Patricia Benner Nursing Theorist From Novice to Expert

Patricia Benner Nursing Theorist From Novice to Expert By Lindsay Adair, Lauren Luckett, Amanda Mikula, and Courtney Olach

Background Information • In 1964, Patricia received a Bachelor of Arts degree in nursing from Pasadena College. • In 1970, a Master of Science in Medical. Surgical Nursing from the University of California. • In 1982, Patricia received her Ph. D. from the University of California. (Nursing Theory, 2011)

Nursing Experience • In the 1960 s, Benner worked as: – A Head Nurse of the Coronary Care Unit at the Kansas City General Hospital – Intensive Care Staff Nurse at the Stanford University Hospital and Medical Center. (Nursing Theory, 2011)

Benner’s Research Experience From 1970 until 1975, she was a Research Associate at the University of California at San Francisco School of Nursing. Research Assistant to Richard S. Lazarus at the University of California at Berkeley. From 1979 until 1981, she was the Project Director at the San Francisco Consortium/University of San Francisco. Since 1982, Benner has been working in research and teaching at the University of California at San Francisco School of Nursing. (Nursing Theory, 2011)

Benner’s Career Achievements Published ‘Novice to Expert Theory’ in 1982 Published nine books and many articles. In 1995, she was awarded the 15 th Helen Nahm Research Lecture Award from the University of California at San Francisco School of Nursing. (Nursing Theory, 2011)

Benner’s Career Achievements Continued According to Harkreader et al. (2007), Benner “describes caring as a common bond between people in a meaningful situation, which is essential to nursing. She “is credited with helping us understand the decision making process in nursing” (Harkreader et al. , 2007). (Harkreader, 2007)

Stages of Skill Acquisition As defined in Harkreader et al. (2007), “ stages of skill acquisition in professional nursing practice reflect changes in three general aspects. The first change is from reliance on abstract principles stored in the memory to the use of past concrete experiences to guide actions. The second change is in the individuals perception of the situation; it is seen as a whole in which only certain elements are relevant. The third change is from being a detached observer to being an involved performer. ” Development in the novice to expert nurse evolved from this theory. (Harkreader, 2007)

A Word From Patricia Benner http: //youtu. be/5 g. X 65 g. QFc. QI ("Patricia benner: Who, " 2010)

Novice to Expert Theory Level 1 Beginner with no experience Follow rules to help perform tasks Novice Practice is often limited and inflexible Believe rules are: context-free, independent of specific cases, and applied universally (Nursing Theories, 2011)

Novice to Expert Theory Level 2 Demonstrates acceptable performance Has gained prior experience in actual situations to recognize recurring meaningful components (Nursing Theories, 2011) Advanced Beginner Principles, based on experiences, begin to be formulated to guide actions

Novice to Expert Theory Level 3 Are more aware of long-term goals Typically a nurse with 2 -3 years experience on the job in the same/similar area Competent Gains perspective from planning own actions based on conscious, abstract, and analytical thinking Achieve greater efficiency and organization (Nursing Theories, 2011)

Novice to Expert Theory Level 4 Typically has 3 -5 years experience Perceives and understands situations as whole parts Proficient More holistic understanding improves decision-making Learns from experiences what to expect in certain situations and how to modify plans to meet patient needs (Nursing Theories, 2011)

Novice to Expert Theory Level 5 5 -15 years experience Performance is now fluid, flexible, and highlyproficient Expert Has intuitive grasp of clinical situations No longer relies on principles, rules, or guidelines to connect situations and determine actions (Nursing Theories, 2011)

The 4 Global Concepts in Patricia Benner’s Theory What are the 4 global concepts? These are the metaparadigm of nursing -Human Being -Environment -Health -Nursing (Chitty and Black, 2011)

4 Global Concepts Human Being: This includes individuals, families, and communities who are participating in nursing Environment: This includes physical surroundings, as well as regional and local. Also includes cultural, social, and economic conditions that are associated with our health (Chitty and Black, 2011)

4 Global Concepts Continued Health: State of wellbeing, human process of life and death Nursing: the definition of nursing. Working with a patients to attain set goals. (Chitty and Black, 2011)

