THEORETICAL FOUNDATIONS OF NURSING

NURSING THEORIES: BENNER AND ERIKSSON

Week 5 | September 12-16, 2022
Sherrmaine Joyce S. Clarianes, RN, CRN, MPA, MIH Faculty-in-Charge

OBJECTIVES
● Provide an overview on the lives of the following theorists:
○ Patricia Benner
○ Katie Eriksson
● Discuss the following theories:
○ Nursing Expertise Levels
○ Caritative Caring Theory
● Relate and apply these theories in nursing practice.

PATRICIA BENNER

● Born: August 31, 1942, Hampton, Virginia

● She is a nursing theorist, academic and author.
● She is known for one of her books, From Novice to Expert: Excellence and Power in
Clinical Nursing Practice (1984).
● Benner, her parents and her two sisters moved to California when she was a child.
● Benner decided to become a nurse while working in a hospital admitting
department during college

● She earned an associate degree in nursing from Pasadena City College

simultaneously with a bachelor's degree from Pasadena College in 1964.
● She married Richard Benner in 1967 and they had two children. Benner earned a
master's degree in nursing from UCSF in 1970 and a PhD from the University of
California, Berkeley in 1982.
● Benner joined the nursing faculty at UCSF in 1982. Early in her academic career,
Benner led the Achieving Methods of Intra-professional Consensus, Assessment and
Evaluation Project
● She wrote her influential book, From Novice to Expert: Excellence and Power in
Clinical Nursing Practice, in 1984, based on her work with the AMICAE Project.
● The work describes a five-stage career trajectory from novice nurse to expert.

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 STAGES OF NURSING EXPERTISE THEORY

● Novice to Expert Theory

● Benner's novice to expert theory asserts that expert nurses develop their
knowledge of patient care and extensive skill set by obtaining experiences
collected over a course of time as well as having an education background.

● The theory focuses on how nurses acquire their nursing knowledge,

particularly how a nurse could gain knowledge or "know-how" without
learning a theory, referred to as "know-that".

● The novice to expert process is one of skill acquisition and is supported as well as
defined by the Dreyfus model of skill acquisition, which acts as a foundation for
the theory.

● This model demonstrates how students gain knowledge or skills.

● Benner applies this theory to the nursing profession by outlining the same five
stages or levels of clinical competency:

STAGES OF NURSING EXPERTISE THEORY

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 STAGES OF NURSING EXPERTISE THEORY

● These five levels represent an overall change in two aspects of a nurse's skills,
increased independence in reliance on abstract ideas and principle and an increase
in critical thinking.
● As one collects more concrete experiences, they are then able to use these as
paradigms rather than abstract principles, which also leads to an increase in critical
thinking.
● Experiences gained over time will enable a change in perception. Such a change in
perception will then open up a new level of thinking that is based on each situation
and is more holistic, rather than abstract and pieced-together knowledge that a
novice might have.

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 STAGES OF NURSING EXPERTISE THEORY

KATIE ERIKSSON

● Born: November 18, 1943, Finland.

● Belongs to the Finland-Swedish minority in Finland, and her native language is
Swedish.
● She graduated at Helsinki Swedish School of Nursing in 1967 and completed her
public health nursing specialty education at the same institution.
● She is considered to be one of the pioneers of caring science in the Nordic
countries.
● When she started her career, she had to open the way for a new science.
● She graduated in 1970 from the nursing teacher education program at Helsinki
Finnish School of Nursing.

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 ● She continued her academic studies at University of Helsinki, where she received
her MA degree in philosophy in 1974 and her licentiate degree in 1976.
● In 1984, Eriksson was appointed Docent of Caring Science (part time) at
University of Kuopio, the first docentship in caring science in the Nordic countries.
● She was appointed Professor of Caring Science at Åbo Akademi University in
1992. Between 1993 and 1999, she held a professorship in caring science at
University of Helsinki, Faculty of Medicine, where she has been a docent since
2001.
● Since 1996, she has also served as Director of Nursing at Helsinki University
Central Hospital, with responsibilities for research and development of caring
science in connection with her professorship at Åbo Akademi University.

THEORY OF CARITATIVE CARING

● This model of nursing distinguishes between caring ethics, the practical
relationship between the patient and the nurse, and nursing ethics.

