Patterns Of Knowing In Nursing

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)

Theory is an arrangement of thoughts meant to describe something. These thoughts and ideas usually have basic principles that validate the purpose of the proposed theory. Nursing theory is a well thought out scholarly structure of concepts. These concepts are created to help guide nursing practice. They explain the fundamentals of nursing care. Multiple clinical decisions are based upon nursing theories. There are many different types of nursing theories developed primarily by nurses. Nursing theorist’s main goal is to examine nursing practice and explain the working or non-working parts

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

According to Carper, one pattern described in the pattern of knowing is aesthetics. Aesthetics is essentially empathy, or having the capacity to understand what another person is experiencing (Carper, 1978). Aesthetics is purely subjective, exclusive, and open to interpretation. “Aesthetics require from the nurse to be fully engaged in the moment of the experience and interpret a client situation all at once by elucidating the meaning of the process and looking beyond the situation to focus on what might be (envisioning), so as to act according to what has been envisioned (Mantzorou & Mastrogiannis, 2011, p. 253). In essence, aesthetics is the process of nursing that involves caring for our

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.

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.

Patterns of Knowing that Define Nursing Barbara A. Carper (1978) introduced four fundamental patterns of knowing that are interrelated processes that a nurse must strive to master in order to deliver optimal care. Empirics, esthetics, personal knowing, and ethics entail specific characteristics that when employed, present the nurse with heightened consciousness not only in his or her care giving, but also about the intricacies involved in nursing as a practice (Carper, 1978). Each pattern of knowing is distinctive and offers the nurse a necessary and unique proficiency and when used synergistically, they allow the nurse to deliver truly holistic care (Carper, 1978). Empirics as a pattern of knowing focuses on facts that are testable and

I appreciate your thoughts and examples of the ways of knowing in nursing. I agree that Watson's Theory of Human Caring aligns nicely with personal knowing. Watson expounds that through transpersonal caring may be developed by identifying ourselves with others or by finding the patient’s dilemmas in ourselves. When transpersonal caring occurs, self-knowledge and wisdom are developed (Watson, 1999). Watson further discusses in her book, Post Modern Nursing and Beyond, this type connectedness keeps alive common humanity (Watson, 1999). In turn, this personal connection allows the nurse to have more insight and knowledge to provide individualized and holistic nursing care. Watson, J. (1999). Postmodern nursing and beyond. Santa Fe, NM: Harcourt

What determines if one is considered to be a “good” nurse? Perhaps if tested, what is the criteria to which one would be graded? According to the founder of modern nursing, Florence Nightingale, “The very elements of what constitutes good nursing are as little understood for the well as for the sick.” (BrainyQuote.com, n.d.). Since the beginning, the nursing process has been continually evolving in the pursuit of better accommodating the needs of its patients and their families. “Nursing is a dynamic profession and therefore needs continual exploration of the various concepts linked to its educational and evaluative processes.” (Zander, 2007, p.7). In 1978, a woman named Barbara A. Carper wrote an article titled “Fundamental Patterns of Knowing in Nursing” that has since been used as one of the many “backbones” of modern nursing (Carper, 1978). “In 1978, Carper wrote that nursing sought to develop a holistic, individualistic, and therapeutic model of practice that took the profession away from the autocratic, reductionist, and behaviorist characteristics of the medical model.” (Zander, 2007. p.7). Carper simplified this approach to ways of knowing in nursing into four categories: Empirics, Ethics, Esthetics, and Personal (Carper, 1978). During the following, these attributes will be discussed in further detail and examples will be provided of each.

I agree. Nursing intuition is a vital part of what we do. Most of us nurses feel that our profession is more than a job, it’s a calling. I have often wondered if some of my “gut feelings” are from God. Years ago, my crew and I were on the ambulance and we were called to a residence to assist a toddler that had a witnessed seizure and was not breathing. On the way to the house, I lifted my hands up and said, “God, here are these hands, do with them as you please”. I did that because I was not comfortable in caring for children, and I knew that if a miracle were going to occur God would need to assist. When we arrived, the paramedics on scene were frantically doing everything per protocol, and I began to assist. In the end, the child survived

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)