Patricia Benner is a contemporary theorist who is most noted for her research in nursing. Her research has received many rewards because it has contributed strongly to nursing and changed the way that nursing was done. She is also a prolific writer in the field. Major Concepts
The major premise of her work is knowledge. She wants to "discover and describe" the role that knowledge has in the nursing practice. She calls her work "articulated research" and it distinguishes a difference between practical and theoretical knowledge (Tomey and Alligood, 2006, p. 142). According to Benner:
Knowledge development in a 'practical discipline' consists of extending practical knowledge (know-how) through theory-based scientific investigations and through the chartings of the existent 'know-how' developed through clinical experience in the practice of discipline (Tomey and Alligood, p. 142). Although this idea may seem common sense, it is the basis for all of the work that Benner has produced. She sees that knowing how to do something is different than the theory of scientific event and often practical knowledge can be more important than the theoretical framework that has been taught. Practical knowledge can also be developed before the scientific theories can be born.
Benner saw that different clinical settings could create many different clinical experiences. In her view clinical experience is what makes new knowledge available to the practicing nurse and this information creates better nurses. When practice and theory are used together, they promote a harmony experience and allow nurses to see more possibility in their practice (Tomey and Alligood, p. 143).
Benner later met Hubert Dreyfus who studied phenomenology and she adapted much of his work to the nursing profession. The Dreyfus Model of Skill Acquisition became the model for Benner's Novice to Expert Theory. Five Stages of Benner's Theory
Benner's model suggest that nurses move through several experiences that she calls "stages" to get to a knowledge base. Novice
An individual comes into a situation with no knowledge and will learner as they work in an environment. This stage can be repeated in higher levels of nursing if they move into an unfamiliar setting. Advanced Beginner
As the nurse has more clinical experience, they begin to show better performance, especially when they have a mentor. During this stage they are more apt to follow the rules and complete tasks in specific ways according to the rules. They still have challenges learning how to work with clients on a larger scale. In this stage, they also learn to "intuit" what to do in situations with clients as they change. Benner also says that at this stage the advanced beginner "feels highly responsible for managing patient care" (Tomey and Alligood, p. 145) but they are still relying on someone who is more experienced to help. Competent
Once the nurse has gone through these first few stages she becomes competent. Now they are working on being more consistent and predictable while learning how to become more competent in their practice. By this time, they have learned a variety of methods for working with clients. The nurse will find more mastery at this stage because emphasis is placed on time management and on how the tasks work in the "real" world instead of on timing and the patient's needs. Benner says that at this stage, nurses may feel as though they are more responsible for patients than they are and may be more critical of themselves when they make a mistake. This stage is also one of the pivotal stages because nurses now have to understand what aspects of what they do are important and which ones are not. They see new rules and how to let the situation they are in guide their responses to the type of care that is needed for the patient. Proficient
To be proficient in this model, the nurse demonstrates a new ability to see situations that are before...