously. Good organizations can help them stay on top of everything while providing quality care.

6. Adaptability :

The healthcare environment is constantly changing, so being flexible and adapting quickly is a critical skill for nurses. It helps them stay ahead of the curve and create better patient experiences.

Also, the  healthcare industry  (and workers) must be successfully adaptive to provide the best quality patient care possible.

7. Integrity :

In  nursing , integrity means being honest and ethical regarding patient care. Good nurses trust their judgement and ensure safety is always a top priority in the workplace.

8. Patience :

Managing multiple tasks with tight deadlines can be stressful for nurses, so having patience is essential for success. Good nurses take the time to listen to patient’s concerns and provide them with quality care without rushing through anything.

9. Self-Confidence :

Having confidence in your skills as a nurse allows you to think independently and make informed decisions quickly in challenging situations.

10. Interpersonal Skills :

Working in teams is an essential part of nursing, so good nurses need to be able to collaborate and communicate effectively with colleagues.

11. Leadership :

Nurses often take on leadership roles within the healthcare environment, so they must lead their team positively while still providing quality care.

Strong attention to detail is one of the  nurse’s personality traits  that can easily and quickly determine how successful they’ll be in their role.

12. Emotional Intelligence :

Nurses need to recognize emotions in themselves and others and act accordingly. Being emotionally aware can help them create better relationships with patients, families, and colleagues.

13. Professionalism :

Professionalism is essential for nurses as it impacts how others view them and their profession. Good nurses are always professional when interacting with their patients, no matter the situation.

14. Motivation :

Being motivated and having a positive attitude is vital for nurses to stay focused and successful in their nursing job.

15. Work Ethic :

Good nursing careers have a strong work ethic and are dedicated to providing quality patient care. They take ownership of their responsibilities and strive to do their best with the available resources.

16. Problem-Solving Skills :

A good nurse needs to think on their feet and creatively solve problems as they arise in patient care.

17. Flexibility :

Handling last-minute changes or requests from colleagues or patients is another essential skill for nurses, allowing them to adapt quickly to different situations.

Additionally, Experienced nurses offer a wealth of knowledge to their creative counterparts, who eagerly tap into those resources for personal and professional growth. This cycle of sharing enriches the entire nursing community with an abundance of insight and understanding.

18. Stress Management :

Nurses often have to juggle multiple tasks simultaneously, so managing stress is essential. Good nurses can prioritize their tasks, reduce anxiety and maintain a positive outlook in high-pressure scenarios.

19. Compassion :

Compassion for patients, family members and colleagues are essential for good nurses as it helps them better understand the needs of their patients and provide quality care throughout the process.

20. Empathy :

Good nurses must put themselves in the patient’s shoes and understand their origin to give appropriate advice and treatment options. Being empathetic can also help build trust with patients, which is essential for successful outcomes in healthcare settings.

21. Time Management :

Other Nurses often have to work long hours and handle multiple tasks, so managing their time wisely is critical for success. Good nurses can prioritize their jobs efficiently and complete them promptly.

22. Attention to Detail :

The ability to pay close attention and notice even the most minor details can make all the difference in patient care. Good nurses take the time to double-check every aspect of their work before making decisions or taking action.

23. Research Skills :

Many medical decisions require research, and evidence-based practice, so strong research skills are essential for success in nursing careers. Good nurses can utilize medical resources and evidence-based practice to make informed patient decisions.

24. Technology Skills :

As technology evolves, nurses must keep up with the changing landscape to use new medical tools and technologies successfully. Strong technology skills allow them to navigate electronic medical records and other medical software quickly and accurately.

25. Cultural Competency :

Knowing how to interact with people from different backgrounds is essential for successful nursing care. Good nurses can recognize cultural differences, respect those differences, and provide culturally competent care.

26. Communication Skills :

Clear and effective communication is essential for successful nursing care as it helps build trust with patients and colleagues. Good nurses can communicate their ideas concisely and respectfully while listening intently to ensure they understand the patient’s needs.

27. Teamwork :

Working with other healthcare professionals is essential to providing quality patient care. The professional nurse knows how to collaborate with colleagues, share resources, and utilize each other’s strengths to provide the best possible outcome for every patient.

28. Critical Thinking skills: 

Being able to think critically and assess information quickly is essential for nurses. Good nurses can weigh the pros and cons of different treatments or procedures, consider feedback from colleagues, and make decisions based on evidence-based nursing practice to provide the best possible care.

These skills are all critical components of being a successful nurse, so having these traits will help any nurse excel in their career. Good nurses can draw from these skills to provide quality care and help improve the lives of their patients.

We hope that this list has provided an abundance of insight and understanding into the essential skills that every nurse should possess. Nurses can provide comprehensive care and ensure positive patient outcomes with these skills. Good luck in your nursing career.

Mrs. Marie Brown has been a registered nurse for over 25 years. She began her nursing career at a Level I Trauma Center in downtown Chicago, Illinois. There she worked in the Emergency Department and on the Surgical Intensive Care Unit. After several years, she moved to the Midwest and continued her nursing career in a critical care setting. For the last 10 years of her nursing career, Mrs. Brown worked as a flight nurse with an air ambulance service. During this time, she cared for patients throughout the United States.

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Qualities of a Nurse

Updated 13 November 2023

Subject Nursing ,  Work

Downloads 28

Category Health ,  Life ,  Profession

In the nursing profession, different qualities contribute in making a successful nursing career. In addition to passing exams, successful nurses possess different traits that can either make them successful in their work or not. In an effort to establish successful career, nurses are required to show traits or natural qualities so as to be regarded as a great nurse. These include qualities such as empathy, adaptability, effective " therapeutic communication, humility and efficiency. Additionally, trustworthiness, compassion, respect and knowledge also plays key role in identifying a competent nurse. This essay identifies three key qualities of a nurse, as well as analyzing articles addressing the qualities.

One of the selected component for this essay with reference to qualities of nursing is compassion. The practice of nursing requires the efforts, ensuring the patients receives the best care possible. This in turn calls for nurses to be kind, understanding as well as caring towards their patients. This in turn contributes to one being a compassionate nurse. Compassion can be shown through empathy, listening to the patient, being positive towards others, positive body language, positive interaction and socialization and often checking on patients. These actions represent symbols of compassion in nursing.

On the other hand, trustworthiness is another factor that has become an integral element defining successful and competent nursing. The nursing ethics considers trust as an aspect rising form people, or nurses' ability to trust others and in turn extend the trust to another within the healthcare sector. In order for trust to thrive it have some key antecedents. These include; frequent communication between the patient and the care provider, acknowledging the nurses role, professionalism and commitment. However, negative influencing factors include; lack of effective conflict management as well as deteriorating employment conditions. However, being trustworthy remains a challenge as due to different expectations from patients, managers, professional bodies etc. Empathic knowledge remains a detrimental and relevant factor in caring and nursing practice. There is a wide range of theoretical and practical knowledge, with nursing today demanding a considerable amount of knowledge as to offer the best and appropriate level of care to patients (Galvin " Todres, 2011).

