In 1978, Carper wrote that nursing sought to develop a holistic, individualistic, and therapeutic model of practice that took the profession away from the autocratic, reductionist, and behaviorist characteristics of the medical model. This futuristic evolution of nursing called for a shift away from the ontological and epistemological assumptions associated with “oldschool’ nursing and nursing education toward a more flexible paradigm. In order to be able to make this dramatic shift. Carper proposed that four ways or patterns of knowing be utilized to structure nursing education and evaluate nursing practice. These patterns or ways of knowing were empirics, ethics, esthetics, and personal (as cited in Zander, 2007). In addition, the theme “knowing” gave insight into how the nurses used different types of knowing.
The nurses described knowing about different diseases, knowing obtained through their nursing experiences, and knowing from the patient and family as persons. Thus, knowing your patient, knowing what this person feels, knowing their spiritual beliefs, knowing their cultural beliefs. All of those things have to come into play. You can’t just use a cookie cutter formula for every patient. Every patient has to be individualized to apply pattern of Knowing (Ferguson, 2018).
Ways of knowing, and nursing care are clearly linked (Terry, Carr, & Curzio, 2017). Having said that, According to Carper (1978, p. 23), “the four fundamental patterns of knowing in nursing are essential to nursing approach which involve critical analysis of what it means to know, and the type of knowledge that is most valuable”.
Morever , Chinn & Kramer (2008) added emancipatory knowing to address the issue of equality, justice, and transformation in all areas of practice to include nursing leadership. By combining these five patterns of knowing, nurses will develop clinical knowledge which guides nursing actions in different situations and beneficial to nursing theory specifically because they were developed by nurses and for nurses.