1.

Introduction
Becoming a nurse is like a dream come true for me as I always wanted to be a nurse and

as I undergo all the training together with my several years of working in this noble profession, I
began to realize that nursing is absolutely a unique profession and also a professional career. No
one could be a nurse without a proper training and this set us, the nurse, apart from other
profession in this world. Nursing is exceptional profession whereby the experiences gain by the
practitioner is the most significant factor to ones nurse growth and also their knowledge
development. A successful nurse will learn more based on his or her experiences compare to any
imparted knowledge and these experiences have become their sole weapon in becoming more
exclusive nurse that one could offer.
By using all the experiences, a good nurse will build a concrete knowledge of this
profession. The nurse will also experience the personal growth to occupy the needs in this work
force. Born in Hampton, Virginia, on August 1942, Dr. Patricia Benner, a renowned philosopher
as she introduced a well-known nursing theory: From Novice to Expert: Excellence and Power
in Clinical Nursing Practice (Sunkes, 2010). From the theory Benner mentioned that based on
her study in the nursing area, she believed that experiences gain by the nurse will depict the
unique characteristics and also the knowledge embedded by the nurse. Now, the theory is widely
used to enhance the knowledge on the development, professional growth and also innovative
changed within the nursing profession (Sunkes, 2010).
Thus this paper will discuss more on the theory proposed by Dr. Patrica Benner and also
use the theory to relate with my own experiences and also growth of becoming a nurse. I will
also explain more about Dr.Patricia Benner and her theory and also depict the unique of the
theory proposed by her and point out some similar attributes as well as the influence of the
theory in my nursing profession. The main purpose of this paper is to reflect and also to
determine both my nursing experiences and also knowledge are based on the theory suggested by
Dr.Patricia Benner. I will reflect on my knowledge, personal growth and also my professional
attribute grounded by the theory.

2.0

Nurse Theorist: Patricia Benner

2.1

The Life of Patricia Benner

I.

Early Life of Patricia Benner

Patricia Benner was a middle child to a happy couple; Shirley and Clint Sawyer and she
has two sisters. Patricia was born in August 1942 in Hampton, Virginia and towards in her
teenager years, her parents moved to California. In California, Patricia and her two sisters
completed their middle school and when she was in her high school, her parents get divorced.
During this time, Patricia and also her two sisters were having difficult time and this somehow
has affected her life (Sitzman, 2011). Patricia has developed her interest in nursing profession
when she was a clerk at a local hospital while she was studying in college. She began taking a
like to nursing when she was admitting the local hospital and this has changed her view on
nursing work force.
Patricia then met her soul mate, Richard Benner and married him in August, 1967. They
were blessed with two beautiful children, that is a son born in the year 1973 and a daughter
afterwards that was born in the year 1981. Benner and her husband then worked together to
create clinical practice development models (CPDMs); then the two love birds travelled together
to different hospitals across the world consulting with nurses in regards to CPDMs (Brykczynski,
2010).
II.

Patricia Benners Educational Background

Patricia Benner has a wonderful educational background as she first started her college
years in Pasadena College. But as soon that she realised that she wanted to study nursing, she
then transferred to Pasadena City College because in Pasadena College, there was no nursing
major offered in that college (Sitzman, 2011). In the year 1964, she finally received both her
associates of art in nursing from Pasadena City College and a baccalaureate of art from Pasadena
College. Patricia Benner did not stop her quest for knowledge and went continuing her study in
education and she received a masters degree in nursing with an emphasis in medical-surgical
nursing from the University of California, San Francisco (UCSF) in the year 1970. Later on in

the year 1982, she then completed her PhD in stress, coping and health at University of
California, Berkeley (Sunkes, 2010).
III.

Patricia Benners Achievements

According to Sunkes (2010), Patricia Benner has a wide range of clinical work
experiences that includes;
i.
ii.
iii.

Acute medical-surgical nursing

Critical care
Home health care

In UCSF, Banner used to work as a post graduate nurse researcher at the school of nursing in that
college. Meanwhile in Berkeley, she also worked as research assistant for Richard Lazarus, the
person that Benner regards on influencing her stress and coping theory development
(Brykczynski, 2010). During her master and doctoral years, Benner had taught for several years
and she retired from full teaching in the year 2008.
Patricia Benner has astonishing accomplishments in her life. She has written several
books, included her most widely known book that is From Novice to Expert: Promoting
Excellence and Power in Clinical Nursing Practice (Sunkes, 2010). Due to her delightful
achievements, Benner has received numerous awards and honours for her work in nursing. Some
of her awards are the Linda Richards Award for Leadership in Education in year 1989 and also
Excellence in Nursing Research/Education in year 1990 (Sunkes, 2010). Besides all of her
achievements and also awards bestowed to her, she is a noted researcher and lecturer on health,
stress and coping, skill acquisition and ethnics morality. Patricia Benner has recently elected
into the honorary fellow of the Royal College of Nursing for her influential research; which
provides the basis for new legislation and design for nursing practice and education for three
states in Australia (Sunkes, 2010).

