by: Rocelle Joan Sasa, RN
I can say Patricia Benner’s From Novice to Expert shows the stages in the development of the career of nurses. I believe this may also be applicable not only to us but also to varied professions as well.
Novice.
I had my first clinical exposure during my second year in College (2003-2004). It was also the time when we first wear our duty uniforms in the hospital and in the community. To be specific, I had my related learning experience in the delivery room of Ospital ng Maynila and my community days were spent in health center in Sta. Cruz, Manila. Different feelings were felt as we say, ‘everything firsts.’ But we do have a Clinical Instructor (C.I.) to teach and guide us.
We were also exposed in areas such as Medical Surgical Ward, Operating Room, Pediatric Ward, Intensive Care Unit, and Psychiatric Ward to cite some when I was a student. In these areas, we were given patient assignments, do specific nursing interventions like, Vital signs taking, CBG monitoring, preparation and giving of medications, health teaching, getting intake and output, charting, making an individualized NCP as supervised by our C.I. I can say that our tasks are being ‘spoon-fed.’ That is, the Clinical instructor will tell us what can we do or not.
The transition from a student to a practicing nurse was somewhat challenging for me as I was not employed immediately. Before I started working in PGH, I had volunteered in a hospital in Paranaque for about a year, had assisted and acted as a private duty nurse when needed and also tried being a company nurse.
Advanced Beginner
Gaining enough experience during my student, volunteer, and training days, I can say that when I started to practice in the institution, I acted as an advanced beginner being guided by rules. But still whenever faced with uncertain situations, I still seek the advice of my Senior nurses. There is little supervision more of with adjustment in the clinical area where I was assigned – Medicine Department.
Competent
Gone were the days, I went home late to finish my bedside care and my documentation in the area tasked with 1 is to utmost 17 patients. I already know how to effectively manage my time having acquired the rules and being able to prioritize and solve different problems of patients with sound judgement, and also being able to intervene according to their needs. The nurse is also able to form his own rules that may facilitate his care while maintaining delivery of optimal nursing care to his patients.
Proficient
As for me my immediate supervisor, my Head Nurse is the concrete example of a proficient nurse. Endowed with years of experience in the hospital, she is managing the unit holistically. Specifically, she is handling the management of the entire ward or unit, its staff, from institutional workers to nurses and also, ensuring quality care to patients and their families.
Expert
In the hospital, we have the Deputy Director for Nursing, the highest position of a nurse in the Administrative Department of our institution. She’s able to solve nursing-related problems easily without focusing much on rules. She is frequently invited to attend seminars as a resource person and share her own rich experiences. She also goes personally in each unit to see the needs of our patients and plan and intervene on how to meet those needs.
Each step builds on the previous one as abstract principles are refined and expanded by experience and the learner gains clinical expertise. 
