Benner’s theory of Novice to Expert has been adopted by the operating room where I practice. This theory was chosen because the operating room has unique educational requirements and novice versus expert hierarchy issues that are not usually found in general nursing units. The intent of this paper is to give a brief history of the evolution of nursing and how the practice of nursing has evolved into a theory based profession. The next section, Benner’s theory, Novice to Expert, will contain an analysis of the key concepts of the theory and how this theory relates to the nursing metaparadigm. The third section will illustrate how Benner’s theory is applied in clinical practice and outline the roles of nurses, nursing leadership and nurse educators. Lastly, the fourth section will conclude what has been learned from analyzing this theory.
The Importance of nursing theory The nursing profession has been around for centuries, long before formal education was introduced. In 1863 the University of Pennsylvania offered a six month course in nursing, and is considered one of the first organized schools for nurse in the United States. Many other schools followed suit, and began offering formal education for nurses under the direction of physicians, and was structured as an on-the-job training program within the hospitals. These colleges taught the same theoretical format to the nursing students, using mainly rules, principles of practice and traditions. In the same era, Florence Nightingale was creating an education and theoretical approach to nursing in Europe. As the profession established itself as a care-maiden to physicians, the profession and the theory of nursing practice didn’t advance until nearly a century later.
The Term Paper on Nursing Theories
Introduction Theories are a set of interrelated concepts that give a systematic view of a phenomenon (an observable fact or event) that is explanatory & predictive in nature. Theories are composed of concepts, definitions, models, propositions & are based on assumptions. They are derived through two principal methods; deductive reasoning and inductive reasoning. Objectives to assess the ...
Beginning in the early 1950s, nursing practice took a dramatic change from rules and tradition to scientifically based higher education and practice theory. In the 70s, the National League of Nursing required that nursing curricula be based on theoretical and conceptual framework. At this time theorists began to advance and expand as colleges taught nursing theory as a framework for higher education. Nursing theory defines the nature, structure, concepts and relationships between nursing concepts (Fawcett 1995, Meleis 2005).
Patricia Benner is a nursing theorist who first published From Novice to Expert: Excellence and Power in Clinical Nursing Practice, in 1984. This theory is still widely used and respected, and has continued to evolve. According to Benner, the theory of nursing encompasses both the medical and nursing scientific knowledge that has been imparted to the trainee, mostly in nursing school, and the rules of thumb that are largely acquired during on-the-job training and experience (Benner, Tanner & Chesla, 2009).
This theory outlines the evolution of the nurse from novice to expert in professional practice and focuses on the nurse’s role independent of the physician. Benner’s Theory, Novice to Expert
Benner‘s theory, Novice to Expert, states that practice and theory are intertwined. Neither can stand alone, and each play an integral role in the development and proficiency of the practicing nurse. To further describe the importance of the relationship between theory and practice and define the purpose of the theory, Benner states, “nursing is a caring practice that goes beyond theory altogether and shows that where human meaning is at stake, one needs a kind of intuition that can never be captured by rational theory, theory is dependent on practice, and reason requires intuition”(Benner, Tanner & Chesla, 2009).
The Term Paper on Application Of Grand Theory To Nursing Practice
In today’s world there are many nursing theories and theorists that not only define the nursing profession, but also are used as the basis to guide a nurse in his or her current practice. Meleis defines nursing theory “as a conceptualization of some aspect of nursing reality communicated for the purpose of describing phenomena, explaining relationships between phenomena, predicting consequences or ...
This has been my experience as a new nurse in the operating room many years ago and, presently, as an operating room nursing director. Benner’s theory is designed around several phases in the evolution of the nurse from entering the field after graduation, to achieving a level of practice competence, to becoming an expert with the ability to deliver sound, consistent clinical judgment.
The nursing metaparadigm outlines nursing care in four basic concepts, person, environment, health and nursing practice. The question is, are new nurses able to meet the four concepts of the nursing metaparadigm upon entry into practice? Benner’s premise was centered on an area of nursing that had not been studied, the actual practice and clinical learning of new nurses (Benner, 1984, Benner, & Benner, 1979).
