Carper Ways Of Knowing In Nursing

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.

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.

Nursing was, for my sixteen year old self, taking care of the sick. Little did I know the complexities of that definition. Still, taking care of the sick was interesting enough to make nursing my major. I started practicing nursing years ago. However, I still struggle defining and explaining my profession to others. I usually start by differentiating nursing from medicine. Nurses see patients as humans rather than a disease that needs treatment (Zaccagnini & White, 2014, p. 15). However, as I advance my career, I must actively incorporate nursing theory into my practice. Nursing theory gives a foundation to understand patients and their health problems better. The use of nursing theory provides a framework to evaluate nurses’ interventions on a higher standard (Zaccagnini & White, 2014). Kenney described five steps to follow once the decision to include nursing theory has being made. This paper will explore the process of applying the Kenney’s five steps into my practice.

Background - The modern nurse has a rewarding, but extra challenging, career. The role of the 21st century nurse is not limited to assisting physicians, but to be more of a partner with both the doctor and patient as an advocate, teacher, researcher, counselor, case manager, and of course, caregiver. Because of the complexities of the marketplace, HMOs, governmental structure, rising costs, lack of adequate staff and support, the nurse must rely on a number of tools in order to be effective and successful. The nurse must have the ability to analyze materials from other nurses and scholars, and must remain current with both scholarship and practice. It is therefore advantageous for the nurse to have access to understanding many of the theoretical templates that nursing scholarship has to offer. While unlikely that a nurse will utilize only one theoretical view, the more robust the toolbox, the better the nurse will be able to handle difficult situations (Kozier, Erb and Blais, 1997).

After struggling to accommodate to her new life with the help from one friend for an entire week, M.M sought support after coming into Lanigan Hospital. Here, we would help get home care in place, and consider other accommodations M.M would now need to live functionally on her own with added support. By using Carpers Fundamental Ways of Knowing, we can explain this situation from the perspectives of empirics, personal and ethical knowing to understand how things such as this slip through the cracks and how to better prevent situations such as these from occurring in the future.

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.

My journey to nursing began with my personal healthcare experience, and has continued to evolve since entering the nursing program at State University. My personal philosophy of nursing is related my life experience and my personal philosophy of life. Using reflection-on-action, I have begun to understand the influences that have lead me to nursing. I discovered client and family centered care to be an important quality when I look at the influential nurses in my life. To develop a positive therapeutic nurse-client relationship, nurses must integrate all 5 dimensions of the therapeutic nurse-client relationship into their practice (CNO, 2006). When it comes to providing client-centered care, the dimensions of trust, empathy

Throughout the history of nursing, there have been many nursing theorists who have each made significant contributions towards the shaping of nursing knowledge. Each of these theorists have differing perspectives and interpretations of how each domain of the nursing metaparadigm fit into their respective theories. The four domains of the nursing metaparadigm are: person, environment, health and illness, and nursing. The purpose of this reflection is to provide an overview of the domains related to the metaparadigm of nursing as well as to introduce this author’s perspective on their developing personal philosophy of nursing. In this paper, the author will take a closer look at each of these areas, how they are individually defined, and how they each fit into the nursing metaparadigm as a whole. At the conclusion of this overview, readers will be introduced to how these theorists and their perspectives have enabled this author to begin to create their own philosophy of nursing.

Regrettably, the existence of nursing depends on the medical inadequacy of others. Unfortunately, nursing exists because people get hurt, cannot care for themselves, or need assistance with daily activities. Carol Taylor (2011), author of Fundamentals of Nursing: The Art and Science of Nursing Care, writes, “Nursing care involves any number of activities, from carrying out complicated technical procedures to something as seemingly as holding a hand” (p. 5). Taylor explains it is the duty of a nurse not only to learn the pertinent skills but also to bond with and comfort others. Nurses have to do and become many things: They must be stern when necessary, compassionate when needed, open minded

The purpose of this assessment is to provide a reflection using the four patterns of knowing by Carper, which is empirical, aesthetic, ethical, personal factors and the importance of implementing them into my nursing practice.

