Human beings are not born with the skills to perform most technical activities. People learn them through not only education but also a reflection on past experiences. Sometimes, individuals are often new to specific jobs but later gain more knowledge about them, becoming experts. Nurses graduate from nursing institutions every year to begin their entry-level jobs with healthcare facilities. During this period, they gain new skills and more insight into their practice through their colleagues within the workplace. The following paper presents an overview of the nursing practice in relation to Benner’s theory from Novice to Expert. It also explores the competence journey of caregivers in the provision of quality and holistic care to patients.
Benner’s theory presents a systematic method of understanding how a nurse develops skills and understanding of practice over time. The concept was developed from the Dreyfus Model of Skill Acquisition, where the longer an individual performs by following rules and procedures; the practitioner becomes experienced and competent (Benner, 2019). Benner’s idea applies to nursing since nurses depend more on previous experiences (Miller et al., 2018). Therefore, caregivers are required to deepen their process of acquiring knowledge through their clinical situations. However, the model does not dispute the use of critical thinking in knowledge development, which is required at all levels, especially when ethical dilemmas arise. According to Benner (2019), experience is a prerequisite for becoming an expert. However, this is a situational classic rather than a trait.
Stages of Clinical Competence
The model has five distinctive stages relevant to clinical competencies, where the latter phase depends on the former. They are; proficient, advanced beginners, novices, experts, and competent (Goree 2018). Novice is the initial step, where people have no prior experience with arising situations. The individuals are taught context-free rules and applied globally to perform tasks (Hampton et al., 2020). Since practitioners lack previous experience, there is an inability to use discretionary judgment, thereby struggling to decide which responsibilities are more relevant.
As beginners gain a deeper understanding of their roles, they progress to the advanced learner stage. This phase assumes that an individual has experienced real-world situations that the recurrent one is easily identified. The major problem with practitioners is having an uncontrolled focus on the rules learned in the initial step. Therefore, they require help from other competent staff members to comprehend how to prioritize duties to enable them to comply in various circumstances to meet patients’ needs. The knowledgeable employees are mentors whose responsibility is to offer feedback and support to the advanced beginner to gain further knowledge and skills (Gregg, 2020).
After attaining the ability of task prioritization, the practitioners gradually become competent within their practice. This leads to the third level, where the nurse can utilize past experiences when dealing with most of the situations presented. An individual qualifies to be competent after working for 2-3 years in the same area and having the capacity to set practical goals (Lauderbaugh et al., 2021). However, workers in this stage lack flexibility and multitasking capability compared to proficient nurses.
After working in the same field and experiencing similar situations for more than three years, the nurses are promoted to proficiency. At this level, an individual can provide direction to other staff members. Proficient nurses can reflect on experiences, determine common situations, and redesign objectives to ensure the set goals are accomplished (Lauderbaugh et al., 2021). They often have a holistic understanding of the presented conditions and hence can make proper and sound decisions. The final phase of competency is expert, where nurses have extensive knowledge and a comprehensive background of experience of the situation. This allows for confidence and an intuitive grasp of the patient’s health status. The principles are no longer applicable at this stage since the practitioners have a broader base of understanding. Their performance is fluid, flexible, and highly proficient, satisfying the competency requirements.
From the transitions discussed above, it can be noted that the change in nurses’ perception of patients’ conditions occurs as a whole rather than in pieces. Also, there is integration from relying on abstract principles to using past experiences to guide the action plan. However, skill acquisition is more important than the time taken in the field since people may think one is competent after working for more than three years in the same area, but the reality may be the opposite.
Advanced practice in nursing refers to pursuing further education, specifically post-graduate level in the nursing field. Nurses working at this level may be specialists or in general capacity, for example, clinical nurse specialists and nurse anesthetists. They are grounded in theory and research, which guide their clinical practice. According to Eriksson et al. (2018), these professionals treat and diagnose illnesses and actively manage chronic conditions. Additionally, their scope is to remain ahead of any technological or methodological development in the nursing field through continuous education. Furthermore, they are responsible for analyzing diagnostic tests, providing counseling to the family, maintaining patient records, and developing therapeutic care plans. They involve in preventive care, where regular campaigns are held to advise the public on health issues.
Novice versus Advanced Practice Nurse
An advanced practice nurse performs the following tasks; obtaining medical history, conducting a holistic assessment, and ordering and analyzing laboratory tests and results. According to Schober (2018), they also make the treatment schedule, provide diagnoses, keep client records, organize patient referrals, and participate in pure and applied research projects. On the other hand, novice nurses receive instructions from other advanced staff members. They have advanced skills in technology, for instance, in computing, which eliminates documentation through paper; hence, they share most of the modern technology findings with advanced practitioners.
NMBA Standards of Practice
The Nursing and Midwifery Board of Australia (NMBA) is widely known for nursing practice regulation. The body has several standards that govern and control its operations. For instance, a nurse is expected to think critically and analyze the situation (Takashima et al., 2019). Critical thinking is a skill every practitioner possesses from training, but the skill varies from one stage to the other. For instance, an expert demonstrates effective use of the craft when conditions arise compared to novice staff. Secondly, a nurse is expected to engage and establish therapeutic and professional relationships. Novice caregivers have a reduced capacity to interact with patients holistically compared to competent colleagues; hence, they may find it challenging to establish a connection. The third standard is maintaining the capability for the exercise where they are expected to embrace change. Beginners are more flexible since they can adjust to change than competent personnel.
The other standard is the conduction of assessments comprehensively and holistically. Expert nurses have experience with the situations presented by patients and hence can conduct holistic valuations. Additionally, a caregiver is expected to develop a working practice plan. Developing care and practice plan skills increases with competence and experience. A proficient nurse would prepare a comprehensive and practical working strategy compared to advanced beginners. Providing safe, quality, and responsive nursing practice is the responsibility for all practitioners (Howie et al., 2021). However, through experience, the quality of care accorded to patients is increased since there is faster and more accurate decision-making. Therefore, competent nurses are more likely to offer quality nursing services than advanced beginners.
The provision of holistic care to patients depends on the clinical competence of the nurse. Benner’s theory presents an overview of the transition a practitioner undergoes from novice to expert. Experiences gained at each phase, the ability of an individual to grasp skills, and duration in a specific department determine their competence. In addition, they become knowledgeable by attaining further studies, master’s, and Ph.D. levels; hence, they are termed, advanced practice nurses. They play a preventive role in society by organizing and educating members concerning health issues.
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