Understanding of nursing science

Which two ways of knowing have had the most influence on your understanding of nursing science?

The first way of knowing that influenced my nursing science understanding is empirical knowledge.  My initial degree is an Associate in Applied Science.  The focus of this learning is about anatomy, physiology, pathophysiology, pharmacology, and psychology to build the fundamentals of nursing.  These fundamentals are based on science and facts.  One part of nursing practice is built upon facts and science to develop evidence-based practices (Ferguson, 2018).

Secondly, personal knowing influenced my nursing science understanding.  Prior to my nursing degree, I worked as a tech/nurse’s aide in the hospital and nursing home.  During this time, I learned through listening to stories of patients, families, nurses, and colleagues.  There is a lot to be said in getting to know others through sharing of experiences and it can be humbling.  They helped me develop and learn about myself through reflection and self-awareness.  In allowing me to have a better understanding of myself, I was genuine and able to create strong nurse-patient relationships (Campbell et al., 2018).

Which two ways of knowing have you not considered previously and how will these ways of knowing to shape your future nursing practice?

I have not considered the unknowing as a way of knowing.  Being open to the ideas of others is key in developing new skills.  I feel through the sharing of ideas a stronger nursing practice can be developed.  Many times, it is not the strength of one person or the other, but the combination of all ideas (Campbell et al., 2018).  I can use this way of knowing to build my nursing practice as I am newer to nursing leadership.  Being open to others can increase my knowledge through their experiences and ideas, which can guide my facility’s development in nursing practice even further.

Emancipatory knowing is a concept of knowledge I have not considered previously.  Emancipatory knowing is about patient/human rights.  It also incorporates being aware of the social factors influencing the patient’s situation and what actions can be taken to help the larger communities with similar social factors (Campbell et al., 2018).  As a leader, knowing the social factors influencing the community, I can guide our community supporting events.  When it is identified there is limited access to healthcare in a section of the community, I could promote primary care office expansion to that area.  When there is a need for a healthy lifestyle of living, I could promote community gardens and education sessions.

Provide an example of how nursing science encompassed the six ways of knowing to bridge a gap to improve healthcare outcomes.

The ways of knowing were developed by Carper in 1978, with the additional way of knowing by emancipatory by Chinn and Kramer in 2008.  These ways of knowing lead nursing to create its own profession and became the foundation for nursing education and practice.  Understanding the ways of knowing prompts critical thinking and reflection of advanced learning (Campbell et al., 2018).

When nursing utilizes the ways of knowing it can improve healthcare outcomes.  Griffith and Board (2018) have shared a scenario and reflection.  A patient was experiencing chronic leg ulcers and was receiving care by a home health nurse, wound care nurse specialist, and primary care provider (PCP).  Most recently the specialist recommends hospitalization for intravenous antibiotics and the patient has declined this option.  The home health nurse utilized her empirical knowledge of evidence-based practice, wound care, dressing changes practices, and previous observations to guide her recommendations.  She utilized her unknowing knowledge by reaching out to colleagues and drug representatives for additional advice.  In collaboration, the PCP, home health nurse, and patient chose a treatment option of a new dressing type that allowed her to stay home.  One principle of ethics is respect for autonomy.  The home health nurse uses her ethical knowledge to respect the patient’s autonomy and right to give consent for treatment.  The patient needs to be adequately informed to make this decision.  Having a patient-centered approach to conversation is important to prevent overutilization of power.  It is necessary for the home health nurse to reflect on her personal knowledge.  She and others may have a different opinion and she must be mindful those thoughts do not impact the care she is providing.  At this point, the home health nurse must become a patient advocate.   The home health nurse’s aesthetic knowledge helps her to understand the clinical situation the patient is experiencing.  For this patient, she may be feeling pain or self-isolation.  In utilizing empathy, she understands the patient’s perception of her situation (Griffith & Board, 2018).  This patient may have difficulty with transportation or financial struggles with hospitalization leading to the patient’s desire to receive treatment at home.  It is valuable for the home health nurse to incorporate her emancipatory knowledge to consider these social circumstances.  This scenario shared how the nurse utilized her ways of knowing to meet the goal of the patient and close the gap to achieve the desired healthcare outcome.

References

Campbell, T., Penz, K., Dietrich-Leurer, M., Juckes, K., & Rodger, K. (2018). Ways of knowing as a framework for developing reflective practice among nursing students. International Journal of Nursing Education Scholarship, 15(1). https://doi.org/10.1515/ijnes-2017-0043 (Links to an external site.)

Ferguson, R. (2018). Ways of knowing and caring used by nurses in community hospice agencies. Journal of Hospice & Palliative Nursing, 20(1), 74–80. https://doi.org/10.1097/njh.0000000000000400 (Links to an external site.)

Griffith, L., & Board, M. (2018). Influences on clinical decision-making during a community placement: Reflections of a student nurse. British Journal of Community Nursing, 23(12), 606–609. https://doi.org/10.12968/bjcn.2018.23.12.606