Nursing Practice and Nurses Term Paper

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Patricia Benner's Theory of Novice to Expert: Does It Remain Valid?

What makes a nurse a good nurse? Patricia Benner's Theory of Novice to Expert examines the growth of a nurse's expertise and emotional development from her first years of practice to what Benner calls expertise, or higher-level competency. In Benner's view, expertise depends upon the development of the nurse's intuitive capacity. As noted by Lyneham, Parkinson, & Denholm (2008), this competency that Benner defined as "intuitive" is a little-understood term, given the basis of modern nursing in evidence-based practice (p.380). By intuition, Benner meant the internalization of experience as well as technical capabilities. To better understand Benner's ideas, the authors adopted a qualitative, phenomenological approach, interviewing 14 emergency room nurses who met Benner's standards of expert practice, to determine if Benner's framework was relevant. Specifically, the study attempted to respond to criticisms of Benner's model of expert practice.

Critics of the Benner model view intuition as inappropriate to use in nursing practice, which they view as a scientific, evidence-based exercise of knowledge (Lyneham, Parkinson, & Denholm, 2008, p.381). Not only does Benner allow for intuition to be used; she regards it as the highest manifestation of nursing practice. It should be underlined that Benner does not disregard or discount the need for the nurse to have technical, research-based knowledge but views the acquisition of these skills as part of the earlier stages of gaining expertise.

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Defenders of the Benner model thus counter that Benner is hardly anti-science, but rather that Benner strives to underline nursing's basis in an individual, patient-focused approach and a craft that is honed by years of experience. Nursing, in short, requires book knowledge but expertise cannot be honed from reading alone. Nursing is an art as well as a science.

One of the challenges of studying the Benner model is the difficulty of defining what is meant by intuition at all as an object of study. In contrast to years of schooling or the number of degrees possessed by a nurse, intuition is not something which can be quantified. This is one of the reasons the researchers selected a qualitative approach. Intuition, according to the researchers' criteria, is defined as knowledge which is "non-inferential" in nature, is not strictly rational, and takes place "below the threshold of consciousness" (Lyneham, Parkinson, & Denholm, 2008, p.382). The study involved a voluntary sample of one male nurse and 13 female nurses with 5 or more years of experience in Australian emergency rooms. The authors used a series of semi-structured interviews to gather data. What emerged is that the expert nurses all had different practices and used their intuition in different ways, but all seemed to operate….....

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