The Important Foundational Skills in Nursing

<strong>The Important Foundational Skills in Nursing</strong>

Foundational skills are fundamental, transferable skills that enhance performance. To deliver quality patient care, nurses need these as well as clinical skills. Communication, teamwork and interpersonal interaction are essential for nurses working with their team and other healthcare professionals. These competencies help nurses to connect with patients and provide high-quality care. 

Regularly receiving learning and development at work to improve skills, expand knowledge, and stay up to date with regulatory standards is an effective way to keep up with foundational skills. Training can increase motivation, reduce skill gaps, provide a robust development plan, and raise morale.

To find out how to become a nurse with a bachelor’s degree, visit the Rockhurst University website. They deliver a 16-month online accelerated Bachelor of Science in Nursing for students with a degree in a different subject.

Case study

One of the foundational skills for nurses is communication. According to work by Wolf, 95% of patients believe that being listened to is very or extremely important, an even higher percentage than for fast pain relief.

Nancy E. Loos was a nursing director when she became interested in nurse listening. Loos faced very low nurse listening scores and an order to improve them quickly. She could not find much information on listening in a healthcare setting, so she did her own research. She conducted a study as part of her PhD in nursing. She interviewed a group of adults recently discharged from the hospital and asked the following questions:

  • Which nurse behaviors implied listening had occurred?
  • Which nurse behaviors implied listening had not occurred?
  • How did the perception of listening and non-listening affect you, both in and beyond the hospital?
  • What advice do you have for nurses as it relates to listening?

Below is a list of actual patient quotes answering the fourth question about listening.

  • “Listening brings out compassion”
  • “When you’re distracted, you’re only partially listening”
  • “The most crucial part of your job is listening to patients. To excel, you must first listen, process what you hear, and then act”
  • “Nurses are no good to anybody if they don’t understand what the patient is saying or what the problem is. You must be listening”
  • “When you listen, I believe you will advocate for me”

Below is a list of other advice that the participants would give nurses on what they should do.

  • “Be respectful”
  • “Look at the patient”
  • “Use kind words; they go a long way”
  • “Just touch someone and make sure he or she is ok”
  • “If you think my request is unreasonable, ask more questions before saying ‘no’”
  • “Look up from your screen, or leave the computer outside”
  • “Ask what the best thing you can do for me is; you’ll see a difference”
  • “Be honest”

Digital literacy

Nurses need digital literacy to navigate and use electronic health records (EHRs) to access patient information, document care and communicate with other healthcare providers. This requires knowledge of how to use a computer, the internet, and relevant software programs. Digital literacy enables nurses to find resources to improve patient safety and care. This includes guidelines, protocols, best practices, and staying up to date with new research and treatments.

It is beneficial for nurses to access online educational resources, such as online journals, webinars, and continuing education courses, which are important for staying up to date with new developments in the field of nursing.

Nurses need to be able to communicate with other healthcare providers using email, instant messaging and teleconferencing. This allows for more efficient and effective care coordination and can improve patient outcomes.

Digital literacy also enables nurses to use technology such as wearable devices and other digital tools to care for patients who are not physically present in a healthcare facility. Software and technology can allow data to be collected, analyzed and interpreted so that informed decisions can be made about patient care.

Critical thinking 

Critical thinking is an essential skill in many areas of life. It is the process of analyzing information, arguments and evidence to make informed and logical decisions. Engaging in critical thinking and analysis allows you to predict outcomes and make informed decisions.

It involves the ability to think independently and to evaluate information systematically and reflectively. Nurses need to have various critical thinking skills to provide safe and effective patient care. These skills include:

  • Problem-solving: identifying and solving problems related to patient care
  • Clinical reasoning: understanding the patient’s condition and making appropriate decisions
  • Decision-making: making decisions about patient care, often in complex and rapidly changing situations
  • Critical analysis: evaluating information and evidence to make informed decisions about patient care
  • Reflective practice: reflecting on their practice and making changes when necessary to improve patient outcomes

Communication skills

Communication skills are essential for nurses because they are critical in ensuring safe and effective patient care. Nurses need to communicate effectively with patients to understand their concerns and needs and provide emotional support. This helps to build trust and rapport, which is essential for the patient-nurse relationship. Nurses also need to be able to navigate conflicts and difficult situations with patients, families, and other healthcare team members professionally and effectively. 

