THEORY REFERENCE

Patricia Benner believed that the best nurses develop their skills over time. Education and experience help to contribute to this development, allowing a nurse to fully understand what it means to provide high quality patient care. This process of development would become the foundation for the Novice 

to Expert Nursing Theory.

Benner believed that nurses gained knowledge and skills, lending to their personal expertise, even if they didn’t realize that this process was happening. This idea would become the “Knowing How, Knowing That” component of this theory.

She also believed that this process of development could occur in any applied discipline with the medical field. Every person, Benner theorized, would follow through specific steps of development, allowing them to progress from novice to expert if they were given enough time to do so.
What Are the 5 Stages of Clinical Competence?

Patricia Benner believed that how an individual understands nursing would proceed through 5 specific steps. Each nurse would need to proceed through these steps in order to achieve “expert” status, even if they were not aware of their progression through the steps. Benner suggested in the Novice to Expert Nursing Theory that these would be the steps that every individual would need to follow.

Stage #1 – Novice: Individuals at this stage of competence would be first starting their nursing career. It could be an individual in their first year of a clinical trial, working their way through college classes, or perhaps their first days on the job as a nurse or nursing assistant. People in this stage would have a very limited ability to predict what could happen to their patients. To recognize certain signs and symptoms being experienced, a novice would need to be introduced to those same signs and symptoms in other patients.

Stage #2 – Beginner: In this stage, you’d find recent graduates working in their first jobs. It could also be a nurse without a formal education, but has 1-2 years of experience in the field. Beginners have the ability to recognize recurrent situations, have knowledge that they can act upon, and can often work independently because they have enough personalized in-depth experience they can draw upon.

Stage #3 – Competence: This is the stage where nurses formalize their knowledge and education into practical daily applications. They have organizational skills, recognize patterns quickly, and can implement care strategies with consistent accuracy. Because of this, most nurses who reach this stage will focus on enhancing their speed and flexibility while performing their duties because they can recognize immediately how they must react to most situations.

Stage #4 – Proficiency: In this stage, nurses begin to realize that there is a bigger picture that can be embraced. Instead of managing specific events and being reactionary to patient care, nurses begin to realize that they can become proactive with certain aspects of care as well. This causes the nurse to modify their response plans to different events, even if there isn’t the ability to have advance planning or scheduling involved in the thought process.

Stage #5 – Expert: In this stage, a nurse can recognize resources and demands. They can then use this recognition in order to attain specific goals. Nurses know what needs to be done, so they implement a care plan to properly care for a patient. Instead of relying on rules or procedures, they rely on their knowledge and experience to act on intuition when necessary. They stay focused on relevant problems, use tools when necessary, and ignore events that don’t need to be addressed.

How Patricia Benner Developed the Novice to Expert Nursing Theory

Benner’s theory focuses on how nurses acquire nursing knowledge. It does not focus on the actual process of what it takes to become a nurse in the first place. This is why it is possible to follow the stages of Benner’s theory without actually wanting to be a nurse in the first place.
This is an idea that is based on the Dreyfus Model of Skill Acquisition. The Dreyfus brothers believed that learning was an experiential process, supplemented by a situation-based process. People could learn to be a pilot, for example, by watching how an experience pilot is able to steer an aircraft. In order to apply practical knowledge to flying, however, the person learning to become a pilot would also need to be able to take the controls of the airplane so they could gain relevant experiences.
The one setback to the Novice to Expert Nursing Theory is that it does not allow for critical thinking. It relies on intuition and observation of that intuition rather than the logical thought processes that individuals have when completing a task. Because of this, it may become possible for some individuals to “skip” certain stages within the progression of this theory because they act upon their own observations without being trained to do so.
What Is Notable About the Novice to Expert Nursing Theory?
Benner proposes that nurses should always be moving forward in their progression through these five stages. In the beginning of a nursing career, there tends to be a reliance on to-do lists, checklists, and specific policies or procedures because the nurse is attempting to apply abstract principles to real events. Over time, experience expands the perspective of the nurse, allowing them to change their perception of what needs to be done for every patient.

There are four key reasons why this model can be used effectively for all people, not just those who are engaged in the nursing profession.

1. It allows for an assessment of progress within the development of a personal skill set.
2. It helps to define what an organization or individual may consider to be a desired level of competence for a specific skill.
3. It supports development progression for specific skills because it understands that there are different needs and/or styles required at each stage of progression.
4. It helps to determine when an individual has progressed far enough to be able to teach others the same skills they learned in previous stages.

This creates changes in how the medical field should treat nurses. Instead of the nurse with the most experience or the most extensive degrees receiving the top jobs, Brenner’s theory would propose that the nurses who provide the best nursing care in a consistent manner should be rewarded. It is the process of care that experience is developed, not the process of working with administrative components.
By recognizing who the most experienced nurses happen to be, the quality care all patients can receive will increase. Promoting forward progress will help to achieve better care as well, which is why the Patricia Benner Novice to Expert Learning Theory will always have merit in modern medicine.
Reference:  Patricia Benner Novice to Expert Nursing Theory Explained. (    2017, February 03).  Retrieved from http://healthresearchfunding.org/patricia-benner-novice-to-expert-nursing-theory-explained/