In the previous exploration of competency, we discussed the governing bodies of nursing competency and ways that competency may be obtained and proven. When looking for effective, competent nurses (such as a Sexual Assault Nurse Examiners) there are varying factors to ask for and assess. Please note the below can be used by the criminal justice system when assessing competency BUT also will be looked at by a Board of Nursing when licensure is being investigated.
Overall nursing practice history is an important aspect to consider. Schooling, work history, required continuing education to maintain credentialing and competency. Nurses could have educational levels from an associate degree, bachelor’s degree, master’s, or doctorate degree. There are also post education certifications that nurses can have.
Memberships in various professional organizations aid in the maintenance of competent practice for nurses, and most nursing specialties have this option available to them. Specific activities utilized in maintaining competency allow the nurse to keep up with changes in practice, scope, and standards. Some of these may be continuing education courses, being a member of a professional organization, attending conferences, presenting to peers, creating content for educational purposes, and/or publishing in a journal. In some cases, if a nurse has not done any continuing education since their initial training to certify, and practices without keeping up with evolving standards of practice, the state board of nursing may consider them to be acting outside their scope of practice, because they are not maintaining their expertise in the field by keeping up with current standards.
Every state crime lab and state organization governing practice has their own standards and set of competencies. Any nurse, regardless of how long they have been practicing in the state, needs to have knowledge and clear understanding of practice standards for the state in which they are currently practicing. Along with the standards listed above, the nurse is also obligated to understand facility policy to support practices. Nurses need to be able to have access to facility policies and understand any limitations or requirements of their nursing practice.
In the example of a SANE (Sexual Assault Nurse Examiners), there is specialty equipment often utilized to collect and maintain isolation of forensic evidence. Practicing SANE nurses need to ensure that this equipment is maintained by the facility to comply with standards of practice. If a SANE does not have access to this equipment, there could be questions regarding how the evidence was collected. Deviation from standards of practice can be common in specific healthcare settings, but there must be reasonable explanations as to why. For example, a standard of care for victims of violence is to allow as much control as possible throughout the exam. It is also protocol that the SANE collect vaginal swabs. To allow the patient a sense of control and provide a healing environment, the SANE (at the request of the patient and advocate) explains to the patient how to collect the swabs herself when she is not comfortable allowing the SANE to collect them. This is a reasonable deviation from standard practice that is acceptable by multiple governing SANE practice organizations. Deviations from standards of practice are common throughout all nursing practices, but there should always be a reasonable explanation, and there must be documentation that supports the deviation.
When utilizing a SANE as a witness it is important to have a general understanding of how standards of practice, policy, and continuing education define competency and guide initial questioning during examination. Demonstrating competency and standards play into how the testimony will add to validity of practice and base knowledge obtained by the judge and jury.
Stay tuned for future blog posts exploring important issues like short staffing and frequent changes in management. These issues and more effect patient care and healthcare outcomes and will be explored to improve our understanding of our current healthcare system.
ANA Scope and Standards- Nursing Scope and Standards of Practice | ANA (nursingworld.org)
Oregon Board of Nursing Scope and Standards Link [this link provides definitions of practice for disciplines including CNAs, LPNs, RN’s, Advanced Practice Nurses(this is a nurse practitioner)]- Oregon State Board of Nursing : Oregon Nurse Practice Act : State of Oregon
Oregon SANE information Oregon SATF SANE and SAE Program — Oregon SATF