3.0

Patricia Benners Renown Nursing Theory

3.1

The Theory

Patricia Benner has develop a famous theory in nursing profession after she published the
book From Novice to Expert: Promoting Excellence and Power in Clinical Nursing Practice
in the year 1894. In the theory she believed that overtime, nurses will develop skills and
knowledge through sound education and experiences. Within this theory, Patricia Benner
believed that one could gain knowledge and also skills that is knowing how without having
ever learning the theory that suggest knowing that (Miller, 2013). This nursing theory
proposed by Patricia Benner suggested that expert nurses develop skills and understanding of
their patient care over time through proper educational background and as well as multitude
experiences. According to Miller (2013), she used the Dreyfus Model Skill Acquisition as a
foundation for her work. This Dreyfus Model, was described by Brothers Stuart and Hubert
Dreyfus, is actually a model based on the observations of chess players, Air Force pilots, army
commanders and also tank drivers. Based on the observation, these two brothers believed that
learning was experiential that is learning experience, as well as situation-based, and that a
student had to pass through the five very distinct stages in learning that is from novice to expert
(Sitzman, 2011).
After looking at this theory proposed by Dreyfus Brother, Dr. Patricia Benner found the
similar parallels in nursing. She found that improved practice depended on experience and
science, and in way to develop skills was a long and progressive process. Patricia Benner also
discovered that when a nurse is engaged in various situations, and learned from them, they
developed skills of involvement with their patients and family (Miller, 2013). Looking at
Patricia Benners model, her model is also relevant for ethical development of nurses since
perception of ethical issues is also dependent on the nurses level of expertise. Patricia Benners
model has been applied to several disciplines beyond clinical nursing, and understanding the five
stages of clinical competence helps nurses support one another and then appreciate that expertise
in any field is a process learned over time (Sitzman, 2011).

3.2

Description of Theory: Novice to Expert

According to Sunkes (2010), Patricia Benners novice to expert theory is a theory of skill
acquisition. In this theory, Banner poses that developing nursing skills through situational
experiences is a prerequisite for expertise (Nursing Theory, 2011). As Banner adapted the
Dreyfus Model of Skill Acquisition to nursing practice, she has identified five levels of
proficiency. The levels are as follow:
i.
ii.
iii.
iv.
v.

Novice
Advanced beginner
Competent
Proficient
Expert

Miller (2013), added that the model also assert that as an individual progress through these
levels, changes are reflected in three aspects of skill performance. They are:
1. The individual moves from dependency on abstract principles to the use of concrete experience.
2. There is a change in the individuals perception of the situation; the situation is seen less as separate,
equal pieces and more as whole where only certain pieces are pertinent.
3. The individual changes from an observer of the situation to an involved performer.

(Miller, 2013)
A. Novice
According to Benner (1984), novice can be defined as a beginner with no
experience of the situation in which they are expected to perform. Thus, in order
to perform for the novice nurse to develop the skills, the nurse must be put into
new clinical situations. Benner (1984) also stated that novice nurses must be
taught about a patients condition in objective and also measureable parameters.
This is done so the novice can recognise the features of the patients condition
without any situational experiences. Sitzman (2010), also added that novice nurse
in practice is very limited and inflexible. They are utilizing to the straight rules to
govern practice because they have limited to no clinical experience. Therefore,
because of this inflexibility and rule based practice, the novice nurse cannot

separate out the relevant pieces of the situation; instead all pieces are seen as
equal. This novice nurse will act in a manner of tell me what I need to do and I
will do it (Nursing Theories, 2011).
B. Advanced Beginner
Advanced beginner is the next level of skill acquisition. In this level, Benner
stated that advance beginner as a nurse that is:
who can demonstrate marginally acceptable performance, one who have
coped with enough real situation to note the recurring meaningful situational
components that are termed aspects of the situation
(Dreyfus Model, 1984)
Based on the Nursing Theories (2011), the advanced beginners develop
principles based on the experiences and begin the use of these experiences to
guide their actions.
C. Competent
Benner (1984) claimed that a competent nurse is a nurse who has gained two
to three years of experience in the same work area or in similar day-to-day
situations. Benner also states that the competence develops when the nurse
starts to see or plan his or her actions in terms of long-range goals. The
competent nurse is unlike the novice and advanced beginner nurse, plans
actions based on the pertinent aspects of the situation instead of including all
aspects. For the competent nurse a plan establishes perspective, and the plan
is based on considerable conscious, abstract, analytic contemplation of the
problem (Benner, 1984). It is the planning, that is characteristic of this skill
level; it is what helps the competent nurse to be more efficient and organized.
D. Proficient
Miller (2013) stated that the proficient nurse perceives situations as a whole
instead of in terms of aspects. According to Benner (1984), perspective is not
thought out but presents itself based upon experience and recent events. Thus,
perception is fundamental to the proficient nurse. In this level, the nurse
understands more holistically, thus improving decision making (Nursing Theories,
2011). The proficient nurse has learned from experience typical events to expect

in a clinical situation and how plans need to be modified to response to these

events (Sitzman, 2010).

