Over the years working as a talent management consultant on Select International’s Healthcare Team, I've conducted competency-based job analyses with dozens of healthcare organizations ranging from large academic hospitals to small, rural community-based hospitals to help them build a nursing talent strategy. I've spoken with hundreds of top-performing nurses, nursing managers, directors of nursing, and even chief nursing officers across the nation.
In these discussions, I've noticed a few consistent trends in nurse hiring when participants discuss the behavioral-competencies critical for success in the role:
When speaking to what differentiates the top performing and low performing nurses, decision-making and critical thinking skills are consistently noted. Highly successful nurses are able to consider the whole picture of a patient’s care.
They are able to integrate information from multiple resources (e.g., charts, vital signs, medications, changes in patient statuses, etc.) to be proactive and anticipate the needs of a patient. This isn't too surprising when you consider the research that points to cognitive ability as one of the best predictors of job performance.
Ask a nurse if their day is the same day after day. Or, ask a nurse if their patients are all the same and have the same conditions. I'll do you a favor, the answer you will get is NO!
Patient acuity, or the amount/intensity of nursing care that a patient requires, is one factor that changes with each patient and requires adaptive behaviors to provide the care a patient needs. Some patients are in a more critical condition that must be accounted for, and nurses must be able to act and adapt rapidly in changing situations.
Not only must nurses be able to adjust behaviors to accommodate to changing circumstances, it is often cited that the ability to continue to function effectively with calmness during times of change as being equally significant to performance. If there is one industry more rapidly changing than healthcare, I have yet to find it.
As healthcare continues to move toward Value-Based Purchasing, not only are reimbursements tied to quality, but the way patients are treated and cared for by the staff are also large components tied to reimbursement (i.e., HCAHP scores).
Although reimbursement is not cited as the reason compassionate care is a critical behavior by nurses, it is often cited as one of the top differentiators in a great nurse. A top performing, highly rated nurse more frequently exhibits a patient first demeanor. A nurse’s job is to be the patient’s advocate, know the patients’ needs, and be able to speak up on the patients’ behalf for the best plan of care.
Nurses that receive the majority of accolades in the hospitals (i.e., “best of the best”), are always mentioned with stories of going above and beyond to meet patient expectations. Exhibiting compassionate care by going above and beyond and ensuring everything is done to ensure the patient is satisfied will play an insurmountable role in the quality of care for patients, as well as play a role in reimbursement for the hospital.
While this list is not inclusive, other behaviors often cited as critical to performance in the nursing role are attention to detail, collaboration/teamwork, and initiative. One thing that very rarely comes up in conversations with nursing leaders are technical skills. As one CNO told me, “If you can get me a nurse with the soft skills like compassion, quality focus, critical thinking, and adaptability, I can teach them the clinical skills. I can’t teach the soft skills.”