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Systematic process for classifying sources of knowledge

Question:

Discuss about the Reflective Practice in Nursing for Aboriginal Patient.

Carpers’s fundamental ways of knowing is a systematic process which is helpful in classifying the different sources form which proefessionals can derive knowledge and belifes in professional practice (Carnago and Mast 2015 pp 389). The utility of it can be shown with the help of an event and then sequentially describing the knowledge accordingly.

An aboriginal patient was admitted to the ward by his son and daughter in law where they told that their father is facing severe issues with the pain of osteoarthritis and increased body weight. He had been sleepless the entire night due to the pain and he was found to be very weak. He had been mostly unresponsive to the various questions asked to him and was not willing to cooperate with the nurses who were trying to ease him of the pain. The family members told that he was humiliated as the nurses on duty in the previous hospitals did not maintain his dignity and pressurized their intervention on them. When he wanted to inquire about the intervention, they insulted him saying he was illiterate and a backward class and that he would have no idea even if they discuss their decisions with them. His fear for such humiliation had prevented him to visit other hospitals as well as and hence the situations with his osteoarthritis had become so worse. He was not responding to any questions asked and he was also not cooperating with the treatment interventions given. His self-respect was overpowering his will to live and this created a challenge for the nurses on duty including me. 

One can gain empirical knowledge form research as well as objective facts. The knowledge usually remains systematically organized in a number of different general laws and also in theories (de Olivera and Toledo 2017 pp 33). The best ways by which empirical knowledge is gained is by the evidence based practices. While I faced the issue with the patient, I tried to search for articles that would help to match up with the case I was handling. The articles that I came across helped me to develop an idea that in such cases, becoming aggressive with the patients or forcing him to take interventions would have negative effects. Instead, developing a therapeutic relationship with him full of compassion and empathy may help him to develop trust on the nursing professionals (Nielson et al. 2014 pp 95). Making him feel important by sharing with him the interventions applied on him and also involving him in decision making was suggested by the researchers who conducted qualitative studies on patients with similar symptoms (Hole et al. 2017 pp 1668). Therefore this ways, evidence based practice helped me to develop an idea about how to approach with the task assigned to me and helped me to act as a responsible professional. From this kind of knowing, I learnt that I would use person centered care, value the patient’s decision making skills, discuss the treatment plan with him and concentrate on developing a therapeutic relationships with him. However, I faced various issues while conducting this procedure as I was not rightly using the correct search terms and therefore it took me a large amount o time to find correct evidences. Hence, is should develop my skill in searching engines for evidence based practices.

Event with an aboriginal patient and use of evidence-based practice

It mainly refers to the form of nursing where the profession is considered to be an art. Proper knowing of different aspects of the profession with the correct understanding of phenomena is the main central part of this type of knowing (Garrett and Cutting 2015 pp 99). It mainly focuses on the new perspectives that individuals develop when they uncover something new through their interventions and practices while treating for patients. I was previously a follower of routine method of caring where I used to communicate very less with the patients but however never ill treated patients. As a result my introvert behavior offended many patients and they could not open themselves with me. However, with the seriousness of the mentioned patient, I tried to change my working style and with the help of the advices of my mentor nurses, I learnt to strike a right kind of conversation with the patient. I gradually came to understand how developing a therapeutic relationship helped not only me to apply my interventions easily but also helped the patient t get over his insecurities and find a friend and companion in me (Ray 2016 pp 455-460). I gradually noticed that developing a therapeutic relationship with the patient helped the patient to recover faster (Jacob et al. 2016 pp 319). Whereas the empirics helped me to learn about some strategies from evidence based knowledge, esthetics helped me to develop idea form my own experiences.

Personal knowing refers to the knowledge one his about himself or her and also about anything that he or she has experienced or seen. This type of knowledge usually comes through the process of observation, self reflection and self actualization (Robert, Tilley and Peterson 2014 pp 351). It is through this knowledge which when gained by the professional help them to establish the authentic, therapeutic relationships as these attributes help the professional to attain integrity and wholeness. On a personal, level, I had very few experiences as I was a new comer and I needed more time to observe, learn and establish new interventions strategies to handle these situations I could not gain any help from my personal knowledge learning procedure as is was not experienced enough to dvelop personal learning form situations.

