Quote from trishrpn80
i am a licensed pratical nurse getting my bachelors..
ok so i have a dilemma. my aunt just passed away and i have a paper to write (actually phase 2 of a previous paper). it is a reflective paper based on a situation we encountered in our practice and using carper's ways of knowing to analyze said situation.
so the situation i decided to do was a recent one where i came to a patients home and patients presentation was different than previously, her family spoke of confusion and decreased appetite, and her vital signs were stable with no obvious signs of immediate distress but i felt something was off. i was there to give a fragmin injection postoperatively. i did a thorough cardiorespiratory assessment and although i couldn't name what i heard i knew something was wrong with her cardiac assessment. i consulted with a coworker and decided to give the fragmin injection and send her to er. turned out she had a blood clot in the aortic valve...
so for phase 2 of my paper i have to identify a key issue and relate ways of knowing back to the key issue...
i have no clue what the key issue was...i really can't identify one except maybe for lack of confidence and second guessing my decision and needing to consult with a coworker before sending her to er... but i don't see that as being bad.
this is going to get interesting with the revisioning portion since i don't feel that i did anything wrong therefore i would do it again. maybe with a tad bit more confidence...
the typology identifies four fundamental "patterns of knowing":
- empirical: factual knowledge from science, or other external sources, that can be empirically verified.
- personal: knowledge and attitudes derived from personal self-understanding and empathy, including imagining one's self in the patient's position.
- ethical: attitudes and knowledge derived from an ethical framework, including an awareness of moral questions and choices.
- aesthetic: awareness of the immediate situation, seated in immediate practical action; including awareness of the patient and their circumstances as uniquely individual, and of the combined wholeness of the situation. (aesthetic in this sense is used to mean "relating to the here and now", from the greek αἰσθάνομαι (aisthanomai), meaning "i perceive, feel, sense"; the reference is not to the consideration of beauty, art and taste).
the emphasis on different
ways of knowing is presented as a tool for generating clearer and more complete thinking and learning about experiences, and broader self-integration of classroom education. as such it helped crystallize johns' (1995) framework for reflective investigation to develop reflective practice.
the typology has been seen as leading a reaction against over-emphasis on just empirically derived knowledge, so called "scientific nursing", by emphasising that attitudes and actions that are perhaps more personal and more intuitive are centrally important too, and equally fit for discussion........
ok so what i get from this is you did exactly what this theory advocates. you had a feeling that something wasn't right and you acting upon it. that little voice that says.....something isn't right here that although you did not have the experience or learning to completely recognize the "different heart sounds" you followed your gut and intervened by sending her to the hospital therefore in all likelyhood...saving her life.