Nursing Theory: From Novice to Expert & Application to Patient Care

This presentation provides an in-depth analysis of Patricia Benner's 'From Novice to Expert' nursing theory, which describes the progression of a nurse's skills and understanding through five levels of experience: novice, advanced beginner, competent, proficient, and expert. The presentation delves into the major concepts of each level, highlighting the shift from reliance on abstract principles to the application of real-world experience and intuition. It discusses the major assumptions of the theory, including the importance of experience in developing expertise and the four metaparadigms of nursing: person, health, environment, and nursing. The presentation then applies the theory to the scenario of a distressed patient, outlining a practical approach to patient care based on the principles of the theory, including how a nurse at different experience levels can provide effective care. The presentation concludes with a list of relevant references.

Nursing Theorists
Name :
FROM NOVICE TO EXPERT NURSING THEORY

Introduction
 Nursing profession has significantly developed to accommodate
high acuity levels of patients, incorporation of healthcare
technology and thus increasing the need for expert nurses.
 Due to the increasing complexity of acute nursing care, it is
impossible to standardize and assign all duties of a nurse.
 As a result, there is need for long-term and continuous career
advancement, hence the need for a clear distinction between
experienced and novice nurse.
 This presentation will examine the “From Novice to Expert nursing
theory” by Benner (1984), and its application to a distressed
patient.

Major concepts of the theory
 There are five Levels of Nursing Experience according to Benner (1984).
1) Novice
2) Advanced beginner
3) Competent
4) Proficient
5) Expert
 The levels are a reflection of the variations in two main features of skilled
performance
 Change in the discernment and insight of a demand situation to an accumulation of
routine tasks
 Shift from dependence on abstract ideologies to real experience
(Brykcznski, 2013)

Major concepts of the theory…
1) Novice Nurse
 Generally applies to student nurse
 Apprentice with no experience
 Instructed on the basic rules to undertake nursing roles
 Guidelines:
 based on any relevant context, not reliant on explicit cases, generally applied.
 Controlled behavior is restricted and inflexible
2) Advanced Beginner Nurse
 Exhibits satisfactory performance
 Has previous experience in nursing practice, thus able to identify frequent significant aspects
 Aware of nursing principles, judgements are based on experiences
 Initiated into guide actions
(Brykcznski, 2013)

Major concepts of the theory…
3) Competent Nurse
 This is a nurse with 2-3 years experience on a given job position or with related
experience in routine practice
 Much cognizant of long-term objectives
 Simultaneously manages multiple tasks
 Reliable, predictable and good time manager
 Likely to demonstrate hyper responsibility for the patient
 Commences to distinguish patterns
 Decides the aspects of a situation that requires consideration and those that
can be disregarded

Major concepts of the theory…
4) Proficient Nurse
 Recognizes and comprehends circumstances as whole parts
 Has a holistic view of patients
 Can predict changing relevance in a situation
 Exhibits high self-assurance in their understanding and skills
 Is no longer dependent on the existing goals of the institution
5) Expert Nurse
 Not dependent on principles or procedures to link situations and decide on actions
 Performances are flexible and professional
 There is natural flow of expertise
 More competent and orderly
 Quickly comprehends the needs of the patient
 Displays proper understanding of clinical practice and general nursing practice
(Bender & Feldman, 2015).

Major assumptions
 Experience is a requirement for expertise: The theory
assumes that an individual acquires knowledge and skills on
nursing practice through experience more than customary
education (Petiprin, 2015).
 The author assumed that expert practice can only progress
once proposals are examined and assessed in workplace
environment
 The assessment of the present learning level of a nurse can
improve learning because it is possible to individualize
strategies that foster development
 Each level is based on the previous one as experience
develops

Major assumptions…
 Benner came up with the notion that
theory should be informed by nursing
practices and not the other way round
 The change in the definition of expert
nurse to a provider of optimal are is
attributable to the “From Novice to
Expert nursing theory”
(Brukezensky, 2010)

Major relationships
 The author perceived nursing to consist of four metaparadigms:
 Person -
 the care of a persons central need is a critical aspect of healing
 Caring is critical to healing and human proficiency
 Health –
 a patient’s health is fostered ones there is a good nurse-patient relationship
 An environment of healing is fostered by:
 Creating hope in themselves, nursing workforce, and the patient
 Comprehending the situation
 Helping the patient to utilize social, spiritual and emotional assistance
 Environment – practice environment is dynamic and influences nurse’s decision making
 Nursing – nurses play a helping role, education, diagnostic, administration, monitoring
etc. (Cherry & Jacob, 2016)

Major relationships
 Environment –
 Consist of the setting in which the nurse is practicing or offering
patient care
 practice environment is dynamic and influences nurse’s decision
making (Reimer & Moore, 2010).
 Nursing – nurses have an important relationship with seven
domains of care
 play a helping role, education, diagnostic, effective control of dynamic
situations, administration, monitoring and ensuring quality healthcare,
and institutional role and capabilities etc. (Cherry & Jacob, 2016)

Application: Distressed Patient
 Ensure there is privacy, room is comfortable and well lit
 Introduction: the nurse should introduce herself then seek to know the
name of the patient and any basic information.
 The nurse should then inquire of her need, then reassure her that all will
be well.
 The nurse is careful to continue reassuring the patient and help complete
some common words if necessary or by nodding
 The nurse is fully prepared and able to guide her in finding solution to the
current distress, and even provide contacts for local support in her area.
 The nurse provides way forward incase the condition persists.

References
Bender, M., & Feldman, M. S. (2015). A practice theory approach to
understanding the interdependency of nursing practice and the
environment. Advances in Nursing Science, 38(2), 96-109.
Brykcznski, K. A. (2013). Benner’s philosophy in nursing practice. Nursing
theory:
Utilization and application, 118-137.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, &
management. Elsevier Health Sciences.
Reimer, A. P., & Moore, S. M. (2010). Flight nursing expertise: towards a
middle‐range theory. Journal of advanced nursing, 66(5), 1183-1192.
Ulrich, B. (2011). From novice to expert. Nephrology nursing journal, 38(1), 9-
10.