Carper's Pattern of knowing
1. Empiric knowing
2. Ethical knowing
3. Personal knowing
4. Aesthetic knowing
Level of proficiency according to Patricia Benner
Benner's Stages of Nursing Expertise
Novice - no experience
- Performance is limited, inflexible, and governed by context-free rules & regulations
rather than experience
Advance beginner - demonstrates marginally acceptable performance.
- Recognizes the meaningful aspects of a real – situation
Competent – has 2-3 years of experience
- Demonstrates organizational and planning abilities
- Differentiates important factors from less important aspects of care
- Coordinates multiple complex care demands
Proficient – has 3-5 years of experience
- Perceives situations as wholes rather than in terms of parts
- Uses a maxim as guides for what to consider in a situation
- Has holistic understanding of the client, which improves decision making
- Focuses on long term goals
Expert – performance is fluid, flexible & highly proficient
- No longer requires rules, guidelines, or maxims to connect an understanding of a
situation to appropriate action
- Demonstrate highly skilled intuitive & analytic ability in new situations
Is inclined to take certain actions because it felt right
Roles & Functions of a Professional Nurse
- Caregiver - Leader
- Communicator - Clinician
- Teacher/Educator - Manager/Coordinator
- Counselor - Researcher
- Client Advocate - Case Manage
- Change Agent - Collaborator
Care provider – the nurse supports the client by attitudes & actions that show concern
for client welfare & acceptance of the client as a person.
Communicator – the nurse communicates with the clients, support persons & colleagues
to facilitates all nursing actions
Teacher – the nurse provides health teaching to effect behavior change which focuses on
acquiring new knowledge or technical skills
- This role gives emphasis on health promotion & health maintenance
Counselor – The nurse helps the client to recognize & cope with stressful psychological
or social problems, to develop improved personal relationships & to promote growth
Client advocate – The nurse promotes what is best for the client, ensures that the client’s
needs are meet & protects the client’s rights
Be PRANING:
P - Participation of client in his own cared ensured
R - Rights of client protected, supported
A - Autonomy of client is safeguarded
N - Needs of client communicated
I - Information related to his care & condition are provided
N - Nurture therapeutic alliance (client is an active partner in his care)
G - Given options & choices for decisions
Roles & Functions of a Professional Nurse
Change agent – the nurse initiates changes & assists the client make modifications in the
lifestyle to promote health.
Leader – The nurse through the process of interpersonal influence helps the client make
decisions in establishing & achieving goals to improve his well-being
Clinician – use of technical expertise to administer nursing care & initiate & modify care
based on the client’s needs
Manager – The nurse plans, gives directions, develops staff, monitors operations, gives
rewards fairly, & represents both staff members & administration as needed
Researcher – The nurse participates in scientific investigation & uses research findings
in practice.
Case manager – The nurse coordinates the activities of the other members of health care
team such as nutritionists & physical therapists when managing a group of client’s care
Collaborator – the nurse works in a combined effort with all those involved in care
delivery, for a mutually acceptable plan to be obtained that will achieve common goals
- The nurse initiates nursing actions with in the health tea
DIFFERENT FIELDS OF NURSING
Community Health Nursing /Public Health Nursing
– may include:
School Nursing
Industrial Nursing
Community Health Nursing
- is a nursing approach that merge knowledge forms the public health sciences
with professional nursing theories to safe guard & improve the health of
populations in the community
Public Health Nursing
- focus requires understanding the needs of population, or a collection of
individuals (e.g. high risk infants, older adults, or a cultural grou such as Aetas,
Mangyans, Manobo, etc.) who have in common one ore more personal or
environmental characteristics.
Manager
– organizing the nursing service of the local health agency, the PHN is
responsible for the delivery of the services provided by the program to the target
clientele
Supervisor
– PHN is a supervisor of the midwives & other ancillary health workers, who
formulates a supervisory plan & conducts supervisory visits to implement the plan
Nursing care provider
– an inherent function of the nurse
The PHN cares for individuals, families & communities toward health promotion
& disease prevention
Collaborator & coordinator
– PHN brings activities or group activities systematically into proper relation or
harmony with each other
Health promoter & Educator
– to perform the function of health promotion, the PHN should understand that
health is determined by various factors
As an educator, the nurse provides information that allows clients to make
healthier choices & practices
Trainer
– PHN initiates the formulation of staff development & training of midwives &
other ancillary health workers
Researchers
– PHN participates in the conduct of research & utilizes research findings in her
practice
DIFFERENT FIELDS OF NURSING
Independent Nursing Practice
– it involves advanced nursing practice & requires a Master’s degree in Nursing,
advanced education in pharmacology & physical assessment & certification & expertise
in a specialized area of practice
Independent Nursing Practice
The nurse may function as a clinician, educator, case manager, consultant & researcher
within his or her area of practice, to plan or improve the quality of nursing care for the
patient & family
Nursing in Other Fields
(Expanded Nursing Roles)
Nurse Practitioner (NP)
-Has advance education (at least a Master’s degree in Nursing) & is a graduate of Nurse
Practitioner program
Clinical Nurse Specialist (CNS)
-Has a master’s degree in nursing & may have advanced experience & expertise in a
specialized area of practice (e.g., Gerontology, pediatrics, critical care, oncology,
endocrinology, cardiovascular disease or pulmonary disease)
Nurse Midwife
– is educated in nursing & midwifery & is licensed to provide independent care for
women during normal pregnancy, labor & delivery
Nurse Anesthetist
– provides general anesthesia for clients undergoing surgery under the supervision of a
physical prepared in anesthesiology
-They are RNs with advanced education in anesthesiology
Nurse Researcher
– is responsible for the continued development & refinement of nursing knowledge &
practice through the investigation of nursing problems
