Nursing theories are the guidelines to perform nursing practice effectively. Since the origin of nursing practice, there are many remarkable theories have been developed. According to Toomey & Alligator (2006), these theories have been classified mainly into four different groups, which are, Philosophy, Conceptual model and Grand theories, Theories and Middle range nursing theories. Banner’s Dresses model of skill acquisition theory comes under the first category, which is the philosophy.
This essay discusses the significance of Dry Patricia Banner’s skill acquisition theory based on the Dresses model, reviewing the five different levels of the theory including its application in today’s nursing practice and assessing its importance in my own future clinical practice.
Background of Dry Patricia Banner Banner was born in Hampton, Virginia in 1955, and shifted to California, where she gained her university education.
She successfully completed her Bachelor Degree in Nursing from Pasadena College in 1964, her Master’s Degree in Medical Surgical Nursing and PhD in Stress and Caring and Health from the University of California, in 1 970 and 1982 respectively (Johnson & Webber,2005 ).
Banner has proved her efficiency in various clinical settings, especially, in critical care, home health care and acute medical- surgical care. As a nurse, she is really follower of Virginia Hudson. Her researches and writings are really an asset not only to the nursing practice but also to the clinical ethics and clinical practice.
Considering her valuable contributions to the nursing profession, she has been felicitated by many awards including American Journal of Nursing Book of the Year Award. She is an author of nine books related to nursing, including her first kook, ‘From Novice to Expert’ (1984), where she introduced the Dresses model of skill acquisition. She is an internationally noted nursing researcher and writer. And her ‘Skill Acquisition Theory’ or the ‘Novice to the Expert Model’ brought far reaching changes in the field of contemporary nursing practices (Banner, 1 984; Toomey & Alligator, 2006).
This theory depicts how the nurses become an expert by developing their skills which they have imbibed in the various stages since they are students. Framework of Bennett theory Banner framed the Dresses Model of Skill Acquisition in nursing profession. According to this theory, a student nurse passes through four different stages to become an expert nurse at the fifth stage. All these five stages indicate a vibrant growth in the quality of the performance in profession. In the first stage, the Novice stage, many beginners do not have any sort of idea about the new field which they have recently entered.
They learn some fundamentals as a part of their skill improvements without linking to the actual situations. When the student nurses enter into the situations to practice the newly learnt basic rules or fundamentals, they feel it is too rigid to handle. Additionally, nurses who eve into a new department, where they have no experience, are also treated as novices in that department regardless if they have had rich experience in some other departments (Banner, Tanner & Chelsea, 2009; Johnson & Webber, 2005).
In the second stage, a beginner progresses to be an Advanced Beginner. In this period, the person exhibits more acceptable performance through the continuous practice from the Novice stage. Banner puts new graduate nurses in at this stage. Because they have received enough experience related to multiple situations. They can successfully incorporate the learnt rules with various actual circumstances. At the same time, they approach the clinical situations to assess their ability rather than sort out the problems of the health consumers.
Importantly, they need supervision to perform their tasks to ensure that they don’t miss out any task and do everything on priority basis rather than doing things according to their own choice (Stoking, 2008; Banner et al. , 2009). Next is the Competent stage, which is the main stage of nursing practice. During this stage, nurses are capable of differentiating the cases according to its seriousness. They show competency, uniformity, good time management, lancing and mastery in their tasks and they try to practice the learned rule in various suitable situations.
A few years of practice make them absolutely fit enough to the profession (Banner, 1984; Toomey ; Alligator, 2006; Callaghan, 2011). The fourth stage is the Proficient. This stage is a pathway towards the Expert stage. Proficient nurses have a holistic approach towards the situation and they are directed by the maxims. Because of this approach, they can set long – term goals and it makes them unique in the profession. Additionally, they never find any difficulty in decision making and they can easily deal with he complex situations.
