According to Carper (1978), the fundamental patterns of knowing in nursing include personal, ethical, empirical, and aesthetic. In this paper, the fifth pattern, emancipatory, is also discussed. Intertwined functional, organic, and relational knowledge patterns guide patient care and provide the basis for holistic well-being (Peart & MacKinnon, 2018). I have experience with a patient who was to undergo chemotherapy to defeat his cancer. As listed by Rosa et al. (2023), cancer patients would experience chronic nausea, vomiting, and loss of appetite after a chemotherapy session. My patient had these symptoms. The purpose of this paper is to explore the five patterns of knowing by analyzing my past experience with a cancer patient undergoing chemotherapy at the oncology department.
On one of my oncology shifts, I encountered a 55-year-old Mr. Smith, a patient with metastatic lung cancer. I had the opportunity to take the patient through a patient education session concerning chemotherapy. I also involved the patient’s family in this education, touching on the adverse effects that might arise and how to deal with them. Oral or intravenous chemotherapy will interfere with many rapidly dividing cancer cells around the body (Rosa et al., 2023). Once the patient started the chemotherapy process, the patient got overwhelmed, and he developed severe and persistent nausea and retching. I thought this could be out of anxiety. As time passed, the patient’s grief transformed his mood from having expectations to being alarmed. I had to stay close to encourage him while giving intravenous antiemetics and repositioning him.
As Chinn et al. (2021) put it, despite the obstacles, nurses need to be with patients and their families through tough times, and their primary responsibility is to put patients at ease and provide them with comfort and health. I applied several approaches, like changing the rate of chemotherapy infusion or adding more drugs to help manage the patient. Being around and available for those patients worked a great deal, and after some time, Mr. Smith’s symptoms improved, and he expressed his gratitude.
This is related to self-awareness, empathy, understanding one’s worldview, and how one looks at the world (Carper, 1978). This was manifest in this case, where I was psychologically prepared for the possible side effects of the chemotherapy process. I was, therefore, quick to understand my patient’s agony and moved close to give comfort and encouragement. In doing so, I appealed to my own experiences and values, which enabled the development of a therapeutic link with Mr. Smith.
Ethical knowing is geared toward asking: Am I doing the right thing? (Peart & MacKinnon, 2018). Understanding what the chemotherapy process entails and seeking the patient’s autonomy by conducting patient education before starting the process was inevitable. This involved providing complete information about the potential negative impact of the chemotherapy. By repositioning the patient continuously, I minimized the suffering the process would cause the patient, such as intense pain. This was ethical and in line with the principle of non-maleficence. According to the American Nurses Association (2009), provision 3.2 in the ANA Code of Ethics provided me with insights that required that, as nurses, carrying out my responsibilities concerning the patient’s autonomy and advocating for them is inevitable. This reduces the level of uncertainty the next of kin may face by giving them a platform to source the required information that will enable them to make appropriate decisions about care.
This is developed using an approach that includes scientific evidence, underlying theory, and clinical practice (Carper, 1978). In my experience with Mr. Smith, empirical knowledge was discovered underpinning my actions based on evidence-based guidelines and protocols for managing chemotherapy-related side effects. According to Rosa et al. (2023), the technique dictated dosages and infusion rate adjustment, while additional medications were provided to relieve the symptoms, ensuring the safety and effectiveness of the care delivery.
In aesthetics, knowing, the beauty of creativity, and the essence of the nursing profession are highlighted (Carper, 1978). In addition to the physical factors involved, aesthetic knowledge marked my efforts to use artful interventions to remedy Mr. Smith’s situation. I gauged his posture and medicated him against nausea, creating a therapeutic environment where he felt comfortable and safe. Rosa et al. (2023) stipulate that the psycho-social components of treatment manifest the nurses playing a pivotal role through empathetic conversation and gentle gestures.
Emancipatory knowing fosters identifying inequities in healthcare and taking actions toward achieving equity and addressing social issues (Peart & MacKinnon, 2018). Developing emancipatory knowledge was demonstrated by my advocating for enhanced access to supportive services and resources required for the chemotherapy process. One of the ways I promoted equity was to aid Mr. Smith in advocating for his choices and needs. I, therefore, contributed to a more just and patient-focused healthcare system through that.
In this scenario, the relevant objective of Healthy People 2030, which is within the Social and Community Context domain, is to raise the number of adults that use the internet for health purposes. This objective tries to make health information more accessible and help people with health problems, including cancer patients having chemotherapy (Healthy People 2030, 2020). As a patient advocate, I understand that managing patients during complex medical processes like chemotherapy requires deliberate actions. Mr. Smith’s stress during chemotherapy only conveys the impact of social determinants of health factors, including transportation, finances, and social support. A solution could be transportation assistance programs for oncology patients, ensuring they have easy and quick access to chemotherapy sessions and supportive care services without paying much money or encountering logistical challenges.
Having explored my experience with Mr. Smith and how the five patterns of knowing were involved in the scenario, the need to put patients’ interests first when interacting with them is evident. The paper delved deeper into my experience with a patient undergoing chemotherapy and how the five patterns of knowing are employed to achieve holistic patient care during difficult times. Therefore, I achieved this purpose by enlightening and successfully engaging the patterns of knowing in alleviating pain from my patient. After finishing my analysis, the paper completes its purpose by successfully linking the complexities of oncology nursing with the five patterns of knowing in nursing practice.
American Nurses Association. (2009). Nursing administration: Scope and standards of practice. Nursesbooks. Org. https://search.worldcat.org/title/312625398
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-24. https://journals.lww.com/advancesinnursingscience/citation/1978/10000/Fundamental_Patterns_of_Knowing_in_Nursing.4.aspx
Chinn, P. L., Kramer, M. K., & Sitzman, K. (2021). Knowledge development in nursing: Theory and process (11th ed.). Elsevier. https://books.google.co.ke/books?hl=en&lr=&id=cSBCEAAAQBAJ&oi=fnd&pg=PP1&dq=Chinn,+P.+L.,+Kramer,+M.+K.,+%26+Sitzman,+K.+(2021).+Knowledge+development+in+nursing:+Theory+and+process+(11th+ed.).+Elsevier.&ots=BXLFzn4yAv&sig=OYslpFB62E29PsVIJ-30EUtVPXc&redir_esc=y#v=onepage&q&f=false
Healthy People 2030. (2020). Social determinants of health. https://health.gov/healthypeople/priority-areas/social-determinants-health
Peart, J., & MacKinnon, K. (2018). Cultivating praxis through Chinn and Kramer’s emancipatory knowing. Advances in Nursing Science, 41(4), 351-358. DOI: 10.1097/ANS.0000000000000232
Rosa, W. E., Lynch, K. A., Hadler, R. A., Mahoney, C., & Parker, P. A. (2023). “It took away and stripped a part of myself”: Clinician distress and recommendations for future telepalliative care delivery in the cancer context. American Journal of Hospice and Palliative Medicine®, 40(2), 235-243. https://doi.org/10.1177/10499091221101883