to moment, a realization of a person as a dynamic,
living, unpredictable human being. Importantly,
knowing the “who or what” of persons helps nurses
realize that a person is more than simply the phys-
iochemical and anatomical being. Knowing per-
sons allows the nurse to know “who and what” is
the person.
Knowing When Using Technology
From such a view, it may be a perception that the
process of knowing is only possible when using
technologies in nursing. This is not necessarily true.
This perception is supported by the idea that nurs-
ing is technology when technology is appreciated as
anything that creates efficiency, be this an instru-
ment or a tool, such as machines, or the activity of
nurses when nursing. Sandelowski (1993) has ar-
gued about the metaphorical depiction of nursing
as technology, or with technology as nursing, and
the semiotic relationship of these concepts.
Regardless, the idea of knowing persons guiding
nursing practice is novel in the sense that there is
no prescription or direction that is the ideal; rather
there is the wholesome appreciation of an in-
formed practice that allows the use of multiple
ways of knowing such as described by Phenix
(1964) and expanded by Carper (1978). These ways
of knowing involve the empirical, ethical, personal,
and aesthetic. Aesthetic expressions document,
communicate, and perpetuate the appreciation of
nursing as transpiring moment to moment.
Popular aesthetic expressions include storytelling,
poetry, visual expressions as in drawings, illustra-
tions, and paintings, and aural renditions such as
vocal and instrumental music. Encountering aes-
thetic expressions again allows the nurse and the
nursed to relive the occasion anew. Reflecting on
these experiences using the fundamental patterns
of knowing (Carper, 1978) enhances learning, mo-
tivates the furtherance of knowledgeable practice,
and increases the valuing of nursing as a profes-
sional practice grounded in a legitimate theoretical
perspective of nursing.
The use of technologies in nursing is consequent
to the contemporary demands for nursing actions
requiring technological proficiency. There is no let-
ting up, because advancing technology currently
encompasses the bulk of functional activities that
nurses are expected to perform, particularly when
the practice is in a clinical setting. Clinical nursing
is firmly rooted in the clinical health model (Smith,
1983) in which the organismic and mechanistic
views of human beings as persons convincingly
dictate the practice of nursing. Nevertheless, the
process of knowing persons will prevail, for the
model of technological competency as caring in
nursing provides the nurse the fitting stimulation
and motivation, and the prospected autonomy to
judge critically a mode of action that desires an
appreciation of persons as whole.
The model articulates continuous knowing.
Continuing to know persons deters objectification,Continuing to know persons deters objecti-
fication of persons, thus inhibiting the
process that ultimately regards human
beings as “stuff ” to care about. As such
persons are knowledgeable participants
of their care.a process that ultimately regards human beings as
“stuff ” to care about, rather than as knowledgeable
participants of their care. Participating in his or her
care frees the person from having to be “assigned” a
care that he or she may not want or need. This re-
lationship signifies responsiveness (Hudson, 1988).
Continuous knowing results from the contention
that findings or information appreciated through
consequent knowing further informs the desire to
know “who is” and “what is” the person. Doing so
inhibits substantiation as the ultimate reason for
nursing. Continuous knowing overpowers the mo-
tivation to prescribe and direct the person’s life.
Rather, it affirms, supports, and celebrates his or
her hopes, dreams, and aspirations as a participat-
ing human being.CALLS AND RESPONSES FOR NURSING
Calls for nursing are illuminations of the persons’
hopes, dreams, and aspirations. Calls for nursing
are individual expressions by persons who seek
ways toward affirmation, support, and celebration
as person. The nurse appreciates the uniqueness of
persons in his or her nursing. In doing so, the nurse
sustains and enhances the wholeness of the human
being, while facilitating the realization of the per-
sons’ completeness through “acting for or with” the
person. This is a way of affirming, supporting, and
celebrating the person’s wholeness.
The nurse relies on the person for calls for386 SECTION IV Nursing Theory: Illustrating Processes of Development