E. Expert
The next level in the skill acquisition model is the expert nurse. According to
Benner (1984), the expert nurse has a deep connection and understanding of the
situation. The expert nurse is no longer relies on analytic principle; instead they
have the expert and also an intuitive grasp of situations that is utilized to
determine actions. The performance of the expert nurse is fluid, flexible, and
highly proficient (Nursing Theories, 2011). Though the novice to the expert
theory, the expert nurse can make assumptions based on hunches, Benner
points out that the expert nurse still needs to be exceedingly skilled in the use of
analytic tools, as these tools need to be used in new situations or if the nurse gets
the wrong hunch (Sunkes, 2010).

4.0

Relation Patricia Benners Theory to Personal Nursing Experiences

4.1

Novice

As a novice or a beginner nurse, I pain careful attention to the content that what I
have learned during my nurse practice. During the time, I was intimidated if I
were left alone without being supervised by anyone or some other nurse to help
me with the patients. This condition is much more the same as me following the
given rules to determine actions on the basis features, like a computer following a

program (Expertise in Nursing Practice, n.d.). My time in this novice stage is my

first year of clinical and I have very limited ability to predict what might happen
in a particular patient situation. I can only recognize some signs and also
symptoms after I had experienced similar symptoms with other patients.

4.2

Advanced Beginner

From a beginner, then I progressed to advanced beginner after my first year in

the clinical nursing. It is believed that nursing practice as an advanced beginner is
a time of extraordinary transition in terms of knowledge, feeling comfortable in
the practice environment and self-understanding as a nurse (Miller, 2013). I am
feeling calmer in the clinical nursing setting and I do not rely too much on other
peoples help. According to Benner (1984), advanced beginner move from acting
like a nurse to the early stages of coming into their own as nurses and developing
their sense of what it is to embody the nursing role. I believed that I was coming
into my own as a nurse and feeling more confident about myself.

4.3

Competent

Then I advanced myself into competent nurse after more years in clinical nursing
environment. At this stage, I no longer solely focused on the content or depended
on any notes or help from my superior. I was able to be a better nurse as I am
more competent in recognizing patterns and nature of clinical situations more
quickly and accurately than advanced beginners stage. At this stage, I have been
a nurse with 2-3 years of experience in the nursing and I am more aware of my
long term goals.

4.4

Proficient

After being a competent nurse, I developed myself into proficient nurse. I was
able to see the situations as wholes rather than pars. The proficiency that I
gained comes from the experience on what events typically occur and I was able
to modify plans in response to different events. According to Miller (2013), this
proficient stage is a transition stage because once a nurse begins to see changing
relevance; a current clinical situation can be seen in terms of a past clinical
situation, thus enabling a higher skill of perception.

4.5

Expert

As an expert nurse, I no longer rely on the principles, rules or even guidelines to

connect situations and determine actions. Now in this stage, I have much more
background of experiences and have intuitive grasp of clinical situations. My
performance is now more fluid, flexible and also highly-proficient. I am more
focus on the most relevant problems and not irrelevant ones.
All of these stages reflect the movement and the growth that I gain trough years in clinical
nursing. Each stage builds and helps me to become a better nurse and expanded my experience to
be a clinical expertise.

5.0

Closure

Becoming a nurse with such confidants level and also personal growth is not an easy task as the
nurse to become better clinical nursing practitioner. Reflection and experience gain from every
clinical situation is an opportunity for a nurse to learn and also help them to find a better
understanding of them. This will assist them to improve on patient care outcomes and use that to
build up their confidence to facilitate them to be an expert nurse in the future.

References
Benner, P. A. (1984). From novice to expert: Excellence and power in clinical nursing practice.
Menlo Park, CA: Addison-Wesley
Brykcznski, K. A. (2010). Benners philosophy in nursing practice. In M. R. Alligood (4th Ed.),
Nursing theory: Utilization and application (pp. 137-159). Heights, MO: Mosby Elsevier

Miller, J. (2013). Guide for reflection using the clinical judgement. Cambridge: London
Nursing Theorists (2011, September 16). From novice to expert: Patricia E. Benner. Retrieved
September 28, 2011, from http://currentnursing.com/nursing_theory/Patricia_Benner
_From_Novice_to_Exp ert.html
Sunkes. J.K. (2010). Nursing theory: utilization and application. Mosby Comp: Illinois
Sitzman, H. (2010) in Brykcznski, K. A. (2010). Benners philosophy in nursing practice
In M. R. Alligood (4th ed.), nursing theory: Utilization and application (pp. 137-159)
Heights, MO: Mosby Elsevier