Nursing Competency and Professional Attitude among Novice Nurses in a Department of Health (DOH) Retained Hospital

This study assessed the level of nursing competency and professional attitude among novice nurses and examined their relationships with selected demographic characteristics. A quantitative descriptive–correlational design was employed in government retained hospital in the Surigao del Norte, Philippines. A complete enumeration of 126 newly hired registered nurses engaged in direct patient care participated. Data were collected using the Nursing Competency Scale (NCS) and the Professional Attitude Scale for Nurses (PASN). Descriptive statistics, Chi-square tests, Cramer’s V, and Pearson correlation coefficients analyzed the data. Ethical standards and informed consent were observed throughout the study. Most respondents were 18–35 years old, female, single, and held a bachelor’s degree. Overall, novice nurses demonstrated high nursing competency across all domains, excelling in Helping Role, Teaching-Coaching, and Therapeutic Interventions, with slightly lower performance in Diagnostic Functions. Professional attitude was predominantly high, indicating strong ethical awareness, accountability, and engagement in professional roles. Sex was significantly associated with both competency and professional attitude, while educational attainment correlated with professional attitude. A strong positive relationship was observed between competency and professional attitude (r = 0.692, p < 0.001), suggesting that clinical skills and professional behavior are interdependent. Novice nurses in a DOH-retained hospital exhibit high competency and professional attitude, with gaps in diagnostic interpretation and complex decision-making. Targeted mentorship, structured training, and continuous professional development are recommended to strengthen readiness for high-acuity patient care.

Novice nurses, Nursing competency, Professional attitude, Early-career nurses, Hospital practice

1. Ahmed, S., & Khalil, R. (2023). Gender differences in clinical performance and collaboration among nurses. Journal of Nursing Research, 31(2), 120–130. https://doi.org/10.1097/JNR.0000000000000572 [Google Scholar] [Crossref]

2. Ahmed, H., Khan, S., & Al-Farooq, R. (2022). Early-career nurse proficiency and patient safety outcomes. BioMed Central Nursing, 22, 374. https://doi.org/10.1186/s12912-023-01305- [Google Scholar] [Crossref]

3. Alghamdi, M. G., Alshammari, F., & Ahmad, M. M. (2021). Factors influencing nurses’ competency in Saudi Arabia: A cross-sectional study. BioMed Central (BMC) Nursing, 20, 110. https://doi.org/10.1186/s12912-021-00617-8 [Google Scholar] [Crossref]

4. Alibudbud, R. (2023). Competence of nurses and their influence on patient safety outcomes in Philippine hospitals. International Journal of Nursing Sciences, 10(1), 23–29. https://doi.org/10.1016/j.ijnss.2022.11.004 [Google Scholar] [Crossref]

5. Al Maqbali, M., Albougami, A., & Falatah, R. (2020). What impacts nurses’ resilience during the COVID 19 pandemic? A qualitative study of frontline nurses in Saudi Arabia. Journal of Nursing Management, 28(8), 1986–1993. [Google Scholar] [Crossref]

6. Al-Mugheed, K., Al-Rashid, F., & Al-Mutairi, A. (2021). Therapeutic relationships and patient satisfaction in early-career nurses. International Journal of Nursing Practice, 27(5), e12945. [Google Scholar] [Crossref]

7. Alshaer, R., & Sowan, A. K. (2021). Professional attitude and its impact on job performance among nurses. Journal of Nursing Management, 29(4), 735–744. https://doi.org/10.1111/jonm.13141 [Google Scholar] [Crossref]

8. Alshahrani, A., Assiri, A., & Alosaimi, D. (2022). Workplace learning, professional development, and clinical competence among Saudi nurses: A correlational study. Nurse Education Today, 110, 105262. https://doi.org/10.1016/j.nedt.2022.105262 [Google Scholar] [Crossref]

9. Amare, A. (2022). Educational preparation and professional attitude among early-career nurses. Journal of Nursing Education, 61(8), 415–422. https://doi.org/10.3928/01484834-20220719-04 [Google Scholar] [Crossref]

10. American Nurses Association. (2021). Nursing: Scope and Standards of Practice (4th ed.). ANA Publishing. [Google Scholar] [Crossref]