How does Patricia Benner’s Model Define the Concepts? Human Being a self-interpreting being, that is, the person does not come into the world predefined but gets defined in the course of living life (Fly, 1993) Health Defines health as what can be assessing where as welling is the human experience of health of wholeness Nursing is focused on the relationship between disease and the lived experience of health -“enabling condition of connection and concern" (Fly, 1993) Environment “explained as situation which implies social significance and the interaction of people within that situation” (Fly, 1993)

Conclusion Benner’s theory focuses on the journey each nurse goes through as they advance through the five stages she identifies as “Novice”, “Advanced Beginner”, “Competent Practitioner”, “Proficient Practitioner”, and “Expert Practitioner”. Each stage is associated with it’s own achievements, views, and competencies. This theory can be applied to any and all aspects of nursing. Although this theory revolves around nursing and the individual growth of each nurse as they move through their career, the basic concepts of advancement and growth through the gain of knowledge and experience are easily applied to many other fields.

References Chitty, K. K. , & Black, B. P. (2011). Conceptual and philosophical bases of nursing. Professional nursing: concepts and challenges (6 th ed. ) (p. 304 ) Maryland Heights, MO: Saunders Fly, N. A. (1993)Beyond professional caring: teaching nursing students the art of christian caring, Institute for Christian Teaching Education Department of Seventh-day Adventist Harkreader, H. , Hogan, M. , & Thobaben, M, . (2007) Fundementals of nursing: Caring and clinical judgment. (3 rd ed. ) St. Louis, MO: Saunders Elsevier. Jones and Bartlett, LLC () Nursing theories: Introduction to theoretical nursing knowledge. Retrieved from http: //samples. jbpub. com/9781449626013/72376_CH 01_Masters. pdf on February 26, 2012. Nursing Theories. (2011). From Novice to Expert: Patricia E. Benner. Retrieved from, http: //currentnursing. com/nursing_theory/Patricia_Benner_From_Novice_ to_Expert. htm Nursing Theory. (2011). Patricia Benner: Biography and Career of Patricia Benner. Retrieved from, http: //nursing-theory. org/nursing-theorists/Patricia-Benner. php Patricia benner: Who were your most important teachers? [Web]. (2010). Retrieved from http: //www. youtube. com/watch? v=5 g. X 65 g. QFc. QI

CASE STUDY Karen works on a medical/surgical unit where she recently completed her orientation. This is her first job since graduating from nursing school. One of Karen’s patients begins to complain of chest pain. Karen questions the patient regarding the quality, intensity, and location of the pain. She then leaves the room to page the physician to notify of him of the change in condition and to receive orders. The charge nurse for the day, Tina, overhears what is going on and quickly goes into the patient room where she applies 2 liters of oxygen, obtains a set of vital signs, and calls for an electrocardiogram (EKG). While on the phone with the physician, Karen is unable to answer the physician’s question regarding the patient’s vital signs and he becomes upset. The physician orders an EKG, cardiac enzymes, and oxygen and instructs Karen to call him back with the results of the EKG and also with a set of vital signs. Karen goes back into the patient room where she finds Tina already in the process of completing these tasks. Karen asks Tina how she knew to do those things before receiving an order from the doctor. Tina explains to Karen that she doesn’t need an order to obtain vital signs and that should always be done when there is a change in patient condition. She also stresses that the doctor will always want to know the vital signs when they are called for things like this. She also explains that an EKG and oxygen are standard things that are done when a patient has chest pain. Tina has been a nurse for five years and knows that the doctors trust her clinical judgment. The results of the EKG and cardiac enzymes show that the patient is having a myocardial infarction. The physician is notified and he states he will be right there and to prepare to transfer the patient to another facility that performs heart catheterizations. By the time the physician arrives, Tina has all the transfer paperwork filled out and ready for him to sign. She has also notified EMS who will be transferring the patient and they are on stand-by. Tina also called the receiving facility and obtained the information needed for Karen to call report. The patient is transferred and Karen thanks Tina for all of her help and guidance.

Case Study Questions 1. What stage of nursing proficiency is Karen in? What characteristics of this stage does she exhibit? 2. What specific tasks did Karen perform or not perform that places her in the stage that you have placed her in? 3. What stage of nursing proficiency is Tina in? What characteristics of this stage does she exhibit? 4. What specific tasks did Tina perform or not perform that places her in the stage that you have placed her in?