nursingsfundamentalpatternsofknowing-120804010818-phpapp02.ppt

8/14/2019 nursingsfundamentalpatternsofknowing-120804010818-phpapp02.ppt

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Carper (1978) Fundamental

patterns of knowing

Knowledge development for a practice discipline


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The problem of Nursing as a

practice discipline

Nursing involves processes of dynamic

interactions

Nurses in practice know more than they can

communicate to others

Historically what nurses know has not been

communicated well

Empirical knowledge only partially reflectsnursing knowledge

This can be improved when all forms of

knowing are integrated and valued


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Why develop patterns of knowing

The aim of Carpers theory was to:

Formally express nursing knowledge

Provide a professional and discipline

identity

Convey to others what nursing contributes

to healthcare Create expert and effective nursing

practice


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Knowing and knowledge

Knowing and knowledge

Knowing refers to the way of perceiving

and understanding self and the world

Knowledge refers to knowing that is

expressed in a form that can be sharedand communicated to others


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Nursings fundamental patterns

of knowing

Carper (1978)

Ethics

Personal knowing

Aesthetics

Empirics

Chinn and Kramer

(2008) Emancipatory

Knowing

The praxis of nursing


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Ethics: the component of moralknowledge in nursing

Guides and directs how nurses conducttheir practice

Requires Experiential knowledge of social values

Ethical reasoning Focus is on:

Matters of obligation, what ought to be done

Right , wrong and responsibility

Ethical codes of nursing Confronting and resolving conflicting values,

norms, interests or principles


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Sources of Ethical knowing

Nursings ethical codes andprofessional standards

An understanding of different

philosophical positions Consequentialism

Deontology

Duty Social justice


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Personal knowing: acceptance of self thatis grounded in self-knowledge and

confidence

Concerned with becoming self-aware Selfawareness that grows over time through

interactions with others

Used when nurses engage in thetherapeutic use of self in practice Scientific competence, moral/ethical practice,

insight and experience of personal knowing

Personal reflection Informed by the response of others

Openness to experience


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Personal knowing

Personal knowing needs to be

integrated or reconciled with

professional responsibilities

Personal Knowing is the basis of the

therapeutic use of self in the nurse

patient relationship

Perceiving self feelings, and prejudices

within the situation


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Aesthetic knowing: the art ofnursing

Expressed through: Actions, bearing, conduct, attitudes, narrative

and interaction

Knowing what to do without conscious

deliberation Involves:

Deep appreciation of the meaning of a situation

Moves beyond the surface of a situation

Often shared without conscious exchange ofwords

Transformative art/acts

Brings together all the elements of a nursing care

situation to create a meaningful whole


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Aesthetic knowing

Perceiving the nature of a clinicalsituation and interpreting this

information

To respond with skilled action

It uses the nurses intuition andempathy

Is based on the skill of the nurse in a


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Empirics: the science of nursing

Based on the assumption that what is knownis accessible through the physical senses:seeing, touching and hearing.

Reality exists and truths about it can be

understood A pattern of knowing that draws on traditional

ideas of science

Expressed in practice as scientific

competence Competent action grounded in scientific

knowledge including theories and formaldescription

Involves conscious problem solving and logicalreasoning


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Empirical knowing

Positivist science Knowledge is systematically organised

into general laws and theories

Source of this knowledge

Research

Theory


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Emancipatory knowing (Chinn

and Kramer)

Emancipatory knowing addresses thesocial and political context of nursing andhealthcare and critiques the four

fundamental patterns of knowing It recognises serious social barriers to

health and well-being

Emancipatory knowing requires an

understanding of the nature of knowledge Praxis is the process of emancipatory

knowing. It requires both critical reflectionand action


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Methods of turning knowing into

knowledge Problem based learning

An instructional method in which students work in small

groups

Used to gain knowledge and acquire problem-solving skills.

Clinical Supervision An exchange between practicing professionals to enable

the development of professional knowledge and skills

Structured reflection on practice Johns (1994) model of structured reflection used Carpers

fundamental patterns of knowing

Section 5 of the model considers learning gained from the

experience. It asks how has this experience changed my

ways of knowing? Empirics/ Aesthetics/Ethics/Personal

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