advanced practice developed because practicing rn's had a thirst to learn more about nursing and healthcare and could see ways that their expertise could be used in a different way to help patients. they "kicked it up a notch" and roles of nurse practioner's, clinical nurse specialists and nurse midwives developed.
how do you really know what area of advance practice will interest you and will keep you satisfied if you not been exposed to varrious nursing postions?
so many students say " i want to be a mom-baby nurse...want to work icu...want to do oncology, but when they get that first job find out they dislike position, not what they thought etc and switch to another postion which they find satisfying. as moderator here, i see many posters wanting to skip that first step, go to the top then are frustrated and going back to school as "not what they expected".
all new grads from any educational program are novices.
having the solid knowledge of rn + experience one has moved away from beginning practioner towards expert level. there are so many situtations using critical thinking and problem solving skills one has engaged in with at least a year of practice that one can get if they've never been exposed to beginning practive. advanced practice is meant to add another layer of skills.
from benner's stages of clinical competence
beginners have had no experience of the situations in which they are expected to perform. novices are taught rules to help them perform. the rules are context-free and independent of specific cases; hence the rules tend to be applied universally. the rule-governed behavior typical of the novice is extremely limited and inflexible. as such, novices have no "life experience" in the application of rules.
- stage 2: advanced beginner
advanced beginners are those who can demonstrate marginally acceptable performance, those who have coped with enough real situations to note, or to have pointed out to them by a mentor, the recurring meaningful situational components. these components require prior experience in actual situations for recognition. principles to guide actions begin to be formulated. the principles are based on experience.
competence, typified by the nurse who has been on the job in the same or similar situations two or three years
, develops when the nurse begins to see his or her actions in terms of long-range goals or plans of which he or she is consciously aware. for the competent nurse, a plan establishes a perspective, and the plan is based on considerable conscious, abstract, analytic contemplation of the problem. the conscious, deliberate planning that is characteristic of this skill level helps achieve efficiency and organization. ... the competent person does not yet have enough experience to recognize a situation in terms of an overall picture or in terms of which aspects are most salient, most important..
the proficient performer perceives situations as wholes rather than in terms of chopped up parts or aspects, and performance is guided by maxims. proficient nurses understand a situation as a whole because they perceive its meaning in terms of long-term goals. the proficient nurse learns from experience what typical events to expect in a given situation and how plans need to be modified in response to these events. the proficient nurse can now recognize when the expected normal picture does not materialize...
this is why i and most mod team members here feel strongly that at least a year of nursing experience is so important before embarking on higher level practice.