Nursing Theorist - PowerPoint Presentation

Slide1

Nursing Theorist Patricia Benner

From Novice to Expert

By: Amy Bowers, Amy Bradley, Michael Dugan, 

Amanda Hubbard, & Dawn PlattSlide2

Purpose & IntroductionThe purpose of this presentation is to discuss and examine the Nursing Theorist, Patricia Brenner, and her nursing theory: From Novice to Expert.  Patricia Brenner's theory explains how a nurse develops a sense of intuition in their practice and develops their critical thinking skills as a nurse (Blum, 2010).

http://www.truthaboutnursing.org/news/2010/jan/16_education.html#axzz1nRDAlWVi

Slide3

Origins of the Nursing ModelWhat Motivated Benner’s Novice to Expert Theory?

1. Patient

needs increasing2. Lengths

of stays decreasing

3

. Advancement

in medical technology

4

. Increased

learning for nurses

5

. Need

for more specialized nursing 

6

. Need

for more experienced nurses



With

all that is required in the nursing field, Benner (1982) wanted to provide an understanding for nurses, as they develop their skills, of what makes a novice nurse become an expert nurse (Benner).Slide4

Historical Background

Similarities

•Five developmental stages

•Increase in skills and experience gets advancement in stages

Benner’s nursing theory of novice to expert is also based on five levels of skills; novice, advanced beginner, competent, proficient, and expert (Benner).  Associate Professor Cheryl Martin finds that nurses move through the five levels as they “develop clinical expertise through experience and [gain] knowledge” (Martin).

Hubert & Stuart Dreyfus

http://socrates.berkeley.edu/~hdreyfus/

 http://www.ieor.berkeley.edu/People/Faculty/dreyfus.htm

Theory based on Dreyfus’s (1980)  “A five stage model of the mental activities involved in  direct skills acquisition” model (Dreyfus).Slide5

Benner's Philosophy    Benner worked in a variety of nursing areas including Intensive Care Unit (ICU), medical-surgical, emergency, and coronary.  She became interested in not how to do nursing but how do nurses learn to do nursing. 

    Using the Dreyfus model, Patricia applied the philosophy of learning to nursing.  Aspects of Benner's philosophy include:

practical situations are more complex than they seem and formal methods such as textbook descriptions, theories and models are inadequate to explain the complexities.  Experience and mastery are required to bring a skill to a higher level.Slide6

Benner's Philosophy, cont.the connections between external and internal events.  Even though it may not be apparent on the outside, nurses develop and use their own philosophies about patients and their care using experience, ethics, and personal knowledge.  Benner believes nurses should "interpret their own concerns, practices, and life experiences" (

Altmann

, 2007, Philosophical Underpinnings section, para 1).

Benner describes her work as interpretive phenomenology which means observing and interpreting actual nursing practice to find the meaning of the experiences (

Altmann

, 2007).Slide7

Content of Nursing ModelStages of Novice to Expert Model

•Novice

–Generally applies to student nurses

–Can

also apply to experienced nurses in an area or situation

of unfamiliarity

(

Alligood

&

Tomey

)

–Has little background and limited practical skills

–Relies on rules and expectations of others for directions (Chitty & Black

)

http://nursing-informatics.com/nrth100.html Slide8

Stages of Novice to Expert Model

•Advanced Beginner

–Applies to most newly graduated nurses

–Feel highly responsible for managing patient care

–Still rely on the help of the more experienced nurse (

Alligood

&

Tomey

)

–Has marginally competent skills

–Uses theory and principles much of the time

–Experiences difficulty establishing priorities (Chitty & Black)

http://nursing-informatics.com/nrth100.html Slide9

Stages of Novice to Expert Model

•Competent

Practitioner–Usually applies to nurses with 2-3 years experience

 –Coordinates several tasks simultaneously (Chitty & Black)

