Carper Ways Of Knowing In Nursing

Regrettably, the existence of nursing depends on the medical inadequacy of others. Unfortunately, nursing exists because people get hurt, cannot care for themselves, or need assistance with daily activities. Carol Taylor (2011), author of Fundamentals of Nursing: The Art and Science of Nursing Care, writes, “Nursing care involves any number of activities, from carrying out complicated technical procedures to something as seemingly as holding a hand” (p. 5). Taylor explains it is the duty of a nurse not only to learn the pertinent skills but also to bond with and comfort others. Nurses have to do and become many things: They must be stern when necessary, compassionate when needed, open minded

Therefore, it is necessary to examine the nature of nursing and the knowledge base nurses bring to the clinical setting to define the scope of nursing practice (Berragan, 1998). To better understand nursing practice, Barbara Carper in 1978 identified four patterns of knowing nurses adopt in clinical practice. They are empiric knowing, ethical knowing, personal knowing, and aesthetic knowing.

My journey to nursing began with my personal healthcare experience, and has continued to evolve since entering the nursing program at State University. My personal philosophy of nursing is related my life experience and my personal philosophy of life. Using reflection-on-action, I have begun to understand the influences that have lead me to nursing. I discovered client and family centered care to be an important quality when I look at the influential nurses in my life. To develop a positive therapeutic nurse-client relationship, nurses must integrate all 5 dimensions of the therapeutic nurse-client relationship into their practice (CNO, 2006). When it comes to providing client-centered care, the dimensions of trust, empathy

According to Carper (1978), in order for nurses to learn and be taught, there must be an understanding, by both the educators and students, of the patterns of nursing practice. These patterns have been categorized into four ways of knowing: empirical, esthetics, personal knowledge, and ethics. Zander (2007) identifies four other ways of knowing; experience, intuition, unknowing, and sociopolitical.

The nurse also has to be aware of the nature of the nurse-patient relationship, the environment in which it takes place in, as well as an understanding of the context and the moment of the interactions in order to share a meaningful experience. Finally, nurses have to be passionate about his or her career. Nurse’s care and tend to the patients’ needs because nurses are passionate about the career. Even though the fundamental pattern of personal knowing, it provides a holistic nature of knowing. Many humanistic theories and models of nursing have been derived from personal knowing such as Peplau’s interpersonal relation theory, Kolcaba’s comfort theory, and Jean Watson’s theory of caring.

There are many concepts in nursing theory that need further clarification. A concept analysis can provide a thorough explanation of a term in nursing theory that will help healthcare professionals better communicate. The Walker and Avant approach to perform a concept analysis was specifically formulated with nurses in mind (McEwen & Wills, 2014). Walker and Avant proposed a concept analysis be used to further understand the meaning of a term or concept in anticipation that those using the term would have the same understanding (McEwen & Wills, 2014). When a term or concept is in question or needs further questioning in any field of nursing, a concept analysis is indicated (McEwen & Wills, 2014). Walker and Avant’s concept analysis is comprised of eight steps; select a concept, determine the aim of the concept, list all possible uses of concept, defining attributes, model case, alterative case (borderline, related, contrary, invented, and illegitimate), list antecedents and consequences, and lastly list empirical referents (McEwen & Wills, 2014). The defining attributes are deemed most beneficial in obtaining comprehension due to the fact that these attributes show which show up in regularity when relating to the concept (Linda & Judith, 2011). Using the Walker and Avant concept analysis model a formal concept analysis will be performed on the term “pain”. Middle range nursing theory gave the example of pain as one of many concepts used in nursing (McEwen & Wills, 2014).

This paper explores Carper’s four fundamental ways of knowing, including its relationship and application to nursing theory. Carper (1978) identifies four ways of knowing as empirical, personal, ethical, and aesthetic. Each is individually important to nursing, but cannot adequately address the fundamental principles of nursing alone. This paper examines each pattern as expressed herein and ensures that all the relevant areas of nursing are attended to in the most professional, competent, and ethical manner.

Throughout the development of theory in the discipline of nursing there are concepts of knowledge that are fundamental. Four of these patterns of knowing were first explored by Carper (1978) which included: empirical knowing, ethical knowing, personal knowing, and aesthetic knowing. Later, an additional facet was added by Chinn and Kramer (2008) which introduced emancipitory knowing. While all of these forms of knowledge are critical for holistic nursing care, this paper will place an emphasis on personal knowledge and how it contributes to the development of knowledge within nursing and the roles of advanced care practitioners.

