Fundamental Patterns of Knowing

¶ … Patterns of Knowing

This nurse's experience does provide evidence of the fundamental patterns of knowing. There are overarching patterns in knowing: empiric (through the senses), ethics (obligation), personal, aesthetics (relating to the art of nursing), and emancipatory knowing (Chinn & Kramer, 2008). There are five dimensions to the knowledge process: critical questions, creative processes, formal practice of knowledge and knowing, integrative practice of knowledge and knowing, and authentication processes (Chinn & Kramer, 2008). To some degree, all of the overarching patterns in knowing and their related dimensions were in evidence in the nurse's story.

One element from the reading that seemed extremely relevant to the nurse's story was the idea that "as the scientific worldview gained dominance, so did the idea that human progress would be achieved by harnessing science to create technology for the achievement of human ends" (McEwen & Willis, 2007). The nurse in question wanted to go right into medical surgical nursing, but did not find that type of position. Instead, she was assigned to deal with an older gentleman who had received a terminal diagnosis. She began working with him with a negative personal attitude. She feared death and did not think that she would be able to help her patient. Moreover, he had a very negative and gruff attitude, which made him seem intimidating. Initially, the barriers between them made it seem like, as a nurse, she would not be able to help him. She could not offer him medical assistance through scientific advances, and she did not yet believe she had the experience necessary to treat him compassionately and ease him from life to death. Their relationship was transformed, not through any application of technical nursing skill, but because of a bonding experience that was not related to her capacity as a nurse: the nurse sharing her fear of death, which she had learned after watching the movie The Night of the Living Dead and the patient having her watch that movie to help show her that there was nothing to fear about death.

The empiric pattern of knowing is demonstrated through the nurse's first acquiring her fear of death. As a young child, she watched a very frightening zombie movie, which left her scared of death and dying. Moreover, because she did not want to reveal her fear and subject herself to ridicule, she never gave herself the opportunity to confront this fear. The ethical pattern of knowing is demonstrated by the steadfast way that the nurse initially approached the patient; though she was scared of dealing with a person who was dying, she knew that she was obligated to try to care for him to the best of her ability, and she did so, even if she feared him. The personal pattern of knowing is best described by the patient having her view the scary movie with him; by watching it with her, he was able to help her learn that there was nothing to fear about death, and to ask her to help him die. It helped transform knowledge she had learned empirically (the fear of death) into knowing that death in real life was nothing like death in a scary movie. Because the story focuses on an emotional interaction between the patient and the nurse, it seems difficult to see aesthetic patterns of knowing. However, it is critical to keep in mind that the art of nursing always requires the nurse to go beyond the scientific aspects of