Examining the relationship between self-reported competence and caring efficacy in registered nurses

Competence is the creation of new rules, reasoning procedures, and the integration of skills, values, knowledge, and attitudes to specific, contextual practice situations (Benner, 2001; Benner, Tanner, & Chesla, 2009). Caring is the essence and central focus of the nurse’s role that is embedded in personal and cultural meanings and commitments that are both instrumental and expressive (Benner, 2001; Benner, Tanner, & Chesla, 2009; Hess, Dossey, Southard, Luck, Schaub, & Bark, 2013). The purpose of this study was to examine the relationship between competence and caring efficacy of practicing registered nurses (RN) while controlling for the impact of nurse education, nursing experience, specialty certification, and job role. Guided by Benner’s Novice to Expert Model, a cross-sectional non-experimental design used to describe nurses’ self-perceptions of competence and caring. The seven subscale, 73-item Nurse Competence Scale (NCS) and 30-item Caring Efficacy Scale (CES) were used to examine these perceptions in an online survey. A final convenience sample of 189 practicing, licensed registered nurses involved in direct patient care at least 50% of the time and recruited from four nursing organizations and a Veterans Affairs Medical Center, were used in data analysis. Descriptive statistics were used to describe the demographic data. Most participants were female with an average age of 47 and 18 years of experience. Most held undergraduate degrees, possessed a nursing specialty certification, and worked as staff nurses. Hierarchal multiple regression was used to examine the relationship between competence and caring efficacy. A moderate, positive relationship between nurse competence and caring efficacy was found. This relationship was not influenced by education, experience, specialty certification, or job role. Correlations were used to compare the frequency of use versus perceived competence on the subscales of the NCS. No relationships were noted between use and perceived competence on six of seven subscales. There was a small correlation in the help domain. These findings suggest that nurse competence and caring develop according to Benner’s Novice to Expert Framework and affirm that experience is not a linear process but a continuum of experiential learning opportunities and skills acquisition.