NMH Nursing Standards Competencies
Toolkit
Toolkit
August 2009
Introduction:
The purpose of this toolkit is to introduce the new NMH Nursing Standards Competencies and
their benefits in evaluating performance. As a manager it is your responsibility to present these
competencies to your staff. In this toolkit you will find the following:
• The NMH Nursing Standards Competencies document, which describes the seven
competencies and the behaviorally anchored rating scale. A behaviorally anchored rating
scale uses ratings to illustrate different levels of performance requirements.
• A case scenario you can use with your staff to help familiarize them with the competencies
and sample behaviors of each rating. Staff could complete the blank side and then compare
their ratings to the manager’s rating on the opposite side.
• In order to assist managers in the evaluation of performance, staff will be asked to provide
feedback for colleagues. For nursing colleagues, the feedback should tie back to the Nursing
Standards Competencies. Examples of comments for feedback are also provided.
• A sample meeting agenda, which provides the talking points you need to share with your
staff about this transition.
Objectives:
1) Describe the NMH Nursing Standards Competencies.
2) Explain the behaviorally anchored rating scales.
3) Explain how to will share the new NMH Nursing Standards Competencies and behaviors
with my nursing staff.
Background - Why the change?
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
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The current evaluation form lacks focus on staff nursing behaviors.
To move from an evaluation to a performance management system.
Currently, employees are evaluated with marginal input from peers or colleagues.
Magnet found deficiencies in our current system.
Benefits:
 The manager and employee are clear about the behaviors that need to be demonstrated for
each rating of the competency.
 Staff are clear about what is expected of them and what they need to do to improve and
move to the next level of performance.
 From these objective behaviorally anchored rating scales, it should be easier to hold staff
accountable for their performance.
The next page gives a description of the competency and the behaviorally anchored rating scale.
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NMH Nursing Standards Competencies
Use this document for self- evaluation, feedback, and staff nurse performance by the manager.
Nursing Standards Competencies Sample Behaviors
Does Not Meet: Avoidable errors in patient care; Does not complete care during shift.
Knowledge
Description:
 Assesses and cares for patients
safely.
 Provides competent patient care.
 Serves as clinical resource for
other staff.
Accountability
Description:
 Demonstrates compliance with
patient care policies.
 Practices with accountability
using the nursing process.
 Displays dependability.
 Assumes responsibility for
personal development plan and
education and updates
professional record.
 Properly responds to e-mails,
phone calls and call lights in a
timely manner.
Approaching Expectations: Inconsistently provides safe patient care; Requires prompting to complete
mandatory unit/NMH requirements.
Meets Expectations: Provides safe patient care; Assists staff during and after their orientation, though
not functioning as preceptor.
Exceeds Expectations: Sought out by peers as a resource for clinical issues; Super User roles; Preceptor
for new employees and students.
Exceptional: Achieves/maintains certification in nursing specialty; Teaches classes or in-services related
to orientation.
Does Not Meet: Shows non-compliance with the application of the nursing process; Fails to comply with
patient care policies.
Approaching Expectations: Receives verbal/written warning for absenteeism/attendance; Inconsistent
compliance with patient care policies.
Meets Expectations: Attends educational in-services offered by Northwestern Memorial; Meets
attendance requirements; Consistently follows patient care policies and procedures.
Exceeds Expectations: Identifies and corrects breaks in clinical practice; Assists others in applying the
nursing process.
Exceptional: Recommends and implements action plans to improve safety; Achieves perfect attendance;
Enrolls in an advanced degree program.
Does Not Meet: Viewed negatively by peers; Often blames others; Makes negative comments.
Approaching Expectations: Viewed neutrally by peers; Needs intermittent reminders to take
Description:
responsibility for incomplete work.
 Engages in effective conflict
Meets Expectations: Viewed favorably by peers.
management and problem
Exceeds Expectations: Viewed as a role model by peers; Identifies when others need assistance.
solving.
 Performs well as viewed by peers. Exceptional: Viewed as a mentor by peers; Helps co-workers to identify when colleagues need help.
Professional Image
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Nursing Standards Competencies Sample Behaviors
Does Not Meet: Argues over most team assignments; Questions every decision; Substantiated
Compassion
Description:
 Maintains a positive attitude,
work, and service ethic.
 Demonstrates Patient’s First in
all activities.
Advocacy
Description:
 Facilitates coordination of patient
education.
Collaboration
Description:
 Works constructively and
collaboratively with all team
members.
 Displays effective verbal and
nonverbal communication skills
across departments and
disciplines.
