NR 501 Week 6 Discussion, Middle Range Theory

NR 501 Week 6 Discussion, Middle Range Theory NR 501 Week 6 Discussion: Discuss how a specific middle-range nursing theory has been or could be applied by nurse leaders or nurse managers to effectively deal with an administrative issue (i.e., staffing, use of supplies, staff performance issues). Include an example from the literature or your own experience to illustrate your points Patricia Benner’s Model of Skill Acquisition in Nursing is a middle-range theory that would be considered helpful for nurse managers and leaders to be familiar with in order to effectively deal with certain administrative issues. This model describes five stages of skill acquisition in nursing; novice, advanced beginner, competent, proficient, and expert. Benner’s model acknowledges the different levels of skill that a nurse withholds dependent on the nurses’ level of experience and clinical expertise; for example, the hospital I work for has a twelve-week new graduate orientation program. This program is run by nurse educators and managers. It enables new graduate nurses to begin their journey from novice to expert nurse. During the twelve weeks, the new graduate nurse works under supervision of an experienced nurse, also known as a preceptor. The preceptor guides and evaluates the new nurse during this period. After completion of the twelve weeks, the new graduate nurse is now considered an advanced beginner and can work independently. At this point, clinical competence is determined by experience. After a couple of years, the nurse is then considered a competent nurse. With continued experience, the nurse becomes more proficient, eventually becoming an expert. According to McEwen and Wills, expertise develops when the nurse tests and refines clinical expertise and practical knowledge (2014). A specific administrative issue that needs improvement would be the shortage of registered nurses. According to Murphy, “A shortage of registered nurses is projected to spread across the country between 2009 and 2030 (2012).” As the shortage of registered nurses is expected to increase, retention and recruitment of nursing staff is imperative. It is with the use of Benner’s model, that healthcare organizations recognize and emphasize the importance of rewarding nurses for their clinical expertise, advanced education, and leadership skills through what is known as a clinical ladder program. Many healthcare organizations utilize clinical ladder programs as a recruitment and retention tool for experienced nurses. Generally, the nurse must apply and meet certain criteria before being accepted into the clinical ladder program. Once accepted, a nurse must remain at that level for a period of time before advancing. Advancing through the clinical ladder program provides nurses recognition and rewards for their clinical expertise in delivering direct patient care. According to Murphy, many hospitals with clinical ladder programs reported success in retention and recruitment of their nurses (2012). It is believed that rewarding the nurses financially and professionally helps to retain those nurses and allows for more experienced nurses to remain at the bedside and be available as a mentor for newer nurses. In conclusion, rewarding and recognizing the nurses leads to increased job satisfaction and ultimately patient satisfaction (Murphy, 2012). McEwen, M., & Wills, E. (2014). Theoretical basis for nursing (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. Murphy, D. (2012). Novice to Expert: Clinical Ladder Programs as a Recruitment and Retention Tool. Ohio Nurses Review, 87(5), p.16-17.