Entry-Level Competencies for the

Practice of Registered Nurses

March 2019
 Competencies

Approved by the College and Association of Registered Nurses of Alberta (CARNA) Council,
March 2019.

CARNA is currently operating under the newly branded name College of Registered Nurses
of Alberta (CRNA), however, the Health Professions Act (HPA) continues to identify our
organization as CARNA.

Use of this document is permitted for the purposes of education, research, private study or
reference.

Ensure you are using the current version of this document by visiting our website.

College of Registered Nurses of Alberta

11120 – 178 Street
Edmonton, AB T5S 1P2

Phone: 780.451.0043 (in Edmonton) or 1.800.252.9392 (Canada-wide)

Fax: 780.452.3276
Email: [email protected]
Website: nurses.ab.ca

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Table of Contents
BACKGROUND .................................................................................................................................................................................. 3
THE CONTEXT OF ENTRY-LEVEL REGISTERED NURSING PRACTICE .......................................................... 3
OVERARCHING PRINCIPLES .................................................................................................................................................. 4
STRUCTURE......................................................................................................................................................................................... 5
COMPETENCIES .............................................................................................................................................................................. 6
COMPETENCY CATEGORY 1: CLINICIAN .................................................................................................................................... 6
COMPETENCY CATEGORY 2: PROFESSIONAL ......................................................................................................................... 8
COMPETENCY CATEGORY 3: COMMUNICATOR ...................................................................................................................... 9
COMPETENCY CATEGORY 4: COLLABORATOR ......................................................................................................................10
COMPETENCY CATEGORY 5: COORDINATOR .........................................................................................................................10
COMPETENCY CATEGORY 6: LEADER ....................................................................................................................................... 11
COMPETENCY CATEGORY 7: ADVOCATE................................................................................................................................. 12
COMPETENCY CATEGORY 8: EDUCATOR ................................................................................................................................ 13
COMPETENCY CATEGORY 9: SCHOLAR ................................................................................................................................... 13
GLOSSARY .......................................................................................................................................................................................... 15
REFERENCES ..................................................................................................................................................................................20

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Background
In 2017 the Canadian Council of Registered Nurse Regulators (CCRNR) initiated the revisions
of the Entry-Level Competencies of Registered Nurses in Canada (the “ELCs”). A working
group comprised of 11 jurisdictions representing registered nurse (RN) regulators in Canada
led this initiative. CCRNR reviews the ELCs every five years to ensure inter-jurisdictional
consistency and practice relevance. Consistency between jurisdictions supports the
workforce mobility requirements of the Canadian Free Trade Agreement. The results of an
environmental scan, literature reviews and stakeholder consultation provide the basis for
revisions. The regulatory body in each jurisdiction validates and approves the ELCs and
confirms they are consistent with Provincial/Territorial legislation.

Each ELC in this context is defined as “an observable ability of a registered nurse at entry-
level that integrates the knowledge, skills, abilities, and judgment required to practice
nursing safely and ethically.”

Regulatory bodies use ELCs for a number of purposes including but not limited to:

▪ academic program approval/recognition

▪ assessment of internationally educated applicants
▪ assessment of applicants for the purpose of re-entry into the profession
▪ input into the content and scope of entry-to-practice exams
▪ practice advice/guidance to clinicians
▪ reference for professional conduct matters
▪ public and employer awareness of the practice expectations of registered nurses

The Context of Entry-Level

Registered Nursing Practice
The design and application of the listed competencies is at entry to practice, i.e., when entry-
level RNs are at the point of initial registration or licensure, following graduation from an
approved nursing education program. Their beginning practice draws upon specific
experiences during their education program which shaped a theoretical and experiential
knowledge base. They are health-care team members who must accept responsibility and
demonstrate accountability for their practice. They will recognize their limitations, ask
questions, exercise professional judgment, and determine when they require consultation.
Entry-level RNs realize the importance of identifying what they know and do not know, what
their learning gaps may be, and how and where to access available resources. They display
initiative, a beginning confidence, and self-awareness in the decisions they make in providing
care.

