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"A nurse is a nurse is a nurse": In search of clinical competence--the employer's perspective

Jeanne Shepherd Murphy, University of Massachusetts Amherst


The study was designed to explore with selected nurses in the employment setting their perspective of the clinical competence of newly graduated nurses as they entered practice. The study had three elements. The initial focus of the study was to examine the readiness of graduates from all preparatory programs to enter hospital practice, addressing, in particular, the clinical competence of the nurse and, therefore, the ability of that nurse to meet the nursing needs of the patient. The second element was to explore the differences, if any, between graduates of Baccalaureate, Associate Degree and Diploma Programs as those differences relate to clinical competence. The third area dealt with the nurturing and socialization of the new graduate in the practice setting and examined the methods employed by the hospital to orient the nurse to the practice setting and provide support and additional education and experience to bring the nurse to the practice level expected. Major findings identified differences in graduates from the three types of nursing programs. Graduates of Baccalaureate programs were described as having a stronger theoretical knowledge base and better critical thinking skills. It was expected the Baccalaureate graduate would become the more competent nurse over time. Graduates of Diploma Programs were reported to have better clinical skills. Associate Degree Program graduates were said to be lacking in both clinical skills and theoretical knowledge. Two factors were mentioned as important in shaping clinical competence. Individual differences which the nurse brings with her are thought to be a significant factor, even more than the program from which the nurse was graduated. Programs, which prepare the same type of graduate, do not always graduate nurses of the same quality. Graduates of all programs were noted as needing extensive support as they began their new role. Concern was expressed by the majority of respondents about the readiness of new graduates to enter the practice setting. Most respondents would like to see the clinical practice component strengthened in the curriculum of all nursing programs. Recommendations for Nursing Education and Nursing Practice and for further study are included.

Subject Area

Health education|Vocational education|Nursing

Recommended Citation

Murphy, Jeanne Shepherd, ""A nurse is a nurse is a nurse": In search of clinical competence--the employer's perspective" (1990). Doctoral Dissertations Available from Proquest. AAI9101649.