N108: Transition to the Registered Professional Nurse Role Study Guide 4. Think of and use a second-order strategy, such as recommend an unusual or off-the-wall idea. Becoming a Registered Nurse During the process of becoming a nurse, the student will gradually begin to see herself/himself as a member of the nursing profession. This process involves more than learning techniques and information. • The student learns proficiency in specific tasks or specific information. • The student begins to identify with a peer group. • The student adopts the values of the larger profession and begins to identify with it. Adoption of professional goals is required for socialization into nursing. • The terms socialization or re-socialization are used to describe the theory that the nursing student is remade. This theory assumes values are learned from the environment. Current research argues that most behavior is determined by genetics rather than learned from the environment. Patricia Benner suggests that nursing re-socialization should happen in five stages from novice (newly graduated) to expert (with at least three to five years of experience). The behavior of the novice relies on rules. However, experts have developed an intuitive understanding of situations and the actions required. Benner also believes that becoming an expert requires experience, as expert judgment develops when expectations are compared with reality in practice over time. Clinical ladder programs grew out of Benner’s novice to expert theory, as a way to keep expert nurses at the bedside. Clinical ladders differentiate and describe the skills and performance expected of nurses in terms of advancing levels. Typically, three or four levels of performance are defined, with each higher level having greater responsibility and authority than the previous one. A new graduate nurse usually enters the system as a clinical nurse one and moves to clinical nurse two and then to clinical nurse three as that individual becomes more proficient with his or her skills. Salary increases typically accompany movement from one level to another, and the responsibility the individual is expected to assume also increases. Sometimes additional formal education or continuing education is required for advancement. Through this process the nurse is supported and encouraged to develop greater clinical expertise. The clinical ladder also serves as a mechanism for recognizing and rewarding nurses who wish to remain in direct care positions rather than seek administrative positions. Dalton argues that a career nurse develops from being an apprentice or student, to being an independent colleague, to being a mentor who is responsible for other nurses, then finally becoming a sponsor with the power to direct others. The student is socialized into nursing and then re- socialized after understanding the realities of the job. Some programs may use re-socialization to ease the professional orientation of their graduates. This is done through attending meetings and workshops, completing nursing research, belonging to a nursing organization, writing articles on nursing, and other methods of demonstration.