They have acquired this holistic approach from their vast experience, which makes them capable not to stick on the rules in their decision making and they are fully satisfied with their performance (Banner, 1984; Banner et al. , 2009). The last is the Expert stage, a stage of ‘intuition’. The Expert nurses can easily find out the solution of any problem without reviewing the rules, maxims or guidelines. Their rich experience in the profession makes them capable of approaching the situation with intuition. They can undoubtedly deal even with complex situations in an extraordinary manner.
Their expertness reflects on their style of functioning. Therefore, a qualitative approach is needed to assess their performance. Indeed, junior nurses can seek advices from the Expert nurses in various complex clinical issues (Banner et al. , 2009; Toomey ; Alligator, 2006; Marble, 2009). Explicating Banner’s concept of expert practice. Banner applies effectively in various clinical situations. According to the article of Lehman, J. , Parkinson, C. , & Tenfold, C. (2008) the Expert stage of Banner’s theory has been introduced effectively in emergency nursing care.
According to he fifth stage of her theory, expert nurses use ‘intuition’ in nursing practice. They don’t worry about the rules. Their rich experience gives them an intuitive approach towards the situation, which enable them to take an appropriate decision in their nursing care. Similarly, the expert emergency nurses are able to understand the pre-existing clinical situation with their ability of intuition. Many years of experience help them to reach up to that level of understanding. From their day to day practice, these expert nurses acquire new knowledge and their previous knowledge becomes the part of their experience.
As they gain fresh knowledge and skills, this reflects in their practice. Meanwhile, they reach a level where they can take quick decision on any clinical situation without having much intellectual involvement. Also, it is the outcome of their intuition which they gain from their years of experience Banner, 1984; Smith, 2009). According to Lehman et al. , (2008) at this stage, nurses pass through three different types of intuitions. Initially, they reach into cognitive intuition, where they cannot take clinical decisions quickly. Next is transitional intuition, where they move out of the out dated factors.
Finally, they are in embodied intuition, where the nurses make absolutely correct decision since their intuition is really trusted. Significance of Banner’s theory in my clinical practice. While going through a number of theories, which reflect the different facets of contemporary nursing practice. Though, each theory has its own merits and demerit, I think, Banner’s model will play an important role in my nursing profession (English, 1993). Because this theory is more convincing, coherent and uninterrupted advancement towards the excellence in theoretical and clinical knowledge.
Furthermore, the five stages from ‘Novice to Expert’ very Leary draw a progressive chart of nursing profession (Banner et al. , 2009). According to this theory, being a student nurse, now I am in the Novice level. This theory is a parameter for my nurse educators to assess the performance in my clinical placement. Again, this theory is more accurate to evaluate my real performance. Similarly, the skill acquisition achieves through the nursing practice after completing my studies helps me to enhance my skills further in the clinical areas.
Moreover, Banner (1984) portraits the seven domains of clinical practice and these domains are quite useful for me in the patient care. Similarly, hen I start my profession as a new graduate, I will be an Advanced Beginner. During that period I will use my all the learned rules into my clinical practice to caring patients. Also, it will be an opportunity for me to assess my ability in patient caring. After a few years of experience, I will reach into the Competent stage. During this is the most significant level, I will be able to identify the cases according to its seriousness.
Also, I will be able to perform the tasks with good accuracy and time management (Banner, 1984; Toomey & Alligator, 2006; Test, 2008). When reaches in proficient level; I will develop a holistic approach awards the clinical situation. Here I will be directed by maxims and I can develop a great vision about the profession. Additionally, I never find any difficulty in decision making and I can easily deal with the complex situations. The rich experience of my previous stages makes me efficient in decision making and I will be fully satisfied with my profession.
Simultaneously, I will reach into the Expert stage, a stage of intuition; I will be capable of dealing even with the complex situation in an excellent way. Additionally, I can support the junior nurses to carry out their various tasks (Banner, 1984; Banner et al. , 2009; Spinal, Smith amp; Logon, 2011). Conclusion In summary, this essay has analyses the significance Banner’s theory based on Dresses model of skill acquisition in the nursing profession. Similarly, it throws light on the five stages of the theory and tries to explain the steady advancement from one stage to the other.
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