Patricia Benner Novice to expert theory

Novice to expert theory
The novice to expert theory postulated by Patricia Benner revolves around cultivation of skills in an individual. Benner basically states how important it is for nurses to gain skills through practical experience. In the formulation of this theory, Benner employs the Dreyfus Model of Skill Acquisition for practicing nurses. The Dreyfus Model has it that an expert in the making passes through five skill levels namely: novice, advanced beginner, competent, proficient, and expert. As the person in question climbs up this skill ladder, his skill set changes positively in a number of ways (Benner, 1984).
The foundation stage, as mentioned above, is novice. According to Benner (1984), a novice is an individual just fresh in the field without prior experience of the environment they currently work in. It is important for a novice nurse to be exposed to new clinical environments so that they can grow their skill. Benner is also of the idea that novice nurses should be coached on patients’ conditions in a purposeful and measurable manner. This helps the novice nurse to identify symptoms in patients, having no prior experience. Novice nurses do not normally have much on their table due to their limited ability to handle clinical activities. They are also subjected to stringent rules so as to avoid mishaps. The rules have been known to compromise the flexibility of the nurses, to such extent that they view all pieces of the clinical puzzle as one. They rely solely on issued instructions and cannot reason and act on their own (Benner, 1984).
The second step in skill cultivation is the advanced beginner. According to Benner, the advanced beginner nurse portrays some reasonable performance, given they have been through an adequate number of situations that have made them note some of the recurring aspects in such situation. These aspects are universal traits that need previous experience so as to be able to recognize them. The advanced beginner is therefore one who has gone through situations and successfully developed some principles which he now employs in the current situations (Benner, 1984).
The next on the list is the competent individual. Benner asserts that a competent nurse is one who has worked for a minimum of two years under a constant environment. Competency in this case starts to show when a nurse can relate his/her daily actions to the long term objectives. The competent nurse is able to strategize his actions, based on the relevant aspects of the challenge at hand, rather than considering all the aspects. A competent nurse believes that a plan is a key component of establishing direction, and that the plan must be formulated in a conscious approach, carefully analyzing the challenge at hand. This skill level is largely characterized with planning. Planning helps the nurse perform at optimum (Benner, 1984).
Number four on the list is proficient. A proficient nurse is one who is able to take a challenge in its entirety, rather than seeing the smaller aspects of the challenge. Such overall outlook of situations is not something calculated in the mind. It is seated in the subconscious mind through years of experience in similar situations. Perception is what drives a proficient nurse. The proficient nurse possesses a holistic understanding of situations, which enables them make sound decisions. Experience has taught such nurses what to expect in a range of clinical circumstances, and more so how they can alter plans to cater for varied circumstances (Benner, 1984).
Finally, we get to the expert nurse. In a nutshell, the expert nurse possesses a deep comprehension of clinical circumstances. An expert nurse has surpassed the analytical approach to circumstances. Instead, they possess an inbuilt command of circumstances, which they use to act on presented challenges. An expert nurse is thus flexible, fluent and greatly skilled. The expert nurse can at times use “hunches” to assume a number of things. However, Benner emphasizes the need for them to be extensively skilled in the application of analytic tools, for the basic reason that such tools carry the day in the event that the nurse goes wrong with the hunches. An expert nurse no longer depends on the use of abstract rules and regulations. They use their true experience to handle situations. The expert nurses also have an advanced perception of circumstances. They no longer view circumstances as individual pieces glued together, but rather as a whole item, with particular relevant pieces. The expert nurse thus gets fully involved in circumstances, rather than observe things from a distant as they unfold (Benner, 1984).
Take for instance a qualified nurse in the CCU - She cannot at once lead an operation, no matter how much she is qualified. Nurses should be aware of this fact so that they do not end up frustrated when such a shift occurs at the health care facility. Qualified nurses are known to have an adequate methodical foundation and ability to analyse situations so as to grasp the ailment of each sick individual. Educated nurses on the other hand have that ability to determine the building blocks of the bigger picture and how these components relate to each other. These nurses have also improved their empathetic skills towards the patients and their families, and can normally dig into their history to better understand how to handle their present, and also the future. You will always find expert nurses deliberating with colleagues where tough decisions are to be made, or the challenge at hand is that demanding (Walker-Reed, 2016).
Assumptions
Benner employed the Meta models of health care to make assumptions. The above discussed skill levels of nursing have a common denominator, and that is caring. The caring aspect should be the heartbeat of every nurse as they climb up the skill levels. Nurses, from the very onset of their career, are sensitized on the need to care for the patients. According to Benner, expertise comes after knowledge. She further states that exposure to recurring circumstances builds more confidence in the nurses. Acquired knowledge is a vital component of the nursing practice (Boshuizen, Bromme & Gruber, 2006).
Strengths and weaknesses
Benner has clearly defined her concepts both theoretically and practically. Her classification of nurses on a scale of 1 to 5 forms a good representation of their skills at various levels of practice. Benner also clearly shows the relationship between her theories and the actual practice in health care facilities. She brings out the need for growth in skills among the nurses to improve patient care as a whole. She makes use of interviews, experiences and observations to evaluate the performance of nurses in patient care (Marriner-Tomey, 1994).
On the negative end, the five stages outlined by Benner are not entirely acceptable. First and foremost, the stages have not been properly defined in literature. Secondly, the evidence she claims to have obtained from actual nursing practice is generally weak. The classification is also unreliable, and some experts claim it is not a valid representation of expertise (Marriner-Tomey, 1994).
Practical application
When graduated nurses get into the workforce, their mentors not only impart skills - they also enable new educative experiences, assist nurses in taking appropriate actions, and improve their network within the industry. Mentorship programs can therefore be looked at as excellent tools that influence graduated nurses to make sound decisions as they advance in their career (Boshuizen, Bromme & Gruber, 2006).

References
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley, pp. 13-34.
Boshuizen, H. P., Bromme, R., & Gruber, H. (Eds.). (2006). Professional learning: Gaps and transitions on the way from novice to expert (Vol. 2). Springer Science & Business Media.
Marriner-Tomey, A. (1994). Nursing theorists and their work. St. Louis: Mosby.
Walker-Reed, C. A. (2016). Clinical coaching: The means to achieving a legacy of leadership and professional development in nursing practice. Journal of Nursing Education and Practice, 6(6), 41.

.