Ways of Knowing in Nursing
Deanna Gerowski
Jacksonville State University
How do nurses know what to do? Most would answer that a nurse knows what to do because of the knowledge instilled in them while in school and clinical. But, it is important to refer to the question: How do nurses know? Before this discussion, I would have agreed that knowledge and knowing are the same concept; however, after reviewing Zander’s “Ways of Knowing in Nursing: The Historical Evolution of a Concept,” I agree that, although they are related, the concepts are different. Zander (2007) states knowledge precedes knowing in that it “is the general knowledge an individual possesses prior to entering a discipline such as nursing” (p. 8). Later, however, she visits the ideas of Chinn and Kramer who link knowledge and knowing oppositely stating, “ways of knowing lead to nursing knowledge, rather than knowledge being the basis for knowing in nursing” (Zander, 2007, p. 9). Whether one believes knowledge is established first, knowing establishes knowledge, or vice versa, the important point is that knowledge and knowing are not interchangeable, but separate concepts that contribute to each other. Zander (2007) cites many authors in order to conceptualize different ways of knowing. The foundation of her article is derived from Carper’s four patterns of nursing; however, she includes ideas from other authors who either expanded upon or operationalized Carper’s original work (Zander, 2007, p.
I define my philosophy of nursing within the three nursing domains of person, health, and environment. My goal is to communicate the importance of nursing as a knowledge-based career, depending not only on the nurse fulfilling her role but also on the patient’s compliance. A patient must learn to provide self-care at home in the same capacity as the nurse would provide care in the clinical setting. I discuss various subjects within nursing. I explain why I want to be a nurse, what I believe a nurse’s role is, the different domains of nursing, and where I believe nursing will be in the future. My philosophy demonstrates the interdependence of the nursing domains. You cannot fully evaluate a person without evaluating their health,
The advanced practice nurse (APN) brings the combined training and experience received in school and the clinical practice to enhance patient care. Clinical decisions require problem solving, critical thinking, ethical judgment, and evidence-based practice to ensure patients receive the best care (Pearson, 2013). This unique set of skills allows the APN to determine areas needing further study to improve patient outcome. This paper will introduce the author’s phenomenon of interest and primary philosophic viewpoint for providing patient care, discuss an alternative or opposing philosophic viewpoint to patient care, and summarize the four patterns of knowing in nursing identified by Barbara Carper in 1978.
Several learning theories have been put forward to explain how learning takes place in individuals. These theories have found application in formal learning situations including nursing education and training. In addition, a number of nursing theories also aim to prescribe the best approach to the practice of nursing in a professional environment. Of the learning theories, social learning theory takes into account the role of the environment in shaping responses through interaction with the cognitive skills of the learner. The deliberate nursing process theory also emphasizes the importance of responding to the real environment instead of blindly implementing prescribed solutions. This essay discusses the responses of a nursing professional in a real-life learning environment in the light of social learning theory and deliberative nursing process theory.
It is essential in nursing to continue learning and applying knowledge to the everyday practice. In doing so, it is important to understand how to organize, test, and apply knowledge to nursing. Barbara Carper identified four fundamental patterns of knowing in nursing which are necessary for the teaching and learning of nursing. Carper's four fundamental patterns of knowing in nursing are defined as empirical, ethical, personal and
Nursing knowledge is the result of incorporating what is known and understood through learning, research, experience, and theory. Knowledge depends on research and theory to provide a collective, structured, and current information. This information can be used to explore phenomena, answer questions, generate new theory, and solve problems. DNPs need to be familiar with the components and levels of abstraction in nursing knowledge. The way to comprehend this information is by using the structural holarchy established by Jacqueline Fawcett. It distinguishes the various components of nursing knowledge based on the level of abstraction. Fawcett (2005) develops nursing knowledge into a structural holarchy with five components: metaparadigm, philosophy, conceptual model, theory, empirical indicator. The larger whole is nursing knowledge and each component is a complete whole as well as part of a larger whole. The most concrete component in the holarchy of nursing knowledge is the empirical indicator and the most abstract component is the metaparadigm (Butts & Rich, 2015).