11. Amparo, M. L. (2023). Cultural competency and quality of care of nurses in a public hospital in Southern Philippines. Malaysian Journal of Nursing, 15(2), 45–52. https://ejournal.lucp.net/index.php/mjn/article/view/2645 [Google Scholar] [Crossref]

12. Ayed, A., et al. (2024). Relationship between professional values and caring behavior among nurses in NICUs. BioMed Central Nursing, 23, 318. [Google Scholar] [Crossref]

13. Baclig, L. T., Ramos, E. B., & Mercado, M. L. (2020). Professional autonomy and job satisfaction among Filipino nurses in tertiary hospitals. Philippine Journal of Nursing, 90(1), 34–40. [Google Scholar] [Crossref]

14. Bahreini, M., Shahamat, S., Hayatdavoudi, P., & Mirzaei, M. (2013). Comparison of the clinical competence of nurses working in two university hospitals in Iran. Nursing and Midwifery Studies, 2(1), 39–43. https://doi.org/10.5812/nms.9894 [Google Scholar] [Crossref]

15. Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley Publishing. [Google Scholar] [Crossref]

16. Bautista, J., & Morales, L. (2021). Demographic variables and nursing competence: A comparative study. International Journal of Nursing Studies, 115, Article 103867. https://doi.org/10.1016/j.ijnurstu.2020.10386 [Google Scholar] [Crossref]

17. Cañete, K. P., Lunod, J. M., & Yu, C. J. (2020). Competence and caring efficacy among primary care nurses in a rural health unit in the Philippines. Philippine Journal of Health Research and Development, 24(2), 112–119. [Google Scholar] [Crossref]

18. Çelik, S., & Hisar, F. (2020). The effect of self-evaluation on the development of clinical competence in nursing students. Nurse Education Today, 85, 104257. https://doi.org/10.1016/j.nedt.2019.104257 [Google Scholar] [Crossref]

19. Choi, S., Lee, J., & Kim, M. (2024). Managerial support, professional self-accomplishment, and retention among novice nurses: A cross-sectional study. BioMed Central Nursing, 23(58). https://doi.org/10.1186/s12912-024-01368-5 [Google Scholar] [Crossref]

20. Chuang, J. Y., et al. (2025). A Professional Nurses Competence Scale (PNCS): Development and validation. BioMed Central Nursing, 24, 123. [Google Scholar] [Crossref]

21. Costello, J., Smith, R., & Brown, L. (2022). Generational traits and workplace adaptation in early-career nurses. Journal of Nursing Education and Practice, 12(4), 45–54. [Google Scholar] [Crossref]

22. Dauvrin, M., & Lorant, V. (2020). The impact of leadership and organizational culture on nurse competence development: A correlational analysis. International Journal of Nursing Studies, 107, 103583. https://doi.org/10.1016/j.ijnurstu.2020.103583 [Google Scholar] [Crossref]

23. Department of Health (Philippines). (2015). Administrative Order No. 2015-0025: Definition of DOH-retained hospitals. [Google Scholar] [Crossref]

24. Dizon, R. M., & Dela Cruz, J. P. (2022). Perceived competencies and training needs of public health nurses in the Philippines. Acta Medica Philippina, 56(5), 321–328. https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/9301 [Google Scholar] [Crossref]

25. Elhami, S., Karami, A., Mokhtari Nouri, J., & Mirlashari, J. (2018). The relationship between nurses’ clinical competency and patient satisfaction. Iranian Journal of Nursing Research, 13(5), 1–9. [Google Scholar] [Crossref]

26. Espinosa, R. C., Dela Cruz, F. A., & Salcedo, J. T. (2021). Attitudes toward nursing research and research competence among nurses in North Cotabato: A predictive correlational study. Asian Journal of Nursing Education and Research, 11(3), 345–350. https://doi.org/10.5958/2349-2996.2021.00064.3 [Google Scholar] [Crossref]

27. Fukada, M. (2018). Nursing competency: Definition, structure and development. Yonago Acta Medica, 61(1), 1–7. https://doi.org/10.33160/yam.2018.03.001 [Google Scholar] [Crossref]

28. Garcia, L., & Lee, H. (2024). Work–life balance and career satisfaction among early-career nurses. Journal of Nursing Management, 32(1), 85–92. https://doi.org/10.1111/jonm.13810 [Google Scholar] [Crossref]

