the ways of know

¶ … practice? Provide specific examples for each type of knowing from the practice environment.

Nursing 'ways of knowing' are often classified under four basic rubrics: the empirical knowledge of nursing, which relates to technical practice; the ethical ways of knowing which relate nursing empirical knowledge to the nurse's professionalism and status as a moral being; esthetics (the ephemeral 'art' of nursing knowledge, based upon intuitive and compassionate insight); and personal knowledge relevant from past practice and also the nurse's daily life (Heath 1998: 1056).

The operation of ways of knowing underline the fact that simply disseminating treatment is often not enough to address a patient's needs. For example, a patient with uncontrolled diabetes might come to a hospital, and have his or her blood sugar stabilized using empirical practices by the nurse. However, from an ethical standpoint, the nurse may know that the individual needs additional social support to gain access to regular healthcare and diabetes management. Part of the nurse's ethical duty involves connecting the patient to social services within his or her community. From an aesthetic standpoint, the nurse knows that the patient's unstable life situation (irregular income and work hours) does not support a healthy lifestyle, and from personal knowledge of life and past practice the nurse knows that a regular eating, sleeping, and life schedule is essential in appropriate diabetes management, particularly if the individual is suffering from other mental health issues.

Q2. Identify your preferred paradigm and give supporting rationale for the choice.

I would currently describe my chosen nursing paradigm as holistic in nature (Van Sell 2002: 74). This is based in the fact that so many modern health complaints are due to lifestyle-related issues, such as a poor diet and lack of exercise. The reasons that America has increased rates of heart disease, high blood pressure, and Type II Diabetes are known. People might even have a vague understanding of the fact that they need to move more and eat less. However, helping patient's make lifestyle changes requires an intimate knowledge of a patient's family life and social environment. If the patient has trouble understanding how to eat healthy food on a budget, or finding safe places to exercise, the nurse should direct the patient to informational resources that make it easier for him or her to reach those vitally important health goals.

Q3. How would you change nursing's values and resources to promote knowledge development?

I think the field of nursing has made tremendous strides in shifting from a mechanistic view of human health, to a more holistic and systems-based view of the person. Many health deficits are not linked purely to individual behavior, but are the result of family circumstances and a social environment not immediately under the patient's control. For nurses to be truly effective in the 21st century, nurses must support expanded access to wellness promotion strategies, like having affordable and nutritious food in low-income community, more movement-friendly urban design, and expanded access to healthcare and health insurance for individuals in all locations, and in all demographic segments of America.

As nurses face increasingly cost-conscious environments, the ethical issues related to providing care for all will become even more manifest, and in promoting improved healthcare knowledge nurses must acknowledge the economic and political impact of decisions that are made outside of their immediate nursing environment.

Discussion response:

The concept of ways of knowing, particularly aesthetic ways of knowing, is an important component of understanding why more experienced nurses seem to have additional advantages that new nurses, regardless of their technical qualifications, do not posses. I believe this is for two reasons: one, an older nurse has more hands-on and empirical knowledge based upon personal experience and practice. But this phenomenon is also due to the aesthetic or 'art-based' elements of nursing, which encompasses nursing instincts about patient needs and what is troubling the patient. The ethical component or the striving of the nurse to become a morally sound professional is also a continual negotiation or struggle. Mentorship is thus a vital component of nursing education, to maximize the possibilities that new nurses have a wider range of experiences and practice-based knowledge to draw from.