Identify your specialty area of professional practice.
• Select a nursing theory from the list of specialty track specific theories provided in the lesson plan or one of your own findings.
• Address the following:
briefly identify concepts of the nursing meta paradigm (remember the selected theory may not include all four concepts)
provide an example how the theory could be used to improve or evaluate the quality of practice in your specific setting.
There are four major concepts of the nursing metaparadigm are identified as a person, nursing, health and environment (Bender & Feldman, 2015).
I am a supervisor in the intensive care unit and I am taking executive track specialty. I have chosen Benner’s Novice to Expert Theory.
Benner’s theory validates the importance of shared experiences with colleagues. Nursing experience gained through practice is the impetus for advancing through the five levels of nursing skill acquisition and experience (Vergara, 2017).
Each of Benner’s five levels—from novice to expert—reflects movement from reliance on abstract nursing principles to implementing concrete experiences as paradigms for changes in perception of a situation and viewing the situation in its entirety. Each nursing level builds on the previous level, which refines abstract nursing principles and expands from experience gained in the profession (Vergara, 2017).
• The foundation of Benner’s theory is the observed growth in acquisition of nursing skills from the initial stage of novice nurse through the fifth and final stage of expert nurse. As a nurse acquires experience and skills, he or she demonstrates changes in the following three areas (Vergara, 2017).
• Transitioning from relying on abstract nursing principles to incorporating past nursing experiences that facilitate nursing actions
• Demonstrated changes in the perception of situations as a whole rather than as separate pieces. Benner uses the term “situation” rather than “environment” to describe the concepts of her theory because she believes “situation” captures the human environment (Vergara, 2017).
Recent health care reform legislation has significantly reshaped how organizations operate. This shift in priorities to increase access has had a profound impact on nursing. For example, in the acute care setting, staff satisfaction and staff retention represent 2 major issues that have consistently challenged health care leaders. Establishing and sustaining healthy work environments must become a priority for nurses to make optimal contributions to the care of patients and patients’ families.1 According to Jones,2 a 1% increase in the turnover rate can cost an organization $300,000 annually. Another looming threat is the projected shortage of nurses as more Baby Boomers retire and their health care needs intensify.3 Clearly, there is a need for effective leadership to promote professional growth and development in nursing, increase staff morale, decrease turnover rates, and improve the quality of patient care. (Vergara, 2017).
Benner’s5 “From Novice to Expert” model forms the foundation of this project. Her conceptual framework explains that nurses will evolve through different levels of development as they advance and progress through various career paths. The clinician acquires knowledge and develops skills through experiences gained from patient and colleague interactions. At any point in a person’s career, a change in nursing specialty may result in changes in a clinician’s level of expertise. The 5 stages described in the model include: novice—nurses have no experience with the situation; advanced beginner—nurses start gaining experience and recognizing concepts; competent—nurses develop long-term goals and gain holistic views of the practice; proficient—nurses start perceiving clinical situations as a whole; and expert—nurses develop an intuitive grasp and understanding of different situations and no longer simply rely on basic principles (see Benner5). Building upon this model, the mentorship program’s design can be tailored based on the continuum of practice and proficiency described by Benner (Vergara, 2017).
The early program results have shown a promising trend that supports the adoption of a formal mentorship program to address retention and staff satisfaction. The skills of the leader in utilizing new evidence, fostering collaboration with other stakeholders, and incorporating strategies have greatly contributed to the intervention success. However, the commitment of the organizational leadership and staff will ensure the success, sustainability, and future of this program. The implications of this project are such that any nursing unit, department, or organization can replicate this evidence-based practice with the guidance of a leader using proven strategies to improve staffing and nurse morale, increase the quality of care and contribute to significant savings in health care expenditures. Finally, the overall value of supporting nurses goes to the patients. Providing opportunities to support nurses fosters growth and helps develop confident, skilled, and well-prepared nurses to serve the community, thereby ensuring that the best quality of care is given to individuals and families (Vergara, 2017).