–Consistent, predictable, and able to manage time

–May display

hyperresponsibility

for the patient

–Begins to recognize patterns

–Determines which elements of the situation warrant attention and which can be ignored (

Alligood

&

Tomey

)

http://nursing-informatics.com/nrth100.html Slide10

Stages of Novice to Expert Model

•Proficient Practitioner

–Usually applies to nurses with 3-5 years experience 

–Views patient holistically

–Focuses on long-term goals (Chitty & Black)

–Can see changing relevance in a situation

–No longer relies on preset goals for organization

–Demonstrates increased confidence in their knowledge and abilities (

Alligood

&

Tomey

)

http://nursing-informatics.com/nrth100.html Slide11

Stages of Novice to Expert Model

•Expert Practitioner

–Reached only after extensive experience

–Performs intuitively without conscious thought

–Grasps patient needs automatically (Chitty & Black)

–Demonstrates a clinical grasp and resource based practice

–Possesses embodied know-how

–Able to see the “big picture”

–Able to recognize patterns on the basis of deep experiential background (

Alligood

&

Tomey

)

http://nursing-informatics.com/nrth100.html             Slide12

Benner’s Description of Nursing•A caring relationship, “an enabling condition of connection and concern”

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

•“Nursing is viewed as a caring practice whose science is guided by the moral art and ethics of care and responsibility.”

•Is the care and study of the lived experience of health, illness,

 and disease and the relationships among these three elements

(

Alligood

&

Tomey

, 2011, p.148)

http://www.himolde.no/db/57/3973.jpg

Slide13

Benner’s Description of Person•“A 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. A person also has . . . an effortless and

nonreflective understanding of the self in the world.”

"The person is viewed as a participant in common meaning."

The four major aspects of understanding that the person must deal with: 

The role of the situation 

The role of the body 

The role of personal concerns

The role of temporality 

(

Alligood

&

Tomey

, 2011, p. 148)

http://www.himolde.no/db/57/3973.jpg

Slide14

Benner’s Description of Health•Health is defined as what can be assessed

•Well-being is the human experience of health or wholeness

•A person may have a disease and not experience illness–Illness is the human experience of loss or dysfunction

–Disease is what can be assessed at the physical level

(

Alligood

&

Tomey

, 2011, p. 149)

http://www.himolde.no/db/57/3973.jpg

Slide15

Benner’s Description of Situation (Environment)•She uses the term situation instead of environment because situation conveys a social environment with social definition and meaningfulness

•“Personal interpretation of the situation is bounded by the way the individual is in it.”

–Each person’s past, present, and future, which include their own personal meanings, habits, and perspectives, influence the current situation

(

Alligood

&

Tomey

, 2011, p. 149)

http://www.himolde.no/db/57/3973.jpg

Slide16

InterpretationBy applying the Dreyfus model to nursing, Benner was able to explain how nurses can have different stages of experience and knowledge and how these different stages affect how the nurse sees and interprets the nursing process, the patient, the patient’s health, and the environment (situation) the patient is in. This model demonstrates that the majority of nursing knowledge and expertise comes from actual on-the-job clinical experience.

http://www.ucsf.edu/news/2005/07/6290/ucsf-faculty-member-leads-first-major-study-nursing-education-more-th   

Patricia Benner visits a patient along with Jenna Buffington, a first-year student in the master's entry program in nursing at UCSF.Slide17

Implications and Consequences

Schools of nursing have adopted Benner's model to use as a base for the education of nurses.

Hospitals and other nurse work places use the model as a foundation for perceptor based guidance of nursing students and new graduate nurses.

Social

agencies and nursing continuing education program developers also use Benner's model.

Nursing

administrators utilize the model to help "develop career ladders, staff development, and recognition and rewards programs" (

Altmann

, 2007, "Critique Of The Model,"

para

7).

http://nursetopia.net/2011/06/29/star-wars-flavor-to-dr-patricia-benners-novice-to-expert/Slide18

Implications and Consequences, cont.Benner's model is used to determine expert nurses and as a method in developing more expertise in nurses.  This can help optimize nursing by having the most knowledgeable expert nurses providing care and teaching the less experienced.

