Читать книгу The Nursing Associate's Handbook of Clinical Skills - Группа авторов - Страница 143

Getting to know the patient within the context of his/her specific illness and the context of his/her lives is considered by Dewing et al. (2014) as two types of knowing: the physical and psychological knowing. The physical knowing relates to the patient’s responses, physical function and body type, whereas the psychological knowing reflects the patient’s feelings, perceptions, expectations and beliefs. These will determine the patients’ own health beliefs, including their responses to illness, future life events and experiences.

Knowing the patient is vital in nursing; the nursing associate might state that we ‘know the patient very well’, but what does this really mean? What do we know and how do we know it? Several theories within the literature (Carper 1978; Watson 1985; Swanson 1991) have explored this knowledge for nursing practice, and it is reported that as such a situation as this ‘knowing’ cannot be based on formal scientific knowledge alone. Therefore, knowledge must be seen in another dimension associated with action and decision‐making and is referred to as ‘patterns of knowing’ (Carper 1978). Carper’s (1978) work sets out to bring together all the ways of knowing that are pertinent to nursing, integrating both practical and theoretical knowledge. Conducting a seminal piece of work, Carper (1978) explores the sources that nurses use to develop knowledge and beliefs about their practice and patient care by describing four patterns of knowing: empirical, aesthetic, personal and moral.

The first of Carper’s (1978) four patterns, empirics, refers to the science of nursing, and it is empirical, factual and descriptive in nature. This type of knowing allows the nursing associate to acquire both objective information regarding the patient’s condition and personal information concerning thoughts, feelings and experiences. The second is aesthetics; this refers to the art of nursing. Here, Carper (1978) reflects upon empathy as an important element of aesthetic knowing, suggesting that when a nursing associate learns to empathise, the different perspective of the patient life becomes apparent. The third relates to personal knowledge, and this is concerned with knowing, encountering and actualising of the individual self and in some respects relates to emotional intelligence and can be acquired through the therapeutic use of self (Currid & Pennington 2010).