Conceptual and Theoretical Thinking in Nursing

Examples of Carpers Ways of knowing in Nursing Practice

Gennel Hall

Hall446

Conceptual and Theoretical Thinking in Nursing

Introduction

        Carpers Way of Knowing are four different categories that we, as nursing staff, use to relate to the patient while taking care of him/her. The four ways of knowing are empirical, personal, aesthetical, and ethical. I will describe a patient scenario along with a specific intervention of each of the four ways of knowing. As nurses in the Emergency Department, we have a 4-5 patient assignment based on staffing. By using the ways of knowing, I will describe a typical day with my patients.

Empirical

        Empirical is factual knowledge from Science that can be verified.  (Wikipedia) I look at the board to see who the next patient in room 4 will be. While glancing at their chief complaint and vitals, I take notice that this patient meets criteria for sepsis protocol.  They have had a fever and there have tachycardia.  Research and scientific knowledge have shown that certain vital signs could suggest when a patient is septic, such as an increased heart rate with a fever. As a RN, we do not just look at the patient’s vital signs, we also do a thorough assessment on the patient before acting as an advocate for the patient. We then notify the physician of the vital signs and what the patient looks like to support the possibility of sepsis. We then act quickly by collecting blood work, placing an IV catheter for fluids and antibiotics, as well as placing the patient on a monitor to watch for trends in vital signs.   “Sepsis is the major cause of hospitalization with an increased mortality rate.” (Birriel)  Sepsis needs to be recognized early using protocols in order to rapidly treat the patient.  Using research has developed these protocols to achieve lower mortality rates and increasing survival rates.  

Aesthetical

        The patient in the next room was brought in by EMS and the Police Department due to having suicidal thoughts. This patient seems very flat and distant. While asking the questions, we sit down beside the patient instead of standing at the doorway and listen to what the patient has to say.   Non-verbal communication is very important when establishing a first impression with our patients.  While he/she is talking, we try to empathize with the patient and sometimes talk about difficult situations that we have had to endure in order to relate to the patient. This is the art of nursing otherwise known as an aesthetical way of nursing. Through talking with the patient and being careful to sit with the patient, we develop a nurse-patient relationship by intuition and understanding. If we are unable to relate to the patient, another nurse may have a different way to connect.  After connecting with the patient we realized that the patient doesn’t want to hurt themselves at all they just needed someone to talk to about their fears and anxiety.  

Ethical

        The ambulance then wheels an overdose into the trauma room that I am responsible for. While checking this patient in, he/she states that we will never understand why his/her life is so bad. We have to cast judgment out of our minds and offer him/her guidance on the choices that were made. Through respect and non-judgmental responses we can bond with our patients and advocate for them. This is a form of the ethical way of knowing. “Attitudes and knowledge are derived from ethical framework, including moral questions and choices.” (Wikipedia)  This patient is choosing to use drugs but the questions that need answered is why and what resources do they need to stop.