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RN practice is dynamic and evolving; the ELCs establish the foundation for nursing practice.
Entry-to-practice represents the time when learners become clinicians. Education,
collaboration, and mentorship facilitate further development of RN practice. All groups
involved in the provision of health care share responsibility for creating and maintaining
practice environments that support RNs in providing safe, ethical, and quality health care.
The practice environment influences the transition and consolidation of RN practice and the
development of further competence.

Overarching Principles
Entry-level RNs must meet these competencies; and so too should all practicing RNs,
throughout their careers, relative to their specific context and/or patient population. The
following overarching principles apply to the education and practice of entry-level registered
nurses:

1. The entry-level RN is a beginning practitioner. It is unrealistic to expect an entry-level

RN to function at the level of practice of an experienced RN.

2. The entry-level RN works within the registered nursing scope of practice, and seeks
guidance appropriately when they encounter situations outside of their ability.

3. The entry-level RN must have the requisite skills and abilities to attain the entry-level
competencies.

4. The entry-level RN is prepared as a generalist to practise safely, competently,

compassionately, and ethically:

a. using evidence-informed practice

b. across diverse practice settings

c. in situations of health and illness

d. with all people across the lifespan

e. with all recipients of care: individuals, families, groups, communities, and

populations

5. The entry-level RN has a strong foundation from education at the baccalaureate level
in: nursing theory, concepts and knowledge; health and sciences; humanities;
research; and ethics.

6. The entry-level RN practices autonomously within the parameters of legislation,

practice standards, ethics, and scope of practice in their jurisdiction.

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7. The entry-level RN applies the critical thinking process throughout all aspects of
practice.

The client is the central focus of RN practice and leads the process of decision-making
related to care. In the context of this document, “client” refers to a person who benefits from
registered nursing care and, where context requires, includes a substitute decision maker for
the recipient of nursing services. A client may be an individual, a family, group, community or
population. Client-centred care reflects that people are at the centre of decisions about their
health and are seen as experts, working alongside RNs to achieve optimal health outcomes.

Structure
The document is organized thematically per a roles-based format. There are a total of 101
competencies grouped thematically under 9 headings:

1. Clinician

2. Professional

3. Communicator

4. Collaborator

5. Coordinator

6. Leader

7. Advocate

8. Educator

9. Scholar

Integration of all nine roles enables the entry-level RN to provide safe, competent, ethical,
compassionate, and evidence-informed nursing care in any practice setting. Some concepts
are relevant to multiple roles. For the sake of clarity and to avoid unnecessary repetition,
certain key concepts (e.g., client-centred) are mentioned once and assumed to apply to all
competencies.

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Competencies

Competency Category 1: Clinician

Registered nurses are clinicians who provide safe, competent, ethical,
compassionate, and evidence-informed care across the lifespan in response to
client needs. Registered nurses integrate knowledge, skills, judgment and
professional values from nursing and other diverse sources into their practice.

Competencies

1.1 Provides safe, ethical, COMPETENT1, COMPASSIONATE , CLIENT-CENTRED and EVIDENCE -

INFORMED nursing care across the lifespan in response to CLIENT needs.

1.2 Conducts a HOLISTIC nursing ASSESSMENT to collect comprehensive information on

client health status.

1.3 Uses principles of TRAUMA-INFORMED CARE which places priority on trauma survivors’
SAFETY , choice, and control.

1.4 Analyses and INTERPRETS data obtained in client assessment to inform ongoing
decision-making about client health status.

1.5 Develops PLANS OF CARE using CRITICAL INQUIRY to support professional judgment and
reasoned decision-making.

1.6 Evaluates effectiveness of plan of care and modifies accordingly.

1.7 Anticipates actual and potential health risks and possible unintended outcomes.

1.8 Recognizes and responds immediately when client safety is affected.

1.9 Recognizes and responds immediately when client’s condition is deteriorating.

1.10 Prepares clients for and performs PROCEDURES, treatments, and follow up care.

1.11 Applies knowledge of pharmacology and principles of safe medication practice.

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Words or phrases displayed in BOLD CAPITALS upon first mention are defined in the glossary.

