Feb 23, 2024 NR 501 Week 2 Discussion: Ways of Knowing
NR 501 Week 2 Discussion: Ways of Knowing
NR 501 Week 2 Discussion: Ways of Knowing
Nurses practice in highly challenging environments. The demands in their practice imply that they constantly encounter ethical issues that require the use of critical thinking and problem-solving skills. Therefore, this essay examines a challenging experience I encountered, application of Carper’s Patterns of Knowing and its influence on my practice.
One of the challenging practice situations that I have experienced as a nurse was a guardian who was against the immunization of her child. The guardian declined her child to be vaccinated because of her religious background as well as misconceptions about the negative effects of vaccines on health. I was unprepared to address the issue since it was my first time experiencing it. The important nursing issue that was inherent to the situation was respecting patient’s autonomy. Accordingly, patients have the decision to accept or decline any treatments. Nurses and other healthcare providers should respect their decisions are a way of ensuring autonomy in their practice (Navin et al., 2019). In addition, healthcare providers should inform the patients about the potential consequences of their decisions for them to make informed decisions.
The other inherent nursing issue in the situation is ethical dilemma. Often, nurses experience different forms of ethical dilemmas in their practice. They should make decisions that prioritize the needs of the patients as well as ensuring their optimal health. For example, the situation is an ethical dilemma since the child should be vaccinated to provide her with the desired immunity from communicable diseases. On the other hand, I experienced the challenge of having to respect the needs and decisions of the guardian, hence, the dilemma in addressing it.
Struggling to Meet Your Deadline?
Get your assignment on NR 501 Week 2 Discussion: Ways of Knowing done on time by medical experts. Don’t wait – ORDER NOW!
Meet my deadline
Carper’s Patterns of Knowing can be applied to analyze the situation. The patterns include empirical, personal, ethical, and aesthetic. The model enables nurses to engage in continuous learning and apply knowledge into their daily practice (Brandão et al., 2020). The esthetics pattern of knowing can be applied to understand the underlying reasons for the guardian’s decline for her child to be immunized. One of them is religious beliefs and practices. Religious beliefs and practices influence the uptake of different treatment interventions in a population. Nurses and other healthcare providers should respect the decisions that parents and guardians make regarding the immunization of their children (Nurmi & Harman, 2022). Some states have also adopted laws that recognize the exemption of such children in educational institutions.
The other underlying reason for the guardian’s refusal for her child to be immunized is lack of knowledge about the benefits of immunization. Lack of information contributes to stereotypes that affect the population’s uptake of immunizations. Interventions such as health education may change the attitude and knowledge that parents have towards vaccines. The last potential reason for the refusal is mistrust on healthcare systems. Accordingly, individuals from ethnic minority groups have demonstrated low utilization of health promotion and disease prevention strategies such as immunizations because of their negative experiences with healthcare systems (Nurmi & Harman, 2022). These experiences inform their displeasure and rejection of interventions such as immunization for health promotion.
I gained some insights from the above experience. One of them was the importance of being competent to address ethical dilemmas in nursing practice. I learned about the steps of ethical decision-making that nurses should use in solving issues they experience in their practice. For example, I learned about the importance of collecting accurate data, using the data to formulate alternatives, selecting the best alternative, implementing, monitoring, and evaluating its effectiveness. I will apply the knowledge in addressing ethical issues in my practice. For example, I will use it in addressing similar issues such as refusal for blood transfusion among the patients that I serve in my practice.
In summary, the experience above raised my understanding of the different factors that influence people’s refusal of vaccinations. Carper’s Patterns of Knowing can be applied to understand better challenging situations and develop effective solutions. The experience increased my understanding of ethical decision-making in nursing practice.
