Benner’s Theory and Usefulness
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Comment on the usefulness of Benner’s work in your present or future role. Provide several examples. Patricia Benner formulated one of high middle range theory and was published in 1984.The model which applies the Dreyfus model outlines five stages of nursing, novice, advanced beginner, competent, proficient and expert(Benner1984). The central concepts of Benner’s model are those of competence, skill acquisition, experience, clinical knowledge and practical knowledge. (McEwen &Wills 2014).She also identifies seven domains of nursing practice: Helping role, Teaching or coaching function, Diagnostic client monitoring function, Effective management of rapidly changing situations, Administering and monitoring therapeutic interventions and regimes, Monitoring and ensuring quality of health care practice, Organizational and work role competencies (McEwen &Wills 2014).In my present role as unit educator, I have the opportunity to be also involved with nurse orientation including new graduate nurses and also with clinical advancement programs. Benner’s model is very useful, now as nursing in acute care settings has grown more complex, and it is hard to retain experienced nurses and there is an increased need to prevent nurse turnover.
According to Sorentino, (Sorrentino, 2013) Increased acuity level of patients, decreased length of stay ,increased throughput of patients and increased use of electronic records have made nursing more complex and challenging .Increased staff turnover in hospitals has caused nursing staff shortage and organization has to develop orientation and preceptor program that helped promote nurse retention and decreased costs. (Sorrentino, 2013). In our facility, creating an efficient model of preceptor program that helped nurses to function independently that was also cost effective .Benner’s novice to expert research describes nurses’ moves from rule governed behavior to an intuitive, automatic response. Ongoing development of the orientation program, preceptor development, preceptor assignments are included in the role of orientation and education coordinator of the unit. Developing a preceptor program for the unit was a need for the hospital and Benner’s model was used as per the decision by the nurse management and education department. Preceptors were chosen on the basis of their performance and documentation compliance according to unit standards. Documentation of compliance is validated using chart audits. Nurses who wanted to be preceptors also had to get approval from 3 peers and they write a 500 word essay stating why they want to be preceptors and had to attend an eight hour preceptor class.
Preceptor education is based on Benner’s concept of framework and how they can support new nurses during their orientation process. Different communication and teaching styles and providing feedback also helped with preceptor orientation. New graduate nurses have a residency program and they have an extensive 18 week program of orientation. For first 6 weeks they have an advanced beginner nurse .Advanced beginner nurses who has experience for one to two years can relate to new novice nurse and they have load less than the regular nurses on the floor. There are modules and they complete basic training. Then they go to competent nurses who have an experience of two to five years and have 6 weeks, where they take care of more complex patients. The average load of patients has been increased and new novice nurses gain more knowledge. Finally they have orientation with a proficient nurse who has more than 7 years of experience and novice nurses are able to see how they provide a holistic and have a more grasp and how they are proficient in clinical judgment and decision making and they take full load of patients like other nurses .After starting this residency program, there have been fewer turnovers for new nurses as they have mentors and also they have three different nurses to help them once they complete their residency.
They also meet every two weeks to meet with the manager and unit educators to discuss their progress. Preceptors and the new novice nurses also have debriefing sessions. Charge nurses also help with assignments and unit supervisors help with scheduling. Preceptors are recognized for spending their time and their commitment, precepting new nurses is an activity that can be included for clinical ladder. Good communications between leadership, education department, preceptors and new nurses have helped in the success of this nurse orientation program. Physicians were also involved as they have taken initiatives in teaching some classes for the new residents. For stimulating nurses and to help with professional practice model, nursing clinical advancement programs are also utilized. It is similar to the program that is used in many hospitals nationwide .In order to improve quality of patient care outcomes, and to attract, retain competent nurses, nursing clinical advancement (NCAP) is in progress in many facilities. Benner’s ideas in Novice to expert provides theoretical framework and descriptive titles used for five clinician levels and are used for professional engagement in practice and leadership. All nurses who have completed two years of nursing is allowed to participate in NCAP program.
That also helps nurses to engage in various activities and councils and they willingly participate not only for monetary benefits, but also for professional recognition. Nurses have several opportunities to participate including clinical, research and educational opportunities and also while volunteering in the community. All these activities are taken into consideration and nurses have to put a portfolio together along with a clinical exemplar. Professional practice committee and NCAP committee meets every month and reviews their portfolio with letters of recommendation from peers and from managers and award nurse’s different levels according to their work. Nurses are given different levels according to their years of experience and their contributions and participation in various hospital activities such as participation in various committees, their certifications they hold in different specialties. This also gives nurses a voice in decision making and participation in various hospital committees.
Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407 Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley Sorrentino, P. (2013). Preceptor:Blueprint for successful orientation outcomes. Emergency nurses association, 83-90. McEwen, M., & Wills, E. (2014). 3. In Theoretical Basis for nursing (4th Ed.). Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkins