Benners Novice to Expert Theory Discussion

Provide positive feedback to this post with one paragraph per post Use and cite proper APA references.

Anthony: Advanced nursing practice has many roles and opportunities, such as Certified Registered Nurse Anesthetist, Nurse Practitioner, and Clinical Nurse Specialist. A theory that an advanced nurse may consider is Benner’s novice-to-expert theory. Depending on previous experiences and exposures, as a registered nurse moves into the role of advanced nurse practice, they are moving through this theory of novice to expert. Benner’s theory states that nurses move from novice to expert in stages based on their education and experiences (Sterner et al.,2021). This movement is not always linear, and the fact that the nurse starts as a novice or advanced beginner and then chooses to move into an advanced nurse practice as an expert seems to make perfect sense for those interested in that growth (Kerr & Macaskill, 2020). The advanced practice nurse may start in their new role as a novice or advanced beginner, especially if it is a new specialty. However, since the role is different from the scope of practice of the registered nurse, there will be a time of learning and becoming more competent as an advanced nurse, as described in Benner’s theory.

There is a current healthcare issue in the hospital setting. It is regarding the disproportionate number of novice and beginner nurses to expert nurses at the bedside. Due to the pandemic, there has been a large migration of expert nurses away from the bedside. This has left a massive void of knowledge, experience, and competency in acute situations at the bedside. The novice nurse needs experience and exposure to these critical events to know how to respond or what to expect. Unfortunately, some of the preceptors are also novices or sometimes an advanced beginner themselves, so the training is limited to their knowledge and experience. As clinical educators, we have our work cut out for us in the hospital right now. I think Benner’s theory explains the movement from novice to expert well. It reminds us in an advanced practice role to think of ways to help novice nurses advance with exposure to grow their clinical judgment. One effective way is the use of high-fidelity simulation in scenarios that are emergencies at the bedside. This allows the nurses to work through these situations in a safe, realistic environment (Sterner et al., 2021). Clinical nurse specialists are invaluable in hospitals to help fill knowledge and experience gaps for this novice workforce.

References

Kerr, L., & Macaskill, A. (2020). The journey from nurse to advanced nurse practitioner: applying concepts of role transitioning. British journal of nursing, 29(10), 561–565.

Sterner, A., Ramstrand, N., Palmér, L., & Hagiwara, M. A. (2021). A study of factors that predict novice nurses’ perceived ability to provide care in acute situations. Nursing Open, 8(4), 1958-1969.

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Hannah: Middle range theory can be defined as a theory that helps guide nursing interventions to increase the healthcare outcome by enhancing the care given. The theory is developed by defining what health concern is going on with the patient, why it happened, how it happened and how we can diagnose and treat it. Conti O’Hare’s theory was based off ethics and beneficence. She viewed patients and family members as equal partners in the patient’s healthcare outcome Im, E. O. (2021).

I intend to practice using the guidelines of current data produced from EBP. I do not feel as though I would be successful with research or development that correlates with other theories in this field. I intend to go into a family practice setting and treat patients with the most up to date information. I feel that the middle range theories such as Conti O’Hare’s will be useful in how I help provide care to patients. Improving health outcomes is not only based off how much knowledge I have or what treatments are given but also with the patient being compliant with their part of treatment as well.

One healthcare issue that came to my mind is access to care. There is a large population in the world that either is uninsured or has Medicaid insurance, underinsured. I have seen many times patients struggle to get access to care, medications, procedures etc. due to insurance coverage. Unfortunately, many practices do not accept Medicaid patient panels due to the small reimbursement fees. While I understand the financial aspect of this, it is still the patient who suffers. I work for a clinic where 90% of our patient population has Medicaid. We never turn anyone away from being seen for their inability to pay. The problem in our clinic is the lack of providers and nursing staff. We have such a huge patient population that sometimes we struggle to see patients in the timeframes that insurance says we should.

The middle range theory that I selected can be applied to the healthcare problem mentioned above by providing access to care. The theory aims to provide better health outcomes. When patients have better access to care their healthcare outcomes improve. For example, diabetes management. If glucose levels are controlled by compliance with medication regimens and regular check-ups to the provider, it helps prevent other comorbidities associated with diabetes Nowakowska, M, et al., (2019).

Reference

Im, E. O. (2021). Different types of theories by level of abstraction in nursing: A discussion paper. Research and Theory for Nursing Practice, 35(1), 50-66. DOI: 10.1891/RTNP-D-20-00038

Nowakowska, M, et al., (2019). The comorbidity burden of type 2 diabetes mellitus: patterns, clusters and predictions from a large English primary care cohort. BMC medicine, 17(1), 145. https://doi.org/10.1186/s12916-019-1373-y.

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Jose: A perfect theory that will be applied in advanced nursing practice is Dorothea Orem’s Self-Care Deficit Theory. This theory postulates that people have a natural ability for self-care, and nursing should focus on helping individuals meet their self-care needs. Probably, one of the attractions Orem’s theories has for many nurses is its utility in practice. This is highly evident in the writings of Kinlein (1977, pp. 1-195) and Bromley (1980). As a future nurse practitioner, the importance of Orem’s theory to the practice I am pursuing is highly significant. It accentuates the importance of patient education and empowerment, which lines up with my objective of encouraging patient autonomy and self-management, mainly in chronic disease supervision.

A current healthcare matter is the incorrect control of hypertension, patients with this condition without responsible care of it makes it prevalent and leading to other diseases such a cerebral vascular accident, heart attacks, kidney problems, aneurysms, dementia, heart failure, among others. Patients with this condition constantly come back to their medical doctors or NPs with aggravated condition due to lack of responsibility and bad decisions on illegal drugs, tobacco, alcohol consumption, high sodium and saturated fat diet, and not proper monitoring on medication, among other issues.

Orem’s Self-Care Deficit Theory can be applied to take care this issue. According to the theory, nurses should assess patients’ ability to perform self-care and identify any deficits. For patients with chronic diseases, this could require evaluation of their knowledge about their condition, their ability to follow medication administration, and their skills in lifestyle changes such as diet and exercise. Nurses can give education and support to improve patients’ self-care abilities, by that means promoting better disease management and health outcomes. According to Orem’s self-care model, the client’s power of agency is impaired, in the sense that the patients are not able to manage all their self-care needs because of multiple deviations in their health state. To compensate for the self-care deficits experienced by these clients, the nurse enters into a collaborative relationship with the patients to identify their assets and deficits and determine the therapeutic self -care demands brought about by changes in their developmental needs as well as changes in their health state (Orem, 1980).

References

Bromley, B. (1980). Applying Orem’s self-care theory in enterostomal therapy. American Journal of Nursing, 80(2), 245-250.

Kinlein, M. L. (1977). Independent nursing practice with clients. New York: J.B. Lippincott Company.

Orem, D.E. (1980). Nursing: concepts of practice (2nd ed.). New York: McGraw-Hill Book Company.