Nursing staff must clearly explain medical conditions and treatment options to patients and families and ensure that their questions are answered. This ensures that they clearly understand their health status and any treatment plans.

Communicating effectively with other healthcare team members, including doctors, nurses, and other healthcare professionals, enables coordinated care. This helps to ensure that all aspects of a patient’s care are considered and that the patient receives the best possible care.

Nurses need to be able to document patient information clearly and accurately, including writing progress notes and other reports. This means that other healthcare team members can access all relevant information about the patient’s condition and treatment.


Nurses are expected to follow various ethical codes to ensure that they provide safe, compassionate and ethical care to patients. Critical decisions are a part of nursing, and ethics are intrinsic to the integrity of the nursing profession. Nurses support each other daily to meet their ethical obligations to patients and the public.

Nurses perform many essential health-related tasks every day. Sometimes, the decisions they must make test their professional and personal morality. The nursing code of ethics helps to consider patient needs from several viewpoints and maintain a safe environment. Ethical guidelines remind nurses to treat everyone equally and individually while protecting the patient’s privacy rights. These recommendations also call on nursing staff to be advocates for those in their care.

The aim is to create a safe, non-judgmental healthcare environment. The nursing code of ethics encourages healthcare professionals to incorporate moral guidelines into their personal lives.

Nursing ethics cover several common areas:

  • End-of-life issues
  • Bioethics
  • Advocacy
  • Caregiving
  • Moral courage, moral distress and moral resilience


Nurses need to have prioritization and time management skills. These skills are essential for providing safe and effective patient care. Nurses are often responsible for a large number of tasks and patients. Nurses need to organize their work and set realistic goals to ensure that they can complete their tasks in a timely manner. They must prioritize the most urgent tasks, such as administering medication or monitoring vital signs. This can lead to improved patient outcomes, including faster recovery and reduced complications.

Planning skills are also crucial for nurses to work effectively with other healthcare team members, including doctors, nurses, and other healthcare professionals, to provide coordinated care. This helps to ensure that all aspects of a patient’s care are considered and that the patient receives the best possible care.


Nurses should think creatively, adapt to change and uncertainty, and see different perspectives because these skills are essential in a constantly evolving healthcare environment. Some reasons why these skills are essential for nurses include the following:

  • Problem-solving: nurses are often presented with complex and unique patient care situations that require creative thinking to find practical solutions
  • Adaptability: nurses must adapt to new technologies, treatments and policies.
  • Flexibility: nurses often work in fast-paced and unpredictable environments. Regardless of the situation, they must adjust their plans and approach as necessary
  • Patient-centered care: nurses must see different perspectives to understand the patient’s unique views and needs
  • Cultural competence: nurses need to understand and appreciate different cultures, beliefs and values to provide culturally competent care
  • Teamwork: nurses must work effectively with other healthcare team members to coordinate care. This helps to ensure that all aspects of a patient’s care are considered


Nurses work in multidisciplinary teams that rely on communication and effective teamwork to ensure safe patient care. Nurses use teamwork skills daily, from collaborating with other nurses to supporting doctors in developing patient care plans. Teamwork builds on staff cohesion and reduces nursing errors, resulting in greater patient satisfaction and improved healthcare. This improves efficiency and patient safety, leading to a healthier and happier workplace.

When a new patient arrives, nurses and doctors need to work together to diagnose and treat them. With strong teamwork skills, nurses can ensure that each patient receives the correct medication and quality healthcare.

When a nursing team works together effectively, it is easier to meet workplace goals and reach milestones, such as a specific number of patients to be admitted and treated. This can help improve the nursing unit’s results, making the workplace more efficient.


Empathy in nursing is the ability to understand and share the feelings of others, particularly patients and their families. It is a key component of the nursing profession, as it allows nurses to connect with patients on a deeper level and provide care tailored to their individual needs. Nurses who show empathy communicate in a way that is sensitive and non-judgmental. They actively listen to patients and their concerns to understand the patient’s perspective. 