NR 501 Week 2 Discussion: Ways of Knowing References
Brandão, A. P. da C. L., Peres, M. A. de A., Aperibense, P. G. G. de S., Lopes, R. O. P., Santos, J. de C., & Brandão, M. A. G. (2020). Evidence of nursing patterns of knowing communicated by the brazilian press before Florence Nightingale’s model. Revista Brasileira de Enfermagem, 73. https://doi.org/10.1590/0034-7167-2019-0790
Navin, M. C., Wasserman, J. A., Ahmad, M., & Bies, S. (2019). Vaccine Education, Reasons for Refusal, and Vaccination Behavior. American Journal of Preventive Medicine, 56(3), 359–367. https://doi.org/10.1016/j.amepre.2018.10.024
Nurmi, J., & Harman, B. (2022). Why do parents refuse childhood vaccination? Reasons reported in Finland. Scandinavian Journal of Public Health, 50(4), 490–496. https://doi.org/10.1177/14034948211004323
Ways of Knowing
As a new grad nurse, I had a challenging situation attending to a female patient in her late 40s. The attending physician prescribed an IV antibiotic after being diagnosed with tonsillitis. My duties were to start an IV line and administer the antibiotic, but I had a hard time cannulating her because she was obese. As a result, I injected her severally but failed to get venous access. The patient got angry and demanded that she be handled by a more experienced nurse. She referred to me as a ‘schoolgirl’ and complained that a student attended her. I tried explaining to the patient that I am a qualified nurse and the cannulation was difficult because of her fat mass, but she did not listen and kept demanding for a qualified nurse. I spoke to my supervisor, who calmed the patient, and we were got venous access with the help of a phlebotomist.
The nursing issue inherent in the situation was nonmaleficence since injecting the patient severally without getting venous access was causing pain. Nonmaleficence is a moral duty that requires nurses not to harm a patient intentionally (Stone, 2018). Nurses must provide a standard of care while avoiding risk or minimizing it, as it connects to medical competence (Stone, 2018). In the situation, I felt uncomfortable because the patient did not trust my skills after several failed attempts in getting venous access. Besides, I felt that I was incapable of handling a patient who considered me incompetent since I was a novice nurse. As a result, I doubted my ability to calm the patient and my cannulation skills.
During this reflective practice, I have learned that novice nurses should observe how experienced nurses handle challenging patient situations to learn how to handle the same in future situations. Besides, I have learned that interprofessional collaboration is crucial, and a provider should never be reluctant to ask for help from other providers (Morley & Cashell, 2017). I will apply the insights as an NP by collaborating with the interprofessional team in the care of patients and asking members how we can improve clinical practices and patient outcomes.
NR 501 Week 2 Discussion: Ways of Knowing References
Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of medical imaging and radiation sciences, 48(2), 207-216. http://dx.doi.org/10.1016/j.jmir.2017.02.071
Stone, E. G. (2018). Evidence-Based Medicine and Bioethics: Implications for Health Care Organizations, Clinicians, and Patients. The Permanente Journal, 22, 18-030. https://doi.org/10.7812/TPP/18-030
Ways of Knowing
Nurses practice in highly challenging environments. The demands in their practice imply that they constantly encounter ethical issues that require the use of critical thinking and problem-solving skills. Therefore, this essay examines a challenging experience I encountered, application of Carper’s Patterns of Knowing and its influence on my practice.
One of the challenging practice situations that I have experienced as a nurse was a guardian who was
NR 501 Week 2 Discussion Ways of Knowing
against the immunization of her child. The guardian declined her child to be vaccinated because of her religious background as well as misconceptions about the negative effects of vaccines on health. I was unprepared to address the issue since it was my first time experiencing it. The important nursing issue that was inherent to the situation was respecting patient’s autonomy. Accordingly, patients have the decision to accept or decline any treatments. Nurses and other healthcare providers should respect their decisions are a way of ensuring autonomy in their practice (Navin et al., 2019). In addition, healthcare providers should inform the patients about the potential consequences of their decisions for them to make informed decisions.
The other inherent nursing issue in the situation is ethical dilemma. Often, nurses experience different forms of ethical dilemmas in their practice. They should make decisions that prioritize the needs of the patients as well as ensuring their optimal health. For example, the situation is an ethical dilemma since the child should be vaccinated to provide her with the desired immunity from communicable diseases. On the other hand, I experienced the challenge of having to respect the needs and decisions of the guardian, hence, the dilemma in addressing it.
Carper’s Patterns of Knowing can be applied to analyze the situation. The patterns include empirical, personal, ethical, and aesthetic. The model enables nurses to engage in continuous learning and apply knowledge into their daily practice (Brandão et al., 2020). The esthetics pattern of knowing can be applied to understand the underlying reasons for the guardian’s decline for her child to be immunized. One of them is religious beliefs and practices. Religious beliefs and practices influence the uptake of different treatment interventions in a population. Nurses and other healthcare providers should respect the decisions that parents and guardians make regarding the immunization of their children (Nurmi & Harman, 2022). Some states have also adopted laws that recognize the exemption of such children in educational institutions.