29. García-Sánchez, E., Pérez, M., & López, F. (2021). Adapting to clinical environments: Age and career transition in nursing students. Nurse Education Today, 101, 104900. [Google Scholar] [Crossref]

30. Ghadirian, F., Salsali, M., & Cheraghi, M. A. (2020). Professionalism: An evolutionary concept analysis. Iranian Journal of Nursing and Midwifery Research, 25(1), 5–12. https://doi.org/10.4103/ijnmr.IJNMR_201_18 [Google Scholar] [Crossref]

31. Ghaffari, F., Navvabi, N., & Moosavi, S. (2020). Exploring Iranian nurses’ experiences regarding professionalization: A qualitative study. Journal of Professional Nursing, 36(2), 72–78. https://doi.org/10.1016/j.profnurs.2019.06.005 [Google Scholar] [Crossref]

32. Halabi, J. O., et al. (2023). The Nurse Professional Competence (NPC) Scale—Short version: Evidence of validity. Saudi Journal of Health Sciences, 12(1), 11–20. [Google Scholar] [Crossref]

33. Hartigan-Go, K. Y. (2024). Confronting the nursing crisis (Philippines). Optum Health Education. [Google Scholar] [Crossref]

34. International Council of Nurses. (2020). ICN framework of competencies for the general nurse. https://www.icn.ch [Google Scholar] [Crossref]

35. International Council of Nurses. (2023). Patient safety: ICN position statement. [Google Scholar] [Crossref]

36. Jho, M. Y., Kang, J., & Park, J. S. (2023). Continuing education and its impact on clinical competence and patient outcomes among hospital nurses. International Journal of Nursing Studies, 139, 104473. https://doi.org/10.1016/j.ijnurstu.2023.104473 [Google Scholar] [Crossref]

37. Johnson, P., & Jansson, L. (2022). Gender socialization and communication patterns in nursing practice. Nursing Outlook, 70(4), 574–582. https://doi.org/10.1016/j.outlook.2022.05.009 [Google Scholar] [Crossref]

38. Karami, A., Farokhzadian, J., & Foroughameri, G. (2020). The relationship between professional competency and organizational commitment among nurses. BioMed Central (BMC) Nursing, 19, 74. https://doi.org/10.1186/s12912-020-00454-5 [Google Scholar] [Crossref]

39. Karimi, Z., Mazlom, R., & Norouzinia, R. (2021). Organizational support and professional attitude among nurses. Journal of Professional Nursing, 37(5), 702–709. https://doi.org/10.1016/j.profnurs.2021.08.011 [Google Scholar] [Crossref]

40. Karamoozian, M., Behnampour, N., & Shafiei, Z. (2021). The challenges of developing professional identity among nurses: A qualitative study. BioMed Central (BMC) Nursing, 20, 149. https://doi.org/10.1186/s12912-021-00665-0 [Google Scholar] [Crossref]

41. Khan, A., Begum, T., & Parvin, R. (2021). Self-assessment of clinical competency among nurses in tertiary hospitals in Bangladesh: Implications for training and professional development. BioMed Central (BMC) Nursing, 20, 86. https://doi.org/10.1186/s12912-021-00588-w [Google Scholar] [Crossref]

42. Kim, J., & Lee, H. (2022). Impact of patient education by novice nurses on chronic disease management. Journal of Nursing Care Quality, 37(4), 320–327. https://doi.org/10.1097/NCQ.0000000000000604 [Google Scholar] [Crossref]

43. Kim, S., & Lee, J. (2022). Evidence-based teaching and patient education by novice nurses. Journal of Clinical Nursing, 31(7–8), 895–905. [Google Scholar] [Crossref]

44. Kim, S., & Kim, H. (2024). Novice perioperative nurses’ perceptions of nursing competence and strategies used to enhance competence. Journal of Perioperative Nursing, 37(1), 1–10. https://pubmed.ncbi.nlm.nih.gov/40013687 [Google Scholar] [Crossref]

45. Kim, J., & Park, H. (2023). Influence of gender on professional values and nursing attitudes. Nurse Education Today, 128, Article 105273. https://doi.org/10.1016/j.nedt.2023.105273 [Google Scholar] [Crossref]

