This paper would be dedicated to the assessment of the major stages of the nursing competence (proficiency) - as they are represented in the scientific work of Patricia Benner. These stages of professional development are also referred in the scientific literature as the basic student socialization.
Five following stages have been defied by the author of the theory as the most critical for the professional competence enhancement. They are the following: “novice,” “advanced beginner,” “competent practitioner,” “proficient practitioner,” and “expert practitioner” (Black, 2013). In addition, it was claimed by Patricia Benner that the advancement of the professional competence of nurses takes its place in a gradual manner – as more practical experience in the area of the patient care is gained by them. One of the major factors for stimulation of the clinical judgment is the confirmation of the preconceived notions and expectations with the practical experience.
The first stage (which is referred by the author of the theory as the ‘novice stage’) starts as the nursing school is attended by them for the first time. While these students have little knowledge in the area of nursing and medical theory and practice, they are significantly dependent on the set of the expectations and rules, established form them. In addition, the practical skills of such nurses are limited. For example, when such nurse gets the request of the woman, who is waiting for sharing a glass of wine with her husband, who has the terminal stage of cancer, since such tradition was initially practiced by them. Such request is denied by the novice (even while she or he feels uncomfortable – because of humane considerations), as it violates the general rules and regulations of the healthcare entity, set for all its patients and their visitors regardless their initial family traditions.
At the second stage of professional development of the nurses (referred by the author of the theory as ‘advanced beginner’), the learners have already revealed for themselves the existence of the particular order in the healthcare settings. Their performance may be referred as competent to some extent, as their actions are grounded on both the principles and theoretical knowledge, but at the same time, the set of the complications is faced by them. As an evident example, it is possible to refer to the case when the learners at this stage of their professional development face with the complications in terms of formulating priorities in their activities - as significant number of radically different nursing activities is referred by them as equally important.
The learners, who reach the third stage of their professional development or as they are referred ‘competent practitioners’, already have two or three years of the professional experience as well as theoretical knowledge in their educational establishment and healthcare settings. At this stage of their professional development they are rather competent efficient and their professional duties are properly-organized. It is claimed by the author of the theory that these feelings of being masters are generated by the competence in the area of goal setting as well as by the huge experience in planning. As a result, the nurses, who are at the third stage of their professional development, are able to think analytically and abstractly. As a result, they represent the ability of coordination of the set of the tasks in a simultaneous manner. The fourth stage of nurses’ professional development is referred by Patricia Benner as “proficient practitioners”. In the lion share of case, it is reached by the ordinary learner after 3-5 years of practice. At this stage of professional development, nurses are able to perceive the patients and their needs in a holistic way rather than referring to each particular issue in their clinical history.
The latest stage of professional growth is ‘expert practitioner’. It is reached after the large pool of professional experience is gained by the learners. At this stage, the decisions are made intuitively; such nurses are able to make the prompt shifts from one intervention to another, while taking into account the entire set of specific aspects, related to the current health condition of the patient (Benner et al, 2009).
Currently, I am on the third stage of my professional development and may claim that I am a competent practitioner. This knowledge base enables me to work simultaneously with the set of professional tasks, which are managed by the me at the beginning of the shift – such as investigation of the current needs of the patients (for instance, measure the blood pressure and heart rate) as well as using this experience for planning of the further fundamental care (deciding which particular pills and procedures should be avoided or urgently applied). At this stage of my professional growth I have realized the fact of quick changes in each particular situation, as well as the fact that the proper planning is one of the most effective approaches towards ensuring the fact of the practical implementation of care in such cases as unexpected events or emergency. In addition, my socialization is affected by the step-by-step professional development - as I share experience with the set of other nurses –more competent and beginners, and in such way, the knowledge base is expanded and ability of finding the proper solution in a prompt way is gained.
Benner, P., Tanner, C., Chesla, C. (2009) Expertise in Nursing Practice, Second Edition: Caring, Clinical Judgment, and Ethics. Springer Publishing Company
Black, B.P.(2013) Professional Nursing: Concepts & Challenges. Elsevier Health Sciences