Dynamic
Description:
 Performs care that is timely and
efficient.
 Identifies patients at risk and
accompanying risk reduction
strategies are implemented.
complaints by customer group.
Approaching Expectations: Needs intermittent reminders that every staff is part of the team; Recognizes
the need and focuses on improving customer satisfaction.
Meets Expectations: Takes on challenging assignments; Participates in planned change; Builds effective
interpersonal relationships.
Exceeds Expectations: Offers to take challenging assignments; Initiates departmental change; Consistent
positive customer feedback.
Exceptional: Encourages co-workers to take challenging assignments; Responds proactively to
family/patient concerns to ensure the Best Patient Experience.
Does Not Meet: Fails to initiate and document patient education.
Approaching Expectations: Inconsistent with patient education.
Meets Expectations: Patients and families receive adequate teaching to prepare them for discharge,
procedures, etc.
Exceeds Expectations: Coordinates multidisciplinary education plan; Assists with discharge plan.
Exceptional: Teaches classes for families; Develops teaching tools for families.
Does Not Meet: Often controls peers within earshot of patient and others; Often finds it difficult to
delegate to support personnel.
Approaching Expectations: Needs reminders intermittently by superiors to approach co-workers in
private; Needs intermittent reminders about need to prioritize delegation to support personnel.
Meets Expectations: Usually approaches co-workers in private; Delegates appropriately to personnel.
Exceeds Expectations: Sought out by staff to mediate interactions; Consistently matches assignments to
existing employees’ skill mix; Facilitates teamwork.
Exceptional: Serves as a role model and resource.
Does Not Meet: On corrective action plan for inability to adequately assess/evaluate patient’s clinical
status; Consistently unable to complete nursing care within shift.
Approaching Expectations: Frequently unable to complete nursing care within shift; inconsistent
assessment.
Meets Expectations: Completes nursing care within given shift; Timely completion of risk assessments;
MPET, patient profile.
Exceeds Expectations: Consistently assists others to complete nursing care; Provides clinical expertise in
care of complex patients; Recognizes and responds to emergencies.
Exceptional: Participates in review and revision of unit policies or practices based on scientific evidence;
Practice committee member; Assists with ongoing clinical audits; Assures compliance of peers.
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Case Scenario: Evaluating a Staff Nurse Using New Competencies
Instructions: Below are the behaviors demonstrated by a NMH RN. Using the NMH Nursing Standards Competencies document, determine what
competency is associated with each behavior and then provide a rating for each based on this document’s behaviorally anchored rating scale.
Competency Behaviors
Does Not Approaching
Meets
Exceeds
Exceptional
Meet
Expectations
Expectations Expectations
Certified in specialty.
Never precepted, but will assist staff as needed.
Completes assessments and plans and documents in
Power Chart in a timely manner.
Arrives to work on time.
Rarely take the challenging assignments.
Sometimes complains about the fairness of
assignments.
Is inconsistent in documenting patient education on
the MPET.
Reprimanded a PCT in front of other co-workers
and the manager.
Activated the Rapid Response Team and was
congratulated for catching early signs of
deterioration.
Responds to call lights promptly and answers calls
for other nurses
Assisted with the last clinical audit.
Has taken charge of the unit five times this year;
When in charge good decisions were made
regarding assignments.
Is often asked questions by other nurses related to
the specialty.
Blames others when things do not go well.
Overall Rating:
Additional Comments:
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Answer Key for Case Scenario: Manager Evaluating a Staff Nurse Using New Competencies
Below are the behaviors demonstrated by a NMH RN. The manager of this RN completed her evaluation using the NMH Nursing Standards
Competencies document. The manager has identified what competency is associated with each behavior and then provided a rating for each based on this
document’s behaviorally anchored rating scale (appearing in italicized text). You can compare your evaluation of this RN against the manager’s
evaluation.
Competency
Behaviors
Does Not Approaching
Meets
Exceeds
Exceptional
Meet
Expectations
Expectations Expectations
Knowledge
X
Certified in specialty.
Knowledge
X
Never precepted, but will assist staff as needed.
Dynamic
X
Completes assessments and plans and documents
in Power Chart in a timely manner.
Accountability Arrives to work on time.
X
Compassion
X
Rarely take the challenging assignments.
Compassion
X
Sometimes complains about the fairness of
assignments.
Advocacy
X
Is inconsistent in documenting patient education on
the MPET.
Collaboration
X
Reprimanded a PCT in front of other co-workers
and you.
Dynamic
X
Activated the Rapid Response Team and was
congratulated for catching early signs of
deterioration.