Benner's model was tested and confirmed to be valid.  The stages that Benner developed can be applied to any adult learning scenerio and not just nursing (Chitty & Black, 2011).

http://nursetopia.net/2011/06/29/star-wars-flavor-to-dr-patricia-benners-novice-to-expert/Slide19

Evaluation of the Nursing ModelOrigin

This philosophy can be used in any professional setting. The novice to expert is all about how knowledge, intuition, and experience are achieved. The philosophy was based on a skill acquisition model developed by Dreyfus and Dreyfus that was based on a study of chess players and airline pilots (Benner, 1980).

http://nursetopia.net/2011/06/29/star-wars-flavor-to-dr-patricia-benners-novice-to-expert/Slide20

Evaluation of the Nursing Model

Content

This model adds to the global concept of human being, environment, health and nursing. This model leads the nurse from novice to expert by using education and mentoring to allow nurses to grow to be experts. During the nurses growth the global concepts are in everything you learn and do. According to Hardt

, “The expert nurse profile includes extraordinary clinical knowledge, supreme connection with the patient, and the ability to differentiate between changes that matter and those that are inconsequential.” 

http://nursetopia.net/2011/06/29/star-wars-flavor-to-dr-patricia-benners-novice-to-expert/Slide21

Evaluation of the Nursing Model

View

In the aspects of nursing this model can be used in any type of nursing. Benner herself practiced in Med/Surg, ER, Coronary Care, ICU’s and Home Health Care. According to Chitty and Black (2011), this model can be applied to any adult learning situation giving it a broad view. The concepts of Benner’s theory are pretty specific. You have to master the skills in one level before you can move to the next one. You cannot jump from novice to expert without going through the other three phases first .

http://nursetopia.net/2011/06/29/star-wars-flavor-to-dr-patricia-benners-novice-to-expert/Slide22

Evaluation of the Nursing Model

Practice Situations

Novice/advanced  beginner:I took care of this

neuro

patient the other night. I am not as familiar with this type of patient as some of the others that I have cared for in the year that I have been a nurse. The patient was alert and oriented and then within the span of a few hours was getting more and more obtunded. The MD ordered a stat CT scan and I had to transport the patient for the scan. I was very nervous about this process because I had only taken a few trips to CT scan before as an ICU nurse and was unsure as to what may occur while I was off the unit. Fortunately, I was able to complete the transport and the patient's status did not change much while I was gone. I considered this very successful because I was able to complete this process without any ill effects to the patient.Slide23

Case StudyA nurse, with over 15 years’ experience on the obstetrics floor, is attempting to teach a new mother how to breast feed her infant.  First thing she does is makes sure the new mother has privacy, that the room is warm and the lighting is dimmed.  The mother is now relaxed and comforted by her surroundings.  The nurse proceeds to explain to the mother about how to hold her infant and get him to latch on to her breast.  She shows the mother a pamphlet with pictures explaining how this is done.  The mother is still a bit nervous, so the nurse reassures her that she can do this, with explanations of how it benefits the baby.  With this done, the mother is ready to try breast feeding for the first time.  The nurse is careful to continue reassuring the new mother and to assist her only when it’s necessary.  The nurse notices that the baby still will not latch on to the breast and immediately intervenes before the mother gets discouraged.  An explanation is given that different techniques can be used to hold the infant, so they are more comfortable and can latch on better.  When the mother places the infant, with instruction from the nurse, into the football position the latch on is successful.  Of course, the new mother is over joyed but asked the nurse what she will do if she is at home at cannot get the baby to eat.  The nurse is fully prepared and is able to get the new mother phone numbers for local support groups in her area.Slide24

 Question to Case Study

Given the previous scenario, in what stage is the

nurse in Patricia Benner’s Novice to Expert theory? Slide25

Answer

The answer is the nurse is in the expert practitioner. She performs her education with ease even when the situation changes. She performs instinctively and knows her patients needs automatically. She was able to diffuse a potential negative situation with her patient before the patient got discouraged.  The nurse was fully prepared to answer all questions and provide outside resources (Nursing Theories).Slide26

ReferencesAlligood

, M. R. & Tomey, A. M. (2010).