Empathy also includes understanding the patient’s culture and personal background and, most importantly, being respectful of it. This includes being sensitive to the patient’s language, customs and beliefs. Empathetic nurses understand the patient’s family members and loved ones and their emotional state, which can be crucial to providing effective care.

Conflict resolution

Nurses use conflict resolution techniques to manage conflict in the workplace or with patients and their families. By understanding the perspective and feelings of others, nurses can address the underlying emotions that may be causing the conflict and find common ground. Active listening can be used to hear the concerns and perspectives of everyone involved in the conflict. Repeating back or paraphrasing what has been said can ensure understanding. Critical thinking skills can identify and analyze the problem and generate possible solutions. 

Nurses may use verbal and non-verbal techniques to calm a situation. They may suggest a compromise that addresses the needs and concerns of all parties involved. It is important for nurses to adhere to the facility’s policies and protocols for conflict resolution. When a conflict cannot be resolved, nurses may escalate the issue to a higher management level.


Nursing is a physically demanding job that requires a lot of standing, walking and moving around. Nursing staff are often required to lift, transfer and reposition patients. In an emergency, nurses need to respond quickly and efficiently. This can include lifting or moving heavy equipment, performing CPR, or rushing to get help when a patient’s condition deteriorates.

Physical fitness can help nurses to cope with the demands of the job. Regular exercise has also been shown to reduce stress and improve overall mental and physical wellbeing. With a good level of fitness, nursing staff are less likely to experience work-related injuries. 

However, some nursing jobs are less physically demanding, such as home care, management and ambulatory care. 

Continuous professional development (CPD)

CPD, including learning and developing foundational skills, is essential in the nursing profession. This can be achieved by attending courses, online learning, observing others, mentoring, and getting practice in the workplace. 

One way to improve is self-reflection. Nurses can reflect on what went well or did not go well during their workday and identify areas of improvement or situations in which they should have asked for help. This allows the identification of mistakes and the establishment of new behavior patterns that may help you make better decisions. It is helpful to go through the decisions made during the day and decide if more information was needed or if you could have asked better questions.

When developing critical thinking skills, it can be useful to follow this process:

  • Ask questions
  • Gather information
  • Implement a strategy
  • Evaluate the results
  • Consider another point of view

Practicing effective communication can improve active listening skills and the ability to communicate clearly with staff and patients. Active listening techniques can help gain an insight into nursing performance. Asking staff open-ended questions can give an insight into your patient care techniques.

Patient feedback can indicate how you can improve and continue providing exceptional patient care.

It can be beneficial to build mentoring relationships with nursing teams, physicians, and other clinical staff and support new team members. Being a mentor can help in developing leadership skills as well as helping new staff settle in the workplace. Establishing mentoring relationships can support your career development and help improve nursing skills.

Having a mentor can be beneficial as a new nurse or to progress careers or change specialties. A mentor is a more knowledgeable and experienced staff member who supports, oversees and encourages reflection and learning with someone less experienced and knowledgeable. They aim to facilitate that individual’s career and personal development. Mentorship in nursing has been found to improve job satisfaction and promote professional growth and development. 

The goal of mentorship programs is to provide the following: 

  • Clinical care support
  • Psychological and emotional support
  • Academic advice
  • Career development
  • Nurse leadership opportunities

It is useful to keep up to date on current trends, innovations and recent developments in nursing, healthcare and medicine. Attending lectures is a great way to do this as lectures can introduce new advancements in the healthcare field. Workshops can be informative on new theories, approaches and methodologies in nursing and new ways of interacting with and treating patients. Another way to learn new skills is to participate in research. Activities such as these help in staying up to date in your field and demonstrate a desire to keep improving in your career.

Nurses and nurse managers need leadership skills to enhance how they do their job. Leadership skills can be developed by taking more responsibility within the team and helping to organize and delegate tasks, direct team meetings, and support nurses and medical assistants in improving patient care.


Foundational skills are essential with regard to nursing performance and delivering quality care. Communication skills, empathy and teamwork all contribute to the effective care of patients and a positive, inclusive workplace environment. A commitment to learning can ensure that these qualities are maintained and developed over time. Awareness of the importance of these capabilities in nursing can mean that nurses practice and improve as they get more experience. In units where foundational skills underlie professional practice, performance and patient outcomes will benefit.