"In Texas, licensed nursing practice flows along a continuum from the licensed vocational nurse to the doctorally prepared registered nurse... The curricula of the nursing programs (for each level) differ, resulting in differentiated entry level competencies of graduates. The competencies progress from vocational nursing to diploma/associate degree nursing to baccalaureate degree nursing. The competencies of each educational level build upon the previous level."

Fourteen core competencies form the framework for entry level (see below). "Competencies are defined as effective demonstration, by the time of graduation, of knowledge, judgement, skills and professional values derived from the nursing and general education content. The competencies describe the expected outcomes for students at the time of graduation."

"The competencies are organized according to three major roles of the nurse: Provided of Care, Coordinator of Care and Member of a Profession. Broad competency statements describe the expected behaviors of the graduate. The competencies are then further describe in terms of knowledge needed to achieve the competency and related clinical behaviors and judgements."

The Differentiated Entry Level Competencies for the graduate associate degree nurse are reflected in the philosophy, organizing framework and program objectives of the Department of Nursing Education at San Antonio College. In addition, each course reflects these entry level competencies in its course objectives and content outlines. Upon successful completion of the program, the student will be able to demonstrate the knowledge, judgement, skill and professional values of the entry level associate degree registered nurse.

Differentiated Entry Level Competencies of Graduates of Texas Nursing Programs (DELC)
Diploma/Associate Degree

Provider of Care
1. Determine the health status and health needs of clients* based upon interpretation of health data and preventive health practices in collaboration with client* and interdisciplinary health care team members.
2. Formulate goals/outcomes and plan of care based on nursing diagnoses in collaboration with clients* and interdisciplinary health care team members.
3. Implement plan of care within legal and ethical parameters, including scope of practice, in collaboration with the client* and interdisciplinary health care team to assist client* in meeting health care needs.
4. Develop and implement teaching plans for clients* concerning promotion, maintenance and restoration of health.
5. Evaluate clients* responses and outcomes to therapeutic interventions.
6. Provide for the care of multiple clients* either through direct care or assignments and/or delegation of care to other members of the health care team.
7. Use a critical thinking approach to analyze clinical data and current literature as a basic for decision making in nursing practice.

Coordinator of Care
1. Coordinate human and material resources for the provision of care for clients*.
2. Collaborate with clients* and the interdisciplinary health care team for the planning and delivery of care.
3. Refer clients* to resources that facilitate continuity care.
4. Function within the organizational framework of various health care settings.

Member of a Profession
1. Assume accountability and responsibility for the quality of nursing care provided to clients*.
2. Acts as advocate to promote the provision of quality health care for clients*
3. Participate in activities that promote the development and practice of professional nursing.

*client = individual and family

The complete document of the Differentiated Entry Level Competencies of Graduates of Texas Nursing Programs may be found on the BON web site, www.bne.state.tx.us at the link on that page.