Guest Contributor: Nkem Nneka Kimberly Chiedu
PhD in nursing student, Texas Woman’s University

How many times have nurses heard the phrase, “putting theory into practice”? The phrase has become so familiar that nurses may rarely stop to question what it assumes about where nursing knowledge comes from. It seems to suggest that knowledge originates somewhere outside nursing practice—in textbooks, theories, research articles, classrooms, or policies—and is later carried by the nurse into the clinical setting.

It has become so familiar that nurses almost never question it. The phrase seems to suggest that knowledge originates from somewhere outside of nursing practice like in textbooks, theories, research articles, classrooms, or policies and that knowledge is later carried on into clinical settings alongside the nurse.

Patricia Benner challenges nurses to think differently.

What if nursing practice was not simply a place where knowledge is only applied but what if practice was also a place where nursing knowledge is created?

This question became increasingly intriguing to me as I took time to explore Benner’s philosophical work. Although Benner is known best for her theory for From Novice to Expert framework, her contribution to nursing extends well beyond the sole acquisition of skill. Her phenomenological perspective challenges us to consider how nurses understand and know what they know and what forms of knowledge the discipline is willing to recognize as legitimate.

Nursing Knowledge is More than Knowing Facts

Nursing education appropriately teaches scientific knowledge such as pharmacology, assessment skills, and clinical guidelines. However, knowledge about a patient is not the same as knowing how to care for that same patient at that moment of care. Benner argues that nursing education often highlights applying theory to practice but pays less attention to what nurses actually discover and understand from practice itself (Benner, 2022). Experienced nurses often recognize this discrepancy. Healy (2024) supports this by describing higher-level nursing practice by engaging practical reasoning that considers the circumstances and particular needs of the patient.

This is a main reason why Benner’s philosophy remains important to nursology. Her work challenges a Cartesian understanding that separates mind from body, thinking from action, and knowledge from practice. Knowledge assists us to engage with the world around us. This explains that nursing knowledge is not exclusively abstract, but also embodied, situated, experiential, and relational.

Nursology.net’s resources on Patricia Benner similarly describe practice as a foundation of knowledge instead of a simple arena in which theoretical knowledge is implemented. This distinction deserves greater attention within our discipline.

Expertise is Also Moral

There is another part of Benner’s philosophy that intrigues me and that is expert nursing is not merely technical proficiency. This involves recognizing what matters and Benner supports this. She argues that concern, involvement, and engagement affect perception and situational awareness and what matters to nurses helps in shaping what stands out (Benner, 2022).

Nurses continuously find themselves in situations where several actions may be correct, but the main question is, “What is the most important for the patient right now? That means more than simply completing a task, but requires attentiveness, clinical judgment, responsiveness, and engagement. It also means the nurse must understand the patient who is ill instead of seeing ways that are sensitive to the patient’s circumstances, concerns, and needs.

Benner’s idea of intuition may be understood in this context as well. Intuition should not mean guessing or abandoning scientific evidence. Instead, experienced nurses may recognize patterns before they can articulate the reasoning behind that recognition.

Most importantly, experiences do not make reflection unnecessary. When circumstances are unfamiliar, nurses may need to return to evidence, consultation, and analytical reasoning. Intuition and analysis do not have to be in competition with each other; both can contribute to sound nursing judgement.

What Happens When Everything Must be Measurable?

Benner’s philosophy raises an important question for contemporary nursing: What happens to nursing knowledge when healthcare increasingly values what can be counted, standardized, documented, tested, and measured? Competency checklists have value. Outcomes matter. Evidence matters. Quality indicators matter. However, not everything important about nursing fits neatly into a checklist. How do we account for the nurse who recognizes a subtle change because it resembles a pattern encountered before? How do we quantify knowing when a frightened patient needs a few additional minutes of the nurse’s presence? Where does moral attentiveness appear on a competency checklist? And how do we teach students to recognize what is important rather than simply complete every task listed before them? These questions do not need nursing to choose between science and care which would create a division in care. Instead, Benner’s philosophy invites nursing to recognize that scientific evidence and experiential knowledge can inform one another.

We Need to Talk About What Nurses Learn from Practice

Benner’s philosophy can be brought into practice by giving nurses opportunities to articulate the knowledge embedded in their experiences. Reflection should not be viewed as an educational extra. Clinical narratives, case discussions, mentorship, post-clinical reflection, storytelling, and conversations between novice and expert nurses can help make nursing knowledge more visible. Instead of asking students only, “Which guidelines did you follow?” educators might also ask: What did you notice? What concerned you? What was important in this situation? How did your understanding of the patient shift? What do you anticipate recognizing differently in the future? These kinds of questions allow for nursing education to go beyond information acquisition toward the development of clinical knowledge and wisdom.

Practice Does Not Come After Knowledge

Nurses encounter humanity experiencing health, illness, vulnerability, recovery, suffering, uncertainty, and most importantly hope. Through the variety of encounters, nurses learn things that cannot always be understood from a distance.

Benner helps us recognize these experiences as more than simply accumulated years on the job. They can become sources of professional knowledge when nurses notice, reflect, articulate, question, and share what they have learned. Perhaps nursing knowledge is not simply something carried into practice. Sometimes, it is something discovered there.

References

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

Benner, P. (1994). Interpretive phenomenology: Embodiment, caring, and ethics in health and illness. Sage Publications.

Benner, P. (2022). Overcoming Descartes’ representational view of the mind in nursing pedagogies, curricula, and testing. Nursing Philosophy, 23(4), 1-5. https://doi.org/10.1111/nup.12411

Benner, P., Tanner, C. A., & Chesla, C. A. (2009). Expertise in nursing practice: Caring, clinical judgment, and ethics (2nd ed.). Springer Publishing Company.

Healy, C. (2024). Self-appropriation in nurse engagement: Facilitating the development of expert nurses using Benner and Lonergan. Nursing Philosophy, 25(1), 1-9. https://doi.org/10.1111/nup.12468

About Nkem Chiedu

Nkem Chiedu, MSN, RN, BA, is a doctoral student at Texas Woman’s University with interests in nursing philosophy, nursing knowledge development, and nursing education. Her perspective is shaped by her interest in how nurses develop knowledge through both scientific evidence and lived clinical experience. She writes from the standpoint of a nurse-scholar who values reflection, relational practice, and the knowledge nurses develop through caring for patients, and she is particularly interested in how these forms of knowing contribute to the advancement of the nursing discipline.