Nursing is practically oriented by artistic elements of creativity, in addition to moral judgment, factual judgment, and logical judgment. Thus, Carper presented four basic aspects of knowledge by analyzing the concept of nursing knowledge body and the structure of the syntax. These four-fundamental patterns of knowing included: (1) Empirical knowledge (2) Esthetic knowledge (3) Personal knowledge (4) Ethical knowledge (Carper, 1978).
Clinical Situation: 63 years old male patient presented ER with chief complaints of fatigue and dizziness. He was diagnosed with complete heart block. After receiving a brief SBAR (Situation, Background, Assessment, Recommendation) report from ER nurse, the room prepared with necessary equipment such as standby defibrillator and emergency cardiac medications for the patient who refused temporary transvenous pacemaker insertion. Patient’s anxious family escorted to the family waiting room and the patient’s status informed to them in a timely manner. Patient information and privacy protected by controlling visitors, phone calls, and more. His heart improved from 30’s to 50’s and systolic blood pressure stabilized from 230’s to 150’s from nursing interventions include appropriate cardiac medication administration, replacement of electrolytes, proper pain management, assessment and reassessment, checking vitals every 15minutes and continuous telemetry monitoring. Four hours past his admission to our unit, he started showing signs and symptoms of alcohol withdrawal. Cage (Cut Down, Annoyed, Guilty and Eye Opener) screen performed and CIWA (Clinical Institute Withdrawal Assessment for Alcohol) protocol initiated. Patient’s status and nursing assessment reported to attending physician then received a Detox order per hospital protocol.
Science of nursing (Empirical): Evidence based nursing practice performed per hospital protocol such as utilizing CAGE screen and following CIWA with Detox order.
Art of nursing (Esthetic): I felt he must be sensitive to talk about his health matter. His CAGE screen was administered in a friendly manner in a calm environment.
Experienced knowledge (Personal): As nurse, we provide care not only to patients but also the family. I could decrease family’s anxiousness by separating them from the situation and informing them about the patient’s accordingly.
Moral code (Ethical): Caring the patient who represents him as VIP was challenging. His privacy protected and respected based on hospital guideline for caring VIP.
Holistic approach is important in health care. We are trying to understand and human in a more comprehensive way. The four fundamentals of knowing allows nursing professionals to understand the nursing practice from a holistic point of view.