According to Babaei et al (2017), compassion is an essential quality of nursing as it helps in fostering improved or better relationships between nurses and the patients they serve. One result of compassion is that, it allows patients to have more confidence in the care he/she receives. Nurses' personality plays an important role in an effort to facilitate as well as maintain compassionate nursing. Additionally, attitude and nurse values affect compassionate care. Not only does the article "Contextual Facilitators and Maintaining of Compassion-Based Care" highlight the importance of compassionate in nursing, but also highlights key personal traits that contribute to successful compassionate among nurses.

Galvin " Todres in their article 'Research based empathic knowledge for nursing: A translational strategy for disseminating phenomenological research findings to provide evidence for caring practice' identified empathic knowledge for nursing as an essential factor or quality that makes a successful and competent nurse in the healthcare sector. Empathic knowledge in the nursing care, allows and gives nurses the power to make informed decisions. In summary, it allows for adoption of evidence based nursing practices which in turn improves the nursing practice and individual nurse's contribution to care provision.

Connelly (2016) stated that, trustworthiness increases the aspect of dependability, conformability, and credibility with reference to nursing practice and research. This in turn improves the overall impact of nursing to patients improving the overall success rate of the practice. Additionally, the author advocated for the adoption of positive organizational model that is in turn would pose a barrier to holistic care. Finally, the selected articles provide a credible source of information

Section III

With reference to the evolution of my current perspective of nursing, the nursing education possess the responsibility to make sure, nurses qualify equipped with knowledge and attitudes that are needed for one to establish and maintain trust not only among the workers, but most importantly the nurse-patient trust. On the other hand, the increasing for top quality nursing services as well as adoption of patient centered healthcare plans, the demand for nurses to acquire top qualities have become an inevitable aspect. Different factors have in turn becomes integral mainstays for nurses to be regarded as successful and qualified to serve the ever changing and demanding healthcare sector. In addition, drawing from the peer reviewed articles, the details and information obtained can be termed as credible. In conclusion, the articles provide a different view in terms of nursing, both as a career and services in terms of care giving. Not only does nursing entail giving services to the patients but also delivering quality services to those who need it. More so, the increasing demand for improved services in the healthcare has led to an all-inclusive nursing.

Babaei, S., Taleghani, F., " Keyvanara, M. (2017). Contextual Facilitators and Maintaining of Compassion-Based Care: An Ethnographic Study. Iranian Journal of Nursing " Midwifery Research, 22 (2), 91-96.

Galvin, K. T., " Todres, L. (2011). Research based empathic knowledge for nursing: A translational strategy for disseminating phenomenological research findings to provide evidence for caring practice. International Journal of Nursing Studies, 48

(4), 522-530.

Connelly, L. M. (2016). Understanding Research. Trustworthiness in Qualitative Research. MEDSURG Nursing, 25 (6), 435-436.

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Home — Essay Samples — Nursing & Health — Nursing — Characteristics Of A Successful Nurse

Characteristics of a Successful Nurse

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Published: Mar 16, 2024

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Communication skills, critical thinking.

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Top Qualities of an Exceptional Nurse

Being a nurse is not an easy job, and we thank all nurses for their hard work. Here are some indispensable qualities of an outstanding nurse.

Being a nurse is not an easy job. The best nurses are considered  exceptional  because they have a thirst for knowledge, continual skill development and lots of experience.

What makes a good nurse is more than practical knowledge - their personality traits are every bit as important. Nurses understand how much time and energy they devote to their career, so they feel a tremendous sense of pride and accomplishment when they make a profound difference in the lives of the patients they touch. Exceptional nurses not only use their knowledge and expertise to help their patients cope with illness, they also give a piece of their heart to each and every patient under their care.

Here are the qualities of a great nurse: 

1. an exceptional nurse is compassionate.

Patients are often fearful of how an illness may affect their lives and the lives of people they love. They may feel as if they have lost control of their situation and that they are either too ill or not informed enough to speak for themselves. Nurses must be their patients’ voice, anticipate their needs and advocate for them when they are unable to do so for themselves.

2. An exceptional nurse is empathetic

Nurses are active listeners and make concerted efforts to really understand their patients’ difficulties and challenges. This is done without judgment.  Nurses understand that everyone has their own set of values and life experiences to draw upon and they try to see the situation from the patient’s perspective so that they can best meet the patient’s needs.

3. An exceptional nurse is self-aware

Nurses have a high degree of emotional intelligence. As nurses, we must first understand ourselves and the way we think in order to understand how a patient might feel about his condition or react in a certain situation. We must also recognize how our strengths, limitations, values and beliefs influence our decision-making process so that we can make objective, informed decisions that are in the patient’s best interest.

4. An exceptional nurse is detail-oriented

Nurses are meticulous and must pay close attention to the smallest details. They have excellent organizational skills and strive to maintain order.

5. An exceptional nurse is a quick thinker and utilizes excellent judgment

Nurses must rely on their skills, knowledge and experience to make quick and sound judgments. A combination of knowledge and experience is the key to recognizing a problem and offering the best solution.

6. An exceptional nurse is a lifelong learner

Nurses must be technically strong with a thirst for knowledge. The nursing profession is a scientifically rigorous discipline that requires continuing education. Ongoing nursing education supports the professional practice of nursing and ensures the delivery of safe, evidence-based, high-quality care for patients.

7. An exceptional nurse does not forget the importance of a smile

A nurse’s smile displays kindness and shows confidence in the care we provide. A smile also makes us approachable, allowing our patients and family members to feel comfortable enough to ask questions about their care.

As exceptional nurses, we have the opportunity to participate in the healing of our patients and their families’ heart, mind, soul and body. They might forget your name, but they will never forget how you made them feel.

If this sounds like you, Herzing University can help you become a registered nurse (RN) and empower you to change the lives of those in need. Learn more about our nursing degree programs .

Robin. L. Ihde , BSN-RN, is an Injury Prevention/Outreach Coordinator for Froedtert Hospital where she coordinates injury prevention activities for teens, the elderly and education to healthcare providers. Robin received her Bachelor of Science Nursing from Alverno College Milwaukee, Wisconsin. She has worked in critical care and emergency trauma nursing for close to 40 years and held leadership positions in emergency departments and hospitals.

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* Bureau of Labor Statistics (BLS), U.S. Department of Labor, Occupational Employment and Wage Statistics 2023 / Occupational Outlook Handbook 2022. BLS estimates do not represent entry-level wages and/or salaries. Multiple factors, including prior experience, age, geography market in which you want to work and degree field, will affect career outcomes and earnings. Herzing neither represents that its graduates will earn the average salaries calculated by BLS for a particular job nor guarantees that graduation from its program will result in a job, promotion, salary increase or other career growth.

