Experience counts! Novice to Expert

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How have your skills matured with experience?

I remember a telemetry patient who suddenly became confused and combative. The new grad orientee who had worked as a nursing assistant for years first thought was to restrain him. An LVN wanted to sedate him. The assigned RN knew immediately the patient was hypoxic and treated the flash pulmonary edema preventing a code blue.

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Pat Benner has documented the development of clinical expertise through experience.

From Novice to Expert: Excellence and Power in Clinical Nursing Practice

by Patricia Benner

http://www.amazon.com/gp/product/0130325228/qid=1150260261/sr=2-1/ref=pd_bbs_b_2_1/104-9946786-0562337?s=books&v=glance&n=283155

http://www.powells.com/biblio/65-0130325228-0

Expertise in Nursing Practice: Caring, Clinical Judgement and Ethics by Patricia E. Benner

http://www.powells.com/biblio/73-082618703x-0

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My supervisor gave me a copy of that book when I passed my CCRN exam in 1989.

Sadly, nobody seems to think my experience is worth two cents right now. Oh, well.

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Specializes in Trauma, ER, ICU~CCRN,CNRN.
My supervisor gave me a copy of that book when I passed my CCRN exam in 1989.

Sadly, nobody seems to think my experience is worth two cents right now. Oh, well.

Catlady..you are so right. Got my CCRN a couple years ago and it doesn't seem to matter to anyone but me!~

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Specializes in Surgical/Telemetry.

As a new nurse, I really respect the experience and extra credentials of the nurses that I work with and am very glad that they are there for the patients. I do understand that many nurses feel that they are not fairly compensated for experience and credentials, and this is understandably frustrating.

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Specializes in Nurse Scientist-Research.

I noticed when I was a new nurse that everytime my shift got a new charge nurse (and typically the new charge had fewer years experience than the previous one) we would have an upswing in our Code Blue's. I attibuted this to the fact that the more experienced charge nurses would round early and could "sense" problems and get on the stick with the MD, get interventions or transfer to ICU for unstable patients.

I also remember as a novice nurse making walking rounds with the day nurse. She commented on exiting the room that the patient had a really bad "heart" color. There were no other signs/symptoms; pt reported no distress (was enjoying her breakfast, reading a paper and greeted us cheerfully), all vitals stable and within her baseline, telemetry rhythm unchanged. I reiterated all this to the new day nurse (who wasn't being picky, she was actually a friend).

That patient coded and died on her shift; sudden overwhelming MI. I'm not sure experience could have saved her but that day nurse knew something wasn't right with the patient.

In the NICU knowing how a "sick" baby acts vs a well baby means about as much as objective data. I've had several infants that didn't have any reportable data but I've known they were sick. Eventually the objective data will show they really are sick (bad CBC, bloody stool/residual). And nothing really teaches you how a "sick" baby acts except for a couple years experience.

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Specializes in Almost everywhere.

I really think experience makes a difference and I have been fortunate in my career to experience many things. I wouldn't trade it for anything and I am hoping that it will all help me as I further my education. My intuition is pretty sharp...took years of honing! :wink2:

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