There are different types of knowledge and different ways of knowing. Four fundamental concepts of knowing in nursing highlighted by Caper (1978) are empirical, personal, ethical and aesthetic. He divided knowledge into two forms which are tacit and explicit. Tacit is insights and based on experience and not easily visible and expressible, difficult to share and communicate with others which is highly personal. Empirical sources of knowledge depend upon an individual’s manner of observing and responding to events in the outside world (Higgs et al, 2004). Whereas explicit is formal and based on rationality and easily can be expressed, shared, communicate which are highly universal principles. Rationalism comes from within the individual and
The first pattern of knowing in nursing presented is the Empirics: the science of nursing. Carper (1978) described this empirical knowing as factual evidence and proven medical research or documentation used for patient treatment. This empirical knowledge is vastly related explanations and predictions from facts and things that have been proven. This author believes that most of this scientific evidence or knowledge stems from books and clinical experiences gained in healthcare facilities under the leadership of trained educators or licensed medical providers. This author believes this because as a nursing student, she will learn nursing techniques such as inserting foley catheters, and doing injections first by observing the nursing
“Why do you want to be a nurse?” A question that has been asked more times than can
Nursing is not just a collection of tasks. To provide safe and effective care to the clients, nurses must integrate knowledge, skills and attitudes to make sound judgement and decisions. This essay describes some of the essential knowledge, skills and attitudes of nursing and discusses why they are essential attributes of a competent nurse.
Patricia Benner is known as one of the most recognized theorist of our time. Patricia born in 1955 in Hampton, Virginia spent most of her childhood in California. It was there that she received her professional education. This paper will focus on her Novice to Expert theory using the Model of Skill Acquisition through defining concepts within her conceptual framework, identifying assumptions within her theory, discussing the significance of her theory as it relates to advanced practice nursing, and addressing how applicable her theory is to actual nursing 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.
Carper's Way of Knowing- In 1978, Barbara Carper, Professor of Nursing at Texas Woman's University, proposed patterns of healthcare knowing in a journal article in Advances in Nursing Science. Her rationale was that there needed to be a guide that would act as a developmental tool for nurses so that they could share their experience and enhance the goals of patient management, education, and further research (Carper, 1978). Like Jean Watson's Theory of Caring, many experts in the nursing field
So I bring up this controversial topic again, about both mental and physical health and how important it is to take some time out of our crazy busy lives as nurses just to sit with our patients for a few minutes to discuss their pain. By pain, I mean both mental and physical pain. The purpose of this paper is to discuss a situation I was involved in as a nursing student in the clinical setting and how I can critically analyze this situation using Carper’s Fundamental Patterns of Knowing in Nursing (1978). This model has helped many practitioners to consider what they learn throughout reflection on their experience within a holistic way.
Patricia Benner described the first stage as the novice nurse who is taught general rules to perform tasks without any, or very few, clinical experience. This rule-governed behavior is limited and inflexible (“From Novice to Expert”, 2013). Most nursing students are in the novice stage while they are completing their educational requirements (Cherry & Jacob, 2014). Although they have some exposure to clinical experience, it is limited and under the guidance of a nursing instructor rather than in a “real world” setting. According to Cherry & Jacob (2014), once the nursing student graduates, he or she will begin the progression into the advanced beginner stage (second stage). The advanced beginner nurse is able to make some judgment calls based on having experience in actual situations and performance is adequate. During this stage, the nurse begins to formulate principles to guide actions (“From Novice
Historically, the nursing discipline has borrowed its basis for knowledge and practice from other disciplines (Weaver & Olson, 2006). Today, inquiry specific to nursing is continually changing and growing, as nurses are increasingly interested in developing their own unique body of knowledge. This interest results partially from the emergence of nursing paradigms in recent years. According to Weaver & Olson (2006), paradigms are practices and beliefs that manage our knowledge by proving a framework with which to utilize within our profession, and to guide nursing research. A paradigm shapes our quest for epistemological awareness (Weaver & Olson, 2006). Examples of paradigms common within nursing are empirical, interpretive, and critical paradigms. While each paradigm is unique with sometimes competing focuses, each contributes greatly to nursing knowledge, practice, and research.