16 Therefore, specific training that addresses these skills is necessary, ideally through the development of a complete and standardised training. In a survey of nursing directors of healthcare institutions in Quebec, Canada, these same issues were reported. A narrative review of the literature that we have carried out 16 shows, to the best of our knowledge, that training for CNs is not widely offered in the field nor is it standardised or empirically validated, and training is often incomplete as it does not incorporate the five essential CN skills. 14 15 Lessard 1 adds that when CNs begin their career, standardised training is essential in order to better define roles and responsibilities and prepare CNs to step into their position. 9 12 Indeed, without specific training, a gap persists between the complex requirements of this position and the ability to perform it in practice. 10 11 By the same token, this lack of CN training has implications on three levels: (a) for the healthcare institution, where the CN may create a compromised workflow and provide suboptimal supervision or clinical support to staff, physicians and patients 9 12 (b) for the CN, as their role will be unclear, which will lead to a lack of understanding of the essential skills needed and how to acquire them to perform well, negatively affecting their leadership skills 12 13 and (c) on the users, as this will affect the continuity and quality of care provided. More specifically, the CN receives little training in the strengthening of clinical-administrative management skills during the initial training nor when CNs take up their duties, which makes it a challenge to perform optimally. 8 9 Despite this, it has been reported that the CN receives almost no guidance when they begin their new position. The position of CN is vital 5 as CNs ensure the quality and safety of care 6 7 as well as the overall functioning of the unit. These are: leadership, interpersonal communication, clinical-administrative caring, problem solving, and knowledge and understanding of the work environment. In this regard, Plourde 4 identified five essential skills for the CN. ![]() 3 These two elements of competence, ‘being competent’ and ‘having skills’, are important for the CN in assuming their position. Furthermore, ‘having skills’ means having ‘the personal resources necessary to know how to act in a professional situation’. According to Boterf, 3 ‘Being competent’ refers to ‘a process consisting of “knowing how to act” in a professional situation by mobilizing an appropriate combination of internal personal and external resources and by making use of guidance mechanisms’. ![]() Lessard 2 thus suggests that the clinical and administrative skills of a CN complement each other well. Administrative activities refer to procedures and processes that must be respected, particularly in the coordination of human and material resources and the management of patient admissions and discharges. Specifically, according to Lessard, 2 clinical activities refer to clinical evaluation, the quality and safety of care, and ensuring that one’s knowledge and skills are kept up to date for the purpose of professional development. 1 The clinical-administrative management position is described as that held by a professional who assumes the clinical responsibilities of their practice, and the administrative responsibilities related to the organisation of their work, along with the ability to apply bureaucratic processes. In the Canadian province of Quebec alone, there are approximately 6630 CNs, representing 8.47% of the total number of active registered nurses. ![]() ![]() In general, the position requires working in collaboration with the unit manager to coordinate care activities. The charge nurse (CN) performs a clinical-administrative management position within the clinical care sector of healthcare institutions.
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