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"Knowing that" means establishing interactional, casual relationships between events. "Knowing how" is the skills we acquire. An example of "knowing that" is recognizing the knowledge of doing something, and "knowing how" is having the knowledge, but actually being able to carry out that knowledge. An example of this is a nurse having the knowledge that an antibiotic is the cure to a bacterial infection, but not knowing how to administer the medication in the clinical setting.

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-no longer rely on analytical principle
-enormous background of experience
-can describe clinical experiences where their interventions made a difference
-rely on instinct

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perceive situations as a whole
based on experience of recent events
begins to look at long term goals
able to prioritize
learn best through case studies

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Beginners have no experience in clinical situations, they have basic skills i.e. weight, I&O, vital signs, etc. The novice nurse needs a lot of support from the rest of the staff members or the health team. The novice nurse needs guidance and rules developed from the rest of the health team. The novice nurse can be considered a student or a person entering the clinical setting where they have no previous clinical experience, and most of what they know and understand came and is adapted from the classroom.

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Aspect Recognition is when a nurse is able to have a readiness to learn. identified through prior experience

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Question 8: Describe Stage 2: Advanced Beginner

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Question 8: Describe Stage 2: Advanced Beginner

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advanced beginners demonstrate marginally acceptable performance because the nurse has had prior experience in actual situations. he/she is efficient & skillful in parts of the practice area, requiring occasional supportive cues. Knowledge is still developing; may/may not be within a delayed time period.

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the expert nurse started her analysis in the hallway on her way to the patient room

she noticed the urgency in the other's nurses voice

Significance of prior expertise- she was able to asses the situation, diagnosis, act appropriately, implement, use resources, evaluate

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The Dreyfus model of skill acquisition is a model of how learners acquire skills through instruction. Students pass through 5 stages: novice, advanced beginner, competent, proficient and expert. The three general aspects of skill acquisition are cognitive, associative and autonomous. In the novice stage, this equates to the cognitive aspect of skill acquisition. Associative would be advanced beginner and competent. Autonomous is proficient and expert stages because they are still learning but are not as dependent on others for help.

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Interpretative strategy uses synthesis rather than analysis. For example, the meaning of a bed bath changes with the condition of the client

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A nurse who has been on the same job, or similar situations for 2-3 years. Competence develops when the nurse begins to see their actions in terms of long-term goals of which they are consciously aware. For a competent nurse- plans are based on considerable, conscious, abstract, analytic contemplation of a problem. The competent nurse lacks the speed and flexibility of the proficient nurse but does have a feeling of mastery and ability to cope and manage with many contingencies in clinical nursing.

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Intentions: a determination to act in a certain way

Empathy: the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner

Intentions and Empathy have the potential to affect clinical situations, especially as a novice nurse, because as a new nurse you may have the intention to act in the best manner possible to promote the best care for your patient, but your understanding of the situation and the clinical competence the novice nurse has surrounding the situation may affect the care the patient receives, regardless of the intent that novice nurse has for the patient.

On the other hand, having empathy for the situation and the patient you have may make the novice or experienced nurse more sensitive to the case at hand, and help the nurse develop a holistic approach to patient care.

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We would describe a sense of "possibility" as providing our patients with a sense of hope or positivity in an unlikely situation.
An example of this during our clinical experience was when we were on a acute pediatric care unit and an infant was in the hospital for a while with lack of support. We provided him with a sense of hope and positivity, even though he could not converse back with us, through talking to him and making sure he knew he had people there with him.

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Characteristics of an expert nurse:

confidence

clinical knowledge

intuitive grasp

deeper understanding - pattern recognition

"Knows" what to do

Characteristics of a novice nurse:

Lack of confidence

Lacks clinical knowledge

Lacks intuitive grasp

Requires cues and instructions

It plays a significant part when you have a critical patient who requires and intuitive knowledge on their situation. A novice nurse may know something is wrong but may not know the actions to take. An expert nurse will see the problem and act accordingly in a timely manner with no instruction needed. Referring to the above characteristics, expert nurses are required for high intensity situations, while novice nurses are still learning.

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Question 4. what do you think about a global set and example from clinical

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Question 4. what do you think about a global set and example from clinical

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precieved notion
be openminded
never assume, always assess

ex- having one code blue and knowing what to expect the next time there is a code blue, you are familiar with what happens
ex- getting a patient in report and assuming they are a certain way just from report and then meeting patient and they are completely different