Four Fundamental Concepts of Knowing in Nursing Essay

For centuries the development of nursing knowledge has been influenced by numerous theorists and their respective theories. These theories have influenced, and continue to influence, nursing education, practice and research. (Johnson & Webber, 2005)

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.

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

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.

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.

Carper’s ways of knowing provide a fundamental source of information regarding nursing knowledge and practice. Any professional field is built around a variety of knowledge tenets, which help to organize ideas, test those ideas, and then apply them. Carper’s ways of knowing outline fundamental patterns of deriving knowledge and building experience as far as teaching and the practice of nursing are concerned (Zander, 2007). These patterns are used to explain or develop theory in the teaching of nursing, besides helping practitioners to build more knowledge and to enhance their practice. Carper’s ways of knowing identifies four different patterns of knowledge, which are analyzed in this case within their syntactical and conceptual frameworks. They include empirical, personal, ethical, and aesthetic.

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.

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.

In the nursing profession we are able to use multiple ways of knowing. We may not use them all at the same time and some more than the others, but we do use them. “Four fundamental patterns of knowing have been identified from an analysis of the conceptual and syntactical structure of nursing knowledge” (Reed & Crawford Shearer, 2012, p. 200). The four patterns of knowing include: empirical, esthetics, personal, and ethical.

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.

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

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed

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.

The ability to be aware of something either by observation, getting information or through inquiry enable us to know. Knowledge is acquired when one is informed about an object or subject. However in Nursing knowledge is acquired either through scientific or Research (Explicit) and Tacit or Experience (Synthesis of Information)