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Writing Tips for Nursing School Students

• Nursing School Writing Types
• Writing a Nursing Essay
• Citations Guide
• Common Writing Mistakes
• Writing Resources

Are you ready to earn your online nursing degree?

Writing is an essential skill nurses should achieve proficiency in early in their career. It is a crucial part of the profession, as nurses need to be able to effectively communicate with patients, families, and other healthcare professionals.

While verbal communication also plays a vital role in nursing, being able to write well builds the nurse’s ability to provide better care.

Being able to accurately detail a patient’s personal history, symptoms, and diagnosis allows for the execution of a precise treatment plan that is clearly communicated to all parties involved, both professional and personal.

From registered nurses to clinical nurses and beyond, being able to communicate effectively and efficiently is a critical soft skill that will help nurses in any role increase their ability to treat their patients.

This guide provides an overview of the types of writing nurses will experience throughout their educational training. Utilize the following tips and tricks to help strengthen your writing skills, which will ultimately help in the development of transferable career skills .

Types of Writing Nurses Will Do in School

Personal statements for nursing school.

Nursing schools want candidates who meet academic and professional requirements. They also want a candidate who demonstrates a sincere passion for patient care and individual connections. You should always craft a personal statement, even when the application doesn’t explicitly require one. Personal statements allow you to describe your goals, characteristics, credentials, volunteer work, and meaningful life experiences. A well-crafted essay can help you stand out among other qualified applicants. And, as with any piece of writing, you must take the time to revise.

In your personal statement, you should portray yourself as determined and empathetic, with characteristics, goals, work ethic, and healthcare philosophy that align with a program’s values. Some nursing schools ask for a general personal statement, while others require a specific prompt. Colleges commonly ask students to describe a hardship they overcame, a difficult task they accomplished, or a professional goal they hope to achieve through the program. Many schools also ask students to detail previous experiences in healthcare. You may decide to write about how you connect with patients or how you provide practical and emotional support to loved ones.

You will also encounter writing prompts during examinations, including standardized tests like the GRE or MCAT, nursing school entrance exams , and course-specific evaluations. You may also take exams to get state licensure or professional certification. In most of these instances, you will need to write one or several long-form essays. Proper planning is key. Though you won’t know what specific prompt the test will require, you can expect certain common topics. You can search online or use study guides to determine which prompts usually appear on each test.

On test day, you should begin by creating an outline that lists three main points in response to the prompt. Using these points, work backwards to write a central thesis to guide the essay’s structure. Review what you’ve written to ensure that the essay actually responds to the prompt at hand. Be sure to leave time to correct spelling, grammar, and stylistic errors.

Research Papers

Like essays, research papers follow a long-form structure. Unlike an essay, which heavily relies on the writer’s point of view, a research paper presents an in-depth investigation of a topic using data, expert opinions, and insights. While an essay evaluates general critical thinking and writing skills, a research paper tests your knowledge, research skills, and original contributions. Research papers also allow you to prove you understand what has been argued and discovered about a topic. Research papers, especially at the graduate and doctoral levels, require independent research and analyses. These papers sometimes take months or years to complete.

To write a successful research paper, you should pick a topic relevant to your interests and the nursing field. Possibilities include elderly care challenges, patient safety and ethics, mental health treatment and regulations in the U.S., and nursing shortages and possible solutions. Whatever your choice, you must plan accordingly. Advanced papers such as dissertations may require funding or help from professors. Research papers often consist of the following sections: abstract, introduction, literature review, methods, results, discussion, conclusion, and references. You should keep this general structure in mind as you prepare notes and outlines.

How Do You Write a Nursing Essay?

In nursing school, essay writing includes academic papers, personal narratives, and professional compositions. You should become familiar with each of the five major forms below. There are many similarities between these essay types, such as an overarching thesis and a supportive, logical structure. You should support claims with factual, statistical, anecdotal, and rhetorical evidence. However, each form requires distinct skills to achieve specific results.

Comparative

Cause and effect, citations guide for nursing students.

Citations allow readers to know where information came from. By citing sources, you avoid plagiarizing or stealing another person’s ideas, research, language, and analyses. Whether intentional or unintentional, plagiarism is one of the most egregious errors one can make. Consequences for plagiarism include automatic course failure, disciplinary actions from the university, and even legal repercussions. You should take special care to ensure you properly cite sources.

American Psychological Association (APA) Style

APA is the most commonly used style among natural scientists, social scientists, educators, and nurses. Like other citation styles, APA emphasizes clarity of font style, font size, spacing, and paragraph structure. APA citations focus on publication date, and in most cases, the date comes right after the author’s name. This order makes the style particularly useful for scientists, who value new research and updates on current findings. For more information on APA style, visit this official website .

(Author and year of publication, page number) “Punishment, then, will tend to become the most hidden part of the penal process” (Foucault, 1977, p. 9).

Chicago Manual of Style (CMS)

CMS (also known as CMOS or, simply, Chicago) features two citation systems, the notes and bibliography, and the author and date. This style is used primarily by historians, who place high importance on a text’s origin. The notes and bibliography include a superscript number with a corresponding footnote or endnote. Scientific professionals use the author and date citation, a generic parenthetical system with similarities to other citation styles. The CMS official website provides additional information, including changes to citation systems in the current edition.

“Punishment, then, will tend to become the most hidden part of the penal process”. 1 1. Michel Foucault, trans. Alan Sheridan, Discipline and Punish: The Birth of the Prison (New York: Pantheon Books, 1977), 9.

(Author and year of publication, page number) “Punishment, then, will tend to become the most hidden part of the penal process” (Foucault 1977, 9).

Modern Language Association (MLA) Format

MLA format traces its history to 1951 when it was first published as a thin booklet. Today, MLA is the primary format used by academics and professionals in humanities, English, literature, media studies, and cultural studies. To adapt to the rapid growth of new mediums over the past few decades, MLA updates its citation system. Visit the MLA Style Center for in-depth information on new guidelines and ongoing changes. In general, in text citations consist of author and page number, or just page number if the author’s name appears in the text.

(Author and page number) “Punishment, then, will tend to become the most hidden part of the penal process” (Foucault 9).

Associated Press (AP) Style

Published in 1952, the original AP Stylebook was marketed to journalists and other professionals related to the Associated Press. AP now stands as the go-to style for professionals in business, public relations, media, mass communications, and journalism. AP style prioritizes brevity and accuracy. The style includes specific guidelines regarding technological terms, titles, locations, and abbreviations and acronyms. Unlike the previous styles, AP does not use parenthetical or in-text citations. Rather, writers cite sources directly in the prose. For more information, including style-checking tools and quizzes, visit the Associated Press Stylebook .