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1.12 Implements evidence-informed practices of pain prevention, manages client’s pain,

and provides comfort through pharmacological and non-pharmacological
interventions.

1.13 Implements THERAPEUTIC NURSING INTERVENTIONS that contribute to the care and
needs of the client.

1.14 Provides nursing care to meet PALLIATIVE CARE and end-of-life care needs.

1.15 Incorporates knowledge about ethical, legal, and regulatory implications of MEDICAL
ASSISTANCE IN DYING (MAID) when providing nursing care.

1.16 Incorporates principles of HARM REDUCTION with respect to substance use and misuse
into plans of care.

1.17 Incorporates knowledge of epidemiological principles into plans of care.

1.18 Provides RECOVERY -ORIENTED NURSING CARE in partnership with clients who
experience a mental health condition and/or addiction.

1.19 Incorporates mental HEALTH PROMOTION when providing nursing care.

1.20 Incorporates suicide prevention approaches when providing nursing care.

1.21 Incorporates knowledge from the health sciences, including anatomy, physiology,
pathophysiology, psychopathology, pharmacology, microbiology, epidemiology,
genetics, immunology, and nutrition.

1.22 Incorporates knowledge from nursing science, social sciences, humanities, and
health-related research into plans of care.

1.23 Uses knowledge of the impact of evidence-informed registered nursing practice on

client health outcomes.

1.24 Uses effective strategies to prevent, de-escalate, and manage disruptive, aggressive,
or violent behaviour.

1.25 Uses strategies to promote wellness, to prevent illness, and to minimize disease and
injury in clients, self, and others.

1.26 Adapts practice in response to the spiritual beliefs and cultural practices of clients.

1.27 Implements evidence-informed practices for infection prevention and control.

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Competency Category 2: Professional

Registered nurses are professionals who are committed to the health and well-being of
clients. Registered nurses uphold the profession’s practice standards and ethics and are
accountable to the public and the profession.

Competencies

2.1 Demonstrates ACCOUNTABILITY, accepts responsibility, and seeks assistance as

necessary for decisions and actions within the legislated SCOPE OF PRACTICE .

2.2 Demonstrates a PROFESSIONAL PRESENCE , and confidence, honesty, integrity, and

respect in all interactions.

2.3 Exercises professional judgment when using agency policies and procedures, or when
practising in their absence.

2.4 Maintains client privacy, confidentiality, and security by complying with legislation,
practice standards, ethics, and organizational policies.

2.5 Identifies the influence of personal values, beliefs, and POSITIONAL POWER on clients
and the HEALTH-CARE TEAM and acts to reduce bias and influences.

2.6 Establishes and maintains PROFESSIONAL BOUNDARIES with clients and the health- care
team.

2.7 Identifies and addresses ethical (moral) issues using ethical reasoning, seeking
support when necessary.

2.8 Demonstrates professional judgment to ensure SOCIAL MEDIA and INFORMATION AND
COMMUNICATION TECHNOLOGIES (ICTs) are used in a way that maintains public trust in
the profession.

2.9 Adheres to the self-regulatory requirements of jurisdictional legislation to protect the

public by:

a. assessing own practice and individual competence to identify learning needs,

b. developing a learning plan using a variety of sources,

c. seeking and using new knowledge that may enhance, support, or influence
competence in practice, and

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d. implementing and evaluating the effectiveness of the learning plan and

developing future learning plans to maintain and enhance competence as a
registered nurse.

2.10 Demonstrates FITNESS TO PRACTICE .

2.11 Distinguishes between the mandates of regulatory bodies, professional associations,

and unions.

2.12 Recognizes, acts on, and reports unprofessional conduct to the appropriate person,
agency or professional body.

2.13 Recognizes, acts on, and reports HARMFUL INCIDENCES , NEAR MISSES , and NO HARM
INCIDENCES .

2.14 Recognizes, acts on, and reports actual and potential workplace and occupational
safety risks.

Competency Category 3: Communicator

Registered nurses are communicators who use a variety of strategies and relevant
technologies to create and maintain professional relationships, share information, and
foster therapeutic environments.

