Domains of Nursing Practice Effective Management of Rapidly Changing Situations

(Benner, 1984)
Skilled Performance in Extreme Life-Threatening Emergencies: Rapid
The Helping Role
Grasp of a Problem
Contingency Management: Rapid Matching of Demands and Resources in
The Healing Relationship: Creating a climate for and Establishing a
Emergency Situations
Commitment to Healing.
Identifying and Managing a Patient Crisis Until Physician Assistance Is
Providing Comfort Measures and Preserving Personhood in the Face of
Available
Pain and Extreme Breakdown
Presencing: Being with a Patient Maximizing the Patient’s Participation and
Administering and Monitoring Therapeutic Interventions and
Control in His or Her Own Recovery.
Regimens
Interpreting Kinds of Pain and Selecting Appropriate Strategies for Pain
Management and Control
Starting and Maintaining Intravenous Therapy with Minimal Risk and
Providing Comfort and Communication Through Touch
Complications
Providing Emotional and Informational Support to Patients’ Families
Administering Medications Accurately and Safely
Guiding Patients Through Emotional and Development Change
Combating the Hazards of Immobility
Creating a Wound-Management Strategy that Fosters Healing, Comfort, and
The Teaching – Coaching Function
Appropriate Drainage
Monitoring and Ensuring the Quality of Health Care Practices
Timing: Capturing a Patient’s Readiness to Learn
Providing a Backup System to Ensure Safe Medical and Nursing Care
Assisting patients to Integrate the Implications of Illness and Recovery into
Assessing What Can Be Safely Omitted from or Added to Medical Orders
Their Lifestyles
Getting Appropriate and Timely Responses from Physicians
Eliciting and Understanding the Patient’s Interpretation of His Illness
Providing and Interpretation of the Patient’s Condition and Giving a
Organizational and Work-role Competencies
Rationale for Procedures
The Coaching Function: Making Culturally Avoided Aspects of an Illness
Coordinating, Ordering, and Meeting Multiple Patient Needs and Requests:
Approachable and Understandable.
Setting Priorities
Building and Maintaining a Therapeutic Team to Provide Optimum Therapy
The Diagnostic and Monitoring Function
Coping with Staff Shortages and High Turnover
Detection and Documentation of Significant Changes in a Patient’s
Condition
SOURCE: Benner, P. (1984). From Novice to Expert: Excellence and
Providing an Early Warning Signal: Anticipating Breakdown and
Power in Clinical Nursing Practice. Menlo Park, CA: Addison
Deterioration Prior to Explicit Confirming Diagnostic Signs
Wesley.
Anticipating Problems: Future Think Understanding the Particular
Demands and Experiences of an Illness: Anticipating Patient Care Needs
Assessing the Patient’s Potential for Wellness and for Responding to
Various Treatment