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Nursing Theorist:

Patricia Benner, R.N., P.h.D., FAAN,F.R.C.N

 

Patricia Benner is a Professor in the Department of Physiological Nursing in the School of Nursing at the University of California, San Francisco.

Dr. Benner received her bachelor's degree in nursing from Pasadena College, her master's degree in medical surgical nursing from the University of California, San Francisco, and the Ph.D. from the University of California, Berkeley, in Stress and Coping and Health under the direction of Hubert Dreyfus and Richard Lazarus.

Dr. Benner categorized nursing into 5 levels of capabilities: novice, advanced beginner, competent, proficient, and expert.

 She believed experience in the clinical setting is key to nursing because it allows a nurse to continuously expand their knowledge base and to provide holistic, competent care to the patient.

 Her research was aimed at discovering if there were distinguishable, characteristic differences in the novice’s and expert’s descriptions of the same clinical incident.

Client/ Person – “The person is a self-interpreting being, that is the person does not come into the world predefined but gets defined in the course of living a life.”- Dr. Benner

Health – Dr. Benner focuses on the lived experience of being healthy and being ill. Health is defined as what can be assessed, whereas well being is the human experience of health or wholeness. Well being and being ill are understood as distinct ways of being in the world.

Environment/Situation – She uses situation rather than environment because situation conveys a social environment with social definition and meaningfulness. “To be situated implies that one has a past, present, and future and that all of these aspects….influence the current situation.”- Dr. Benner

Nursing – Nursing is described as a caring relationship, an “enabling condition of connection and concern.” -Dr. Benner

“Caring is primary because caring sets up the possibility of giving and receiving help.”.

Nursing is viewed as a caring practice whose science is guided by the moral art and ethics of care and responsibility. She understands that nursing practice as the care and study of the lived experience of health, illness, and disease and the relationships among the three elements.

LEVELS OF NURSING EXPERIENCE

She described 5 levels of nursing experience as;

1.    Novice

2.    Advanced beginner

3.    Competent

4.    Proficient

5.    Expert

6.   

Novice

Ø  Beginner with no experience

Ø  Taught general rules to help perform tasks

Ø  Rules are: context-free, independent of specific cases, and applied universally

Ø  Rule-governed behaviour is limited and inflexible

Advanced Beginner

Ø  Demonstrates acceptable performance

Ø  Has gained prior experience in actual situations to recognize recurring meaningful components

Ø  Principles, based on experiences, begin to be formulated to guide actions

 Competent

Ø  Typically a nurse with 2-3 years experience on the job in the same area or in similar day-to-day situations

Ø  More aware of long-term goals

Ø  Gains perspective from planning own actions based on conscious, abstract, and analytical thinking and helps to achieve greater efficiency and organization

Proficient

Ø  Perceives and understands  situations as whole parts

Ø  More holistic understanding  improves decision-making

Ø  Learns from experiences what to expect in certain situations  and how to modify plans

Expert

Ø  No longer relies on principles, rules, or guidelines to connect situations and determine actions

Ø  Much more background of experience

Ø  Has intuitive grasp of clinical situations

Ø  Performance is now fluid, flexible, and highly-proficient

Ø  Different levels of skills reflect changes in 3 aspects of skilled performance:

Ø  Movement from relying on abstract principles to using past concrete experiences to guide actions

Ø  Change in learner’s perception of situations as whole parts rather than in separate pieces

Ø  Passage from a detached observer to an involved performer, no longer outside the situation but now actively engaged in participation