Competencies

3.1 Introduces self to clients and health-care team members by first and last name, and
professional designation (protected title).

3.2 Engages in active listening to understand and respond to the client’s experience,
preferences, and health goals.

3.3 Uses evidence-informed communication skills to build trusting, compassionate, and

THERAPEUTIC RELATIONSHIPS with clients.

3.4 Uses CONFLICT RESOLUTION strategies to promote healthy relationships and optimal
client outcomes.

3.5 Incorporates the process of RELATIONAL PRACTICE to adapt communication skills.

3.6 Uses ICTs to support communication.

3.7 Communicates effectively in complex and rapidly changing situations.

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3.8 Documents and reports clearly, concisely, accurately, and in a timely manner.

Competency Category 4: Collaborator

Registered nurses are collaborators who play an integral role in the health-care team
partnership.

Competencies

4.1 Demonstrates collaborative professional relationships.

4.2 Initiates collaboration to support care planning and safe, continuous transitions from
one health-care facility to another, or to residential, community or home and self-care.

4.3 Determines their own professional and INTERPROFESSIONAL role within the team by
considering the roles, responsibilities, and the scope of practice of others.

4.4 Applies knowledge about the scopes of practice of each regulated nursing
designation to strengthen intraprofessional collaboration that enhances contributions
to client health and well-being.

4.5 Contributes to health-care team functioning by applying group communication

theory, principles, and group process skills.

Competency Category 5: Coordinator

Registered nurses coordinate point-of-care health service delivery with clients, the health-
care team, and other sectors to ensure continuous, safe care.

Competencies

5.1 Consults with clients and health-care team members to make ongoing adjustments
required by changes in the availability of services or client health status.

5.2 Monitors client care to help ensure needed services happen at the right time and in
the correct sequence.

5.3 Organizes own workload, ASSIGNS nursing care, sets priorities, and demonstrates
effective time management skills.

5.4 Demonstrates knowledge of the assignment and supervision process.

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5.5 Participates in decision-making to manage client transfers within health-care

facilities.

5.6 Supports clients to navigate health-care systems and other service sectors to optimize
health and well-being.

5.7 Prepares clients for transitions in care.

5.8 Prepares clients for discharge.

5.9 Participates in emergency preparedness and disaster management.

Competency Category 6: Leader

Registered nurses are leaders who influence and inspire others to achieve optimal health
outcomes for all.

Competencies

6.1 Acquires knowledge of the Calls to Action of the Truth and Reconciliation
Commission of Canada.

6.2 Integrates CONTINUOUS QUALITY IMPROVEMENT principles and activities into nursing
practice.

6.3 Participates in innovative client-centred care models.

6.4 Participates in creating and maintaining a healthy, respectful, and psychologically

safe workplace.

6.5 Recognizes the impact of ORGANIZATIONAL CULTURE and acts to enhance the quality of
a professional and safe practice environment.

6.6 Demonstrates self-awareness through reflective practice and solicitation of feedback.

6.7 Takes action to support CULTURALLY SAFE practice environments.

6.8 Uses and allocates resources wisely.

6.9 Provides constructive feedback to promote professional growth of other members of

the health-care team.

6.10 Demonstrates knowledge of the health-care system and its impact on client care and
professional practice.

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6.11 Adapts practice to meet client care needs within a continually changing health-care
system.

Competency Category 7: Advocate

Registered nurses are advocates who support clients to voice their needs to achieve
optimal health outcomes. Registered nurses also support clients who cannot advocate for
themselves.

Competencies

7.1 Recognizes and takes action in situations where client safety is actually or potentially
compromised.

7.2 Resolves questions about unclear orders, decisions, actions, or treatment.

7.3 Advocates for the use of Indigenous health knowledge and healing practices in
collaboration with Indigenous healers and Elders consistent with the Calls to Action of
the Truth and Reconciliation Commission of Canada.