46. Kukkonen, P., et al. (2025). The professional competence of newly graduated nurses in international comparisons. International Journal of Work-Integrated Learning in Health, 14(2), 1–10. [Google Scholar] [Crossref]

47. Kumar, S., & Singh, R. (2023). Gender diversity in nursing: Impacts on teamwork and clinical communication. Nurse Education Today, 129, 105404. https://doi.org/10.1016/j.nedt.2023.105404 [Google Scholar] [Crossref]

48. Labrague, L. J., De los Santos, J. A. A., & Resurreccion, D. L. (2022). Professional identity, organizational commitment, and turnover intention among nurses: The mediating role of work engagement. Journal of Nursing Management, 30(3), 736–744. https://doi.org/10.1111/jonm.13566 [Google Scholar] [Crossref]

49. Labrague, L. J., et al. (2024). Reality shock, caring ability, and missed nursing care among newly graduated critical care nurses. Intensive and Critical Care Nursing, 78, 103600. [Google Scholar] [Crossref]

50. Lee, Y., & Kim, S. (2023). Reflective practice and professional identity development in Korean hospital nurses: A mixed-methods study. Nurse Education Today, 125, 105814. https://doi.org/10.1016/j.nedt.2023.105814 [Google Scholar] [Crossref]

51. Lewis, L. S. (2022). Nursing education practice update: Competency-based education and clinical judgment. Nurse Educator, 47(6), 301–305. [Google Scholar] [Crossref]

52. Lewis, M., Smith, K., & Lee, J. (2023). The impact of advanced education on clinical competency: A systematic review. Nurse Education Today, 125, 105612. https://doi.org/10.1016/j.nedt.2023.105612 [Google Scholar] [Crossref]

53. Lindfors, K., et al. (2022). New graduate registered nurses’ professional competence over the first nine months. BioMed Central Nursing, 21, 325. [Google Scholar] [Crossref]

54. Liu, Y., Aungsuroch, Y., & Yunibhand, J. (2023). Predictors of clinical competence among nurses: A structural equation model. International Nursing Review, 70(2), 135–144. https://doi.org/10.1111/inr.12800 [Google Scholar] [Crossref]

55. Liu, Y., Zhang, H., & Wang, J. (2022). Professional attitude and ethical sensitivity in early-career nurses. Nursing Ethics, 29(5), 1234–1245. [Google Scholar] [Crossref]

56. Lopez, R., Martinez, P., & Garcia, L. (2023). Simulation-based training and decision-making skills of novice nurses. Journal of Clinical Nursing, 32(14), 2740–2752. https://doi.org/10.1111/jocn.16432 [Google Scholar] [Crossref]

57. Lopez, M., Torres, A., & Fernandez, R. (2023). Simulation-based training and prioritization skills in new nurses. Nurse Education in Practice, 63, 104153. [Google Scholar] [Crossref]

58. Martinez, L., Perez, S., & Gutierrez, M. (2023). Quality improvement engagement of novice nurses in hospital systems. Journal of Nursing Management, 31(3), 456–468. [Google Scholar] [Crossref]

59. Nakayama, M., Kato, Y., & Nagai, M. (2018). A concept analysis of nursing competency. Nursing & Health Sciences, 20(3), 341–349. https://doi.org/10.1111/nhs.12410 [Google Scholar] [Crossref]

60. Navales, R. R., Sanchez, J. E., & Millares, K. P. (2022). Research attitude and competence of nursing students in a Philippine university: Implications for curriculum enhancement. Journal of Nursing Education and Practice, 12(4), 52–58. https://doi.org/10.5430/jnep.v12n4p52 [Google Scholar] [Crossref]

61. Nguyen, T., & Tran, M. (2022). Educational attainment and clinical reasoning in nursing practice. International Journal of Nursing Studies, 129, 104271. https://doi.org/10.1016/j.ijnurstu.2021.104271 [Google Scholar] [Crossref]

62. Nguyen, T., Tran, H., & Pham, D. (2021). Diagnostic reasoning and mentorship in early-career nurses. Journal of Nursing Education, 60(4), 201–210. [Google Scholar] [Crossref]