In the book, “Discipline and Punish: The Birth of the Prison,” first published in English in 1977, philosopher Michel Foucault argues that “Punishment, then, will tend to become the most hidden part of the penal process”.

Which Style Should Nursing Students Use?

Because nurses rely on scientific terms and information, professionals in the field usually use APA style. Regardless of the purpose and specific genre of your text, you should always strive for concise, objective, and evidenced-based writing. You can expect to learn APA style as soon as you enroll in a major course. However, you should also prepare to learn other styles as part of your academic training. For example, freshman composition classes tend to focus on MLA guidelines.

Common Writing Mistakes Students Make

Active vs. passive voice.

Active and passive voice represent two different ways to present the same piece of information. Active voice focuses on the subject performing an action. For example, the dog bites the boy. This format creates clear, concise, and engaging writing. Using active voice, nurses might write, I administered patient care at 11:00. Passive voice, on the other hand, focuses on the object of the sentence or the action being performed. For example, the boy was bitten by the dog. A passive sentence is usually one that contains the verb “to be.” Using passive voice, you might write, patient care was administered at 11:00.

Professionals in the sciences often use passive voice in their writing to create an objective tone and authorial distance. Passive voice can prioritize specific terms, actions, evidence, or research over the writer’s presence. Additionally, nurses use passive voice because it is usually clear that the reported thoughts, actions, and opinions come from them. However, you must also learn how to use active voice.

Punctuation

There are 14 punctuation marks in the English language, each with multiple and sometimes overlapping uses. Additionally, certain punctuation marks only make sense in highly specific and nuanced grammatical instances. To master punctuation, you must learn through practice, particularly by revising your own writing.

For example, colons and semicolons are often used interchangeably, when they actually serve distinct purposes. Generally used before itemized lists, colons stand in for the phrases “here is what I mean” or “that is to say.” For example, I am bringing three things to the picnic: applesauce, napkins, and lemonade. Semicolons separate two independent clauses connected through topic or meaning. For example, It was below zero; Ricardo wondered if he would freeze to death. Comma splices, which create run on sentences, are another common mistake. You can identify a comma splice by learning the differences between an independent and dependent clause.

Grammar refers to the rules of a particular language system. Grammar determines how users can structure words and form sentences with coherent meaning. Aspects include syntax (the arrangement of words to convey their mutual relations in a sentence) and semantics (how individual words and word groups are understood). Unless you major in writing, literature, etymology, or another related field, you generally won’t examine English grammar deeply. Through years of cognitive development and practice, native users implicitly understand how to effectively employ the language.

Distinct grammatical systems exist for each language and, sometimes, even within a single language. For example, African American Vernacular English uses different syntactic rules than General American English. You should learn grammatical terms and definitions. Common errors include subject/verb agreement, sentence fragments, dangling modifiers, and vague or incorrect pronoun usage. Hasty writers can also misuse phonetically similar words (your/you’re, its/it’s, and there/their/they’re).

Writing Resources for Nursing Students

Apa style central, reviewed by:.

Shrilekha Deshaies, MSN, RN

Shri Deshaies is a nurse educator with over 20 years of experience teaching in hospital, nursing school, and community settings. Deshaies’ clinical area of expertise is critical care nursing and she is a certified critical care nurse. She has worked in various surgical ICUs throughout her career, including cardiovascular, trauma, and neurosurgery.

Shri Deshaies is a paid member of our Healthcare Review Partner Network. Learn more about our review partners here .

Page last reviewed November 30, 2021

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Writing an Outstanding Application Nursing Essay

Embarking on the path to a nursing career involves navigating through various challenges and significant moments, with the nursing application essay standing out as a key component. This essential part of your application transcends mere formality; it presents a special chance for you to highlight your character, commitment, and aptitude for the nursing profession. In this detailed guide, we aim to explore the intricacies of creating a standout nursing application essay. Whether you’re just starting to explore the nursing field or are ready to submit your application, this article is your roadmap to success.

Understanding the Purpose of the Essay

What do nursing schools seek in your essay.

Nursing schools are looking for candidates with the academic qualifications and personal qualities essential for nursing. Your essay should reflect your compassion, empathy, commitment to the profession, and understanding of the nursing role.

The Essay’s Role in Your Application

Your application essay is your voice in the admission process. It’s where you can speak directly to the admissions committee, tell your story, and explain why you are drawn to the nursing field. This essay can be the deciding factor in your application, setting you apart from other candidates.

Preparing to Write

• Research: Aligning with the School’s Values

Prior to beginning your essay, it’s essential to familiarize yourself with the fundamental ideals and beliefs of the nursing school you’re applying to. Spend time browsing their website, absorbing their mission statement, and comprehending their perspective on nursing education. This crucial insight will help you tailor your essay to resonate with the school’s philosophy. This research will help you tailor your essay to resonate with their ethos.

• Self-reflection: Your Nursing Journey

Reflect on your experiences and why you chose nursing. Think about moments in your life that led you to pursue this career. These reflections will help you create an authentic and personal narrative.

• Brainstorming: Crafting Your Story

Take time to brainstorm ideas for your essay. Think about your strengths, experiences, and what aspects of nursing excite you. Make sure to note down these key points; they will be the essential framework for your essay.

Structuring Your Essay

• Introduction: Making a Strong First Impression

The introduction of your essay is your first chance to capture the reader’s attention. Begin with an engaging story, a meaningful personal experience, or a statement that makes the reader think. This approach will offer a window into your personality and highlight your enthusiasm for nursing.

• Body: Building Your Narrative

Organize the body of your essay around a few key experiences or ideas. Each paragraph should focus on a specific aspect of your journey or a particular quality you possess. Use examples from your life to demonstrate your commitment, compassion, and ability to overcome challenges.

• Conclusion: Leaving a Lasting Impression

Your conclusion should wrap up your essay by summarizing the key points and reaffirming your interest and readiness for a nursing career. This is your final chance to remind the admissions committee why you are a suitable candidate.

Writing Tips and Best Practices

• Clarity and Conciseness

Keep your writing clear and concise. Avoid unnecessary jargon and be direct in your storytelling. Remember, the admissions committee reads many essays, so getting your point across quickly is crucial.

• Authenticity: Be Yourself

Your essay should reflect your true self. Don’t try to be someone you’re not. Honesty and sincerity will resonate more than trying to fit a certain mold you think the school wants.

• Using Specific Examples

Provide specific life examples rather than general statements about your passion for nursing. This might include volunteering, personal experiences with healthcare, or moments of inspiration from other nurses.

• Attention to Technical Details

Proofread your essay multiple times for grammar, spelling, and punctuation errors. Also, adhere to the nursing school’s formatting guidelines, such as word count and font size.

Common Mistakes to Avoid

• Steering Clear of Clichés and Generalities

Clichés and overused phrases can make your essay sound generic. Instead, focus on providing unique insights and personal experiences that highlight individuality.

