Once nurses are in practice, both staff development and continuing education are used to maintain the requisite knowledge and skill needed for contemporary practice in addition to a formal academic degree. Staff development typically occurs in the setting of employment and is described as the delivery of instruction to assist the nurse to achieve the goals of the employer. According to the ANA (1990):
. . . nursing staff development is a process of orientation, in-service education and continuing education for the purpose of promoting the development of personnel within any employment setting, consistent with the goals and responsibilities of the employer.
Orientation is an important organizational tool for recruitment and retention. Orientation sessions typically occur at the initiation of employment and whenever positions and roles change. Content in orientation education unique to the institution of employment includes
philosophy, goals, policies and procedures, role expectations, facilities, resources and special services, and assessment and development of competency with equipment and supplies used in the work setting (ANA, 1990). In-service education is that phase of the staff development process that occurs after orientation and supports the nurse in acquiring, maintaining, and increasing skills to fulfill assigned responsibilities. Challenging learning opportunities in the employment setting include:
• Technology development
• Changing nature of health care and nursing science
• Interdisciplinary practice
• Changing delivery systems
• New equipment and supplies
• Enlarging roles of nursing related to leadership, management, delegation, supervision, and legal and ethical demands on practice
Active orientation and in-service development for nurses is a critical element of a delivery system that holds high standards for quality of care delivery in a cost-effective manner. Staff development is guided by the accreditation standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and ANA’s Standards for Nursing Staff Development (ANA, 1990). Professional nurses are responsible for their own continuing education. Continuing education offers both personal and professional growth to the nurse and may serve as an incentive to pursue an academic degree. Continuing education builds on acquired knowledge, attitudes, and skills and constitutes an essential dimension of lifelong learning. Although half the boards of nursing require continuing education units (CEUs) as part of the licensure renewal process to document the registered nurse’s competency, increasing evidence supports the assertion that “CE [continuing education] requirements do not guarantee continuing competence” (PEW Health Professions Commission, 1995, p. 1). With the release of the full PEW Health Professions Commission report and the repeal of Colorado’s mandatory continuing education legislation, the debate over the value of mandating continuing education is certain to escalate (Hewlett & Eichelberger, 1996).
Lifelong learning is essential to career development and competency achievement in nursing practice. Technology has expanded the delivery and scheduling flexibility of continuing education for nurses in different geographic sites. Accessibility to continuing education will continue to improve the ability of the nurse to be flexible, factual, futuristic, and functional. The nurse of the future will be the professional who knows how to obtain and use the relevant scientific base of nursing and health care delivery to achieve quality outcomes for health care.