The Philosophy Of Nursing And Development Of Knowledge In The Profession

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Throughout my journey of becoming a nurse, I have started to develop my personal philosophy of what nursing is. My philosophy views nursing as a way of healing others, caring for others, respecting others and treating others the way you would want to be treated. I believe that we learn from our mistakes. Each mistake is a learning experience which helps us become a better nurse. In my opinion, nursing is both an art and science. To me the art of nursing involves both the patient and the family. A collaborative approach helps the patient to recover faster. I believe nursing is about knowing how to connect with those around us through caring and compassion in order to provide a healing environment for our patient. Nursing is also a science. As nurses we are taught the theories and the scientific knowledge in order to understand a patient's disease process, medication needs and aids us individualized nursing care. There is so much that I have already encountered as a nursing student and still have a whole lot more to learn. But one thing that has always stayed with me is my ability to heal and respect everyone. I always walk into my patients room with a smile. A smile makes a big difference. My philosophy views nursing as a way of healing through trust and empathy. I am able to view the patient as a whole and not just a set of signs and symptoms or as a disease. I don’t just give medications and leave. I talk with the patient and help them in all possible ways I can. As nurses we heal by using therapeutic touch, active listening, being present in the moment and instilling hope. I believe that I have learned just a bit and there is a lot more to learn. Each day and each patient is a new learning experience for me. As I continue my journey in becoming a nurse I will continue to learn new knowledge and grow from my experiences. These values and beliefs are what built on my personal philosophy of nursing.

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Patricia Benner is a nursing theorist, a nursing educator and an author. She was born on August 31, 1942. She is best known for her book From Novice To Expert: Excellence and Power in Clinical Nursing Practice (1984). She is the first nursing theorist to develop a model for the stages of clinical competence. Her nursing theory proposes that expert nurses develop skills and understanding of patient care through a proper educational background as well as a multitude of experiences. Dr. Benner’s theory was basically focused on how nurses acquire nursing knowledge and not how to be a nurse. She believed that one could gain knowledge and skills without ever learning the theory. “Knowing how” is the concept of personal (concrete) experience and “knowing that” is the concept of abstract principles. The theory consists of five phases which build on each other as the nurse refines and expands learned theories and develops clinical expertise through gained experiences. Dr. Benner used the Dreyfus Model of Skill Acquisition as a foundation of her work. The Dreyfus model describes how individuals progress through various levels in their acquisition of skills and subsumes ideas with regard to how individuals learn. The Dreyfus brothers- Stuart and Hubert believed that learning was experimental (learning through experiences) as well as situation-based, and that a student had to pass through five very distinct stages in learning-novice to expert. Dr. Benner found nursing to be similar to this, where improved practice depended on experience and science, and developing those skills was a long and progressive process. She found out that when nurses were involved in various situations, they learned from the situations and they developed “skills of involvement” with patients and family. The five stages of clinical competence according to Dr. Benner include the following:

  1. Novice: This would be a nursing student in his or her first year of clinical education. According to Dr. Benner, novices have a very limited ability to predict what might happen in a particular patient situation. A novice nurse has an incomplete understanding, approaches tasks mechanically and needs supervision to complete them.
  2. Advanced Beginner: This would be the newly graduated nurses in their first jobs. They have had more experiences that enable them to recognize recurrent, meaningful components of a situation. Advanced beginners have a working understanding and tend to see actions as a series of steps. They can complete simpler tasks without supervision.
  3. Competent: These nurses have a good working and background understanding, sees actions at least partly in context and is able to complete work independently to a standard that is acceptable though it may lack refinement. These nurses lack the speed and flexibility of proficient nurses but have some mastery.
  4. Proficient: At this level, the nurse has a deep understanding, sees actions holistically and can achieve a high standard routinely.
  5. Expert: These nurses are able to see recognize demands and resources in situations and attain their goals. They know what needs to be done. They have an authoritative or deep holistic understanding, deals with routine matters intuitively and is able to go beyond existing interpretations. They are able to achieve excellence with ease.

This is Patricia Benner’s nursing theory and I believe that each step builds from the previous one as we gain knowledge from experience. According to Dr. Benner, beginner nurses focus on tasks and follow a “to do” list, whereas expert nurses focus on the bigger picture even when performing tasks and are able to notice subtle changes in a patient.

According to Dr. Benner’s theory, I believe I am in the novice stage beginning to advance into the advanced beginner stage. As a nursing student, I know the theory; signs and symptoms of certain diseases, but I am just learning on applying it to real life symptoms. I agree with Dr. Benner on how expert nurses develop skills and understanding patient care over time and experience. Like I said before, I believe that we all learn from mistakes. Just like that, Dr. Benner says that we learn from our experiences. It takes years to become an expert nurse, but with hard work and experience, I hope that one day I will also become an expert nurse.   

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