• Directly Answering the Essay Prompt

It’s crucial to stay on topic and answer the essay prompt directly. Deviating from the prompt can lead the admissions committee to question your attention to detail and ability to follow instructions.

• Avoiding Excessive Jargon

Revising and Refining Your Essay

• The Importance of Drafts and Revisions

Your first draft is just the beginning. Be prepared to revise and refine your essay several times. This process helps fine-tune your message and improve the overall flow and clarity.

• Seeking Feedback

Get feedback on your essay from mentors, teachers, or peers. They can provide valuable insights and suggest improvements you might not have considered.

• Final Proofreading

Before submitting your essay, do a thorough proofreading. Check for grammatical errors or typos, and ensure your essay adheres to the specified word limit and formatting requirements.

Crafting your nursing application essay is an opportunity for self-reflection and a chance to convey your zeal for nursing. It’s important to remain authentic, be truthful in your narrative, and allow your sincere passion for nursing to be evident. With careful preparation, thoughtful structure, and attention to detail, your essay can prove your readiness for a nursing career.

Table of content

Crafted with Care:

Nursing Essays!

Precision, Passion, & Professionalism in Every Page.

• Open access
• Published: 16 May 2024

Competency gap among graduating nursing students: what they have achieved and what is expected of them

• Majid Purabdollah 1 , 2 ,
• Vahid Zamanzadeh 2 , 3 ,
• Akram Ghahramanian 2 , 4 ,
• Leila Valizadeh 2 , 5 ,
• Saeid Mousavi 2 , 6 &
• Mostafa Ghasempour 2 , 4  

BMC Medical Education volume  24 , Article number:  546 ( 2024 ) Cite this article

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Metrics details

Nurses’ professional competencies play a significant role in providing safe care to patients. Identifying the acquired and expected competencies in nursing education and the gaps between them can be a good guide for nursing education institutions to improve their educational practices.

In a descriptive-comparative study, students’ perception of acquired competencies and expected competencies from the perspective of the Iranian nursing faculties were collected with two equivalent questionnaires consisting of 85 items covering 17 competencies across 5 domains. A cluster sampling technique was employed on 721 final-year nursing students and 365 Iranian nursing faculties. The data were analyzed using descriptive statistics and independent t-tests.

The results of the study showed that the highest scores for students’ acquired competencies and nursing faculties’ expected competencies were work readiness and professional development, with mean of 3.54 (SD = 0.39) and 4.30 (SD = 0.45), respectively. Also, the lowest score for both groups was evidence-based nursing care with mean of 2.74 (SD = 0.55) and 3.74 (SD = 0.57), respectively. The comparison of competencies, as viewed by both groups of the students and the faculties, showed that the difference between the two groups’ mean scores was significant in all 5 core-competencies and 17 sub-core competencies ( P  < .001). Evidence-based nursing care was the highest mean difference (mean diff = 1) and the professional nursing process with the lowest mean difference (mean diff = 0.70).

The results of the study highlight concerns about the gap between expected and achieved competencies in Iran. Further research is recommended to identify the reasons for the gap between the two and to plan how to reduce it. This will require greater collaboration between healthcare institutions and nursing schools.

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Introduction| Background

Nursing competence refers to a set of knowledge, skills, and behaviors that are necessary to successfully perform roles or responsibilities [ 1 ]. It is crucial for ensuring the safe and high-quality care of patients [ 2 , 3 , 4 , 5 ]. However, evaluating nursing competence is challenging due to the complex, dynamic, and multi factorial nature of the clinical environment [ 3 ]. The introduction of nursing competencies and their assessment as a standard measure of clinical performance at the professional level has been highlighted by the Association of American Colleges of Nursing [ 6 , 7 ]. As a result, AACN (2020) introduces competence assessment as an emerging concept in nursing education [ 7 ].

On the other hand, the main responsibility of nursing education is to prepare graduates who have the necessary competencies to provide safe and quality care [ 3 ]. Although it is believed that it is impossible to teach everything to students, acquiring some competencies requires entering a real clinical setting and gaining work experience [ 8 ]. However, nursing students are expected to be competent to ensure patient safety and quality of care after graduation [ 9 ]. To the extent that the World Health Organization (WHO), while expressing concern about the low quality of nursing education worldwide, has recommended investing in nursing education and considers that the future to require nurses who are theoretically and clinically competent [ 5 ]. Despite efforts, the inadequate preparation of newly graduated nursing students and doubts about the competencies acquired in line with expectations to provide safe care for entering the nursing setting have become a global concern [ 10 , 11 , 12 , 13 ]. The results of studies in this field are different. The results of Amsalu et al. showed that the competence of newly graduated nursing students to provide quality and safe care was not satisfactory [ 14 ]. Some studies have also highlighted shortcomings in students’ “soft” skills, such as technical competency, critical thinking, communication, teamwork, helping roles, and professionalism [ 15 ]. Additionally, prior research has indicated that several nursing students have an unrealistic perception of their acquired competencies before entering the clinical setting and they report a high level of competence [ 2 ]. In other study, Hickerson et al. showed that the lack of preparation of nursing students is associated with an increase in patient errors and poor patient outcomes [ 16 ]. Some studies also discussed nursing competencies separately; Such as patient safety [ 17 ], clinical reasoning [ 18 ], interpersonal communication [ 19 ], and evidence-based care competence [ 20 ].

On the other hand, the growing need for safe nursing care and the advent of new educational technologies, the emergence of infectious diseases has increased the necessity of nursing competence. As a result, the nursing profession must be educated to excellence more than ever before [ 5 , 21 , 22 ]. Therefore, the self-assessment of students’ competence levels as well as the evaluation of nursing managers about the competencies expected from them is an essential criterion for all healthcare stakeholders, educators, and nursing policymakers to ensure the delivery of safe, and effective nursing care [ 9 , 23 , 24 ].

However, studies of nurse managers’ perceptions of the competence of newly graduated nursing students are limited and mostly conducted at the national level. Hence, further investigation is needed in this field [ 25 , 26 ]. Some other studies have been carried out according to the context and the needs of societies [ 3 , 26 , 27 , 28 ]. The results of some other studies in the field of students’ self-assessment of perceived competencies and managers’ and academic staff’s assessment of expected competency levels are different and sometimes contradictory, and there is the “academic-clinical gap” between expected and achieved competencies [ 25 , 29 , 30 ]. A review of the literature showed that this gap has existed for four decades, and the current literature shows that it has not changed much over time. The academe and practice settings have also been criticized for training nurses who are not sufficiently prepared to fully engage in patient care [ 1 ]. Hence, nursing managers must understand the expected competencies of newly graduated students, because they have a more complete insight into the healthcare system and the challenges facing the nursing profession. Exploration of these gaps can reveal necessities regarding the work readiness of nursing graduates and help them develop their competencies to enter the clinical setting [ 1 , 25 ].

