Addressing practice competencies across acute and community nursing to reduce healthcare disparities

• Background and Issues: Students in a statewide RNBS program focus on acute care prior to the 9 credit, 2 term Population Based Care course.  The goal-evolve professional level nursing competency understanding to include public health practice. 
• Description: A framework of 10 competencies guides AA and BS nursing education in Oregon.  In the first cohort’s end-of-term reflections on these competencies, faculty were surprised when students listed therapeutic communication and health education as not applicable to their community setting without direct patient care.  In a second cohort, students reflected on the competencies by week three with help from their community preceptor. 
• Lessons Learned: Without a solid understanding of nursing competence in population nursing, acute care nurses risk creating healthcare disparities for their patients.    For example, one acute care nurse student identified a potential healthcare misunderstanding: “I wasn’t sure how the school nurse would meet this competency of collaborating as part of the health care team. That was a very grave misconception on my part. The school nurse is often at the hub of collaborating in the health care team for a pediatric patient… to achieve optimal health outcomes in their patient in order to assist them in continuing to …attend school.”

• Recommendations:  Reflection on population based nursing competencies provides an effective activity to bridge understanding of diverse nursing roles within health care. This understanding can bridge gaps created between acute care and the community for patients and nurses in our emerging healthcare system.