Ways of knowing in nursing

1. Ways of knowing in nursing ANALYSIS OF A CONCEPT KNOWLEDGE (What is) is antecedent (existed before) to KNOWING (How to..) knowledge is a solid base on which to structure or perceive action, way of being or perspective. �extensive information & understanding�, active comprehension of things known, action requiring skill Nurses acquire knowledge in many ways � learning style, multiple intelligences, whole brain or combo. Epistemology = Greek �episteme� = knowledge & �logos� = study or theory of . Relational b/w the seeker (you) and the goal (knowledge itself) Explicit knowledge = formal knowledge coming from written words, rules, facts, etc. Novice nurse vs Expert Nurse Tacit knowledge = develops with more experience �knowing that��, increases with more experience and decreases reliance on rules. Tacit knowledge is that which is not written down but is known by the experts. Knowledge is the accurate representation of perceived world of a discipline (Chinn & Kramer, 1999)KNOWLEDGE (What is) is antecedent (existed before) to KNOWING (How to..) knowledge is a solid base on which to structure or perceive action, way of being or perspective. �extensive information & understanding�, active comprehension of things known, action requiring skill Nurses acquire knowledge in many ways � learning style, multiple intelligences, whole brain or combo. Epistemology = Greek �episteme� = knowledge & �logos� = study or theory of . Relational b/w the seeker (you) and the goal (knowledge itself) Explicit knowledge = formal knowledge coming from written words, rules, facts, etc. Novice nurse vs Expert Nurse Tacit knowledge = develops with more experience �knowing that��, increases with more experience and decreases reliance on rules. Tacit knowledge is that which is not written down but is known by the experts. Knowledge is the accurate representation of perceived world of a discipline (Chinn & Kramer, 1999)

2. CARPER�s WAYs of KNOWING Considered to be epistemology of nursing.. Written in 1975, and has been foundational to nursing knowledge since then Other ways of knowing have been proposed, Ways of knowing are: Empirics Ethics Esthetics Personal What does the epistemology mean again = theory or study of how learning occurs. What does the epistemology mean again = theory or study of how learning occurs.

3. Empiric Knowing - objective , abstract, quantifiable - can be verified with testing - arranged into theories - case knowledge (biomedical model) - concerned with �monitoring of disease and therapeutic responses� - quantitative research uncovers this type of knowing

4. Ethical Knowing - moral knowledge, based on values of profession - choosing, justifying and judging actions based on duty, rights and obligations - CNA ethical framework guides development of this type of knowing � e.g.: research on human subjects, care of those who are different� - universal values to profession, as well as personal values of the nurse

5. Esthetics Knowing - Art of nursing, intangible essence of what nursing is - attends to uniqueness of �contextual wholeness� rather than particular moment. - is anticipation of outcome rather than just evaluation of select intervention - expressive, intuitive and creative aspect of nursing, and difficult to verbalize (Expert nurse actions done before actual event �How did they know that???) How did the nurse know the patient was going sour???How did the nurse know the patient was going sour???

6. Personal Knowing - awareness of self in relationship - does not require mediation through language - engagement , active, empathetic participation of nurse as �knower� - means being authentic � incorporating that theory of interpersonal relationships until it is second nature - the �a-ha� experience Coming into room and sensing pt in pain but no facial expressions When you have a transformational experience � example � care of simple GB, no big deal, but�pt remembered me and even recognized me on the street and spoke to me to thank me for my care Coming into room and sensing pt in pain but no facial expressions When you have a transformational experience � example � care of simple GB, no big deal, but�pt remembered me and even recognized me on the street and spoke to me to thank me for my care

7. Criticisms Hasn�t fully developed the aesthetic way of knowing Does not make a distinction between concepts of knowing and knowledge Theory vs pattern of knowledge in nursing

8. Other ways of knowing Experience (Experiential) Benner Novice to Expert Knowing how or �knowledge-as-ability� vs knowing that (Carper�s view, according to Benner). Skill based Intuition Non-rational thought processes of feeling or sensing Not logically explained results with vast amounts of experience Unknowing Position of openness to understand the world view of the patient (client-centered). Leads to empathy and pt�s perspective

9. Sociopolitical Seeks to understand the �wherein � of nursing as a practice profession. Understanding of what nursing is by public, and what society and its politics are by nurses.