Although research has been carried out on this topic in other countries, the educational system in those countries varies from that of Iran’s nursing education [ 31 , 32 ]. Iran’s nursing curriculum has tried to prepare nurses who have the necessary competencies to meet the care needs of society. Despite the importance of proficiency in nursing education, many nursing graduates often report feeling unprepared to fulfill expected competencies and they have deficiencies in applying their knowledge and experience in practice [ 33 ]. Firstly, the failure to define and identify the expected competencies in the nursing curriculum of Iran led to the absence of precise and efficient educational objectives. Therefore, it is acknowledged that the traditional nursing curriculum of Iran focuses more on lessons organization than competencies [ 34 ]. Secondly, insufficient attention has been given to the scheduling, location, and level of competencies in the nursing curriculum across different semesters [ 35 ]. Thirdly, the large volume of content instead of focusing on expected competencies caused nursing graduates challenged to manage complex situations [ 36 ]. Therefore, we should not expect competencies such as critical thinking, clinical judgment, problem-solving, decision-making, management, and leadership from nursing students and graduates in Iran [ 37 ]. Limited research has been conducted in this field in Iran. Studies have explored the cultural competence of nursing students [ 38 ] and psychiatric nurses [ 39 ]. Additionally, the competence priorities of nurses in acute care have been investigated [ 40 ], as well as the competency dimensions of nurses [ 41 ].

In Iran, after receiving the diploma, the students participate in a national exam called Konkur. Based on the results of this exam, they enter the field of nursing without conducting an aptitude test interview and evaluating individual and social characteristics. The 4-year nursing curriculum in Iran has 130 units including 22 general, 54 specific, 15 basic sciences, and 39 internship units. In each semester, several workshops are held according to the syllabus [ 42 ]. Instead of the expected competencies, a list of general competencies is specified as learning outcomes in the program. Accepted students based on their rank in the exam and their choice in public and Islamic Azad Universities (non-profit), are trained with a common curriculum. Islamic Azad Universities are not supported by government funding and are managed autonomously, this problem limits the access to specialized human resources and sufficient educational fields, and the lower salaries of faculty members in Azad Universities compared to the government system, students face serious challenges. Islamic Azad Universities must pay exorbitant fees to medical universities for training students in clinical departments and medical training centers, doubling these Universities’ financial problems. In some smaller cities, these financial constraints cause students to train in more limited fields of clinical training and not experience much of what they have learned in the classroom in practice and the real world of nursing. The evaluation of learners in the courses according to the curriculum is based on formative and summative evaluation with teacher-made tests, checklists, clinical assignments, conferences, and logbooks. The accreditation process of nursing schools includes two stages internal evaluation, which is done by surveying students, professors and managers of educational groups, and external accreditation is done by the nursing board. After completing all their courses, to graduate, students must participate in an exam called “Final”, which is held by each faculty without the supervision of an accreditation institution, the country’s assessment organization or the Ministry of Health, and obtain at least a score of 10 out of 20 to graduate.

Therefore, we conducted this comprehensive study as the first study in Iran to investigate the difference between the expected and perceived competence levels of final year nursing students. The study’s theoretical framework is based on Patricia Benner’s “From Novice to Expert” model [ 43 ].

Materials and methods

The present study had the following three objectives:

Determining self-perceived competency levels from the perspective of final year nursing students in Iran.

Determining expected levels of competency from the perspective of nursing faculties in Iran.

To determine the difference between the expected competencies from the perspective of nursing faculties and the achieved competencies from the perspective of final-year nursing students.

This study is a descriptive-comparative study.

First, we obtained a list of all nursing schools in the provinces of Iran from the Ministry of Health ( n  = 31). From 208 Universities, 72 nursing schools were randomly selected using two-stage cluster sampling. Among the selected faculties, we chose 721 final-year nursing students and 365 nursing faculties who met the eligibility criteria for the study. Final-year nursing students who consented to participate in the study were selected. Full-time faculty members with at least 2 years of clinical experience and nurse managers with at least 5 years of clinical education experience were also included. In this study, nursing managers, in addition to their educational roles in colleges, also have managerial roles in the field of nursing. Some of these roles include nursing faculty management, nursing board member, curriculum development and review, planning and supervision of nursing education, evaluation, and continuous improvement of nursing education. The selection criteria were based on the significant role that managers play in nursing education and curriculum development [ 44 ]. Non-full-time faculty members and managers without clinical education experience were excluded from the study.

The instrument used in this study is a questionnaire developed and psychometrically tested in a doctoral nursing dissertation [ 45 ]. To design the tool, the competencies expected of undergraduate nursing students in Iran and worldwide were first identified through a scoping review using the methodology recommended by the Joanna Briggs Institute (JBI) and supported by the PAGER framework. Summative content analysis by Hsieh and Shannon (2005) was used for analysis, which included: counting and comparing keywords and content, followed by interpretation of textual meaning. In the second step, the results of the first step were used to create tool statements. Then the validity of the instrument was checked by face validity, content validity (determination of the ratio and index of content validity), and validity of known groups. Its reliability was also checked by internal consistency using Cronbach’s alpha method and stability using the test-retest method. The competency questionnaire comprises 85 items covering 17 competencies across 5 domains: “individualized care” (4 competencies with 21 items), “evidence-based nursing care” (2 competencies with 10 items), “professional nursing process” (3 competencies with 13 items), “nursing management” (2 competencies with 16 items), and “work readiness and professional development” (6 competencies with 25 items) [ 45 ]. “The Bondy Rating Scale was utilized to assess the competency items, with ratings ranging from 1 (Dependent) to 5 (Independent) on a 5-point Likert scale [ 46 ]. The first group (nursing students) was asked to indicate the extent to which they had acquired each competency. The second group (nursing faculties) was asked to specify the level to which they expected nursing students to achieve each competency.

Data collection

First, the researcher contacted the deans and managers of the selected nursing schools by email to obtain permission. After explaining the aims of the study and the sampling method, we obtained the telephone number of the representative of the group of final year nursing students and also the email of the faculty members. The representative of the student group was then asked to forward the link to the questionnaire to 10 students who were willing to participate in the research. Informed consent for students to participate in the online research was provided through the questionnaires, while nursing faculty members who met the eligibility criteria for the study received an informed consent form attached to the email questionnaire. The informed consent process clarified the study objectives and ensured anonymity of respondent participation in the research, voluntary agreement to participate and the right to revoke consent at any time. An electronic questionnaire was then sent to 900 final year nursing students and 664 nursing faculties (from 4 March 2023 to 11 July 2023). Reminder emails were sent to nursing faculty members three times at two-week intervals. The attrition rate in the student group was reported to be 0 (no incomplete questionnaires). However, four questionnaires from nursing faculty members were discarded because of incomplete responses. Of the 900 questionnaires sent to students and 664 sent to nursing faculties, 721 students and 365 nursing faculty members completed the questionnaire. The response rates were 79% and 66% respectively.