● Nursing ethics are the ethical principles that guide a nurse’s

decision-making abilities.

● Caritative caring consists of love and charity, which is also known as caritas, and
respect and reverence for human holiness and dignity.

● According to the theory, suffering that occurs as a result of a lack of caritative

care is a violation of human dignity.

CARITAS
● Means love and charity.
● In caritas, eros and agapé are united, and caritas is by nature unconditional love.
● Caritas, which is the fundamental motive of caring science, also constitutes the
motive for all caring.
● It means that caring is an endeavor to mediate faith, hope, and love through
tending, playing, and learning.

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CARING COMMUNION
● Constitutes the context of the meaning of caring and is the structure that
determines caring reality.
● Caring gets its distinctive character through caring communion, it is a form of
intimate connection that characterizes caring.
● Requires meeting in time and space, an absolute, lasting presence, characterized by
intensity and vitality, and by warmth, closeness, rest, respect, honesty, and
tolerance; and is seen as the source of strength and meaning in caring.

THE ACT OF CARING

● Contains the caring elements (faith, hope, love, tending, playing, and learning),
involves the categories of infinity and eternity, and invites deep communion.
● The act of caring is the art of making something very special out of something less
special.

CARITATIVE CARING ETHICS

● Comprises the ethics of caring, the core of which is determined by the caritas
motive.
● Deals with the basic relation between the patient and the nurse—the way in which
the nurse meets the patient in an ethical sense.
● It is about the approach we have toward the patient.
● Nursing ethics deals with the ethical principles and rules that guide my work or my
decisions.
● Caring ethics is the core of nursing ethics.

DIGNITY
● Constitutes one of the basic concepts of caritative caring ethics.

INVITATION
● The act that occurs when the carer welcomes the patient to the caring communion.

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 ● The concept of invitation finds room for a place where the human being is allowed
to rest, a place that breathes genuine hospitality, and where the patient’s appeal for
charity meets with a response
SUFFERING
● An ontological concept described as a human being’s struggle between good and
evil in a state of becoming.

SUFFERING RELATED TO ILLNESS, TO CARE, AND TO LIFE

● These are three different forms of suffering:
○ Suffering related to illness
■ It is experienced in connection with illness and treatment.
○ Suffering related to care
■ It is when the patient is exposed to suffering caused by care or
absence of caring, which is always a violation of the patient’s dignity.
■ Not to be taken seriously, not to be welcome, being blamed, and
being subjected to the exercise of power are various forms of
suffering related to care.
● Suffering related to life
○ The situation of being a patient.

THE SUFFERING HUMAN BEING

● The concept that Eriksson uses to describe the patient.
● The patient refers to the concept of patiens (Latin), which means “suffering.”
● The patient is a suffering human being, or a human being who suffers and patiently
endures.

RECONCILIATION
● Refers to the drama of suffering.
● A human being who suffers wants to be confirmed in his or her suffering and be
given time and space to suffer and reach reconciliation.

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 ● Reconciliation implies a change through which a new wholeness is formed of the life
the human being has lost in suffering.
● In reconciliation, the importance of sacrifice emerges, having achieved reconciliation
implies living with an imperfection with regard to oneself and others but seeing a
way forward and a meaning in one’s suffering.
● Reconciliation is a prerequisite of caritas.

CARING CULTURE
● The concept that Eriksson uses instead of the environment.
● It characterizes the total caring reality and is based on cultural elements such as
traditions, rituals, and basic values.
● Caring culture transmits an inner order of value preferences or ethos, and the
different constructions of culture have their basis in the changes of value that ethos
undergoes.

THEORY OF CARITATIVE CARING

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● Caritative nursing means that we take caritas into use when caring for the
human being in health and suffering.
● Caritative caring is a manifestation of the love that ‘just exists.’
● Caring communion, true caring, occurs when the one caring in a spirit of caritas
alleviates the suffering of the patient.
● The ultimate goal of caring is to lighten suffering and serve life and health.
NURSING: Caritative Ethics makes a basic distinction between caring and nursing ethics. Caring ethics, the
core of nursing ethics, deals with the patient-nurse relationship. Nursing ethics deals with ethical principles and
rules that guide nursing decisions.