63. Numminen, O., Leino-Kilpi, H., Isoaho, H., & Meretoja, R. (2022). Newly graduated nurses’ competence and individual and organizational factors: A multivariate analysis. BioMed Central Nursing, 21(1), 47. https://doi.org/10.1186/s12912-022-00813-4 [Google Scholar] [Crossref]

64. Park, S., & Kim, Y. (2022). Quality improvement participation of novice nurses and impact on hospital safety culture. Nurse Education Today, 108, 105–114. https://doi.org/10.1016/j.nedt.2022.105114 [Google Scholar] [Crossref]

65. Pérez-García, E., Ortega-Galán, Á. M., Ibáñez-Masero, O., Ramos-Pichardo, J. D., Fernández-Leyva, A., & Fernández-López, E. (2023). Factors influencing nursing competency: A cross-sectional study in clinical settings. Healthcare, 11(21), 2808. https://doi.org/10.3390/healthcare11212808 [Google Scholar] [Crossref]

66. Perez, M., & Torres, J. (2023). Unit-based support systems and novice nurse competency in high-acuity wards. Journal of Clinical Nursing, 32(15–16), 2468–2477. https://doi.org/10.1111/jocn.16482 [Google Scholar] [Crossref]

67. Podgorica, N., et al. (2024). Nursing Professional Values Scale-3 in an Austrian context. BMC Nursing, 23, 142. [Google Scholar] [Crossref]

68. Ramezanli, S., Khalesi, N., & Hosseini, M. (2021). Professional attitude and job satisfaction in novice nurses: Implications for retention. Journal of Clinical Nursing, 30(7–8), 1012–1021. [Google Scholar] [Crossref]

69. Raqueno, L., et al. (2025). Peer support strategies for newly qualified nurses: A systematic review. International Journal of Nursing Studies, 155, 104331. [Google Scholar] [Crossref]

70. Rodriguez, M., Torres, A., & Liu, H. (2022). Collaboration and professional engagement among novice nurses in hospital settings. Nurse Education Today, 112, 105–118. https://doi.org/10.1016/j.nedt.2022.105118 [Google Scholar] [Crossref]

71. Rosa, J., Santos, M., & Lee, Y. (2023). Patient teaching and coaching by novice nurses: Outcomes on adherence. Journal of Nursing Care Quality, 38(1), 56–64. https://doi.org/10.1097/NCQ.0000000000000651 [Google Scholar] [Crossref]

72. Sánchez-Gómez, M., López, F., & Martínez, A. (2022). Relational competence and patient adherence in early-career nurses. International Journal of Nursing Studies, 126, 104–112. https://doi.org/10.1016/j.ijnurstu.2021.104112 [Google Scholar] [Crossref]

73. Salmond, S. W., Salmond, S. S., Ames, M., Kamienski, M., & Holly, C. (2021). Experiences of frontline nurses during the COVID-19 pandemic: A qualitative study. Nursing Outlook, 69(5), 847–856. https://doi.org/10.1016/j.outlook.2021.03.016 [Google Scholar] [Crossref]

74. Salonen, A., Kaunonen, M., & Meretoja, R. (2022). Exploration of the expected and achieved competency levels of new graduate nurses. Nurse Education Today, 117, 105490. https://doi.org/10.1016/j.nedt.2022.105490 [Google Scholar] [Crossref]

75. Shiferaw, K., & Mehari, K. (2023). Workplace environment and professional attitude among early-career nurses. BioMed Central Nursing, 22, Article 42. https://doi.org/10.1186/s12912-023-01234-6 [Google Scholar] [Crossref]

76. Shin, S., Park, J., & Kim, J. (2021). Professionalism and job satisfaction among nurses: The mediating effect of emotional labor. BioMed Central (BMC) Nursing, 20, 197. https://doi.org/10.1186/s12912-021-00706-8 [Google Scholar] [Crossref]

77. Smith, J., & Curtis, K. (2022). Transition support and skill development in early-career nurses. Nurse Education in Practice, 64, 103484. https://doi.org/10.1016/j.nepr.2022.103484 [Google Scholar] [Crossref]

78. Sterner, A., Ramstrand, N., Palmér, L., & Andersson Hagiwara, M. (2022). A study of factors that predict novice nurses’ perceived ability to provide care in acute situations. Nursing Open, 9(4), 1933–1942. [Google Scholar] [Crossref]