Accountability Responds to call lights promptly and answers calls
X
for other nurses.
Dynamic
X
Assisted with the last clinical audit.
Collaboration
X
Has taken charge of the unit five times this year;
When in charge good decisions were made
regarding assignments.
Knowledge
X
Is often asked questions by other nurses related to
the specialty.
Professional
X
Blames others when things do not go well.
Image
Overall Rating:
X Meets Expectations
Additional Comments:
A discussion with the manager on how the employee views their performance is important. This employee exhibits areas that need improvement. The
manager needs to develop performance improvement plan for the RN. This employee also shows areas of strength. The manager will discuss with this
employee opportunities on how s/he can continue to grow and develop in these areas.
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Examples of Feedback That Could Be Provided for RN
Remember to be honest, objective, and to tie your feedback of the RN to the Nursing Standards Competencies. Below you will find
examples of feedback that can be provided for five of the competencies and how this feedback ties back to the rating scale.
Competency
Does Not Meet
Approaching
Meets
Exceeds Expectations Exceptional
Expectations
Expectations
Knowledge,
Compassion, and
Professionalism
Collaboration and
Accountability
 At least once a
week Sue does
not complete
nursing care for
her patients
during her shift.
 When I am
functioning in the
role of charge
nurse, Sue
questions all my
decisions and
assignments.
 Sue often blames
others when her
care is not
complete.
 John provides safe patient
care 75% of the time.
However, he still needs
reminders to use
universal precautions.
 I’ve heard John complain
about the fairness of
assignments.
 When I have taken over
for John, I’ve frequently
had to remind him to
complete work he began
that he needs to complete
before leaving.
 Sue reprimands
PCTs at the
nurse’s station
where others can
hear.
 Sue takes
frequent
unscheduled
breaks during her
shift.
 I’ve assisted John when
he seems overwhelmed
with prioritization, and
what assistive personnel
can do for him.
 John inconsistently
documents patient
education in the MPET.
 Jane consistently
provides safe patient
care.
 Jane participates in
planned unit change
such as
 Her peers view Jane
favorably.
Sandy is a resource for
staff when it comes to
clinical issues. Staff
seeks her out for
consultation. She
recognizes patterns of
decompensation in
patients and shares her
insight with others.
When Sandy sees an
area that needs
improvement, she will
work through the
proper channels in
initiating the system
improvement.
Sandy is a positive and
reliable role model for
the newer staff. She
will assist the newer
staff when she notices
they need some help.
 Ellen has been certified in
the specialty area for
years. She is the person I
go to if I have a clinical
question.
 If there is a challenging
patient, Ellen encourages
me to take care of that
patient and reassures me
that she will be my
resource if I need any
help.
 I will go to Ellen for
advice if I am not sure
how to proceed with
another department or a
patient’s family member.
 Sandy is a team player
and she provides an
excellent example to her
colleagues of this skill.
 Sandy answers call lights
for other nurses without
being asked.
 Ellen works
constructively and
collaboratively with all
team members. She
serves as a role model
and resource for her
colleagues.
 Ellen just started graduate
school and shares with us
what she is learning that
applies to our practice.


 Jane delegates
appropriately to
assistive personnel.
 When I take over for
Jane, I notice how
she consistently
follows NMH
policies and
procedures in her
nursing practice.
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August 2009
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How to Present the New Competencies to Your Staff
Use your preferred method of communication; newsletters, e-mail, and or staff
meetings. It is recommended you have a meeting and the following agenda can be
used.
Staff Meeting Agenda
Background




The current evaluation form lacks focus on staff nurse behaviors.
To move from an evaluation to a performance management system.
Employees are evaluated with marginal input from peers or colleagues
Magnet found deficiencies in our current system.
Benefits
 The manager and employee are clear about the behaviors that need to be demonstrated for
each rating of the competency.
 Staff are clear about what is expected of them and what they need to do to improve and
move to the next level of performance.
 From these objective behaviorally anchored rating scales, it should be easier to hold staff
accountable for their performance.
NMH Nursing Standards Competencies
 Brief discussion about each competency and it behaviorally anchored rating scale.
Case Scenario (Optional)
 Each meeting participant completes the case scenario and then group compares their
evaluation to manager’s evaluation in the scenario.
Sample Comments for Feedback
 Discuss types of feedback that RNs should provide to their peers.
Question and Answers
If you have questions regarding
the NMH Nursing Standards Competencies
Call Robert Fortney at 6-0139 or
Alan Pietrowski at 6-8530
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