Clinical reasoning is embedded in nurses’ thinking for patient care (Levett-Jones 2013). It is a spiral, continuous mental process, underpinned by critical thinking theory and a sound body of nursing knowledge (Levett-Jones 2013). The clinical reasoning cycle includes considering patient’s situation, collecting cues, processing information, identifying problems, establishing goals, taking action, evaluating outcomes and reflecting on the process undertaken (Levett-Jones 2013). Nursing practice for registered nurses is guided both by the National Competency Standard (Nursing and Midwifery Board of Australia 2006) and the Nursing Practice Decision Flowchart (Nursing and Midwifery Board of Australia 2010) to ensure patients’ safety and to optimise care by challenging medical assumptions and facilitating evidence-based practice. The clinical reasoning framework, therefore, allows nurses to prioritise the most time sensitive and specific information, to recognise deteriorating patients and to manage complex clinical situations (Levett-Jones & Bourgeois 2011). This paper will focus on processing information and identifying the two major problems in the case study of Mr. Brown, a 74-year-old man, who was admitted to hospital after a ‘fainting’ episode with chief complaint of dizziness.

In 1978, Carper identified empirical knowledge as the science of nursing. Its purpose was to reach a conclusion by going through the scientific process. This knowledge has brought upon the literature, theories, models, and principles with which we model our practices on today. Empirical knowledge was the pathway that lead to the science of nursing finding the correlation between health and illness and the impact they have on a person’s life.

“Caring in nursing has been seen as the essence of nursing, as the tradition of nursing, and as a process of interaction and communication in nursing“ (Locsin, 1995.) The act of caring has always had a big association in the profession of nursing. The profession of caring in nursing encompasses many different components that develop a therapeutic nurse-client relationship. Some of these components are: communication, comfort, listening, patience, accountability and honesty (Potter & Perry, 2010.) The purpose of this paper is to explore the nursing concept of suffering. The concept of suffering will be described through multiple different resources and through personal experiences in a professional practice setting. Suffering is a concept that may be only visible in the mind of those who suffer, but leaves an individual portrayed as broken. Therefore nurses should always effectively demonstrate care for those who are suffering whether from trauma, loss or illness.

There are many concepts in nursing theory that need further clarification. A concept analysis can provide a thorough explanation of a term in nursing theory that will help healthcare professionals better communicate. The Walker and Avant approach to perform a concept analysis was specifically formulated with nurses in mind (McEwen & Wills, 2014). Walker and Avant proposed a concept analysis be used to further understand the meaning of a term or concept in anticipation that those using the term would have the same understanding (McEwen & Wills, 2014). When a term or concept is in question or needs further questioning in any field of nursing, a concept analysis is indicated (McEwen & Wills, 2014). Walker and Avant’s concept analysis is comprised of eight steps; select a concept, determine the aim of the concept, list all possible uses of concept, defining attributes, model case, alterative case (borderline, related, contrary, invented, and illegitimate), list antecedents and consequences, and lastly list empirical referents (McEwen & Wills, 2014). The defining attributes are deemed most beneficial in obtaining comprehension due to the fact that these attributes show which show up in regularity when relating to the concept (Linda & Judith, 2011). Using the Walker and Avant concept analysis model a formal concept analysis will be performed on the term “pain”. Middle range nursing theory gave the example of pain as one of many concepts used in nursing (McEwen & Wills, 2014).

By outlining the focus and boundaries of the discipline nursing is able to highlight areas of study that are significant to nursing education and practice, all of which can be traced back to the fundamental concepts. These central ideas feature as integral to nursing development and continue to demonstrate their influence by shaping the way nurses learn and do. The concepts of person, health, environment and nursing are all interrelated, as are the concepts put forward by Newman, Smith, Dexheimer-Pharris and Jones (2008), and can be identified as prominent in nursing studies and the development of nursing theories. The nursing theories based on these fundamental concepts serve as the building blocks for all nursing knowledge and as Smith and Parker (2010) explain “the primary purpose of nursing theories is to further the development and understanding of nursing practice” (p. 8). The structure of knowledge as described by Smith and Parker provides a clear example of how nursing metaparadigms have implications for all levels of nursing theory, education and research from the most abstract or global concepts to the more concrete