7.4 Advocates for health equity for all, particularly for vulnerable and/or diverse clients
and populations.

7.5 Supports ENVIRONMENTALLY RESPONSIBLE PRACTICE .

7.6 Advocates for safe, competent, compassionate and ethical care for clients.

7.7 Supports and empowers clients in making informed decisions about their health care,
and respects their decisions.

7.8 Supports healthy public policy and principles of SOCIAL JUSTICE.

7.9 Assesses that clients have an understanding and ability to be an active participant in
their own care, and facilitates appropriate strategies for clients who are unable to be
fully involved.

7.10 Advocates for client’s rights and ensures informed consent, guided by legislation,
practice standards, and ethics.

7.11 Uses knowledge of POPULATION HEALTH , DETERMINANTS OF HEALTH , PRIMARY HEALTH

CARE , and health promotion to achieve health equity.

7.12 Assesses client’s understanding of informed consent, and implements actions when
client is unable to provide informed consent.

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7.13 Demonstrates knowledge of a substitute decision maker’s role in providing informed

consent and decision-making for client care.

7.14 Uses knowledge of HEALTH DISPARITIES and HEALTH INEQUITIES to optimize health
outcomes for all clients.

Competency Category 8: Educator

Registered nurses are educators who identify learning needs with clients and apply a
broad range of educational strategies towards achieving optimal health outcomes.

Competencies

8.1 Develops an education plan with the client and team to address learning needs.

8.2 Applies strategies to optimize client HEALTH LITERACY .

8.3 Selects, develops, and uses relevant teaching and learning theories and strategies to
address a diversity of clients and contexts, including lifespan, family, and cultural
considerations.

8.4 Evaluates effectiveness of health teaching and revises education plan if necessary.

8.5 Assists clients to access, review, and evaluate information they retrieve using ICTs.

Competency Category 9: Scholar

Registered nurses are scholars who demonstrate a lifelong commitment to excellence in
practice through critical inquiry, continuous learning, application of evidence to practice,
and support of research activities.

Competencies

9.1 Uses best evidence to make informed decisions.

9.2 Translates knowledge from relevant sources into professional practice.

9.3 Engages in self-reflection to interact from a place of CULTURAL HUMILITY and create
culturally safe environments where clients perceive respect for their unique health-
care practices, preferences, and decisions.

9.4 Engages in activities to strengthen competence in NURSING INFORMATICS .

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9.5 Identifies and analyzes emerging evidence and technologies that may change,
enhance, or support health care.

9.6 Uses knowledge about current and emerging community and GLOBAL HEALTH care
issues and trends to optimize client health outcomes.

9.7 Supports research activities and develops own RESEARCH SKILLS.

9.8 Engages in practices that contribute to lifelong learning.

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 Competencies

Glossary
ACCOUNTABILITY – The obligation to answer for the professional, ethical and legal
responsibilities of one’s activities and duties (Ellis & Hartley, 2009).

ASSESSMENT – Systematically gathering, sorting, and organizing client data, and

documenting the data in a retrievable format (Perry, Potter & Ostendorf, 2018).

ASSIGNS – The selective designation of specific responsibilities for client care within employer
policies, legislative scopes of practice, competencies of the health-care provider and
environmental supports (College and Association of Registered Nurses of Alberta [CARNA],
2014).

CLIENT – Refers to patients, residents, families, groups, communities and population (CARNA,
2013).

CLIENT-CENTRED – An approach that involves advocacy, empowerment, and respecting the

client’s autonomy, voice, self-determination, and participation in decision-making
(Registered Nurses Association of Ontario, 2006).

COMPASSIONATE – The sensitivity shown to understand another person's suffering, combined

with a willingness to help and to promote the wellbeing of that person (Perez- Bret, Altisent,
& Rocafort, 2016).

COMPETENT – The collection and application of measurable knowledge, skills, abilities,

judgment and attitudes to practice safely and ethically (Canadian Council of Registered
Nurse Regulators, 2013).

CONFLICT RESOLUTION – The various ways in which individuals or institutions address conflict
(e.g., interpersonal, work) in order to move toward positive change and growth (College of
Registered Nurses of Nova Scotia [CRNNS], 2012).

