The Tennessee Competency Model

Note: Competencies in non-italicized print are from The Mississippi Competency Model. “Selected Demonstrated Skills” by educational/licensure level from South Carolina’s Differentiated Entry Level Nursing Model are presented in italics.

PROVIDER: The nurse, utilizing a systematic process, assists clients* in meeting health care needs in a wide variety of settings. The nurse coordinates the care of clients using a multidisciplinary approach.

	LPN	ADN	BSN	MSN
Care Giver (Nsg process skills, Tech skills, Health Promo Maintenance)	Provides client care, using an established plan to meet basic health needs, under the direction of qualified health professionals.	Plans coordinates, implements and evaluates nursing care designed to promote and/or maintain healthy outcomes for clients.	Coordinates, implements and evaluates nursing care designed to promote and/or maintain health outcomes for clients. Evaluates theoretical and research-based interventions for their applicability to nursing practice.	Provides and evaluates comprehensive, integrated care utilizing specialized knowledge and expertise to promote and/or maintain healthy outcomes.
	Collects patient data; health history & observation using a standard protocol or tool; implements plan of care; reports/records findings; assists in planning and evaluating care.	Performs health assessment (history, physical appraisal) using a standard protocol or tool; formulates nursing diagnosis; plans, implements & evaluates care.	Performs comprehensive health & social assessment; history & physical exam; family & community assessment using a standard protocol or tool; formulates nursing diagnoses; coordinates & manages care; evaluates & modifies care.	Assesses population health. Performs comprehensive health & social assessment, & differential diagnosis; family, community & population.
	Performs fundamental therapeutic & preventative nursing measures & administers treatments & medications as authorized by law & determined by the State Board of Nsg.	Performs therapeutic & preventative nursing measures & administers treatments & medications as authorized by law & determined by the State Board of Nsg, Performs basic health promotion/maintenance & screening.	Performs & modifies therapeutic & preventative nursing measures & administers treatments & medications as authorized by law & determined by the State Board of Nsg. Performs health screening & case finding.	Performs and modifies therapeutic & preventative nursing measures & prescribes & modifies treatment & medication plan as authorized by law & determined by the State Board of Nsg.
Teacher (Patient Education)	Provides basic health teaching for clients, with identified health needs, using an established teaching plan.	Designs, implements and evaluates teaching plans of care for clients.	Designs implements and evaluates teaching plans of care for clients.	Designs, implements and evaluates comprehensive teaching programs for clients and health personnel.
	Teaches basic health promotion/maintenance & self-care to an individual from a designated teaching plan.	Develops teaching plan for individuals to promote health & manage illness of acute & chronic health problems.	Develops teaching plan for complex health problems; adapts teaching plan; teaches individuals & groups; participates in healthy communities initiatives.	Develops teaching plan for complex & multifunctionally impaired pts: teaches staff & pts., adapts teaching plans based on research findings; establishes community partnerships for health improvement.
Communicator / Counselor (Communication Skills)	Establishes and participates in a therapeutic relationship with clients.	Establishes and maintains therapeutic relationships with clients.	Establishes and manages therapeutic relationships with clients.	Develops and evaluates therapeutic relationships with clients. Develops, implements and evaluates counseling strategies.
	Established fundamental interpersonal & therapeutic communication: recognizes individual differences in communication.	Maintains therapeutic & psychotherapeutic communication; modifies communication in response to cultural/language differences.	Manages therapeutic & psychotherapeutic communication; group process; integrates cultural & language difference in nurse/patient interaction.	Advanced practice therapeutic & psychotherapeutic communication; group process; community integration; overcomes system barriers to cross-cultural communication.
Advocate (Mgmt. Leadership & Admin skills)	Recognized issues related to protection of consumers’ rights and notifies RN/MD on behalf of client to protect those rights.	Uses knowledge of consumers’ rights and responsibilities to plan care for and intervene on behalf of clients. Is aware of health policy and its impact on clients.	Disseminates information to increase the knowledge level of clients about health policy and consumer rights and responsibilities. Acts to uphold these rights.	Assume a leadership role in intervening on behalf of clients to uphold and protect consumers’ rights. Engages in health policy development.
	Understands & safeguards the rights of individual patients.	Promotes & assures patients’ rights in a defined health care setting.	Serves as a client & consumer advocate to promote & protect health; advocates for progressive & humanizing change in health care in a defined health care setting.	Advocates for public policy to improve health & health care, promotes nursing to consumers, providers & policymakers.