The other underlying reason for the guardian’s refusal for her child to be immunized is lack of knowledge about the benefits of immunization. Lack of information contributes to stereotypes that affect the population’s uptake of immunizations. Interventions such as health education may change the attitude and knowledge that parents have towards vaccines. The last potential reason for the refusal is mistrust on healthcare systems. Accordingly, individuals from ethnic minority groups have demonstrated low utilization of health promotion and disease prevention strategies such as immunizations because of their negative experiences with healthcare systems (Nurmi & Harman, 2022). These experiences inform their displeasure and rejection of interventions such as immunization for health promotion.
I gained some insights from the above experience. One of them was the importance of being competent to address ethical dilemmas in nursing practice. I learned about the steps of ethical decision-making that nurses should use in solving issues they experience in their practice. For example, I learned about the importance of collecting accurate data, using the data to formulate alternatives, selecting the best alternative, implementing, monitoring, and evaluating its effectiveness. I will apply the knowledge in addressing ethical issues in my practice. For example, I will use it in addressing similar issues such as refusal for blood transfusion among the patients that I serve in my practice.
In summary, the experience above raised my understanding of the different factors that influence people’s refusal of vaccinations. Carper’s Patterns of Knowing can be applied to understand better challenging situations and develop effective solutions. The experience increased my understanding of ethical decision-making in nursing practice.
NR 501 Week 2 Discussion: Ways of Knowing References
Brandão, A. P. da C. L., Peres, M. A. de A., Aperibense, P. G. G. de S., Lopes, R. O. P., Santos, J. de C., & Brandão, M. A. G. (2020). Evidence of nursing patterns of knowing communicated by the brazilian press before Florence Nightingale’s model. Revista Brasileira de Enfermagem, 73. https://doi.org/10.1590/0034-7167-2019-0790
Navin, M. C., Wasserman, J. A., Ahmad, M., & Bies, S. (2019). Vaccine Education, Reasons for Refusal, and Vaccination Behavior. American Journal of Preventive Medicine, 56(3), 359–367. https://doi.org/10.1016/j.amepre.2018.10.024
Nurmi, J., & Harman, B. (2022). Why do parents refuse childhood vaccination? Reasons reported in Finland. Scandinavian Journal of Public Health, 50(4), 490–496. https://doi.org/10.1177/14034948211004323
PEER RESPONSE
Hello Andrew,
This is an in-depth and informative post about your experiences in the initial days of clinical practice. Indeed, I agree with you that it is important to gain in-depth knowledge and practice that relates to a field of specialty prior to practicing. There is always a great disparity between nursing theory gained in school and clinical practice. As such, clinical experience is necessary for nurses before commencing practice. Novel nurses need to consider programs such as residency programs to hone their clinical experience before practice. These programs are developed to support novel nurses as they transition to clinical practice (Lam et al., 2020). Gaining clinical experience is critical in ensuring hands-on job experience, which is essential in preparing novel nurses for a diverse patient-care environment in various settings. Clinical experience before entry into the professional world enables immense knowledge for nurses.
Clinical experience provides the best way to learn to be autonomous on the job and all the steps needed for quality patient care. It also enables novel nurses to learn how to work effectively. Gaining in-depth knowledge and practice that relates to a field of specialty prior to practicing will help novel nurses to become more familiar with high-stress moments. This experience will allow them to improve their practice skills and reflexes to ensure they are prepared for anything in the practice. Clinical learning is also essential in training nurses how to address both high-stress and routine situations on the job without adversely influencing their outcomes (Todd et al., 2019). Overall, clinical experience is essential in facilitating the transition from theory to hands-on practice. Novel nurses get to experience what nursing practice actually entails.