Clinical reasoning is embedded in nurses’ thinking for patient care (Levett-Jones 2013). It is a spiral, continuous mental process, underpinned by critical thinking theory and a sound body of nursing knowledge (Levett-Jones 2013). The clinical reasoning cycle includes considering patient’s situation, collecting cues, processing information, identifying problems, establishing goals, taking action, evaluating outcomes and reflecting on the process undertaken (Levett-Jones 2013). Nursing practice for registered nurses is guided both by the National Competency Standard (Nursing and Midwifery Board of Australia 2006) and the Nursing Practice Decision Flowchart (Nursing and Midwifery Board of Australia 2010) to ensure patients’ safety and to optimise care by challenging medical assumptions and facilitating evidence-based practice. The clinical reasoning framework, therefore, allows nurses to prioritise the most time sensitive and specific information, to recognise deteriorating patients and to manage complex clinical situations (Levett-Jones & Bourgeois 2011). This paper will focus on processing information and identifying the two major problems in the case study of Mr. Brown, a 74-year-old man, who was admitted to hospital after a ‘fainting’ episode with chief complaint of dizziness.

Nursing was, for my sixteen year old self, taking care of the sick. Little did I know the complexities of that definition. Still, taking care of the sick was interesting enough to make nursing my major. I started practicing nursing years ago. However, I still struggle defining and explaining my profession to others. I usually start by differentiating nursing from medicine. Nurses see patients as humans rather than a disease that needs treatment (Zaccagnini & White, 2014, p. 15). However, as I advance my career, I must actively incorporate nursing theory into my practice. Nursing theory gives a foundation to understand patients and their health problems better. The use of nursing theory provides a framework to evaluate nurses’ interventions on a higher standard (Zaccagnini & White, 2014). Kenney described five steps to follow once the decision to include nursing theory has being made. This paper will explore the process of applying the Kenney’s five steps into my practice.

When looking at Nursing as a profession, it is important to identify the body of knowledge which pertains to its profession. According to Carper (1978) the body of knowledge that serves as a rationale for nursing practice has patterns, forms and structure. Understanding these patterns is essential for the teaching and learning of nursing as a profession. Carper (1978) identifies four fundamental patterns of knowing and are known to be empirics, ethical, aesthetics and personal knowledge. Chinn & Kramer (2008) added the fifth pattern to knowing called Emancipatory knowing to address the issues of equality and justice. This essay will explain the five ways of knowing and show how it relates to my nursing practice.

Background - The modern nurse has a rewarding, but extra challenging, career. The role of the 21st century nurse is not limited to assisting physicians, but to be more of a partner with both the doctor and patient as an advocate, teacher, researcher, counselor, case manager, and of course, caregiver. Because of the complexities of the marketplace, HMOs, governmental structure, rising costs, lack of adequate staff and support, the nurse must rely on a number of tools in order to be effective and successful. The nurse must have the ability to analyze materials from other nurses and scholars, and must remain current with both scholarship and practice. It is therefore advantageous for the nurse to have access to understanding many of the theoretical templates that nursing scholarship has to offer. While unlikely that a nurse will utilize only one theoretical view, the more robust the toolbox, the better the nurse will be able to handle difficult situations (Kozier, Erb and Blais, 1997).

After struggling to accommodate to her new life with the help from one friend for an entire week, M.M sought support after coming into Lanigan Hospital. Here, we would help get home care in place, and consider other accommodations M.M would now need to live functionally on her own with added support. By using Carpers Fundamental Ways of Knowing, we can explain this situation from the perspectives of empirics, personal and ethical knowing to understand how things such as this slip through the cracks and how to better prevent situations such as these from occurring in the future.

The purpose of this assessment is to provide a reflection using the four patterns of knowing by Carper, which is empirical, aesthetic, ethical, personal factors and the importance of implementing them into my nursing practice.

“Caring in nursing has been seen as the essence of nursing, as the tradition of nursing, and as a process of interaction and communication in nursing“ (Locsin, 1995.) The act of caring has always had a big association in the profession of nursing. The profession of caring in nursing encompasses many different components that develop a therapeutic nurse-client relationship. Some of these components are: communication, comfort, listening, patience, accountability and honesty (Potter & Perry, 2010.) The purpose of this paper is to explore the nursing concept of suffering. The concept of suffering will be described through multiple different resources and through personal experiences in a professional practice setting. Suffering is a concept that may be only visible in the mind of those who suffer, but leaves an individual portrayed as broken. Therefore nurses should always effectively demonstrate care for those who are suffering whether from trauma, loss or illness.