Carper’s 4 Patterns of Knowing in Nursing

Carper's 4 Patterns of Knowing

• Empirics: the science of nursing, formally expressed through facts, models, theories, and thematic descriptions
• Ethics: the moral component of nursing, focusing on the ethical components of nursing practice and answering questions of what is right and responsible
• Personal knowing: the self and other in nursing, enabling nurses to identify responses, strengths, and weaknesses, and being aware of individual biases affecting the nurse-patient relationship
• Aesthetics: the art of nursing, achieved through empathy, dynamic adaptation, and understanding of components as a whole and specific cases

Stages of Clinical Competence According to Benner (1984)

• Stage 1: Novice
• Has no experience in situations they are expected to perform
• Lacks confidence, requiring continual verbal and physical cues
• Practice is within a prolonged time period, unable to use discretionary judgement
• Stage 2: Advanced Beginner
• Demonstrates acceptable performance due to prior experience in actual situations
• Is efficient and skillful in parts of the practice area, requiring occasional supportive cues
• Knowledge is developing
• Stage 3: Competent
• Demonstrates efficiency, coordination, and confidence in actions
• Establishes a plan based on conscious, abstract, analytic contemplation of the problem
• Care is completed within a suitable time frame without supporting cues
• Stage 4: Proficient
• Perceives situations as wholes rather than in terms of chopped up parts or aspects
• Nursing coursework includes detailed education on human body, disease processes, health policy, and hands-on instruction to develop clinical skillsets
• Continuing education is necessary to improve knowledge and skills

Concept of Self-Awareness

• Self-awareness is a multidimensional, introspective process used to become aware of, scrutinize, and understand one's thoughts, feelings, convictions, and values on an ongoing basis
• Self-awareness can be organized into four components:
• Intrapersonal: focuses on exploring the nurse's personal self and examining personal thoughts
• Relational: analyzes oneself in relation to other people and connects personal thoughts and feelings with that of others
• Extra-personal: continuously expands beyond personal self and focuses on the analysis of the environment
• Contextual: focuses on intrapersonal, interpersonal, and extra-personal analysis within a given context or situation