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Biomedical subjects

P Benner

Publications and source records attributed to P Benner.

16 recordsLinked to original sources
PubMed1992

Lamentations.

Explore the source record for details and available documents.

Christianity↗
PubMed1992

From beginner to expert: gaining a differentiated clinical world in critical care nursing.

The purpose of this study was to further explicate the Dreyfus Model of Skill Acquisition in the practice of critical care nursing. For this analysis data were used from a sample of 105 nurses practicing in the adult, pediatric, and newborn intensive care units of eight hospitals in three metropolitan areas. The data were composed of group interviews in which nurses gave narrative accounts of exemplars from their practice and close observations and intensive personal history interviews of a subsample of nurses. Two interrelated aspects were found to distinguish four levels of practice, from advanced beginner through expert. First, practitioners at different levels of skill literally live in different clinical worlds, noticing and responding to different directives for action. Second, a sense of agency is determined by one's clinical world and shows up as an expression of responsibility for what happens with the patient.

Clinical Competence↗
PubMed1992

Clinical markers of asthma severity and risk: importance of subjective as well as objective factors.

The purpose of this study was to explore patient perceptions of asthma severity and danger from asthma, correlate them with objective measures, and assess the impact of psychologic variables on the perception of severity. Recognition of patients at greatest risk for fatal attacks requires identifying those with severe asthma. In our study of 95 adults with asthma, we found that the subjective factors of perceived severity and perceived danger and the objective factors of medications, hospitalizations, history of intubation, and pulmonary function were important markers of asthma severity and risk. Our findings indicate that asthmatic adults make independent self-assessments that generally correlate with objective markers of increased risk of mortality and increased severity of the asthma. The perception of high severity was significantly correlated with depression, panic-fear, frequency of emergency department visits, and with an objective index of risk of death. The latter includes variables obtainable from history alone (number of medications to control symptoms, need for prednisone, prior intubation, and prior recent hospitalization) and is correlated with spirometric indexes of airflow obstruction, occurrence of nocturnal symptoms, and number of emergency department visits.

Adult↗
PubMed1991

The role of experience, narrative, and community in skilled ethical comportment.

Two major types of narrative--constitutive or sustaining narratives and narratives of learning--are presented to illustrate the functions of narrative in everyday ethical expertise and socially embedded caring practices. Four narrative themes illustrate constitutive and sustaining narratives: healing and transcendence, the heroic saving of a life, fostering care and correction, and stories of being present. Five themes illustrate narratives of learning: the skill of involvement, being open to experience, disillusionment, facing death and suffering, and liberation. Quandary- and rights-based procedural ethics address ethical problems and breakdown and overlook everyday ethical comportment. Public storytelling is recommended as a way to explore notions of the good and ethical concerns.

Assertiveness↗