In 2001, the National Council of State Board of Nursing was reporting something very similar, “new nurses enter practice feeling unprepared, and they report that employers rank the preparation for new registered nurses as inadequate in many areas” (National Council of State Boards of Nursing (NCSBN, 2001).
Benner’s theory designs a culture of acknowledgement that fosters teaching and learning through the continuum of the nurse’s career. This is in an effort to provide safe, competent care to every patient, every time. When the theory is followed, the nurse can ensure the needs of the patient within the nursing metaparadigm are reached. Novice to Expert in Clinical Practice
Benner’s Novice to Expert theory places the onus on nursing leadership and educators to design orientation processes to aid the new nurse in the transition from school to practice. One such recommendation states, “a new-graduate residency program lasting at least 1 year with planned coursework, mentoring, and use of first-person experience-near-nursing narratives of experiential learning to help new nurses reflect on their experiential learning and articulate what they are learning in practice” (Geertz, 1987).
This closely models the Association of Operating Room Peri-operative Nurse 101 training program that is in place in the institution where I practice. Every nine months two nurses are selected (either new graduate or experienced) and are put through an integrated didactic and practical training program.
The Essay on Evolving Practice Of Nursing And Patient Care Delivery Models
Nursing is a career that presents those in it with many opportunities. There are a variety of nurses and the field in which they choose to practice is just as varied. There are oncology nurses, school nurses, home health nurses, trauma nurses and nurse practitioners. They work in clinics, hospitals, schools, prisons, mental health hospitals, community health centers and even in law offices. The ...
They are given lessons on practice theory then paired with a preceptor for on-the-job training. Regular evaluations are performed and the nurse gradually evolves into unsupervised practice. The novice nurses in this program become safe, confident, competent nurses who are able to recognize when they are not the best qualified person to meet the needs of the patient.
On the opposite end of Benner’s theory is the expert nurse. The expert nurse has often been an ill-defined player in the care of the patient. This nurse is the “go-to” person that solves unique problems or has experience with unique clinical presentation. In an article addressing patient mortality rates, the authors Aikinm, Smith and Lake suggest the nurse expert should be treated as: “While competent clinical nurses are highly skilled, the ability of the expert nurse to be proactive rather than reactive, and to see and act on behalf of the patient before the formal indicators are clear, is such a leap in applied nursing that their performance must be recognized, rewarded, and provided the organizational support to operate effectively” (Aikin, Smith, & Lake, 1994).
In the operating room where I practice, nurse experts are acknowledged as experts and have a responsibility that comes with that distinction. Meeting the needs of the patient does not always mean just patient care.
The expert nurse is able to contribute to the nursing metaparadigm concepts of person, environment, health and nursing practice in a more highly skilled fashion. Some expert nurses are trained as preceptors and work in the peri-op training program to help novice nurses grow and view the patient as a complex being, and get beyond performing just tasks. Many expert nurses participate in shared-leadership projects such as patient safety, operating room efficiencies and patient satisfaction. These roles address hospital policy and help put processes in place that make the multifaceted care of the patient safer and more efficient. In an effort to also take the expert into their next roles as leaders, expert nurses are put into the hospital’s talent mapping program for future promotions and leadership training. Bringing nursing theory to the forefront of our everyday practice has had a positive effect on the nurses, phsycians and patients. No longer do we think a nurse is a nurse. There is a conscious acknowledgement of the skill sets of practitioners and everyone is proud of their roles in the patient experience. Conclusion
The Essay on Nursing Information Expert
Nursing is a profession within the health care sector that focuses on protecting and promoting health care. It involves prevention of illness, injury and treatment of human diseases. The nursing profession requires that information of patients should be kept and recorded in a manner that can allow for proper review of patients. Some of the tasks that a nursing information expert is charged with ...
Nursing practice is an ever changing field. Theories in nursing have evolved, and much like Benner’s theory, the theory takes on deeper insight into the care of the patient with respect to the evolution of nurses practice skills and experience and is relevant in todays practice. Benner’s theory is designed to guide nurses and nurse leaders in the maturation process of nursing skills and to elevate those skills to the next level. Nurses must continuously blend practical experience and established theory to create a safe, holistic experience for every patient, every time.
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