President’s Column: Variations on a Theme

Feb 12, 2018

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Patricia Benner’s Novice to Expert theory describes the journey of learning from the time one begins practice to the time one is a seasoned, experienced expert. Most of us can easily recall the triumphs, lessons and surprises that occurred along our learning journeys, as we aspired to practice “in the zone” as masters in our chosen clinical fields.

But there is another journey — one that has not been written about to the same extent but is quite common. It is the journey we take when we move from being at the top of our game to being the new kid again. I call it (with an apologetic nod to Benner), the “Expert to Novice” journey. This is when, for one reason or another, we move from practicing within our comfort zone to something that is unfamiliar, frequently uncomfortable and unexpectedly unpredictable.

Many of us have also taken this journey. Sometimes, it’s a role change — an expert acute care nurse transitioning to critical care, a seasoned clinician returning to school to become an advanced practice nurse, an experienced ICU nurse leaving one hospital for a job in a similar unit in a different facility, a veteran clinical nurse specialist or manager assuming responsibility for a new unit or practice specialty. This happens in everyday transitions, too, such as a new way of administering a familiar medication, floating to another unit, joining a new committee or caring for a patient with an unfamiliar clinical problem.

I’ve talked to many people who’ve taken this journey and note familiar themes in their stories. Almost all admit that even though they understood it would take time to learn the new role or task, they were surprised by how long it took, how uncomfortable it was and how inadequate they felt while learning. Even things they knew how to do well — like starting IVs or hanging blood — took longer in the new setting, because the processes and equipment were different.

Surprisingly, many admit that they’d forgotten how to ask questions … and even which questions to ask. It was more difficult than expected to break tasks into steps and basic elements. Many felt isolated; no longer the “unit guru” where people came to them with questions. They were now the “new guy” trying to translate knowledge and establish credibility in a new setting.

Expert to novice is certainly not a walk in the park, but it is absolutely a journey worth taking. Nurses who have taken this journey say they’re glad they weathered the change despite the turmoil, impatience with themselves and inherent uncertainty about their new reality. They appreciated the opportunity to be learners again. They acquired new skills, developed different ways of doing things, met people with fresh perspectives and rediscovered how to ask WHY. With rare exception, they say that they are now more confident, flexible and curious practitioners. They empathize with others on this reverse journey, generously sharing strategies for success, encouraging patience and translating old knowledge into a new setting.

Our profession encourages lifelong learning, so it’s good to occasionally put ourselves back into the novice role and not let uncertainty or fear of failure prevent us from seeking fresh, exciting experiences. Whether it’s as simple as a single day with new challenges or as complex as taking on an entirely new role, it is possible to navigate this journey by staying connected to our WHY for making the change and the possibilities it offers.

Staying focused on the long-term vision despite the detours and challenges along the way. Honoring your WHY by being patient, asking questions again and trusting the process. Reminding yourself that you’ve been successful before — and you will certainly be successful again.

Have you traveled the Expert-to-Novice journey? Share how WHY guided you until you were back “in the zone” at