CONTINUOUS QUALITY IMPROVEMENT – A continuous cycle of planning, implementing

strategies, evaluating the effectiveness of these strategies, and reflection to see what further
improvements can be made (College and Association of Registered Nurses of Alberta, 2013).

CRITICAL INQUIRY – A process of purposive thinking and reflective reasoning where

practitioners examine ideas, assumptions, principles, conclusions, beliefs, and actions within
a particular context, and is associated with a spirit of inquiry, discernment, logical reasoning,
and application of standards (Brunt, 2005).

CULTURAL HUMILITY – A process of openness, self-awareness, being egoless, and incorporating

self-reflection and critique after willingly interacting with diverse individuals (Foronda,
Baptiste, Reinholdt, & Ousman, 2016).

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 Competencies

CULTURALLY SAFE – An outcome based on respectful engagement free from racism and
discrimination so that patient is a powerful player, not a passive receiver, of health care
(Yeung, 2016).

DETERMINANTS OF HEALTH – Factors that influence health beyond our individual genetics and
lifestyle choices (Government of Canada, 2018).

ENVIRONMENTALLY RESPONSIBLE PRACTICE – Activities that support environmental preservation

and restoration to promote health and well-being (Canadian Nurses Association [CNA],
2017b).

EVIDENCE-INFORMED – Practice based on successful strategies that improve client outcomes

and are derived from a combination of various sources of evidence including client
perspectives, research, national guidelines, policies, consensus statements, expert opinion
and quality improvement data (Canadian Health Services Research Foundation, 2005).

FITNESS TO PRACTICE – Freedom from any cognitive, physical, psychological or emotional

condition and dependence on alcohol or drugs that impairs ability to provide nursing care
(CNA, 2017a).

GLOBAL HEALTH – The optimal well-being of humans from the individual and the collective
perspective (CNA, 2017a).

HARM REDUCTION – Policies, programs and practices to reduce the adverse health, social and
economic consequences of legal and illegal psychoactive drugs without necessarily reducing
drug consumption (CNA, 2017c).

HARMFUL INCIDENCE – A patient safety incident that results in harm to a client (Canadian
Patient Safety Institute [CPSI], 2009).

HEALTH-CARE TEAM – Health-care providers from different disciplines (often including both
regulated professionals and unregulated workers) work collaboratively to provide care for
clients (CNA, 2017a).

HEALTH DISPARITIES – Differences in health status among population groups defined by

specific characteristics (Health Disparities Task Group of the Federal/Provincial/Territorial
Advisory Committee on Population Health and Health Security, 2004).

HEALTH INEQUITIES – Differences in health status or in the distribution of health resources

among different population groups due to the social conditions in which people are born,
grow, live, work and age (World Health Organization [WHO], 2017).

HEALTH LITERACY – The ability to access, comprehend, evaluate and communicate

information to promote, maintain and improve health in a variety of settings across the life-
span (Rootman, & Gordon-El-Bihbrety, 2008).

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 Competencies

HEALTH PROMOTION – Enabling people to increase control over, and to improve, their health
by moving beyond a focus on individual behaviour towards a wide range of social and
environmental interventions (WHO, 2018a).

HOLISTIC – A system of comprehensive or total patient care that considers the physical,
emotional, social, economic, and spiritual needs of the person, the response to illness, and
the effect of the illness to meet self-care needs (Jasemi, Valizadeh, Azmanzadeh & Keogh,
2017).

INFORMATION AND COMMUNICATION TECHNOLOGIES (ICTS) – A diverse set of technological tools

and resources used to communicate, create, disseminate, store, and manage data and
information (Canadian Association of Schools of Nursing [CASN] & Canada Health Infoway
[CHI], 2012).

INTERPRET – To decide what the intended meaning of something is (Cambridge Online

Dictionary).

INTERPROFESSIONAL – Members of different health-care disciplines working together within

their individual scopes of practice to meet the health-care needs of the client (Canadian
Health Services Research Foundation, 2012).

MEDICAL ASSISTANCE IN DYING – The administering of a substance to a patient, at the patient’s

request, that causes the patient’s death or the prescribing or providing by a nurse
practitioner of a substance to a patient, at the patient’s request, so that the patient may self-
administer the substance and in doing so cause his or her own death (CARNA, 2016).