Nursing theorists and their work (7th ed.). Maryland Heights, MO: Saunders, Elsevier.

Benner

, Patricia. (2001).

From Novice to Expert: Excellence and Power in Clinical Nursing Practice

. 

Upper

Saddle River, New Jersey: Prentice Hall Health.

Benner, P. (1982). From novice to expert.

The American Journal of Nursing, 82

(3), 402-407

.

 Retrieved from

http://www.jstor.org/stable/3462928 Chitty, K. K. & Black, B. P. (2011). Professional nursing: Concepts & challenges (6th ed.). Maryland  Heights, MO: Saunders, Elsevier.Dreyfus, S.E., & Dreyfus, H.L. (1980, February). A five stage model of the mental activities involved in direct skills acquisition. United Stated Air Force Operations Research Center Report 80-2. Martin, M. (2002). The theory of critical thinking of nursing. Nursing Education Perspectives. 23(5), 243-247.

Nursing Theories. (

n.d.

). Retrieved February 18, 2012 From

Current Nursing

: 

http

://currentnursing.com/nursing_theory/Patricia_Benner_From_Novice_to_expert.html Slide27

Resources and Web-LinksAmy

BradleyBlum, C. (2010). Using the Benner intuitive-humanistic 

decision-making model in action: A case study

.

Nursing

Education in Practice, 10(5), 303-307.

doi

: 10.1016/

j.nepr

. 2010.01.009

Emerita. (

n.d

). Patricia Benner-01-Career and influence in educating professionals [video file].

Retrieved from http

://www.youtube.com/watch?v=FUIT1_pYBBc&feature= relathttp://www.youtube.com/watch?v=FUIT1_pYBBc&feature=related  Amy BowersDreyfus, S. E., & Dreyfus, H. L. (1980, February). A five stage model of the mental activities Involved in direct skills acquisition. United States Air Force Operations Research Center Report 80-2. Benner, P. (1982). From novice to expert.

The American Journal of Nursing, 82

(3), 402-407. Retrieved from

http://www.jstor.org/stable/3462928

Martin, M. (2002). The theory of critical thinking of nursing.

Nursing Education Perspectives, 23

(5), 243-247.

Nursing Theories. (

n.d.

). Retrieved February 18, 2012 From Current Nursing:

http://currentnursing.com/nursing_theory/Patricia_Benner_From_Novice_to_Expert

. html Slide28

Resources and Web-LinksMike Dugan

Altmann, T. (2007, May-June).  An evaluation of the seminal work of Patricia Benner:  Theory or philosophy? 

Contemporary Nurse, 25.1-2.  Retrieved November 21, 2012, from http://0-go.galegroup.com.libcat.ferris.edu/ps/i.do?id=Gale%7CA166565269&v=2.1&u=lom_ferrissu&it=r&p=AONE&sw=w

http://www.educatingnurses.com/

Amanda Hubbard

Hardt

, Marge. (2001). Core Then Care: The Nurse Leader's Role in "Caring".

Nursing Administration Quarterly,

25(3), 37-45. 

http://www.ihi.org/offerings/IHIOpenSchool/resources/Pages/ProfilesInLeadershipPatriciaBenner.aspx

Dawn Platt

Gardner, L. (2011). From novice to expert: Benner's legacy for nurse education.

Nurse Education Today

, doi: 10.1016/j.nedt.2011.11.011http://nursing-theory.org/nursing-theorists/Patricia-Benner.php