NR 501 Week 2 Discussion: Ways of Knowing References
Lam, C. K., Schubert, C. F., & Herron, E. K. (2020). Evidence‐based practice competence in nursing students preparing to transition to practice. Worldviews on Evidence‐Based Nursing, 17(6), 418-426. https://doi.org/10.1111/wvn.12479
Todd, B. A., Brom, H., Blunt, E., Dillon, P., Doherty, C., Drayton-Brooks, S., … & Aiken, L. (2019). Precepting nurse practitioner students in the graduate nurse education demonstration: A cross-sectional analysis of the preceptor experience. Journal of the American Association of Nurse Practitioners, 31(11), 648. Doi: 10.1097/JXX.0000000000000301
NR 501 Week 2 Discussion: Ways of Knowing
Ways to Know
I achieved most of my objectives this week. I utilized several strategies to achieve them. One of the most important interventions I used was setting realistic plans to achieve the objectives. The plan detailed the prioritized interventions that I needed to achieve the set objectives. It also gave a realistic timeline for achieving the objectives and the resources that I needed. The planning also enabled me to evaluate the effectiveness of the adopted strategies. I improved them based on the evaluation outcomes. For example, I focused largely on successful strategies to eliminate any challenges experienced in achieving the outcomes.
I value several things about my learning this week. One of them is prioritizing tasks. The week’s activities have been immense and requiring most of my attention. However, I discovered that prioritizing the tasks is an important way to achieve most of the tasks that I need to undertake throughout the learning process. Prioritizing ensures the efficiency in the implementation of the different tasks and use of resources to achieve the desired outcomes. The other aspect that I value the most from this week is learning about evidence-based practice (Butts & Rich, 2021). I learned about the effective strategies that I can utilize to incorporate best practices into my nursing care.
I need to explore the application of different nursing theories to grow further as a future nurse practitioner. I want to learn more about the application of different theories to nursing situations and optimize care outcomes. I also need to identify a nursing theory that aligns with my personal and professional values (Smith, 2019). The understanding is important in ensuring the delivery of appropriate and high-quality care.
NR 501 Week 2 Discussion: Ways of Knowing References
Butts, J. B., & Rich, K. L. (2021). Philosophies and Theories for Advanced Nursing Practice. Jones & Bartlett Learning.
Smith, M. C. (2019). Nursing Theories and Nursing Practice. F.A. Davis
NR501NP-10808 Week 2: Ways of Knowing (Orig Post Due Wednesday, Responses Due Sunday)
This is a graded discussion: 75 points possible
Due Jan 22
Week 2: Ways of Knowing (Orig Post Due Wednesday, Responses Due Sunday)
33 unread replies.33 replies.
Purpose
The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.
As a novice nurse, I was employed at a large hospital on a cardiac step-down unit. The training I received was almost non-existent. I was told the best way to learn is by doing, however, the preceptor was always overwhelmed and had very little time to explain things. After completing the brief training period I was assigned a group of patients. On the first day, a patient became unresponsive. I froze and did not know how to call a code or what to do. Shortly after, I quit and obtained a job with a nurse residency program that provided adequate training.
Reflecting on the previous situation, Carper’s Pattern of Knowing empirics would be applicable. A study conducted in Taiwan and the U.K. found that most nurses became preceptors without receiving sufficient training (Hong & Yoon, 2021). Lack of training is a systemic issue in nursing, often leaving new nurses to obtain knowledge by trial and error. Empirical knowledge is obtained by direct or indirect observation and measurement (Chamberlain University, n.d.).
Soon I will be in the same situation, a novice. As a new nurse practitioner, I am concerned about prescribing treatment that is effective and safe. In a study of new psychiatric nurse practitioners (PMHNP) The most prominent challenges reported by students were regarding medication treatment adherence, decision-making, and monitoring symptom-related outcomes. Reflection, combined with faculty- and preceptor-supported clinical education, assists PMHNP students in developing psychopharmacological competency (Mangano, E et al, 2020). I plan to reflect after providing care for every patient, in addition to being open to critique therefore improvement.
References
Chamberlain University (n.d.). Characteristics of Carper’s Patterns of Knowing in Nursing. https://lms.courselearn.net/lms/CourseExport/manual/interactives/CCN/NR501_W2_CapersPatterns/index.html.
Hong, & Yoon, H.-J. (2021). Effect of Nurses’ Preceptorship Experience in Educating New Graduate Nurses and Preceptor Training Courses on Clinical Teaching Behavior. International Journal of Environmental Research and Public Health, 18(3), 975–. https://doi.org/10.3390/ijerph18030975Links to an external site..
