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Where was Benner born?

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Hampton, Virginia

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Where did Benner earn her Bachelor's degree in Nursing?

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Pasadena College (1964)

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Where did Benner earn her Master's degree in Medical Surgical Nursing?

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University of California, San Francisco

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Where did Benner earn her PhD?

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University of California, Berkeley

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What was Benner the first occupant of?

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Thelma Shobe Cook Endowed Chair in Ethics and Spirituality

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What did Benner lecture on?

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Health, stress and coping, skill acquisition and ethics

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Which nursing theorist was Benner influenced greatly by?

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Virginia Henderson

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> "Enabling condition of connection and concern" > Shows a high level of emotional involvement in the nurse-client relationship

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Nursing (Metaparadigm I)

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The care and study of the lived experience of heath, illness and disease and the relationships among these three elements.

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Nursing Practice

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> "A self-interpreting being, that is, the [] does not come into the world predefined but gets defined in the course of living a life." > "A [] also has an effortless and non-reflective understanding of the self in the world." > "The [] is viewed as a participant in common meanings."

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Person (Metaparadigm II)

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The significant major aspects that make up a person/a person must deal with.

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The role of the situation The role of the body The role of personal concerns The role of temporality

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> "On the lived experience of being healthy and ill." > What can be assessed > Described as not just the absence of disease and illness > A person may have a disease and not experience illness because illness is the human experience of loss or dysfunction > Disease is what can be assessed at a physical level

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Health (Metaparadigm III)

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> The human experience of health or wholeness > ___________ and being ill are recognized as different ways of being in the world

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Well-being

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> Benner uses "SITUATION" instead > It suggests a social environment with social definition and meaning > of BEING SITUATED and SITUATED MEANING which are defined by the person's engaged interaction, interpretation and understanding of the situation

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Environment

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Stage of skill acquisition describes that the person has no background experience of the situation in which he or she is involved. > Includes context free rules and objective attributes must be given > Has difficulty discriminating between relevant and irrelevant aspects of situation > Nursing students belong here

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Novice

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Stage of skill acquisition in which the nurse has a sufficient experience to easily understand aspects of the situation. > Aspects cannot be objectified completely because they require experience based on recognition in the background of the situation > A challenge of the nurse's abilities

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Advanced Beginner

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Stage of skill acquisition that considers consistency, predictability, and time management as essential components. This sense of mastery is acquired through PLANNING and PREDICTABILITY > An increase level of efficiency is evident > Time management and nurse's organization of the task are more important rather than on timing > Nurse may display more responsibility for the patient > Most essential in clinical learning > The learner must know how to recognize patterns and identify which element of the situation needs attention

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Competent

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Stage of skill acquisition where the performer perceives the situation as a whole rather in terms of aspects and performance is guided by maxims. > A qualitative leap beyond the competent > Performer identifies the most significant aspects and has a better understanding of the situation based on background understanding > Responds to the situation as it changes > No longer rely on preset goals for organization > Transition into expertise

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Proficient

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Stage of skill acquisition that is accomplished when the expert performer no longer relies on analytical principles like rules, guidelines and maxims to connect his/her understanding of the situation to an appropriate action. > Possessing an intuitive grasp of the problem > No loss of time considering range of alternative diagnosis and solutions > There is a qualitative change as the performer "knows the patient" > Knows typical patterns of responses and knowing the patient as a person

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Expert

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The seven domains of nursing practice

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> Helping role > Teaching/coaching function > Diagnostic client-monitoring function > Effective management of rapidly changing situations > Administering and monitoring therapeutic interventions and regimens > Monitoring and ensuring quality of health care practices > Organizational and work-role competencies

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This includes competencies related to: > Establishing a healing relationship > Providing comfort measures > Inviting active patient participation and control in care

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Helping Role Domain

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This includes: > Timing > Readying patients for learning > Motivating change > Assisting with lifestyle alterations > Negotiating agreement on goals

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Teaching-Coaching Function Domain

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This refers to competencies in ongoing assessment and anticipation of outcomes

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Diagnostic and Patient-Monitoring Function Domain

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This includes: > The ability to contingently match demands with resources > To assess and manage care during crisis situation

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Effective Management of Rapidly Changing Situations Domain

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This includes competencies related to preventing complications during drug therapy, wound management and hospitalization

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Administering and Monitoring Therapeutic Interventions and Regimens Domain

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This includes competencies with regard to: > Maintenance of safety > Continuous quality improvement > Collaborative and consultation with physicians > Self-evaluation > Management of technology

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Monitoring and Ensuring the Quality of Health Care Practices Domain

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This includes competencies in priority setting, team building, coordinating and providing for continuity.

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Organizational and Work-Role Competencies Domain

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Perceptual, recognitional clinical judgement that refers to accurate detection of minute alteration that cannot be qualifies and that are often context dependent. Ex: > Discrete alterations in skin color > Meaning of changes in mood > Different manifestations of anxiety

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Qualitative Distinctions

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Cryptic statements that guide actions and require deep situational understanding to make sense. Ex: > When you hear hoof beats, you automatically think about horses and not zebras > Follow the body's lead

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Maxims

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Often take for granted, tacit beliefs that something is true

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Assumptions

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Notions that something can be reasonably anticipated following a certain scenario

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Expectations

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Inclination or tendencies to respond to anticipated situations

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Sets

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Shared, taken for granted, background knowledge of a cultural group that is transmitted in implicit ways

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Common Meanings

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Clinical experiences that stand out in one's memory as having made a significant impacts on the nurse's future practice and profoundly alter perceptions and future understanding.

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Paradigm Causes

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Robust clinical examples that convey more than one intent, meaning or outcome and can be readily translated to other clinical situations that maybe quite different. Might constitute a paradigm case for a nurse depending on its impact on personal knowledge and future practice

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Exemplars

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Knowledge that develops as the practice of nursing expands into new areas

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Unplanned Practices

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Practical reasoning in an ongoing clinical situation

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Reasoning in Transition

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Embodied intelligent performance which involves knowing what to do, when to do it and how to do it

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Skilled Know-How

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Adapting interventions to meet changing needs and expectations of patients

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Response-Based Practice

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One's sense of and ability to act upon or influence a situation

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Agency

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Ability to tune into a situation and hone in on the salient issues by engaging with the problem(s) and the person(s)

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Perceptual Acuity and Involvement

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Understanding of good clinical practice cannot be separated from ethical notions of good outcomes for patients and families

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Links between Clinical and Ethical Reasoning

Nursing Theorist: Patricia Benner (From Novice to Expert) – Flashcards

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