Overview
The novice to expert theory was developed by Dr Benner who proposed that expert nurses develop their skills over time. She further made the assumption that their skills and understanding of patient care are developed over a period through experiences and proper educational background. The theory does not focus on how to be a nurse rather on how to advance as a nurse where one consistently gains knowledge and skills. To understand the theory, it is prudent to look at the career growth of a nurse who currently works in the Emergency Department at Winter Haven Hospital. The nurse has worked for the hospital for seventeen years both as a full-time employee and as a part-time consultant. The nurse started her work as a graduate nurse immediately after graduating from college seventeen years ago. The past ten years has seen her rise through the ranks and now she currently holds the position of a charge nurse on night shift. By implementing the use of novice to expert theory, the nurse’s career has been on a steady trajectory and has enabled her to gather experience that places her where she currently is. To successful grow to be an expert the nurse had to undergo all the five stages of the novice to expert theory.
The Novice Stage
In developing her career, the nurse started out as a novice. This is the first and initial stage of the novice to expert theory. It is at this stage where the nurse was in the first year of her clinical education. At the novice stage the nurse behaviour in clinical settings is still not flexible, and in many cases, the behaviour is limited to the few things she knew. A novice is considered as a beginner with no experience and who needs to be taught the general rules that govern the nursing practice and help nurses perform tasks (Thomas, 2011). The rules taught to the novice nurse are contextual and free. They are independent of specific cases and are often applied to universal cases. As a novice nurse, one needs to be told what to do every time they are on duty. The rules that govern their behaviour are limited and inflexible. It is at this stage that novice nurses rely heavily on other experienced colleagues to carry out their duties (Thomas, 2011). Without experience in the nursing practice, the nurse is in no position to predict what can happen in any given patient situation. The nurse cannot recognise signs and symptom for changes in patients until she gains some level of experience dealing with patients that have the same symptom.
Advanced Beginner Stage
After gathering experience as a novice, the nurse moved to the advanced beginner stage. At this stage, the nurse was a new graduate landing her first job at the emergency department of Winter Haven Hospital. As an advanced beginner, the nurse has gained some experiencing in the nursing practice. The nurse is now in a position to recognise recurrent meaningful components of given patient situations that might arise (Thomas, 2011). The nurse's performance demonstration at this stage is more acceptable compared to the novice stage where they did not know much about nursing. In the advanced beginner stage, the nurse's principles begin to formulate guiding her action based on the experiences she has gained. The advanced beginner nurse has gained enough knowledge and know-how but still lags behind regarding in-depth experience. This stage can be said to be the crawling stage where the nurse knows what she is doing but still has to call upon other to help especially with new cases.
The Competent Stage
After the advanced beginner stage, the nurse moves to the competent stage. At this state, the nurse still has no speed or even the flexibility of proficient nurses. However, they have some mastery in the nursing practice. The nurse at this stage heavily relies on her ability to plan and her organisational skill in carrying out her duties. At this stage, the nurse can gain her perspective from planning her actions based on analytical thinking. To be a competent nurse one has to have been a nurse for a duration of about two to three years working in the same are or managing similar situations (Thomas, 2011). During this time the nurse will have gained more experience and should be in a position to recognise and handle multiple patient situations. It is at the competent stage that the nurse is more aware of her long term goals. The nurse at this stage can recognise patterns and nature of patients situations faster and more accurately compared to the advanced beginner stage.
The Proficient Stage
After getting through the competent stage, the nurse moves to the proficient stage where she can see and understand situations as a whole and not in parts. The proficient nurse has a more holistic understanding with improved decision-making. The nurse at this stage has more experience than the competent nurse and is in a better situation to handle different patient situations (Thomas, 2011). The nurse is more aware of their working requirement and knows what to expect from given situations and how to handle them. Unlike the competent nurse, the proficient nurse does not rely on her plans to solve patient situations. They can recognise different patterns and modify their plans to respond to situations they were not ready to handle. The proficient nurse experience makes it easy for them to handle the different patient situation more accurately than the competent nurse.
The Expert Stage
After several years working as a nurse, nurses finally become experts in their field. The amount of experience gathered enables the nurse to be more proficient in her work. As a nurse who started out as a graduate employee in the emergency department, a more experienced nurse now holds the position of a charge nurse in the same department. The expert nurse can recognise available resources and demands and use the two to attain her goal. An expert nurse knows what is required of them at work (Thomas, 2011). The nurse rather than using rules to guide their actions relies more on her intuitive grasp of situations. An expert nurse has much more background experience, and her performance is now more fluid, flexible and highly proficient. The expert nurse focuses on important situations and rarely uses analytical tools unless they are faced with new challenges.
Conclusion
The nursing career is a sequential process that starts as a beginner and over time ends as an expert. A beginner nurse in the nursing theory is the novice nurse who has no experience and has to be told what to do. Over given duration, the nurse moves from a beginner to an advanced beginner where she now has more grasp of what is required of her as a nurse. The advanced beginner stage is the stage where the nurse has just graduated school and can now recognise recurrent meaningful components. With more experience, the nurse moves from being a beginner to being a competent nurse. At this stage, the nurse has more mastery of the profession and relies on advanced planning and organisational skills to carry out her duties. After some time as a competent nurse, the nurse moves to being a proficient nurse. It is in this state that the nurse now with more experience is capable of perceiving situations as a whole and can modify her plans to suit any patient situational changes. Finally, the nurse becomes an expert after more years as a proficient patient. As an expert, the nurse is more experienced and knows exactly what needs to be done in handling any situation. The nursing theory is important since it helps nurses build their career as they gain experience with time.
Reference
Thomas, M. (2011). Benner’s stages of clinical competence. Retrieved from http://www.health.nsw.gov.au/nursing/projects/Documents/novice-expert-benner.pdf
