1. Smith, Angela BSN, RN

Article Content

Dear Editor,


As a nurse educator, I read with interest the article, "Remediation a Necessary Function for Employers to Correct Incompetence Regarding Clinical Professional Registered Nurse Practice," by Harding and Connolly in the April-June 2012 issue.1 I agree that remediation is necessary when the competency of a registered nurse is not up to the expected standard. My concern is that managers often go from identifying a problem to remedial education as the solution without looking at processes, systems, or alternatives and favor education as the cure to all quality issues.2


I agree with the definition of remediation put forth by Culeiton3(p26) including the idea "remedial efforts are not a 'one size fits all.'" When leaders use remediation as a "Band-aid" that is quickly implemented without further investigation, especially when all staff are educated because of one individual's mistake, education becomes a punishment. Nurses who perform the skill excellently are placed in the same category as those who cannot meet standards to complete education. They then become disillusioned and can become lower performers, because their high performance is not recognized.4


The authors of this article, in exploring the concept of remediation, discuss education as a part of a disciplinary process or investigation that is part of an effort to show termination was not "arbitrary or capricious."1(p50) Although remediation efforts sometimes fail and end in termination, they should not be used as part of an effort to document a termination decision that has been made before the education begins. As professional educators strive to provide progressive education to form a basis for nurses and employers to better translate evidence-based practice to the bedside, the prevalent management culture that uses education as a punishment for errors or a mechanism to advance termination efforts is not helpful to nurses, patients, or organizations.


Angela Smith, BSN, RN


Clinical Educator


St David's South Austin Medical Center






1. Harding A, Connolly M. Remediation: a necessary function for employers to correct incompetence regarding clinical professional registered nurse practice. JONAS Healthc Law Ethics Regul. 2012; 14 (2): 48-52. [Context Link]


2. Effken J, Verran J, Logue M, Hsu Y. Nurse manager's decisions: fast and favoring remediation. J Nurs Adm. 2010; 40 (4): 188-195. [Context Link]


3. Culeiton A. Remediation: a closer look in an educational context. Teach Learn Nurs. 2009; 4: 22-27. [Context Link]


4. Wright D. The Ultimate Guide to Competency Assessment in Health Care. 3rd ed. Minneapolis, MN: Creative Healthcare Management, Inc; 2005. [Context Link]