Indirect vs. Direct Care Providers’ Core Competencies

The most important part of every health system is the workforce. A lot of health care providers, who have quite a mixed variety of specific responsibilities, are involved in the health care process. Nurses are the largest and one of the most important groups of these specialists. Nurses can be divided into two main groups by their competencies: indirect and direct care providers. Although both these groups are essential in providing quality medical services, the goal of direct care providers is the treatment of patients while the indirect nursing care is aimed at organizational issues such as health care management, reducing medical costs, and improving the patient experience.

The first thing to be considered is the competencies of the direct care provider advanced role. According to the National Organization of Nurse Practitioner Faculties (2014), there are nine competency areas in the direct nursing. These nine areas are the scientific foundation, leadership, quality, practice inquiry, technology and information literacy, policy, health delivery system, ethics, and independent practice. To be a successful nurse practitioner, it is important to pay attention and not to ignore any area. Some core competencies are inherent in a particular area. For instance, nurse practitioners must have capabilities in applying and using knowledge about ethical principles in decision-making, evaluating the ethical consequences of decisions, and applying solutions ethically.

Apart from this, to be able to compare the core competencies of the direct and indirect care provider roles it is important to understand the essence of indirect nursing. The examples of the indirect provider roles are nurse administrators, nurse informaticists, and nurse educators. The competencies of indirect nursing can be seen in the case of nurse administrators. There are five main competency areas, which are communication and relationship management, knowledge of the healthcare environment, leadership, professionalism, and business skills (American Organization of Nurse Executives, 2015). These competencies contribute to the nursing practice in the delivery of safe, timely, efficient, equitable and patient-centered care to patients. The core competencies of the direct and indirect care provider roles have some similarities. Both the direct and indirect nursing care roles follow the one purpose promoting high-quality health care (American Association of Nurse Practitioners, 2017). Moreover, some competency areas are common for both nurse practitioners and nurse administrators. For example, the area of knowledge of the healthcare environment is an essential part of the direct and indirect nursing practices. Nurse practitioners and nurse administrators have to be professionals in the field of health care. A lot of health care administration and management programs offer at least a half or even more health care subjects. The health care management or administration degree provides knowledge of both areas of health care and business studies that involve financial, technical and strategic classes. Moreover, they must be literate in technology and information to promote quality medical services. Also, specialists in both areas the direct and indirect nursing have to possess and practice foundational thinking skills, and they have to know how to demonstrate leadership that uses critical and reflective thinking. What is more, they must practice knowledge effectively. Ethics is one more common thing for nurse practitioners and nurse administrators. Specialists in both areas have to respect and follow ethical standards of practice in decision making, discuss and solve ethical problems.

Despite the similarities between the core competencies of these specializations, it is important to emphasize some differences. The direct care provides services that require direct interaction between a client and nurse practitioner. The direct care provider role consists of such practices in direct patient care as family nurse practitioners, nurse anesthetists, and clinical nurse specialists. Whereas, the indirect care services do not require interaction between the health care provider and the patient. Though indirect nursing is also related to client care, indirect care providers cannot conduct an analysis, order and interpret, diagnose, prescribe and distribute medicines. The most crucial difference is that direct care providers work with the client care, but they may also manage indirect activities as administrators, educators, and informaticists in particular circumstances. Meanwhile, indirect care providers are not enabled to be involved in the direct care work. Apart from this, it is important to mention that to be a successful nurse administrator it is necessary to acquire business skills to provide financial, human resources and strategic management. In contrast, business skills are not required for nurse practitioners.

To sum up, it is necessary to underline that the nursing care system was established to promote, improve, protect health and support wellbeing. Such specialists as nurse practitioners do it through the direct way. Others provide medical services indirectly through education or information. At first glance, it may seem that the contribution of direct care providers is more significant than the role of indirect care providers. However, it is not correct to neglect one role and exaggerate another due to direct and indirect nursing influence. The healthcare system will work efficiently if all its features are coordinated.


American Association of Nurse Practitioners. (2017). Web.

American Organization of Nurse Executives. (2015). AONE nurse executive competencies. Web.

The National Organization of Nurse Practitioner Faculties. (2014). Nurse practitioner core competencies content. Web.

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