NEAR MISS – An event that could have, but did not, result in harm (CPSI, 2009).

NO HARM INCIDENCE – A patient safety incident that reached the patient, but caused no
discernible harm (CPSI, 2009).

NURSING INFORMATICS – Integrating and managing nursing data and knowledge with
information and communication technologies to promote the health of clients (CASN & CHI,
2012).

ORGANIZATIONAL CULTURE – Assumptions and values that members have about their
organization (Sullivan, 2012)

PALLIATIVE CARE – An approach that improves the quality of living for patients who have life-
threatening illness and their families by preventing and relieving suffering of physical,
psychological and spiritual pain or discomfort through early assessment and treatment
(World Health Organization, 2018b).

PLAN OF CARE – A plan that includes priority nursing interventions to achieve client centered
goals (CRNNS, 2017a).

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POPULATION HEALTH – An approach to improve the health of the entire population and to
reduce health inequities among population groups (Public Health Agency of Canada, 2012).

POSITIONAL POWER – The assumed authority or influence a person holds over others by virtue
of the title of his or her position (CRNNS, 2017b).

PRIMARY HEALTH CARE – A focus on delivering client-centred services that include accessibility,
active public participation, health promotion and chronic disease prevention and
management, use of appropriate technology and innovation, and intersectoral cooperation
and collaboration (CNA, 2015).

PROCEDURES - A set of actions that are the official or accepted way of doing something
(Cambridge Online Dictionary).

PROFESSIONAL BOUNDARIES – Spaces between the nurse’s power and the client’s vulnerability
(CARNA, 2011a).

PROFESSIONAL PRESENCE – The demonstration of confidence, integrity, optimism, passion, and

empathy that aligns with legislation, practice standards, and ethics through verbal and
nonverbal communications (Canadian Patient Safety Institute, 2017).

RECOVERY-ORIENTED NURSING CARE – A perspective that recognizes recovery as a personal

process for people with mental health conditions or addictions to gain control, meaning and
purpose in their lives (CASN, 2015).

RELATIONAL PRACTICE – Conscious participation with clients using listening, questioning,

empathy, mutuality, reciprocity, self-observation, reflection, and a sensitivity to emotional
contexts (Doane & Varcoe, 2007).

RESEARCH SKILLS – Ability to critically appraise the various aspects of a scientific research
study.

SAFETY – Reducing and mitigating acts within the health-care system that could cause harm,
as well as using best practices for optimal patient outcomes (CPSI, 2017).

SCOPE OF PRACTICE – The interventions that registered nurses are authorized, educated and
competent to perform (CARNA, 2011b).

SOCIAL JUSTICE – Studying and understanding the root causes and consequences of
disparities regarding the unfair distribution of society’s benefits and responsibilities by
focusing on the relative position of one social grouping in relation to others (CNA, 2017a).

SOCIAL MEDIA – The software applications (web-based and mobile) that allow for creation,
engagement, and sharing of new or existing content, through messaging or video chat,
texting, blogging, and other social media platforms (Bodell & Hook, 2014).

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 Competencies

THERAPEUTIC NURSING INTERVENTION – Any treatment based on clinical judgement and

knowledge which a nurse performs to enhance client outcomes (Butcher, Bulechek,
McCloskey Dochterman, & Wagner, 2019).

THERAPEUTIC RELATIONSHIP – A relationship that is established and maintained with a client by

the nurse through the use of professional knowledge, skills and attitudes in order to provide
nursing care expected to contribute to the client’s well-being (CARNA, 2011a).

TRAUMA-INFORMED CARE – A strengths-based framework that is grounded in an

understanding of and responsiveness to the impact of trauma, emphasizes physical,
psychological, and emotional safety for both providers and survivors, and creates
opportunities for survivors to rebuild a sense of control and empowerment (Hopper, Bassuk,
& Olivet, 2010).

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Butcher, H. K., Bulechek, G. M., McCloskey Dochterman, J. M. & Wagner, C. (2019). Nursing
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