Mangano, E., Gonzalez, Y., & Kverno, K. S. (2020). Challenges Faced by New Psychiatric–Mental Health Nurse Practitioner Prescribers. Journal of Psychosocial Nursing and Mental Health Services, 58(10), 7–11. https://doi.org/10.3928/02793695-20200915-01.
When I think of a challenging situation, many come to mind. I completed an accelerated nursing program at the very beginning of the Covid pandemic. This put me in a unique and challenging situation as I was hired during the worst of Covid to a stroke floor that had become the epicenter of our hospital’s Covid positive patient population. I was hired with the understanding of a comprehensive five month orientation. Due to understaffing, and Covid fears, seasoned nurses saw this as an opportunity to skip some patient care tasks and let the “new grad” handle it. So there I was, brand new, scared, and faced with caring for extremely ill patients while communicating with my preceptor through a glass door when concerns arose. I walked into a room of a 40 something year old woman who was struggling through Covid. Isolated and alone, she was scared. I gave her morning medications and noted two strange findings. One was a large softball sized hematoma on her forearm, she said the doctors told her it was “nothing to be concerned with”. The other was a massive bruise to her abdomen. I immediately found this to be concerning. I asked questions regarding it and the patient told me it came in the last few days and she was told it was due to heparin shots she was receiving. Another complaint that, had I been more experienced, would have triggered a red flag was constant upper leg pain and discomfort that was being addressed ineffectively with flexeril. I came out and voiced my concerns about the hematomas. My seasoned preceptor said “sometimes that happens with the heparin shots,” my gut told me that something was wrong. I kept advocating for the patient and my preceptor finally said “if you are that concerned, go in, draw the curtain, and I will look at it from the door.” I did just that, and was met with overall disinterest. She told me she would make the doctor aware and made me feel that I was unnecessarily concerned. Later that night the patient had a 3 second pause on the cardiac monitor which caused her to become unresponsive for a short period of time. We immediately called a rapid response. All I remember is the patient yelling “am I going to die, I’m scared.” The patient died from a retroperitoneal bleed. The hematoma arose after being on an improperly monitored heparin drip just days before. This situation shook me to my core. It was that inherent knowing that something is not right, regardless of someone telling you not to worry. I was new, I was inexperienced, I tried and unfortunately my concerns fell on deaf ears. By the time the bleed was found it was too late. There were no ICU beds, obtaining central access became an issue, and she began deteriorating faster than the required care could be provided.
There are many nursing issues that came into play in this situation including Covid fears, lack of new nurse confidence, lack of experienced mentors, lack of physician support, communication, ethics, and ultimately, reflection, as much was learned from this situation for all parties involved. Unfortunately, if I had been validated in my concerns by my precepting nurse, or if I had more confidence to take control of the situation, harm could have been avoided and this life could have been spared. The nursing issue inherent in this identified situation is the feeling of being unprepared and uncomfortable. Had I been properly oriented and accompanied, I may have had a better understanding of this patient’s health situation, and been more prepared for the emergency that ensued. Had my precepting nurse been more willing to listen to a “new grad’s” concerns, this situation could have been averted.
In 1978, Carper constructed the fundamental patterns of knowing in nursing including empirical, aesthetic, personal, and ethical ways of knowing (Rafii et al., 2021). Personal knowing is the relationship between the nurse and the patient and demands self reflection and knowledge of self in order to properly engage with the patient and to provide care that is person-centered. According to Jacobs, (2013), there was a proposal for Carper’s model to rephrase personal knowing to become advocacy of nursing. The idea of advocacy in nursing is well known and encompasses personal knowledge, self reflection, with personal caring to treat the patient as a unique, whole, person. This idea of existential advocacy was put forth by Gadow in the 80’s and solved the issue of becoming emotionally “infected” and allowed for indirect feelings or “fellow feelings” as a way to professionally connect on a personal level in nursing (Jacobs, 2013). When reflecting on this situation I can apply Carper’s personal pattern of knowing to recall my thoughts and feelings in response to the situation. I r
Order a similar assignment, and have writers from our team of experts write it for you, guaranteeing you an A
