Many hospitals measure nursing competency through annual skills checklists and training completion rates. Those records may document completion and support regulatory reporting, but they do not show whether a nurse can apply clinical judgment safely at the bedside.
That gap is drawing attention as patient acuity rises and experienced nurses retire. Data from StaffGarden by Ascend Learning indicates 85% of organizations plan to overhaul their competency programs within the next few years, while 59% still manage competency through a general learning management system.1
During a Becker’s Healthcare webinar sponsored by StaffGarden by Ascend Learning, Larissa Africa, MBA, RN, CENP, FAONL, FAAN, Vice President, Healthcare Workforce Solutions at StaffGarden by Ascend Learning; Joel Ray, COL, USAF, NC, MSN, RN, NEA-BC, Chief Clinical Advisor at Laudio and StaffGarden by Ascend Learning; Alicia Potolsky, DNP, RN, NE-BC, DipACLM, Associate Chief Nursing Officer at El Camino Health; and Julie Balluck, DNP, RN, NEA-BC, System Chief Nursing Officer at Texas Health Resources, discussed how to treat competency as a workforce strategy.
Below are four takeaways from their discussion.
1. Competency goes beyond completion
Dr. Balluck said competency becomes risky when organizations treat it only as a regulatory checkbox.
“We may be able to prove that an annual validation occurred, but that does not always tell us whether a nurse can safely apply their knowledge, judgment, communication and technical skill in a complex care situation,” Dr. Balluck said.
Dr. Potolsky distinguished skills from competencies: A skill demonstrates that a nurse can perform a task, while competency confirms that the nurse can apply that skill with the right patient in the right situation and recognize when to escalate. El Camino addressed variation in sepsis care with real-time coaching, case reviews and peer-to-peer education.
“This really emphasizes and demonstrates clinical judgment and application of practice rather than just completion of the educational activity,” Dr. Potolsky said.
2. Build one competency architecture
Health systems often align competency programs with Magnet® designation requirements, The Joint Commission standards, Quality and Safety Education for Nurses principles, and specialty-specific expectations. Ms. Africa said managing these requirements separately can create duplication and overly complex competency models.
“We don’t need any more competency frameworks. What we need is a common competency architecture that connects professional standards, workforce development and organizational outcomes,” Ms. Africa said.
Under this model, foundational competencies such as assessment, communication and infection prevention are standardized across the nursing workforce, with specialty competencies built on top. When a nurse moves units, leaders can see which competencies are already validated and which are new.
3. Make development pathways visible
Mr. Ray presented data from a spring 2026 report by Laudio and the American Organization for Nursing Leadership, “Engaging and Retaining Gen Z Nurses: Trends and Strategies,” indicating that Gen Z nurses have the strongest retention of any generation in their first 30 months. After that, however, they leave faster than any generation except retiring baby boomers, a drop-off he linked to residency and precepting support that tapers off.
Ms. Africa said Gen Z nurses are highly engaged but expect clear development pathways and more frequent feedback than an annual competency event provides.
Dr. Balluck added that nurses finishing a residency may want to try another specialty and they want to know the organization supports them. “Retention is really strengthened when nurses believe that the organization’s invested in their success and helping them build capability,” she said.
At El Camino, a nurse retention specialist offers one-on-one coaching to nurses after their first 30 months with the organization.
4. Turn competency data into workforce action
El Camino once tracked competencies on paper forms staff called the “ghastly greens,” which captured a single point in time. For leaders unsure where to begin, Dr. Potolsky suggested starting with a single use case: define competent care for one patient population, work backward and then scale.
“For me, technology is strategic the moment it turns competency into action,” Dr. Potolsky said.
A digital competency management platform can give authorized leaders visibility into validated competencies and workforce readiness. Before adding a cardiothoracic surgeon, for example, a critical care leader can see how many nurses are competent to care for open-heart patients and start training early.
“Instead of asking what positions we need to fill, we can begin by asking what talent we have, what competencies have been validated and where that capability can be deployed,” Ms. Africa said.1
StaffGarden. (2026). Nursing leader market research survey [Proprietary market research conducted by Topline Research; N = 137].
