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Patricia benner theory of novice to expert
Beginners novice to expert theory
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From Novice to Expert: Reviewing Benner’s Theory on Nursing Education and Development
Since the early 1980’s, Patricia Benner of the University of California, San Francisco has been one of the leading theorist when it comes to understanding how skills and knowledge are both acquired and applied to the practice of nursing. Included in Benner’s theory is the impact of this skill and knowledge acquisition on nursing education, administration, and research (Benner, P. E, 1984). Based on the Dreyfus model, Benner was able to describe her theory on how nursing practitioners move from novices to experts (Brykczynski, 2002). Her philosophy is rather simple. She believes knowing “that” is very different from knowing “how” (Benner, P. E., 1984). In other
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In this way, both Benner’s and Dreyfus’ work was aimed at proposing a viable alternative to traditional nursing practice and education, not to devalue the influence of science on the field of nursing. Benner believes that pattern recognition is a skill that can be taught to nursing professionals and will help them to advance through these five levels of proficiency (Benner, P. E., 1984). As such, her ideas are based off of the difference between practical and theoretical knowledge in the field of nursing (Cash, K., 1995). This is because practical situations are much more complex than the originals appear. In her mind, both experience and mastery of the knowledge base are necessary for a skill to be elevated to a higher level and for the practitioner to progress through the five levels (Benner, P. E., 1984). In her book (1984), Benner also states that nurses develop global sets and paradigms about patients through experience. These paradigms help nursing professionals to develop an expert level of observation and intuition not necessarily apparent to an onlooker (Benner, P. E., 1984). To her, both ethical and clinical knowledge mastery are essential and inseparable for nursing practitioners (Cash, K.,
The skills acquisition concept poses a backwards movement in progress. The competent nurse in this case steps backward down the ladder to the novice level as an NP. Moreover, learning new skills, knowledge, and methods of treatment may technically be a step forward in a person’s career, but it is a step backwards in confidence and experience. The transition theory suggests transition as a never-ending process. The success of this course depends on a person’s support system and methods for coping. The transition theory has three stages: moving in, moving through and moving out. The moving in stage would be entering graduate education. Moving through is the process of completing classes and clinical time. The final stage, moving out, is beginning the first position as an NP. Successfully transitioning through these stages is heavily reliant on support, self-awareness and coping mechanisms. For instance, failure to begin the transition phase in graduate school is a prediction of the inability to properly shift into the role of NP (Poronsky,
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
Carper’s (1978) pivotal work of identifying nursing’s ways of knowing was a seminal work that laid the foundation for further analysis. Her ways of knowing have identified methods that have allowed the nursing discipline to further its own knowledge as well as the profession. Two other ways of knowing have emerged, Munall’s (1993) “unknowing” pattern; and also sociopolitical knowing by Zander (2011, p. 9) or emancipatory pattern (Chinn & Kramer, 2011, p. 5). Here these patterns are discussed through experiences in my personal practice.
This paper will focus on two BNUR leaner outcomes (University of Calgary, 2013) relevant to my learned understanding of nurses as ethical decision makers. I will outline the ways that I have seen ethics used and not used in practice, what I learned about ethics and its use in my theory courses and throughout my practicums, and I will reflect on how this understanding will translate into my professional practice moving forward.
Benner , P., Tanner, C., & Chesla, C. (1996). Expertise in Nursing Practice, Caring, Clinical Judgement and Ethics. New York, New York: Springer.
As a nurse, we serve a society which is very culturally diverse. We provide care to many individuals whom have their own unique set of ethics, values, morals, and beliefs by which may be very different from our own. Because of our professional role, we must use lifelong learning as a tool to broaden our views, increase our knowledge, and understand the influences which affect it. To make this possible, we have to continually educate ourselves about the nursing laws, professional standards, and code of ethics all of which we are committed to.
The term nursing ethics means that the nurse has an obligation judge what is right and wrong in her or his duties as guided by the profession or the moral principles that govern the profession and as prescribed by the professional body. Nursing ethics initially encompassed virtues that were desired in a nurse. At the time, these virtues included physician loyalty, commitment to high moral character and obedience. Evolvement of nursing profession gradually made nurses embrace patients’ advocacy. As patient advocates, nurses work as part of an interdisciplinary team to provide patient care. Nursing ethics have kept pace with the advancement of the nursing profession to include a patient-centered focus, rather than a physician-centered focus.
