Development at the bedside: evolutionary development of the experienced registered nurse.

The purpose of this study was to describe the evolution of skills acquisition required for nurses to develop expertise within their clinical specialty. The goal of the research was to identify a professional career path that could be better supported through institutional infrastructures and educational programs. The results of the study demonstrate that reinforcing developmental and support loops serve as the living foundation for experienced practice and identify blockers and competing forces for skill acquisition. This article presents the nurses' perspectives of their development and focuses on the implications their responses have for staff development educators.