Early Ambulation Paper

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

After previously writing about Caper’s (1978) pattern of knowledge defined as personal knowledge I started to reflect back up on each day of what had previously occurred? What had led to the situation? And what could have I done differently to have bettered my relationship with patients? Searching for these answers during my daily practice has opened self-exploration into what nursing means to me. Within this paper I will discuss my philosophy of nursing, my personal definition of nursing, and what guided me towards becoming

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.

The knowing addresses how nurses understand the knowledge. The doing of nursing entails the actions of nurses, bringing both knowledge and practice together (Butts and Rich, 2015). The four patterns of knowing, developed by Carper, include empirics. ethics, aesthetics, and personal knowledge. Empirical knowledge is the scientific aspect of knowing. It is based on general knowledge, and usually shared with other disciplines such sociologists and psychologists. Ethical knowledge involves morals and judgement. This is used when determining right or good acts in nursing practice, ensuring that the best decision is made and is right for the patient. Aesthetic knowledge, the art aspect of nursing, involve of the nurse’s understanding and acknowledgment of other’s living experiences. Showing empathy and respect to patients as they experience their life’s journey. Personal knowledge entails self-awareness and others, and interpersonal skills. These four patterns of knowing shows that nursing practice consist of holistic patient care, and not being solely scientific

Not all patients are capable of independently identifying and articulate their care needs, so the nurse also adapts the role as an advocate. Clarity and continuity in a trusting environment enables good communication. Progressive identification of needs takes place as nurse and patient communicate with one another in the interpersonal relationship (Peplau 1988, p. 84). Being considerate to the needs and vulnerability of patients is a moral attribute, as nurses are accountable for the care they deliver.

Carper (1978) identified four fundamental patterns of knowing which are (1) empirics, or the science of nursing; (2) personal knowledge; (3) esthetics, or the art of nursing; and (4) ethics, or the moral component of nursing. The purpose of this discussion is to explain how each pattern of knowing affects this author’s practice, and to identify the author’s preferred paradigm and provide justification for choosing this paradigm.

It is important in nursing to continue to educate and apply knowledge to our everyday practice by understanding how to establish, asses, and apply our knowledge to nursing. Mantzorou and Mastrogiannis (2011) applies Carper’s four fundamental patterns of knowing in nursing that is necessary for the teaching and learning for nurses. Carper’s four fundamental patterns of knowing in nursing are identified as empirical, ethical, personal and aesthetic (Carper, 1978). Empirical knowing is based on the physical senses which is described as the science of nursing. It is a description of what we as nurses do. It can be shown through observation, analysis and description. One way we demonstrate empirical is by assessing, gathering patient’s information

For my interview, I spoke with one of the Nurse Practitioners (NP) that I interact with while working my shift at the hospital. I will call her Terri Smith because although I asked to use her quotes in my paper, I did not think to ask for permission to use her actual name. Where I work, many of our internal medicine physicians are hospitalists. During the night, they are covered by the umbrella of Quest Care. There are several NPs that work under the afore mentioned physicians and are there, on-call, when needed for their clinical expertise. It is nice, because even though I can’t develop much of a relationship with the doctors whose patients I work so hard to take care of, I get to have the opportunity to grow strong bonds with the NPs that I see almost every shift.

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.

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

This assignment will explore a case study on an episode of care where a patient with chronic pain was hoisted. This will be written from the perspective of the author, a student nurse. The purpose of this assignment is to underline the ethical, legal and professional issues surrounding the episode of care during nursing practice and how these issues influence the role of the nurse and their professional judgement in delivering holistic, person-centred care for the patient. The author will cover the complications on delivering care when healthcare professionals should consider and respect the patient’s decisions and personal preferences whether it may benefit the patient or not. Therefore, the author will argue the principles of the

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

Clinical reasoning is “the process of applying knowledge and expertise to a clinical situation to develop a solution” (Carr, 2004 cited in Banning, 2008, p.177). Poor clinical reasoning skills can lead to a “failure to recue” (Aitken et al., 2003) the deteriorating patient. Additionally, studies by Hoffman et al. have compared the way in which the expert nurse and the novice nurse accurately collect cues from which they base their decisions. Effective clinical reasoning is therefore linked to “the ability to collect the right cues and take the right action for the right patient at the right time and for the right reason” (Levett-Jones et al., 2010). The ability to apply these “five rights of clinical reasoning” (Levett-Jones et al., 2010) will be discussed in more detail in Nursing Actions and Interventions: A Reflection.

R. that he needs to continue to be autonomous in hygiene care tasks such as grooming,

In the professional setting, knowing the patient through his or her diagnosis, name, history of present illness, laboratory results or reason for staying in the hospital only contributes to the manner of physical care of the patient. However, recognizing the patient 's spiritual needs such as emotional support, mental positivity, and intellectual understanding of his or her situation gives a better assessment, as well as a trusting relationship between the nurse and the patient, as per personal experience. In the ward, it is evident that most of the staff nurses spend their time doing documentations, preparing medications, following-up laboratory requests, as well as reading through the patients ' charts to affirm the physician 's order. Throughout the duration of our shifts as student nurses, I see that the most that the staff nurses get to be conversant with the patient is when certain procedures (such as feeding through nasogastric tube, taking