IntroductionNursing is a career in which those who are new to the profession are faced with many obstacles and challenges. Learning to make the transition from theory to practice is an important process. Content delivered in nursing school enables a student to be a critical thinker, but a student must also have the opportunity to gain experience by applying principles to clinical practice. When a student transitions from an educational setting to a professional role as a registered nurse, he/she is expected to recognize and respond to a variety of new demands including understanding the importance of quality and safety, socializing into a new professional role, managing challenges, and identifying personal learning outcomes to achieve success. To explain the transition a new nurse will make, Patricia Benner developed a concept known as “From Novice to Expert.” Patricia BennerBenner’s concept is based on a theory that a nurse passes through five levels of developmental stages: novice, advanced beginner, competent, proficient, and expert (Benner, 1982). Benner believed that a nurse develops skills and an understanding of patient care through a synthesis of acquired knowledge and personal experience. As a nurse advances to becoming an expert in the profession, he/she will acquire experience, knowledge, and intuition through repetitive skills. The transition from novice to expert is as follows. Stage one: novice. A novice nurse has no experience and universal rules are used as the basis for practice (Jewell, 2013). These nurses lack confidence and they require more assistance and reassurance. For example, when I observed an orientee refer to her handbook to find steps on how to insert an intravenous line. When performing the task, she needed cues and affirmation from her preceptor. Stage two: advanced beginners. Theses nurses can process information based on recurring clinical situations, called aspects, to demonstrate acceptable performance (Benner, 1982). For example, when I observed a relatively new nurse asking the charge nurse for help in setting priorities for her day. Stage three: competent. A competent nurse has worked in the same clinical area for two to three years. These nurses are able to use conscious and deliberate organizational skills to effectively and confidently make a plan towards a long-term goal. For example, I saw that a nurse was being assigned to a new patient but she still had to pass meds and send another patient down to CT. The nurse was able to cope with and manage the situation by organizing a plan of action using analytical thinking. Stage four: proficient. A proficient nurse is able to individualize care and make decisions while combining skill and intuition. For example, when the nurse had the perceptual ability to read the situation and respond appropriately when her patient was declining. She was able to look at the big picture to develop a holistic plan of action. Stage five: expert. An experts’ practice is guided on reflection, flexibility, and a high level of proficiency. An expert uses experience and a profound understanding of the situation to guide action. For example, when I observed a nurse portray comfortability and confidence with her intuition. Her patient was on pain medication, but she felt that something was off with his presentation. The nurse called the doctor because she had a gut feeling that her patient was using unprescribed drugs. The doctor reluctantly ordered tests; it turned out that the patient was positive for other substances since being in the hospital. To transition to this level of an expert nurse, novice nurses must use their acquired fundamental skills while simultaneously learning how to apply experience and intuition to produce high quality patient care. A novice must also learn how to use critical thinking skills to create and implement a solution for complex problems. The expert nurse has already mastered these aspects of care while the novice is still focused on an inflexible to-do-list. To become an expert, a nurse must also be able to move away from seeing patient care as pieces of unrelated information (Benner, 1982). An expert will be able to integrate the pieces of unrelated information into a meaningful plan of care. Before a novice nurse begins the transition to becoming an expert, he/she must be ready to learn, to accept constructive criticism, and to adapt to new cultures and everchanging environments.
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