of colleagues, try to wait until later to share your re-
flections, and only then as you wish to do so. When
you have been still for a time and have taken the op-
portunity to reflect on your practice, you may pro-
ceed with the following questions. Continue to
reflect and to make notes as you consider each
question about your beliefs and values.
ENDURING VALUES
- What are the enduring values and beliefs that
brought me to nursing? - What beliefs and values keep me in nursing
today? - What are those values I hold most dear?
- What are the ties of these values to my personal
values? - How do my personal and nursing values con-
nect with what is important to society?
NURSING SITUATIONS
Reflect on an instance of nursing in which you
interacted with a person for nursing purposes.
This can be a situation from your current practice
or may be from your nursing in years past.
Consider the purpose or hoped-for outcome of the
nursing.
- Who was my patient as a person?
- What were the needs for nursing the person?
- Who was I as a person in the nursing situation?
- Who was I as a nurse in the situation?
- What was the interaction like between the pa-
tient and myself? - What nursing responses did I offer to the needs
of the patient? - What other nursing responses might have been
possible? - What was the environment of the nursing situa-
tion? - What about the environment was important to
the needs for nursing and to my nursing re-
sponses?
CONNECTING VALUES AND THE
NURSING SITUATION
Nursing can change when we consciously connect
values and beliefs to nursing situations. Consider
that values and beliefs are the basis for our nursing.
Briefly describe the connections of your values and
beliefs with your chosen nursing situation.- How are my values and beliefs reflected in the
nursing situation? - Are my values and beliefs in conflict in the situ-
ation? - Do my values come to life in the nursing situa-
tion? - Are my values frustrated?
VERIFYING AWARENESS
AND APPRECIATION
In reflecting and writing about values and situa-
tions of nursing that are important to us, we often
come to a fuller awareness and appreciation of
nursing. Make notes about your insights. You might
consider these initial notes the beginning of a jour-
nal in which you record your study of nursing the-
ories and their use in nursing practice. This is a
great way to follow your progress and is a source of
nursing questions for future study. You may want to
share this process and experience with your col-
leagues. These are ways to clarify and verify views
about nursing and to seek and offer support for
nursing values and situations that are critical to
your practice. If you are doing this exercise in a
group, share your essential values and beliefs with
your colleagues.MULTIPLE WAYS OF KNOWING AND
REFLECTING ON NURSING THEORY
The previous reflective exercises offer guidance for
knowing about values and nursing practice. Carper
(1978) studied the nursing literature and described
four essential patterns of knowing in nursing.
Using the Phenix (1964) model of types of mean-
ing, Carper described personal, empirical, ethical,
and esthetic ways of knowing in nursing. Chinn
and Kramer (2004) apply Carper’s patterns of
knowing to develop a framework for nursing
knowledge. Additional patterns of knowing in
nursing have been explored and described, and the
initial four patterns have been the focus of much
consideration in nursing ( Ruth-Sahd, 2003; Leight,
2002; Thompson, 1999; Pierson, 1999; Boykin,
Parker, & Schoenhofer, 1994; Parker, 2002).
Chapter 4 of this text employs patterns of knowing
to examine nursing theory resources.18 SECTION I Perspectives on Nursing Theory