This assignment objectively looks at my developmental trajectory with growth in adult nursing from the novice level, advanced beginner and through to the competent practitioner level. During the duration of my three years of nursing training I have come to realise the obligation on myself as a student and future staff nurse to build the theory and skills base expected of qualified nurse. I shall look at how my learning evolved in the domain Helping role/caring skills on the basis of the Novice to Expert Model (Benner, 1984) but only as far as my current level, competent practitioner. I shall briefly give the rationale for choosing this domain and also illustrate the reflective practice approach I have utilised during my training. Nursing consists of a unique relationship between patient and nurse whose nature is a vital component of health care and that quality of nursing care can have a great impact on patients, affecting their feelings well-being and health The reason for me to choose this aspect of care is the motivation to improve my nursing practice in this domain of nursing arising from a need to consider my practice in a thoughtful and critical way in meeting the individual needs of my patient. Caring is central to human expertise, to curing and to healing and in that manner is a fundamental way of being in the world (Webb, 1996). I feel if I understand this key relational expression of human concern I would be better equipped to help my patients.
As a nursing student the portfolio is used in assessment of my
learning and competence in the nursing education. In this holistic approach to competence I have been taught to utilise reflection as a basis of developing my professional judgement, using Kolb's (1983) experiential learning cycle. Reflection in my course has been a way to empower me to become fully cognisant of my knowledge and actions to sustain myself in practice, nursing experiences, personal and professional development (Street, 1991).from image to action reflection in nursing practice. Deakin University Press Geelong). The portfolio approach has integrated well with me as an adult learner. Most of our learning is self-directed; I am recouping my past experiences as a rich source for learning, my eagerness to acquire new skills as I tackle real life tasks and problems. Garrison (1991) (cited in Burns & Bulman, 2000) asserts that learning through reflection is a learning technique mostly suited to the adults who have a wealth of past experience and an intellectual maturity to cope with autonomy, differing perspectives and shifting ideas. This reflection can be reflection-in or reflection-on action (Schon, 1987). Though the formal training I am receiving now as a student nurse is providing me with the technical knowledge needed to provide competent care to patients it has also proved to be a good start building competence and am using it for any professional and personal development.
According to Benner (1984) the novice practitioner is characterised by rigid adherence to taught rules or plans, has little situational perception and does not possesses any discretionary judgement. On my first clinical placement, as is evident from the clinical assessment
tool (CAT), I was overwhelmed by the ward environment. I came on to the ward only armed with not so much developed theoretical knowledge from university lectures. I felt the gap between theory and practice on the clinical environment (Clifford, 1993). I found myself helpless "realising my own knowledge and skills limitations I worked my mentor and adopted a questioning approach" (Mawema, 2001). My concept of "caring" as it were, was to meet any physical requirements of patients, like helping patients to the toilet, giving patients proper food, bed making. I...