Benner, P. (1984). From Novice

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley.

Patricia Benner's work From Novice to Expert fundamentally shifts the paradigm of nursing education from its current focus on conveying practical knowledge to the need to create nurses who are good decision-makers. She creates a progressive typology of mastering the profession of nursing. She provides a pedagogical map for nursing educators, mentors, and even administrators as to how to set expectations for levels of nursing competence. Benner's approach is empowering by stressing the value of learning from experience, and the need to infuse situational decision-making abilities into what is often seen as the linear of process nursing.

Benner structures her book around her definitions of nursing confidence and competence, from novice to expert. Mastery at the highest level is defined by not by possessing technical knowledge, but on the ability to independently adapt nursing knowledge to different situations. The novice nurse, for example, is almost entirely rule-bound. No matter how well-educated he or she may be there is a strong level of dependence upon supervisors to define the rules. The novice often does not know how to contextualize his or her behavior. Without reference to life experience, for example, a nurse may not know when to put his or her knowledge in layperson's terms, so as to not frighten a patient with confusing terminology (Benner 20). A novice may not be able to spot an elderly person coming into the hospital who needs personal attention more than medical care, or even simply quickly differentiate between a patient with heart problems or heartburn by asking the 'right questions' as to what the pain feels like.

Advanced beginners finally begin to see that rules are useless in the abstract. They must be applied to patient's lives -- this is the reason that Benner places such a strong emphasis on mentorship as a critical component of training. Mentors and the advice of other nurses are required to teach advanced beginners to begin to 'filter' experience and form meaningful principles (Benner 22). However, for the advanced beginner, mentors are still required to help individuals adapt to the situations they are exposed to, such as, to cite the example given by Benner, a ward of crying babies, all of whom need attention -- an advanced beginner may have trouble doing 'triage,' or understanding what is the most important thing to do in a situation, when confronted with a variety of demands.