Novice: The First Stage on Your Journey

May 17, 2009 02:10 PM

by VickyRN

Staff

Updated May 27, 2009 at 02:43 PM by VickyRN

The novice stage - we've all experienced it. It's a time of stretching and rapid personal and professional growth.

The stretching can be humbling and painful, as shortcomings in our performance are inevitable. If we learn from our mistakes, however, we will eventually grow to proficiency in our newly chosen role. This brings to mind a saying, “To live is to grow, and to grow is to change.” If we are not experiencing any changes, then we are not growing. Growth and development are a necessary part of life.

Patricia Benner identifies five levels of skill acquisition and critical judgment in nursing practice: novice, advanced beginner, competent, proficient, and expert. Benner believes that experiential learning is essential for progression in the long trek from the novice stage to clinical expertise. In other words, the only way to grow in competency is by “doing” on the job. Book learning isn’t enough – to eventually become an expert, we need to apply all that knowledge in the tumultuous practice environment.

The novice stage is characterized by lack of experience in clinical situations. Performance is very limited and inflexible, strictly guided by rigid rules that are often indiscriminately applied. Novice nurses are task-oriented as they focus on a “to do” list, such as baths, vital signs, the head-to-toe assessment, and documentation. What is lacking is the element of critical thinking – the “whys” behind all the tasks, as well as proper prioritization, recognition of abnormalities, and determining effective interventions. This immaturity is not a bad thing as it is a necessary and expected phase in professional development. Nursing students just starting in the nursing program are at this stage.

The advanced beginner, the next level, demonstrates minimally acceptable competence. This practitioner has undergone enough real-life situations to recognize recurring components of care. The patterning from prior similar experiences enables the advanced beginner to make basic clinical judgments and formulate principles to guide actions. Advanced beginners need mentoring and assistance in setting priorities. The new nurse graduate in his or her first job is at this stage.

The competent nurse is able to efficiently organize, plan, coordinate multiple care tasks, and differentiate the most important aspects of care. Competency may occur after two to three years’ experience in the same or similar practice environment. The nurse at this level is developing a long-term, holistic perspective.

The proficient practitioner perceives the overall picture in clinical situations, rather than mere pieces or parts. At this level, analytic principles, long-term goals, and a holistic view of the client are used to guide performance. Proficiency brings speed, flexibility, and a deep understanding of the nuances in a given situation. Three to five years’ worth of experience is required to develop proficiency.

At the pinnacle of practice, the expert nurse demonstrates highly skilled proficiency, lightning quick analytic problem-solving ability, recognition of important subtleties that are nearly imperceptible to a novice or advanced beginner, and uncanny intuition in varied situations. The expert operates from an enormous well of experience, is fluid and flexible, and right “on target” in performance.

The novice stage begins afresh each time we start something new in our nursing career. Starting again is challenging, to say the least. Being an expert in one area does not automatically transfer to another area. Our confidence and self-esteem suffer, as our extensive background of experience is no longer valid in a new practice paradigm. Many items must be “unlearnt” as we assimilate entirely new ways. Decisions require much more time and deliberation. We become dependent on others once again for wisdom and guidance.

Seven years ago, my professional career took a completely new direction, as I made the decision to become a nurse educator. The first year in this new role, especially, was difficult. There were many painful ordeals and obstacles to overcome. I stumbled and almost didn’t make it through my second semester of teaching. However, I persevered and am now enjoying the fruits of a very rewarding career change.

What advice, then, do I offer the novice? First, find a supportive environment in which to launch your nursing career or new nursing venture. This is vitally important. Then, pursue your dream like a bulldog with grit and determination. You must be persistent as you embark on this new road. Finally, show initiative. Take advantage of every learning opportunity, as these are the stepping-stones to expertise. Experiences, even the negative ones, are treasures, if we make the effort to learn from them.

Enjoy this stage or season of your life, as many valuable memories are made. I wish you much success in your journey!

References

Benner, P. (1984). From novice to expert. Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley Nursing.

Benner's Stages of Clinical Competence

Novice to Expert: Through the Stages to Success in Nursing

ngiguere · May 27, 2009, 02:00 PM