Abstract
Over the last 5 years, telemedicine has developed nursing roles that differ from traditional bedside care. In the midst of this transition, current competency development models focused on task completion may not be the most effective form of proficiency validation. The procedure of competency creation for the role of tele-intensive care unit registered nurse requires a thoughtful process using stakeholders from institutional leadership to frontline staff. The process must include stakeholder approval to ensure appropriate buy-in and follow-through on the agreed-upon criteria. This can be achieved using a standardized method of concept stimulation related to the behaviors, not a memorized list of tasks, expected of a telemedicine registered nurse. This process serves as the foundation for the development of criterion-based competency statements that then allows for clearer expectations. Continually reviewing the written competencies, ensuring current applicability, and revising as needed are necessities for maintaining competence and, therefore, patient safety.