Patricia Benner

Caring, Clinical Wisdom and Ethics in

Nursing Practice
• Born in Hampton, Virginia
• BSN Degree from Pasadena College in
1964
• Master’s Degree in Nursing from
University of California, San Francisco
• Approach to knowledge development is
from beginner to expert
 Major Concept
• Novice – person has no background
experience of the situation in which she or
he is involved.
• Context-free, rules and objectives must be
given to guide performance
• This applies to nursing students wherein
they have yet difficulty discerning between
relevant and irrelevant aspects of the
situation
• In the clinical area it is like a new/novice
nurse placed in an area foreign to her
• Ex. Medical ward staff nurse transferred to
neonatal intensive care
• Advanced beginner –person can
demonstrate marginally acceptable
performance, having coped with enough
real situation, or have pointed out by a
mentor.
• Have enough experience to grasp aspect
of the situation
• Nurses functioning at this level are guided
by rules and are oriented by task
completion.
• Clinical situations are viewed by nurses in
the advanced beginner stage as a test to
their abilities and the demands of the
situation placed on them rather in terms of
patient needs and responses
• They are responsible for managing patient
care yet they still rely on the help of those
who are more experienced
• Examples are the newly graduate nurses
• Competent – learning through actual
situations and following instruction of
others, the advanced beginner moves to
the competent level
• Consistency, predictability and time
management are important in competent
performance
• Focus is on time management and the
nurse organization of the task.
• Proficient – the nurse perceives the
situation as a whole rather than in terms of
aspect and the performance id guided by
maxims
• Demonstrate a new ability to see changing
relevance in a situation including
recognition and implementation of skilled
response to the situation as it evolves
• Expert – the expert performer no longer
relies on analytical principles to connect
an understanding of the situation to an
appropriate action
• Have an intuitive grasp of the situation and
being able to identify the region of the
problem without losing time considering a
range of alternative diagnosis and solution
 Nursing Paradigm
• Nursing – is a caring relationship, an
enabling condition of connection and
concern
• -viewed as a caring practice whose
science is guided by the moral art and
ethics of care and responsibility
• Person – a self-interpreting being that is,
the person does not come into the world
predefined but gets defined in the course
of living a life.
• Nurses attend to all dimension of the body
and seek to understand the role of
embodiment in particular situation of
health, illness and recovery.
- The nurse must understand the roles of
each person, their body language,
sensations as well as their customs and
their own understanding of themselves.
• Health – not just the absence of disease
and illness
• - it is defined as what can be assessed
meaning what can be observed from the
patient
• Disease is loss or dysfunction
• Illness is assessment of the physical level/
physical symptoms
• Situation – in other theories this is term as
environment
• Defined as person engaged interaction,
interpretation and understanding of the
situation
• Each persons past, present and future,
which include his own personal meanings,
habits and perspective influence the
current situation
 Katie Eriksson
• Theory of Caritative Caring
 Background
• Born: November 18, 1943 in Jakobstad,
Finland
• Graduated from Helsinki Swedish School
of Nursing (1965)
• Public health Nursing Specialty (1967)
• Nursing Teacher Education Program
(1970)
• MA degree in Philosophy (1974)
• Director of Nursing at Helsinki University
Central Hospital (1996)
• Founded the Department of Caring
Science in Abo Akademi University (1987)
 Major Concepts
• Caritas – means love and charity. Caring
is an endeavor to mediate faith, hope and
love through tending, playing and learning.
• Caring Communion – characterized by
intensity and vitality and by warmth,
closeness, rest respect, honesty and
tolerance .
- Source of strength and meaning
• The act of caring –the art of making
something very special out of something
less special.
• Caritative Caring Ethics – ethics of caring .
- Deals with the basic relations between the
nurse and the patient- the way in which the
nurse meets the patient in an ethical sense
-this means seeing the patient without
prejudice, see the human being with respect
and confirm his absolute dignity.
• Dignity –the right to be confirmed as a
unique human being
• Invitation – refers to the act that occurs
when the carer welcomes the patient to
the caring communion. (a room where a
patient is allowed to rest, breathes
genuine hospitality)
• Suffering – human being’s struggle
between good and evil
 Paradigm
• Person
• An entity of body, soul and spirit.
• Fundamentally a religious being and holy.
• Constantly in change and therefore never
in a state of full completion.
• Dual tendency emerges in an effort to be
unique, while simultaneously longs for
belonging in a larger communion.
• Relationship with concrete other ( human
being) and an abstract other (God)
• Seeks communion where he can give and
receive love, experience faith and hope.
 Nursing
• Love and charity or caritas is the principal
idea in her work
• With love, generosity becomes a human
attitude toward life and joy is its form of
expression.
• Natural basic caring is through tending,
playing and learning in a spirit of love, faith
and hope.
• Tending is closeness, warmth and touch
• Playing is exercise, creativity and
imagination, desires and wishes
• Learning is aimed at growth and change
 Environment
• Ethos refers to home , or to a place where
a human being feels at home
• Ethos symbolizes a human beings
innermost space
 Health
• Defines health as soundness, freshness
and well-being
• A movement toward a deeper wholeness
and holiness
• The person focus on healthy habits and
avoiding illness
• Strives for balance and harmony