Nursing practices carried out in a critical care environment have developed progressively and now it is not possible to regulate or create a routine of a nurse’s duties. In the past delegation and formalization of nursing care and shifting their responsibilities was considered normal and was done for meeting nurse turnover. Patient welfare was not considered essential and there were no motivations or added benefits for permanent careers for clinical nurses in hospitals. This is no longer acceptable because of patient complications, reduced periods of hospitalization and critical levels of treatment and care that is essential for patient welfare. This has created a dire need for very experienced nurses for the handling of patients.

The responsibilities of nurses have increased with the complexities of the profession and nursing today is considered to be progressive with permanent career prospects. This has also highlighted the difference between novice nurses and nurses with the requisite experience essential in today’s complex patient care environment.

For earning the requisite skills to be termed a qualified and experienced nurse, the nursing profession requires a long-term commitment to career development. The acquisition and development of proficient nursing skills are categorized into different levels of knowledge and capabilities.


The different levels depict variations in two perspectives regarding experienced performance. The first is dependence on theoretical and conceptual standards and starting using the experience as the basis for patient welfare and the development of permanent and long terms career prospects for the nursing professions.

The other is the perception regarding a demanding situation where only certain parts have importance. Nursing theory envisages that the road to becoming an expert nurse usually begins with the first stage of starting as a ‘novice’. These nurses first have to learn the rules of the nursing profession and gain experience in the situations in which they are expected to work.

The second or next stage is that of ‘advanced beginners’ and whose behavior is slightly more acceptable than that of the novices. They do have little experience having to be in real situations or being coached by their mentors about the frequently occurring situations. These advanced beginners have obtained some experience in real situations to recognize the components that should be applied in given situations.

Their guiding standards as based on practical experience. The advanced beginner’s stage is followed by ‘competent nursing’ which applies to nurses who have to work for at least two to three years and perceive their actions in terms of long-term objectives that she recognizes as her ultimate destination as an experienced nurse.

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