New93 role standards, now public
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Role standards

Nursing

Registered nurse

What a newly licensed registered nurse must be able to do safely without supervision, drawn from the licensure examination that every US and most Canadian jurisdictions already use to make exactly that decision.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
3
Sources
3
Version
2

Built from National Council of State Boards of Nursing, World Health Organization. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent registered nurse does on day one, dimension by dimension.

Clinical skills

  • Recognises and analyses cues that a patient is deteriorating, prioritises the most urgent hypothesis, and acts before instructed to.
  • Obtains and interprets vital signs in context, and treats an abnormal reading as a finding to act on rather than a number to record.

Workflow and tools

  • Finds, records and acts on information in the record without workarounds that break the audit trail.
  • Documents care accurately and contemporaneously, so the record supports the standard of practice it evidences.

Patient communication

  • Confirms understanding by asking the patient to explain the plan back, and adjusts rather than repeating louder.
  • Holds a distressing conversation with honesty and composure, without withdrawing from it or over-promising.

Compliance and safety

  • Administers medication against the rights of administration, and stops when any one of them cannot be confirmed.
  • Selects and maintains the precautions a specific transmission route requires, including when they are inconvenient.

Role knowledge

  • Gives and receives a structured handoff that transfers responsibility explicitly, including what is still unresolved.
  • Delegates only what is within the delegatee's scope, and retains accountability for the outcome.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Plans to recheck later, or wait for the next scheduled observation, when the patient shows signs of acute deterioration, instead of escalating now.

    Failure to rescue a deteriorating patient is one of the most common preventable causes of death in hospital, and the delay is the harm.

  • Would give a medication when the patient's identity, allergy status, dose or route could not be confirmed, or would override an allergy alert without verifying it.

    A dose that reaches the wrong patient or an allergic one cannot be taken back.

  • Would backdate an entry, record care that was not given, or alter the record to hide what happened.

    A false record misleads every clinician after them and is professional misconduct in every jurisdiction.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not prescribe, or change a prescribed dose, on their own authority.Holds a dose they believe is unsafe and contacts the prescriber.
  • Does not tell a patient a diagnosis or result before the responsible clinician has.Acknowledges the question honestly and arranges for the clinician to speak with them.
  • Does not delegate assessment, teaching or evaluation to unlicensed staff.Delegates tasks within the delegatee's scope and keeps the clinical judgment.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 2, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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