Although many experienced nurses consider themselves as experts in their fields of practice, it is important to keep in mind that they, too, become novices when they encounter a new clinical challenge or situation such as the Covid-19 pandemic. Benner’s (1984) theory, From Novice to Expert, is an excellent nursology theory that can guide clinical practice in the context of current health care challenges related to Covid-19. The theory includes five stages–novice, advanced beginner, competence, proficiency, and expertise. As nurses pass through these various levels of proficiency, they develop holistic clinical knowledge influenced by nursology education, experience, and intuition (Benner, 1984).
The purpose of this blog is to summarize an exemplar of a “novice to expert” nursology educational strategy developed in response to the Covid-pandemic Global Nursing Education exemplar. The exemplar is about a non-profit 501c3 organization, Dr. Gabone QHSC (Quality Healthcare Solutions and Consulting) Inc., which served global novice nurses experiencing a surge in Covid-19 cases in their clinical practice. These novice nurses, especially those assigned to “Covid-19” units experienced common challenges reported in the literature such as exposure and anxiety related to the lack of personal protective equipment and fear of the unknown (Chen, Lai, & Tsay, 2020) . As a result, they relied heavily on emerging knowledge from public health experts as well as clinical expertise from frontline workers who had already experienced the impact and management of the disease in their practice settings. Hence, to better serve the novice nurses, the organization assembled teams of interprofessional Covid-19 frontline healthcare workers from various Covid-19 affected areas to share knowledge about how they utilized their highly skilled analytical problem solving abilities, experience, and education to grasp the emerging situation, events, and behaviors via Zoom meetings.
Six educational sessions were offered as resources to heighten the opportunities for novice nurses around the world, in particular targeting Tanzanian nursologists. The topics covered included:
- Challenges of Covid-19 in nursing practice across various practice settings
- Typical nursing care shifts for Covid-19 patients
- Medication administration and medical protocols
- Infectious disease management
- Effective use of PPE to prevent spread of COVID-19
- Effective coping strategies to promote nurses’ individual and family well-being
- Creating a culture of safety
- Challenges faced by prospective health care workers.
As the frontline workers described their expert practice, they widened the novice nursologists’ perspectives and acceptance of actual and potential challenges and situations they might encounter in their practice settings. For example, the meetings provided demonstrations of how nursologists are interconnected and how they face similar challenges such as lack of PPE and fear of becoming infected. In addition, some nursologists shared ways they reused supplies while ensuring safety and efficiency for patient care.
Overall, the feedback from the participants was positive. The online mode of delivery included interactive elements such as chats, polling, and emails to facilitate discussions to move beyond the content elements and also facilitate experiential learning to develop expertise. Future recommendations for effective online global education delivery and programming include consideration of delivery time for synchronous presentations, as well as access to technology and internet service in resource poor countries and communities.
As we move forward, I call upon nursology scholars worldwide to utilize Benner’s (1984) Novice to Expert theory to examine how the lived experiences of frontline nurses during the Covid-19 pandemic facilitate knowledge development among novice nurses in clinical practice. Questions to ponder are: 1) How and what did frontline nursolgists learn during the Covid-19 pandemic? 2) What new nursing knowledge was generated by the frontline nursologists as they became the experts? 3) How can we utilize the new knowledge in nursology education and practice to manage future outbreaks/pandemics?
Please feel free to share your comments to this blog.
References
Benner, P. (1984). From novice to expert. Addison‐Wesley .
Chen, S-C., Lai, Y-H., & Tasay, S-L. (2020). Nursing perspectives on the impacts of COVID-19. Journal of Nursing Research, 28(3), 5 pages. http://doi.org./10.1097/NRJ.0000000000000389
Thank you Rosemary. Yes I am now thinking about having witnessed two global health events in nursing in my lifetime-HIV/AIDS and now CoVid 19 where the learning curve starts at zero and builds. As nurses we are adapting constantly to patient, family, and community needs while experiencing our own issues and anxiety about exposure for self and family, and fear of the unknown, as you point out. We use the knowledge that is known at that moment in time, and we adapt as experience and knowledge builds. Just when we feel ike experts, we are novices again.
Thanks for sharing about the global nurse to nurse connection for mutual support. Great use of technology.
Thank you Jane! I agree, as nurses we area constantly adapting to the numerous changes that are happening nationally and globally related to diseases influencing public health. The use of technology for primary prevention is currently in high demand. Platforms such as Zoom, Webex and other social media outlets make information sharing easier. This exemplar highlights a potential area for advancing nursing skills in communication and collaboration. We need more nurse to nurse connections at both local, national and global levels.
Thank you Dr. Eustace! I appreciate you highlighting Benner’s Novice to Expert theory in real life.
In my current research, I reflect on Benner’s Novice to Expert theory and Marlene Kramers postgraduation socialization theory with young adult nurses and their well-being during the COVID-19 pandemic. I’ve always been fascinated with the relational coordination aspects within these theories, and how we enable communication across novice’s and experts. I wonder if these nurses you worked with overall felt more supported (socially) in the work environment during the pandemic, because of the theoretical efforts you made for knowledge extension through variable levels of nursing experience… Ultimately does this enhance their well-being and prevent their turnover intentions? Ah the wonders of theory!
Thank you so much Chloe for the comment. Yes, communication across the novice – expert is interesting from a theoretical point of view. As reported in the exemplar https://nursology.net/education-theory/benners-theory-in-global-nursing-education/, the post-training feedback were very positive. You raise great insights into future areas for nursology inquiry guided by Benner’s Theory. We will learn more from emerging empirical studies that articulate and validate the impact of various training modalities such as this one on nursology variables of interest such as acquisition of nursing knowledge, skills and attitude; individual, community and institutional support as well as retention, turnover and recruitment, etc as related to the Covid-19 pandemic. I hope this conversation will stimulate interest.
Hello Chloe, thank you very much for your comments.
The nurses in Tanzania and other parts of the globe had opportunity to attend and participate live via zoom conferences as detailed in this exemplar, https://nursology.net/education-theory/benners-theory-in-global-nursing-education/ , and shared their concerns and challenges with caring for patients with Covid-19. From the feedback during the conferences via chat room, and after each conference, the participants shared their excitements from learning new knowledge and clinical skills from global experts who were currently attending patients in the hospitals. There were increased networking and mentoring opportunities between different experts’ levels of healthcare workers where nurses and doctors shared contact information for ongoing support and further learning opportunities. These collaborations provided much needed support in education and training that addressed the challenges and anxiety that could have affected individual decisions to continue working with the unknown extent of the pandemic. Using the Benner theory, From Novice to Expert, we were able to recruit experts from around the global to share their knowledge and newly gained clinical experienced with the Tanzanian nurses and doctors who were novice in caring for patient with Covid-19 to ensure safety of the patients. As the new challenges occur, nurses ought to respond with any adaptive measures using technology and nursing theory to address the everchanging situation to ensure safety of our patients. Thanks.
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