Data were analyzed using SPSS version 22. Frequencies and percentages were used to report categorical variables and mean and standard deviations were used for quantitative variables. The normality of the quantitative data was confirmed using the Shapiro-Wilk and Skewness tests. An independent t-test was used for differences between the two groups.

Data analysis revealed that out of 721 students, 441 (61.20%) was female. The mean and deviation of the students’ age was 22.50 (SD = 1.21). Most of the students 577 (80%) were in their final semester. Also, of the total 365 faculties, the majority were female 253 (69.31%) with a mean of age 44.06 (SD = 7.46) and an age range of 22–65. The academic rank of most nursing faculty members 156 (21.60%) was assistant professor (Table  1 ).

The results of the study showed that in both groups the highest scores achieved by the students and expected by the nursing faculty members were work readiness and professional development with a mean and standard deviation of 3.54 (0.39) and 4.30 (0.45) respectively. The lowest score for both groups was also evidence-based nursing care with a mean and standard deviation of 2.74 (0.55) for students and 3.74 (0.57) for nursing faculty members (Table  2 ).

Also, the result of the study showed that the highest expected competency score from the nursing faculty members’ point of view was the safety subscale. In other words, faculty members expected nursing students to acquire safety competencies at the highest level and to be able to provide safe care independently according to the rating scale (Mean = 4.51, SD = 0.45). The mean score of the competencies achieved by the students was not above 3.77 in any of the subscales and the highest level of competency achievement according to self-report of students was related to safety competencies (mean = 3.77, SD = 0.51), preventive health services (mean = 3.69, SD = 0.79), values and ethical codes (mean = 3.67, SD = 0.77), and procedural/clinical skills (mean = 3.67, SD = 0.71). The other competency subscales from the perspective of the two groups are presented in Table  3 , from highest to lowest score.

The analysis of core competencies achieved and expected from both students’ and nursing faculty members’ perspectives revealed that, firstly, there was a significant difference between the mean scores of the two groups in all five core competencies ( P  < .001) and that the highest mean difference was related to evidence-based care with mean diff = 1 and the lowest mean difference was related to professional care process with mean diff = 0.70 (Table  4 ).

Table  5 indicates that there was a significant difference between the mean scores achieved by students and nursing faculty members in all 5 core competencies and 17 sub-core Competencies ( p  < .001).

The study aimed to determine the difference between nursing students’ self-perceived level of competence and the level of competence expected of them by their nursing faculty members. The study results indicate that students scored highest in work readiness and professional development. However, they were not independent in this competency and required support. The National League for Nursing (NLN) recognizes nursing professional development as the goal of nursing education programs [ 47 ] However, Aguayo-Gonzalez [ 48 ] believes that the appropriate time for professional development is after entering a clinical setting. This theme includes personal characteristics, legality, clinical/ procedural skills, patient safety, preventive health services, and mentoring competence. Personality traits of nursing students are strong predictors of coping with nursing stress, as suggested by Imus [ 49 ]. These outcomes reflect changes in students’ individual characteristics during their nursing education. Personality changes, such as the need for patience and persistence in nursing care and understanding the nurse identity prepare students for the nursing profession, which is consistent with the studies of Neishabouri et al. [ 50 ]. Although the students demonstrated a higher level of competence in this theme, an examination of the items indicates that they can still not adapt to the challenges of bedside nursing and to use coping techniques. This presents a concerning issue that requires attention and resolution. Previous studies have shown that nursing education can be a very stressful experience [ 51 , 52 , 53 ].

Of course, there is no consensus on the definition of professionalism and the results of studies in this field are different. For example, Akhtar et al. (2013) identified common viewpoints about professionalism held by nursing faculty and students, and four viewpoints emerged humanists, portrayers, facilitators, and regulators [ 54 ]. The findings of another study showed that nursing students perceived vulnerability, symbolic representation, role modeling, discontent, and professional development are elements that show their professionalism [ 55 ]. The differences indicate that there may be numerous contextual variables that affect individuals’ perceptions of professionalism.

The legal aspects of nursing were the next item in this theme that students needed help with. The findings of studies regarding the legal competence of newly graduated nursing students are contradictory reported that only one-third of nurse managers were satisfied with the legal competence of newly graduated nursing students [ 56 , 57 ]. Whereas the other studies showed that legality was the highest acquired competence for newly graduated nursing students [ 58 , 59 ]. However, the results of this study indicated that legality may be a challenge for newly graduated nursing students. Benner [ 43 ] highlighted the significant change for new graduates in that they now have full legal and professional responsibility for the patient. Tong and Epeneter [ 60 ] also reported that facing an ethical dilemma is one of the most stressful factors for new graduates. Therefore, the inexperience of new graduates cannot reduce the standard of care that patients expect from them [ 60 ]. Legal disputes regarding the duties and responsibilities of nurses have increased with the expansion of their roles. This is also the case in Iran. Nurses are now held accountable by law for their actions and must be aware of their legal obligations. To provide safe healthcare services, it is essential to know of professional, ethical, and criminal laws related to nursing practice. The nursing profession is accountable for the quality of services delivered to patients from both professional and legal perspectives. Therefore, it is a valuable finding that nurse managers should support new graduates to better deal with ethical dilemmas. Strengthening ethical education in nursing schools necessitates integrating real cases and ethical dilemmas into the curriculum. Especially, Nursing laws are missing from Iran’s undergraduate nursing curriculum. By incorporating authentic case studies drawn from clinical practice, nursing schools provide students with opportunities to engage in critical reflection, ethical analysis, and moral deliberation. These real cases challenge students to apply ethical principles to complex and ambiguous situations, fostering the development of ethical competence and moral sensitivity. Furthermore, ethical reflection and debriefing sessions during clinical experiences enable students to discuss and process ethical challenges encountered in practice, promoting self-awareness, empathy, and professional growth. Overall, by combining theoretical instruction with practical application and the use of real cases, nursing schools can effectively prepare future nurses to navigate ethical dilemmas with integrity and compassion.

