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Review Benner’s stages of learning. What are examples from Benner’s…
Review Benner’s stages of learning. What are examples from Benner’s stages of learning (1-4) when interviewing a complex client. Examine Peplau’s section on self-awareness when practicing the following thoughts.
What empathic statements did you use during your interaction with a complex client?
What is Peplau’s perspective regarding self-awareness?
How does self-awareness interplay with countertransference and boundaries?
How will self-awareness impact your future practice (e.g., how might you handle a situation differently)?
FYI
Benner’s stages:
Unconscious incompetency is a novice with no experience governed by rules and regulations.
Conscious incompetency advanced beginner recognizes aspects of situations and makes judgments.
Conscious competency competency/proficiency, 2 to 5 years experience, coordinates complex care, sees situations as wholes and long-term solutions.
An unconscious competency expert is flexible, efficient, and uses intuition.
Stages of Learning Benner offers a model (1984) of role acquisition from novice to expert that examines the competency levels of the novice nurse psychotherapist.
The graduate student likely pursuing a master’s degree or postmaster’s certificate as an APPN has practiced as an expert in an area of specialization before graduate studies. Transitioning from an expert back to a novice is often painful and anxiety-provoking.
The beginning nurse psychotherapist has interacted professionally with many different types of patients. However, there is usually much anxiety about the first session with the patient in the role of a psychotherapist.
There is usually no one right thing to say. In psychotherapy, there is much ambiguity and often no correct answers.
The Four Stages of Learning Model is juxtaposed to Benner’s Model, which may help to allay anxiety for those beginning to learn psychotherapy (Table 1.2). Although there is some controversy regarding who developed this model, it is thought that learning takes place in four stages: 1. Unconscious incompetence (i.e., we do not know what we do not know) 2. Conscious incompetence (i.e., we feel uncomfortable about what we do not know) 3. Conscious competence (i.e., we begin to acquire the skill and concentrate on what we are doing) 4. Unconscious competence (i.e., we blend the skills together, and they become habits, allowing use without struggling with the components) The challenge initially for novices is that they are becoming increasingly aware of being incompetent as progress is made. This is likely to generate anxiety.
An additional quality that nurses bring to the role of the psychotherapist is a pragmatic, problem-solving approach using the nursing process as an overall framework for practice. Usually, the patient has tried many things to feel better, and therapy is often a last resort. The patient’s problems have brought the person into treatment, and if these problems could be solved outside of therapy with friends or family, he or she would have already done so. The problem-solving approach needed in the psychotherapeutic process is the same as in the nursing process. Both involve an assessment, diagnosis, plan, intervention, and evaluation. In addition, nurses are used to collaborating with patients and thinking about what will solve the problem, the patient’s perspective, what the person wants, and what the patient’s strengths are. These approaches are derived from a problem-solving, health-oriented, holistic model and are fundamental to nursing practice and the nurse-patient relationship.