Ethical knowledge helps one develop an idea about his or her moral code along with the sense of knowing what is right and wrong. For a nursing professional, personal ethics are based on the duty to protect and respect human lives (Carnago and Mast 2015 pp: 387). A nurse should always follow the Codes of ethics given forward by the NMBA in order to provide quality care to patients and prevent from getting involved in any legal obligations. Codes of ethics advise us to follow that we should never discriminate any patients based on race, ethnicity, religion, culture and classes. Following the ethics, it becomes duty to maintain cultural competency and to provide the best treatment to the patient according to the norms of the culture practiced by them. Here I learnt that we should never force our decisions on them and should never perform anything that affects their cultural sentiments (Josif et al. 2017 pp 93). I noticed that the person was mostly affected because the previous nurses did not important to their cultural norms. The patient declared that the nurse had talked with him by directly looking into his eyes which is a symptom of disrespect for them. Moreover, he previous nurse showed cultural biasness when he said that aboriginals are illiterate and they have no proper ways of maintaining health. This is absolutely a violation of the principle of justice where the responsively of a nurse is provide the best quality acre to the patient irrespective of caste, creed and religion (Freeman et al. 2014, pp: 358). The previous nurse had also not maintained his dignity and autonomy of the patient giving him no scope to take decisions for himself. Hence, I as a nurse, would try to be culturally competent and never discriminate between my patients. This results in mental and emotional turmoil in patients which might affect his health. Hence, I came to know that following the codes of ethics and maintaining the principle of autonomy, justice, beneficence and non-, maleficence are extremely important for providing an ethically safe treatment procedures.

Understanding of esthetic knowing

Conclusion:

The Carper’s system of knowing helps to provide us a systematic process of reflecting on the procedure of the development of knowledge. Empirically, I used a large number of evidence based journals which showed that person centered care can help in the present situation where an aboriginal patient should be treated in a culturally competent environment, allowing him to participate in decision making. Esthetically, I learned how to be more compassionate and empathetic towards my patent and develop a successful relationship with him unlike the routine care of patients that I used to carry on for all patients. I believe with the passage of time, I would develop personal knowledge to cope such strenuous situations. However, ethically, I learnt that how not being compliant with the ethics and not following the principles of justice, autonomy, beneficence and non maleficence may have negative effects on the patients. If a similar situation arise again in front of me,  I would recommend proper reading of journal based articles, develop aesthetic sense and aligning more with the code of ethics and following the principles of nursing would help anyone who overcomes the situation. I would also recommend that I should also perform proper reflective skills and self actualization and closely observe every experience to become expert in the profession.

References:

Cameron, B.L., Plazas, M.D.P.C., Salas, A.S., Bearskin, R.L.B. and Hungler, K., 2014. Understanding inequalities in access to health care services for Aboriginal people: a call for nursing action. Advances in Nursing Science, 37(3), pp.E1-E16.

Carnago, L. and Mast, M., 2015. Using ways of knowing to guide emergency nursing practice. Journal of Emergency Nursing, 41(5), pp.387-390.

de Olivera, A. and Toledo, V.P., 2017. Nursing care in first-episode psychotic patients: a qualitative study. In 5º Congresso Global de Investigação Qualitativa em Saúde. Investigação Qualitativa em (Vol. 10, No. 2, p. 33).

Freeman, T., Edwards, T., Baum, F., Lawless, A., Jolley, G., Javanparast, S. and Francis, T., 2014. Cultural respect strategies in Australian Aboriginal primary health care services: beyond education and training of practitioners. Australian and New Zealand journal of public health, 38(4), pp.355-361.

Garrett, B.M. and Cutting, R.L., 2015. Ways of knowing: realism, non?realism, nominalism and a typology revisited with a counter perspective for nursing science. Nursing inquiry, 22(2), pp.95-105.

Hole, R.D., Evans, M., Berg, L.D., Bottorff, J.L., Dingwall, C., Alexis, C., Nyberg, J. and Smith, M.L., 2015. Visibility and voice: Aboriginal people experience culturally safe and unsafe health care. Qualitative health research, 25(12), pp.1662-1674.

Holland, K., 2017. Cultural awareness in nursing and health care: an introductory text. CRC Press.

Jacob, E., Raymond, A., Jones, J., Jacob, A., Drysdale, M. and Isaacs, A.N., 2016. Exploration of nursing degree students’ content expectations of a dedicated Indigenous health unit. Collegian, 23(3), pp.313-319.

Josif, C.M., Kruske, S., Kildea, S.V. and Barclay, L.M., 2017. The quality of health services provided to remote dwelling aboriginal infants in the top end of northern Australia following health system changes: a qualitative analysis. BMC pediatrics, 17(1), p.93.

Nielsen, A.M., Alice Stuart, L. and Gorman, D., 2014. Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses’ perspectives. Contemporary nurse, 48(2), pp.190-196.

Ray, M.A., 2016. Transcultural caring dynamics in nursing and health care. FA Davis.

Robert, R.R., Tilley, D.S. and Petersen, S., 2014. A power in clinical nursing practice: concept analysis on nursing intuition. Medsurg Nursing, 23(5), pp.343-350.

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