However, the theme of evidence-based nursing care was the lowest scoring, indicating that students need help with this theme. The findings from studies conducted in this field are varied. A limited number of studies reported that nursing students were competent to implement evidence-based care [ 61 ], while other researchers reported that nursing students’ attitudes toward evidence-based care to guide clinical decisions were largely negative [ 20 , 62 ]. The principal barriers to implementing evidence-based care are lack of authority to change patient care policy, slow dissemination of evidence and lack of time at the bedside to implement evidence [ 10 ], and lack of knowledge and awareness of the process of searching databases and evaluating research [ 63 ]. While the European Higher Education Area (EHEA) framework and the International Council of Nurses Code of Ethics introduce the ability to identify, critically appraise, and apply scientific information as expected learning outcomes for nursing students [ 64 , 65 ], the variation in findings highlights the complexity of the concept of competence and its assessment [ 23 ]. Evidence-Based Nursing (EBN) education for nursing students is most beneficial when it incorporates a multifaceted approach. Interactive workshops play a crucial role, providing students with opportunities to critically appraise research articles, identify evidence-based practices, and apply them to clinical scenarios. Simulation-based learning further enhances students’ skills by offering realistic clinical experiences in a safe environment. Additionally, clinical rotations offer invaluable opportunities for students to observe and participate in evidence-based practices under the guidance of experienced preceptors. Journal clubs foster a culture of critical thinking and ongoing learning, where students regularly review and discuss current research articles. Access to online resources such as databases and evidence-based practice guidelines allows students to stay updated on the latest evidence and best practices. To bridge the gap between clinical practice and academic theory, collaboration between nursing schools and healthcare institutions is essential. This collaboration can involve partnerships to create clinical learning environments that prioritize evidence-based practice, inter professional education activities to promote collaboration across disciplines, training and support for clinical preceptors, and continuing education opportunities for practicing nurses to strengthen their understanding and application of EBN [ 66 ]. By implementing these strategies, nursing education programs can effectively prepare students to become competent practitioners who integrate evidence-based principles into their clinical practice, ultimately improving patient outcomes.

The study’s findings regarding the second objective showed that nursing faculty members expected students to achieve the highest level of competence in work readiness and professional development, and the lowest in evidence-based nursing care competence. The results of the studies in this area revealed that there is a lack of clarity about the level of competence of newly graduated nursing students and that confusion about the competencies expected of them has become a major challenge [ 13 , 67 ]. Evidence of nurse managers’ perceptions of newly graduated nursing student’s competence is limited and rather fragmented. There is a clear need for rigorous empirical studies with comprehensive views of managers, highlighting the key role of managers in the evaluation of nurse competence [ 1 , 9 ]. Some findings also reported that nursing students lacked competence in primary and specialized care after entering a real clinical setting [ 68 ] and that nursing managers were dissatisfied with the competence of students [ 30 ].

The results of the present study on the third objective confirmed the gap between expected and achieved competence requirements. The highest average difference was related to evidence-based nursing care, and the lowest mean difference was related to the professional nursing process. The findings from studies in this field vary. For instance, Brown and Crookes [ 13 ] reported that newly graduated nursing students were not independent in at least 26 out of 30 competency domains. Similar studies have also indicated that nursing students need a structured program after graduation to be ready to enter clinical work [ 30 ]. It can be stated that the nursing profession does not have clear expectations of the competencies of newly graduated nursing students, and preparing them for entry into clinical practice is a major challenge for administrators [ 13 ]. These findings can be explained by the Duchscher transition shock [ 69 ]. It is necessary to support newly graduated nursing students to develop their competence and increase their self-confidence.

The interesting but worrying finding was the low expectations of faculty members and the low scores of students in the theme of evidence-based care. However, nursing students need to keep their competencies up to date to provide safe and high-quality care. The WHO also considers the core competencies of nurse educators to be the preparation of effective, efficient, and skilled nurses who can teach the evidence-based learning process and help students apply it clinically [ 44 ]. The teaching of evidence-based nursing care appears to vary across universities, and some clinical Faculties do not have sufficient knowledge to support students. In general, it can be stated that the results of the present study are in line with the context of Iran. Some of the problems identified include a lack of attention to students’ academic talent, a lack of a competency-based curriculum, a gap between theory and clinical practice, and challenges in teaching and evaluating the achieved competencies [ 42 ].

Strengths and limitations

The study was conducted on a national level with a sizable sample. It is one of the first studies in Iran to address the gap between students’ self-perceived competence levels and nursing faculty members’ expected competency levels. Nevertheless, one of the limitations of the study is the self-report nature of the questionnaire, which may lead to social desirability bias. In addition, the COVID-19 pandemic coinciding with the student’s first and second years could potentially impact their educational quality and competencies. The limitations established during the outbreak negatively affected the nursing education of students worldwide.

Acquiring nursing competencies is the final product of nursing education. The current study’s findings suggest the existence of an academic-practice gap, highlighting the need for educators, faculty members, and nursing managers to collaborate in bridging the potential gap between theory and practice. While nursing students were able to meet some expectations, such as value and ethical codes, there is still a distance between expectations and reality. Especially, evidence-based care was identified as one of the weaknesses of nursing students. It is recommended that future research investigates the best teaching strategies and more objective assessments of competencies. The findings of this study can be used as a guide for the revision of undergraduate nursing education curricula, as well as a guide for curriculum development based on the development of competencies expected of nursing students. Nursing managers can identify existing gaps and plan to fill them and use them for the professionalization of students. This requires the design of educational content and objective assessment tools to address these competencies at different levels throughout the academic semester. This significant issue necessitates enhanced cooperation between healthcare institutions and nursing schools. Enhancing nursing education requires the implementation of concrete pedagogical strategies to bridge the gap between theoretical knowledge and practical skills. Simulation-based learning emerges as a pivotal approach, offering students immersive experiences in realistic clinical scenarios using high-fidelity simulators [ 70 ]. Interprofessional education (IPE) is also instrumental, in fostering collaboration among healthcare professionals and promoting holistic patient care. Strengthening clinical preceptorship programs is essential, with a focus on providing preceptors with formal training and ongoing support to facilitate students’ clinical experiences and transition to professional practice [ 71 ]. Integrating evidence-based practice (EBP) principles throughout the curriculum cultivates critical thinking and inquiry skills among students, while technology-enhanced learning platforms offer innovative ways to engage students and support self-directed learning [ 72 ]. Diverse and comprehensive clinical experiences across various healthcare settings ensure students are prepared for the complexities of modern healthcare delivery. By implementing these practical suggestions, nursing education programs can effectively prepare students to become competent and compassionate healthcare professionals.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors extend their gratitude to all the nursing students and faculties who took part in this study.

This article is part of research approved with the financial support of the deputy of research and technology of Tabriz University of Medical Sciences.

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M P: conceptualized the study, data collection, analysis and interpretation, drafting of manuscript; V Z: conceptualized the study, analysis and interpretation, drafting of manuscript; LV: conceptualized the study, data collection and analysis, manuscript revision; A Gh: conceptualized the study, data collection, analysis, and drafting of manuscript; S M: conceptualized the study, analysis, and drafting of manuscript; M Gh: data collection, analysis, and interpretation, drafting of manuscript; All authors read and approved the final manuscript.

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Purabdollah, M., Zamanzadeh, V., Ghahramanian, A. et al. Competency gap among graduating nursing students: what they have achieved and what is expected of them. BMC Med Educ 24 , 546 (2024). https://doi.org/10.1186/s12909-024-05532-w

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DOI : https://doi.org/10.1186/s12909-024-05532-w

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