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Lecture 5

NSE 11A/B Lecture Notes - Lecture 5: Nursing Diagnosis

Course Code
Sherry Mosko

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1. Discuss how the various “Patterns of Knowing” can influence how we come to know, the development of theory
and the description of concepts in the meta-paradigm of nursing
Ways of Knowing In nursing:
Carper (1978) identified four patterns of knowing that nurses value and use in practice.
o Empirics
o Ethics
o Aesthetics
o Personal knowing
Influence on development of theory & description of concepts
Empirical knowing has prevailed as an approach to knowledge development
Patterns of Knowing In nursing:
Why is it important to understand how we come to know things?
Knowledge can provide the rationale for nursing practice
Carper (1978) was the first to categorize the many ways in which nurses come to “know”
Chinn & Kramer (2008) identified socio-political and economic components and labelled it, Emancipatory
Our many ways of knowing, integrated together, enable nurses to provide safe, effective and personalized care
Empirics: the Science of Nursing
Knowledge developed through systemic research
Comes from observation, testing and replication
Empiric knowing is expressed in practice through the nurse’s scientific competence
Ethics: The Moral aspects of Nursing:
Focuses on matters of right and wrong, moral choices
o what ought to be done?
Guides and directs how nurses conduct their practice, what they select as
important, with attention to standards & codes
There may be no satisfactory answer to some ethical dilemmas
alternatives may be more or less satisfactory
responsibility for one’s actions
Ethical knowledge assumes experience
Personal Knowing: Therapeutic Use of Self
Personal self understanding (intertwined with the art of nursing)
“Personal knowledge is concerned with the knowing, encountering and actualizing of the concrete, individual
Used when nurses engage in the therapeutic use of self in practice
Personal reflection
“Revealed through reflection – concerns self-understanding, empathy and compassion” (Gregory, Raymond-
Seniuk, Patrick & Stephen, 2015, p.20)
Esthetics: The Art of Nursing
Requires an appreciation of the meaning of a situation
o draws on creative resources
o links art of nursing with its scientific application
“The art of nursing involves the active transformation of the patient’s behavior into a perception of what is
significant in it-that is, what need is being expressed by the behavior” (Potter & Perry, 2014, p. 70).
Enables the making of meaningful connection with human experiences
Seen in the actions and interactions of the nurse; can include poetry, music, and art
Relies on perception, intuition and how you interpret the context
How you interpret what is needed or expressed by that behaviour
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