The Berners theory of nursing expertise provides significant insight into the complex interaction between nursing theory and practice. It states that there are five stages that nurses must go through for them to become experts in their given fields including the novice, advanced beginner, competence, proficiency, and expertise stage (Gobet & Chassy, 2008). According to the theory, beginners learn through instruction in the first stage and acquire domain specific facts, actions, and features. In other words, their application ignores the nuances of the situation and often result in a limited and inflexible performance. In the advanced beginners stage, individuals begin to utilize and understand the situational elements and are thus able to apply their acquired knowledge based on their previous experiences. On the other hand, the competence stage is usually characterized by an increased level of competency. However, planning is still deliberate, analytical, and conscious (Gobet & Chassy, 2008). In the proficiency stage, persons can to understand and organize situational problems intuitively, but still, require analytical skills to function appropriately. Lastly, in the expert stage, individuals act naturally without explicitly solving problems or making any concrete decisions due to their deeper understanding of the situation in question.
The Berners theory is used to evaluate the importance of intuition in nursing which is often regarded as a defining characteristic of expertise. The theory is based on previous work by Dreyfus brothers who emphasizes on the significance of intuition and a holistic perception in operating at a level of expertise (Gobet & Chassy, 2008). The authors compare the Berners theory with the Gobet and Simons theory of expertise to analyze its strengths and weakness. In this regard, they conclude that the Berners theory is too simple to account for the complex pattern of phenomena that recent research on expert intuition has uncovered. As a result, the writers recommend the Gobbet and Simons theory, which they believe provides a clear mechanism for explaining the relationship between intuitive perceptual decision-making and analytical problem-solving. On the other hand, they feel that two theories share many Rcommon features that can be adopted in designing training and education programs in nursing.
The second article entitled, Advancing the Discipline of Nursing. Nursing Science Quarterly by Mitchell (2004), provides an overview of the Watsons caring healing theory and its application in nursing. It is written by a nurse in advanced practice who illustrates how the Watson theory directs and guides her practice in caring for older persons. It also describes how the author utilizes the theory in her role as an educator and researcher. Key concepts and assumptions of the theory are explained using examples to illustrate how the nursing framework has influenced the writers advanced practice. Examples of key concepts highlighted in the text include transpersonal caring, inter-subjectivity, caring moments, and spirituality. In other words, the article emphasizes the relevance of nurse-client relationship when caring for patients, particularly, the elderly. According to the Watson caring-healing theory, the responsibility of being true to the caring and healing paradigms of nursing is to intentionally and consciously bring the transpersonal relationship into practice (Mitchell, 2004).
The third article is entitled, Watson's philosophy, science, and theory of human caring as a conceptual framework for guiding community health nursing practice. Advances in Nursing Science, and is written by Rafael (2000). It illustrates why the Watson theory is effective in guiding the community health nursing practice based on its philosophic congruence with contemporary global approaches to health promotion and community health. An overview of the theory identifies the centrality of holism, ecology, and caring, and shows how the theory has evolved over the years. In this regard, the writer feels that the theory has the potential to restore the strong nursing identity and vision established by early community health nursing leaders such as Wald and Nightingale (Rafael, 2000). Moreover, the writer refutes claims that existing nursing theories focus only on individuals and have been developed predominantly for practice within the context of disease and infirmity.
In the fourth article entitled, The lingering presence of the Nightingale legacy. Nursing science quarterly by Hegge (2011), the author evaluates Nightingales life, events, quotes, and writing, and links them to practical realities of current nursing practice. She describes how the nursing practice has evolved over the years and the role that Nightingale played in transforming it. In this regard, the writer states that Nightingale constructs were bold and broad enough to embrace diverse theories that have shaped nursing education, research, and practice (Hegge, 2011). She believes that the reforms established by Nightingale were fundamental to society as a whole including health disparities, sanitation, and recognition of human dignity, just to mention. In short, the article draws attention to Nightingale achievements and allows the reader to appreciate the role she played in transforming the nursing profession.
The last article is entitled, Nursing theory and practice: connecting the dot, and is written by Marrs & Lowry (2006). It tries to identify an effective approach to connecting the dots between nursing theory, research, and practice. In this regard, the authors recommend the implementation of an expanded conceptual- theoretical- empirical structure of nursing knowledge and a matrix process to act as a guideline in the placement of nursing information in a contextual whole. In other words, the writers feel that the CTE structure and matrix method will simplify the process of linking nursing theory, research, and practice. Additionally, nurse scholars are encouraged to consider the contributions of other nurses and challenge theories that are not sound to clarify linkages to existing nursing theoretical knowledge.
Gobet, F., & Chassy, P. (2008). Towards an alternative to Benner's theory of expert intuition in nursing: a discussion paper. International journal of nursing studies, 45(1), 129-139.
Hegge, M. J. (2011). The lingering presence of the Nightingale legacy. Nursing science quarterly, 24(2), 152-162.
Marrs, J. A., & Lowry, L. W. (2006). Nursing theory and practice: connecting the dots. Nursing Science Quarterly, 19(1), 44-50.
Mitchell, G. J. (2004). Advancing the Discipline of Nursing. Nursing Science Quarterly, 17(2), 128-128.
Rafael, A. R. F. (2000). Watson's philosophy, science, and theory of human caring as a conceptual framework for guiding community health nursing practice. Advances in Nursing Science, 23(2), 34-49.
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