79. Tahan, H. M., et al. (2025). New graduate nurse competencies—Part II: Perceptions of faculty and practice leaders. Nursing, 55(4), 54–63. [Google Scholar] [Crossref]

80. Takase, M., & Teraoka, S. (2020). Development of the holistic nursing competency scale. International Journal of Nursing Practice, 26(1), e12792. https://doi.org/10.1111/ijn.12792 [Google Scholar] [Crossref]

81. Tanabe, S., et al. (2025). NPC-SF Japanese version: Validity and reliability among graduating students. Belitung Nursing Journal, 11, e-publication ahead of print. [Google Scholar] [Crossref]

82. Tang, C. J., Chan, S. W. C., Zhou, W. T., & Liaw, S. Y. (2021). Collaboration between hospital nurses and physicians: An integrated literature review. International Nursing Review, 68(1), 24–33. https://doi.org/10.1111/inr.12632 [Google Scholar] [Crossref]

83. Torres, A., Lopez, M., & Fernandez, R. (2022). Mentorship and diagnostic accuracy in novice nurses. Journal of Nursing Care Quality, 37(1), 67–74. [Google Scholar] [Crossref]

84. Torres, M., Ramirez, L., & Chen, Y. (2022). Mentorship and diagnostic competency in novice nurses. Journal of Nursing Education, 61(7), 385–392. https://doi.org/10.3928/01484834-20220614-04 [Google Scholar] [Crossref]

85. Twenge, J. M., Campbell, S. M., & Freeman, E. C. (2019). Generational differences in work attitudes and professional behavior. Journal of Organizational Behavior, 40(2), 151–167. [Google Scholar] [Crossref]

86. United Nations, Department of Economic and Social Affairs. (2025). SDG 8: Decent Work and Economic Growth—Summary of the Expert Group Meeting. [Google Scholar] [Crossref]

87. Wang, L., Zhang, Y., & Liu, J. (2021). Professional commitment and competence: A study among early career nurses. Journal of Advanced Nursing, 77(11), 4501–4512. https://doi.org/10.1111/jan.15012 [Google Scholar] [Crossref]

88. Wojtowicz, A., Hagen, B., & O’Grady, L. (2020). The struggle for professional identity: A qualitative study of nursing students in transition. Nurse Education Today, 88, 104366. https://doi.org/10.1016/j.nedt.2020.104366 [Google Scholar] [Crossref]

89. World Health Organization; International Council of Nurses. (2025). State of the world’s nursing: 2025 update—Workforce grows, inequities persist. [Google Scholar] [Crossref]

90. Yang, J., & Kim, H. (2020). The relationship between professional autonomy and organizational commitment among nurses: Mediating effects of job satisfaction. International Journal of Nursing Practice, 26(5), e12817. https://doi.org/10.1111/ijn.12817 [Google Scholar] [Crossref]

91. Yilmaz, M., Demir, R. H., & Alparslan, G. (2022). The role of workplace respect and organizational climate on nurses’ professional behavior. Journal of Nursing Research, 30(2), e191. https://doi.org/10.1097/jnr.0000000000000466 [Google Scholar] [Crossref]

92. Zhang, L. (2022). Gender differences and empathy in nursing practice. Journal of Clinical Nursing, 31(15-16), 2400–2410. https://doi.org/10.1111/jocn.16234 [Google Scholar] [Crossref]

93. Zhao, X., & Sun, Q. (2023). Teamwork and care coordination of novice nurses in hospital settings. Journal of Nursing Management, 31(1), 110–121. https://doi.org/10.1111/jonm.13780 [Google Scholar] [Crossref]

• Knowledge and Attitude of Undergraduate Nursing Students towards Organ Donation
• Cold Hip Bath Therapy for Labor Pain Management: A Review of Non-Pharmacological Interventions in Women's Health
• Work Settings Utilizing the S.C.O.R.E Model on the Psychological Empowerment of Hospital Nurses in Cebu City
• An Assessment on the Quality of Life of PLHIV Residents in Digos City Barangays: Basis for Health Teaching Program
• Work-Related Stress and Its Psychodermatological Impact on Nursing Professionals