untitled

To assist in the study of nursing theory, review
the following descriptions of the Carper patterns of
knowing, along with suggestions for use in the
study of nursing theory.

• Personal knowing is about striving to know the
  self and to actualize authentic relationships be-
  tween the nurse and the one nursed. Using this
  pattern of knowing in nursing, the client is not
  seen as an object but as a person moving toward
  fulfillment of potential (Carper, 1978). The
  nurse is also recognized as always learning and
  growing as a person and in professional prac-
  tice. Reflecting on a person as a client and a per-
  son as a nurse in the nursing situation can
  enhance understanding of nursing practice and
  the centrality of relationships in nursing. These
  insights are useful for choosing and studying
  nursing theory.


• Empirical knowing in nursing is the most famil-
  iar of the ways of knowing to most nurses and
  nursing students. Empirical knowing concerns
  the science of nursing; the nurse uses empirical
  knowing to access data from nursing, from re-
  lated disciplines, and from the client. Particular
  nursing situations may be influenced by many
  facts and theories from many sources and by
  many related facts about the person, family, and
  environment. The amount and quality of em-
  pirical knowing can guide selection of a nursing
  theory as a way to frame and use empirics for
  nursing purposes.


• Ethical knowing is increasingly important to the
  study and practice of nursing today. According
  to Carper (1978), ethics in nursing is the moral
  component guiding choices within the com-
  plexity of health care. Ethical knowing informs
  us of what is right, what is our obligation, what
  the nurse ought to do in this situation. Ethical
  knowing is essential in every action of the nurse
  in day-to-day nursing. These commitments of
  the nurse may be the focus of reflection and may
  be described as part of a nursing situation, guid-
  ing selection, and study of particular nursing
  theories.


• Esthetic knowing is described by Carper (1978)
  as the art of nursing. While nursing is often re-
  ferred to as art, this aspect of nursing may not be
  as highly valued as the science and ethics of
  nursing. However, many nurses realize that es-
  thetic knowing subsumes all other patterns of

knowing, that the personal, empirical, and ethi-

cal knowing are combined in the fullness of es-

thetic knowing.

• It is the experience of these nurses that appreci-
  ation of wholeness, well-being, and a higher level
  of communication are part of esthetic knowing.
  Examples of this most complete knowing are
  frequent in nursing situations in which even
  momentary connection and genuine presence
  between the nursing and client is realized.


• Reflecting on the experience of nursing is
  primary in understanding esthetic knowing.
  Through such reflection, the nurse understands
  that nursing practice has in fact been created,
  that each instance of nursing is unique, and that
  outcomes of nursing cannot be precisely pre-
  dicted. Nurses often express esthetic knowing
  through use of an art form, and thus recreate
  their esthetic knowing in new and unique ways.
  The student of nursing theory who has special
  appreciation for esthetic knowing may explore
  nursing theory that emphasizes presence and
  perhaps spirituality in the relationship of nurse
  and client.

USING INSIGHTS TO CHOOSE THEORY

The notes describing your experience will help in

selecting a nursing theory to study and consider for

guiding practice. You will want to answer these

questions:

• What nursing theory seems consistent with the
  values and beliefs that guide my practice?


• What theories do I believe are consistent with
  my personal values and society’s beliefs?


• What do I want from the use of nursing theory?


• Given my reflection on a nursing situation, do I
  want theory to support this description of my
  practice?


• Do I hope to use nursing theory to improve my
  experience of practice for myself and for my pa-
  tients?

USING AUTHORITATIVE SOURCES

Use your questions and new insights to begin a lit-

erature search. Gather and use library resources,

such as CINAHL. Search the Internet and use on-

line resources for information on nursing theories

and their use in practice, research, education, and

administration. Join an online group dialogue

CHAPTER 2 Studying Nursing Theory: Choosing, Analyzing, Evaluating 19