Ways of Knowing

Barbara A. Carper wrote a book based on 4 fundamental ways of knowing; Empirical knowledge, personal knowledge, ethical knowledge and aesthetic knowledge. I will be discussing these individual ways of knowing and attempt to provide examples of experiences from my nursing career in this paper.

The first way of knowing I will discuss is empirical knowledge. This knowledge is found in textbooks or literature, or through direct or indirect observation. It is factual and can be verified through evidence based practice or literature research. One example I can think of that comes to mind is a 55 year old patient at our facility that came in to the hospital with abdominal pain. A CT of the abdomen was performed and revealed an umbilical hernia. The patient was taken to the operating room and underwent a laparoscopic repair of the hernia with lysis of adhesions. The patient was supposed to go home later that day, however, the patient complained of nausea and vomiting and some abdominal pain. The nurse informed the surgeon of these complaints and the physician ordered Reglan IV and then ordered the patient to be discharged. The nurse went into the room and observed the patient to be grimacing in pain and had vomited up brownish green fluid. She immediately called the surgeon to inform him of the patients pain which was 9 out of 10 and described the vomit. She also questioned the physician as to whether the patient could have had a perforation to his bowel and the surgeon informed her he was coming back to the hospital and requested that she call to the operating room and inform them he would be taking the patient back to the OR. The surgeon repaired a perforated bowel and the patient was taken to the ICU intubated, but was discharged five days later. The nurse was able to identify that this patients pain and nausea and vomiting was not due to the anesthesia he received that day, but a perforated bowel. She was able to do this through direct observation and experience she had received by reading books and caring for similar patients.