Phenomenon Of Interest Paper

As a provider of care, professional nurses depend on research, theories, and evidence based practice to guide the care they provide to patients. Nurses deliver care to their patients based on information they have learned through many years of school and training. Training for nurses and other providers of care is founded on theories, research, and evidence based practice in the healthcare field. Theories, research, and evidence based practice are all important for providing care to patients and each can be used in a different manner depending on the situation. Clinicians often use research based evidence to design and implement care that is high-quality and cost effective for patients. Evidence based practice can be used to provide care to patients in a steadily changing clinical environment. (PDF page 8-9). Nursing theories are frequently used as frameworks for establishing nursing care interventions and assessing

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.

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.

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

The five fundamental patterns of knowing are empirical, aesthetical, personal, ethical and sociopolitical. The patterns or ways of knowing help with the development and application of nursing knowledge. Empirical knowing embodies “factual and publicly verifiable descriptions, empiricism and theoretical explanations or predictions” (Carper, 2012 p.25). In my Oncology setting the science of nursing is very relevant to practice. I use science daily in calculating body surface area for chemotherapy drugs, chemotherapy protocols and febrile-neutropenia protocols with the initiation of specific antibiotics are some examples. Empirical knowing provides facts from empirical research for nursing care and interventions. Aesthetical knowing is known as the “art and act” of nursing, it highlights empathy. This pattern of knowing recognizes the nurse’s perception of what is significant in an individual patient’s behaviour (Carper, 2012). I utilize the art of nursing by acknowledging the patient’s feelings and being present for them during a difficult time and the ability to establish a meaningful connection with the patient.

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

Ethical knowing or the moral direction of nursing is focused on the nurses’ responsibility of knowing what out to be done and what is good and right (Carper, 1978). Ethical knowing “guides and directs how nurses morally behave in their practices” (Chinn & Maeona, 2011, p. 7). This nurse practices ethics by being a patient advocate and preserving his client's right to choose or refuse care. This patient advocacy will continue as this nurse advances to the role of APN.

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.

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

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.

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).

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

“Advanced nursing practice is the deliberative diagnosis and treatment of a full range of human responses to actual or potential health problems.” (Calkin, 1984). Advanced nurse practitioners attempt to maximize the use of knowledge and skills and improve the delivery of nursing and health care services. The field of advanced nursing practice differs from basic practice as the former requires clinical specialization at the master’s level. At this level, nurses become expert practitioners whose work includes direct and indirect patient care. Direct patient care involves caring for patients and their families; this is the focus of my section on nurse clinicians. Indirect patient care includes work as an educator, researcher, and a