*Clients – The recipients of nursing care. Clients for licensed practical and associate degree nurses include individuals, families, and groups. Clients for baccalaureate and masters prepared for nurses include individuals, families, groups and the community. For the purpose of this definition, the community as a client is viewed as a group of individuals living in a geographically related area, sharing common resources and whom others identify as having a relationship.

Note: Competencies in non-italicized print are from The Mississippi Competency Model. “Selected Demonstrated Skills” by educational/licensure level from South Carolina’s Differentiated Entry Level Nursing Model are presented in italics.

MEMBER OF A PROFESSION: The nurse is accountable for the ethical, legal and professional dimensions of the practice of nursing.

	LPN	ADN	BSN	MSN
Scholar	Assumes responsibility for professional development and commitment to lifelong learning.	Pursues professional development as it relates to the improvement of health care.	Pursues and communicates knowledge as it relates to the improvement of health care.	Pursues, develops and communicates advanced knowledge as it relates to the improvement of healthcare.
Collaborator	Participates in collegial relationships for the purpose of improving client outcomes.	Participates in the establishment of collegial relationships for the purpose of improving client outcomes.	Establishes, promotes and evaluates the care environment for the purpose of improving client outcomes.	Establishes and evaluates professional networks for the purpose of improving client outcomes.
Ethicist	Practices within the values framework and legal parameters of the nursing profession.	Practices within the values framework and legal parameters of the nursing profession. Contributes to the decision-making process relative to ethical issues for clients.	Practice within the values framework and legal parameters of the nursing profession. Participants in the decision-making process relative to ethical issues for clients.	Practices within values framework and legal parameters of nursing. Uses established ethical frameworks to monitor and influence health care practices.
Researcher	Recognizes the role research plays in the delivery of client care.	Uses interpreted nursing research findings to improve client outcomes.	Incorporates research findings into practice and consults with nurse researchers regarding identified nursing problems in order to enhance nursing practice.	Participates in designing and conducting research specific to the improvement of client outcomes.

The Tennessee Competency Model

MANAGER: The nurse optimizes resources to achieve desired outcomes for the promotion of health in client populations.

	LPN	ADN	BSN	MSN
Leader	Demonstrates basic management concepts in the provision of client care.	Works with other health care personnel to coordinate care to improved client outcomes.	Assumes an influential role in planning, managing and monitoring health care to improve client outcomes.	Provides visionary direction to create, modify, evaluate and enhance the effectiveness of health care systems through monitoring client outcomes.
	Utilizes basic organizational skills; organizes care for patient assignment; delegates to & supervises UAPs; serves as a nursing team member.	Utilizes basic management & leadership skills; acts as a team leader; supervises & delegates care; serves as nursing team member.	Utilizes management; leadership & administrative skills; manages groups of pts. & staff; applies concepts of resource utilization & basis systems integration; participates as an interdisciplinary team member & case manager.	Utilizes advanced mgmt., leadership & administrative skills; manages pop.; applies concepts of research-based resource utilization, systems integration & design, case mgmt. & disease mgmt.; participates as an interdisciplinary team member/leader & key stakeholder.
Facilitator	Participates in group process to promote the provision of nursing care.	Uses knowledge of group dynamics to improve client outcomes.	Serve as a leader in group process.	Advances group efforts to improve the delivery and quality of health care to multiple constituents utilizing the expertise and skill of nurses and other professional.
Intraprenuer	Uses knowledge of traditional and alternative care delivery systems in the care of clients. Is receptive to changes in health care.	Participates in implementing traditional and alternative care delivery system. Adapts practice to respond to rapid changes in health care.	Assists in the development and evaluation of traditional and alternative care delivery systems. Plans for implementation of changes in health care.	Participates in the establishment and systematic evaluation of client care provided by traditional and alternative care delivery systems. Anticipates, designs and implements needed changes in health care.
Decision Maker	Uses critical thinking and problem solving in making decisions about basic health care needs.	Uses critical-thinking and problem solving approaches as a basis for nursing practice.	Uses critical thinking and problem solving to address complex health issues.	Challenges assumptions and explores alternative avenues in the improvement of client outcomes.
User of information Technology	Uses information necessary to provide basic care for clients.	Uses technology for the improvement of client care.	Integrates multiple technological responses into the delivery of client care.	Creates, manages and evaluates the usefulness of data bases. Evaluates information systems for the improvement of client care.