Reflection Using The Four Patterns Of Knowing By Carper

Stg White has been frequently tarnishing my name and my reputation by talking negative about me to my fellow colleagues and offenders. She has made numerous allegations that I am the worst nurse and I don’t care how I treat offenders. This has been going on for a long time and I thought she will realize and stop, but this has not happened yet. In fact, stg. White has a long history of talking negative about Health service staff and also inciting offenders from being seen by specific providers and nurses. To be specific on Thursday 2/3/16 she called from the unit and reported about an offender who report that she had a boil and wanted to see if she needs to be seen. Based on the information she gave me it didn’t sound like an emergency situation.

Barbara Carper’s Fundamental Patterns of Knowing in Nursing explains the several patterns of knowing as they impact nursing theory development. Carper identified four types of knowing in nursing. These four types of patterns of knowing are: empirical knowing, aesthetics, ethical knowing and personal knowing. This author will analyze these four patterns of knowing and how they relate to nursing today.

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.

Currently, nurses gain nursing knowledge through various sources, such as journals, research articles, books, Internet etc. Nursing knowledge is the basis for conducting research in nursing. This knowledge can be obtained by nurses through personal experience and clinical practice. Carper (1975, 1978) illustrates that the level of understanding is governed by four basic patterns such as Empirics, Aesthetics, personal knowledge

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

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.

Carper’s fundamental ways of knowing include empirics, the science of nursing; esthetics, the art of nursing; the component of a personal knowledge in nursing; and ethics, the component of moral knowledge in nursing (Carper, 1978). Empirical knowing shows the information about the effectiveness with mobilization and the likeliness of being diagnosed with a postoperative complication with delayed mobilization. The aesthetic knowledge shows that some patients may be more at risk for postoperative complications due to certain barriers and their process of trying to prevent any complications may be different from others. Ethical knowledge raises questions on whether or not our care is morally right or wrong (Carper, 1978). Each individual is different and the same approach to mobilization isn’t going to be the same for everyone. One approach that may be beneficial for one patient, can put another patient’s safety at risk. As nurses, we cannot force someone to ambulate, each patient has the right to refuse and in response to that we should be providing patient education to encourage them to ambulate. Personal knowledge is how research affects the way we practice. With the newfound information, I am able to utilize the results in a clinical setting. I am able to see the benefits of early ambulation, the barriers that may cause delayed ambulation and the likeliness

However, human meanings and concerns are difficult to be formalised. Consequently, nursing theorists have considered other legitimate ways of knowing.5 Carper's paper on "patterns of knowing" was a landmark in the nursing literature which extended in a new perspective our understanding of types of knowledge and theory needed in a practice

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)

As an epistemology of nursing, Carper’s ways of knowing encompasses five fundamental patterns of knowing in nursing; empirical knowledge, esthetic knowledge, personal knowledge, sociopolitical knowledge, and ethical knowledge (Carper, 1978). McEwen and Wills (2011) stated that all are essential to the “whole” of nursing” (p. 17). This model of structured reflection challenges habitual practices, interprets the subjective experiences, and projects the effects of nursing actions (Jones, 1994). According to Carper (1978), “an understanding of these patterns is essential for the teaching and learning of nursing” (p. 13). In this paper, I will describe a clinical scenario related to the care of an infant and how the multiple ways of knowing guided my nursing actions in my practice. The names are fictitious to protect the privacy of the patients.

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.

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.

Application of the patterns of knowing is very pertinent to nursing in the delivery of care and improvement of health. Patterns of knowing are everyday nursing. We consciously or subconsciously use these patterns in the fields of nursing to provide care. Barbara Carper (1978) identified four fundamental patterns of knowing to include: personal, empirical, ethical, and aesthetic knowing. These aforementioned patterns of knowing are the fundamental structures that help nurses in advancing their professional knowledge and experience.

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.

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.