With that said, the nursing profession has a unique code of ethics, that though at times challenging, it is each nurses duty to uphold. Specific provisions can guide a preceptor in navigating and facilitating a conversation that can help a student nurse to understand the journey that lies ahead. More importantly, the student must understand how the profession defines their client, or in nursing, the patient. The ANA Code of Ethics defines the term patient by the derivative meaning, “the one who suffers” (ANA, 2001). This is fundamental for the student to understand because no amount of money or job security can retain a nurse when faced the trials, tribulations, perseverance, or jubilation that accompanies caring for “the one who suffers”.
The significance of the knowing patterns conveys that the structure of discipline that must be present for learning, does not represent the complete approach to problems, and/or questions, and that the knowledge of knowing can change (Barbara A. Carper, 1978). By knowing the restrictions, it helps change the process of learning and create new patterns. Conclusion The process of knowing in nursing is a complex process that involves four major components: empirics, esthetics, personal knowing, and ethics. Carper’s compilation of different theorist’s ideas on the fundamental patterns of knowing in nursing reviews what a nurse needs to know to provide the best care possible. It helps address patterns of knowledge that can and cannot be taught to a nursing student.
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal
Nurses use evidence based practice and research to develop knowledge needed to practice in the nursing profession. Nurses use practical knowledge and theoretical knowledge in the many roles that nurses perform. As a provider of care and manager of care, nurses should use evidence based practice, research, and theoretical knowledge to ensure the best possible outcome for the patient. Lifelong education in nursing is necessary to keep up with the changes in nursing practice and to reinforce ethical knowledge and the core values that nurses use in their everyday practice. The professional value of caring as a nurse is one of the most important values. The caring attitudes of nurses will carry over to all other values that nurses should possess,
In her theory, nursing skills and experiences are what is required to become an expert. Each step a nurse takes to build up their skills to master the expert level is built upon the previous steps. The nurse needs to have a good foundation in order to move them closer to obtaining the expert level. Benner’s theory also showed that practicing nurses can and should form theory (Current Nursing, 2013). Benner’s theory has five levels: the novice, advanced beginner, competent, proficient and expert. The novice needs to be told what to do. Advanced beginner can recognize components that reoccur. A competent nurse is one that has had two-three years in the same type of situations. The proficient nurse starts to look at the whole picture and starts to critically think. The expert nurse does not need to look at the guidelines to react. An expert nurse has had many similar situations that, he or she can reflect upon a situation, analyze it and react quickly. Benner’s theory will be applied by discussing the problem,. a strategy to solve the problem,. discussion around the strategy and problem,. and finally the conclusion,. which will state what new knowledge was gathered by the
Ethics is defined as moral principles that govern a persons or a group’s behavior, ethical principles apply to both personal and professional relationships (Webster, 2015). The field of nursing is a profession that has been highly regarded and respected in society. Most nurses enter the profession in order to utilize their clinical skills to help others in their time of need. Those in failing health rely on nurses to care for them in their most vulnerable states, and expect a level of compassion and humanity while receiving care. Nurses have an ethical responsibility to their patients, clients, and their community. Compassion, empathy, and integrity are staple characteristics that nurses possess that allow them to successfully perform their
Theory development and research have provided a framework and body of knowledge for nursing to maintain autonomy and improve quality of care. As early as the 1800s, nursing and non-nursing theorists had developed theories and models which are continually applied to nursing practice (KEEP OR GET RID OF?). Nursing theorist Imogene King developed the theory of goal attainment which focused on interacting systems that affected a person’s ability to attain goals (Frey, Sieloff, & Norris, 2002). Psychologist Laurence Kohlberg created the theory of stages of moral development which places moral reasoning and ethical behavior into six identifiable stages based on a person’s response to moral dilemmas (Kohlberg, 1984). Although King and Kohlberg created theories in different fields, nurses can utilize both to improve patient care. The purpose of this paper is to analyze both theories based on major precepts, usefulness, and application to nursing practice.
English, I. (1993). Intuition as a function of the expert nurse: a critique of Benner's novice to expert model. Journal Of Advanced Nursing, 18(3), 387-393.