Ways of Knowing in Nursing – Care Example

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"Ways of Knowing in Nursing"  is an excellent example of a paper on care. The purpose of this paper is to reflect upon a particular aspect of professional practice that I encountered during my placement. The essay will be written in the first person. It is intended to promote desirable practice by analyzing and exploring past experiences during the practice. I will use John’ s model, which encourages the nurse or practitioner to go through a series of reflective cues to learn from experience. The NMC Code of professional conduct requires effective communication to take place between the patient and a social worker or even the nurse so that the quality of care can be offered (Urdang, 2010). Mrs.

Williams is a 63 years old woman with a mental disorder.   She did not want contact with her two children who live in England.   In her recent admission to the hospital, she gave the contact detail for her son as next of kin.   Upon recovery, Mrs. Williams decided that she does not want any next of kin or family contact.   The patient is very sensitive and dislikes talking about her family life.

She seemed to be happy with the support and care she was receiving from social workers and support workers. She has experienced a series of minor strokes over the past years and a few falls in the last six months.   Presently, she has problems with mobility and needs some assistant for all her daily care.   Mrs. William just moved home into an independent residential home, and needed to complete her tenancy agreement but found it difficult due to the several forms needed to be completed.

She did not like formal communication but communicated well during an informal conversation such as a television program. When I realized her concern about her kids, I had to remove any family contact details from her notes. This is in accordance with the second domain of the Professional Capabilities Framework (PCF). The second domain of the PCF obliges social workers to use social work ethical principles and values in their practice. This requires them to conduct themselves ethically and make ethical decisions. Therefore, I ensured that her views and feelings were respected as I cared for her.

This is also in accordance with the Standards of Proficiency in professional autonomy and accountability (SoP). According to this aspect of the SoPs, the practitioner is expected to understand the needs of the patient and also act in the best interest of the services user in all instances. The Health and Care Professional Council expects the social worker to understand the need to respect and uphold the dignity and value of the service users (HCPC, 2012). Views, desires, and values of the patient fall into this category and thus, by respecting Mrs.

Williams’ s concerns, I was complying with the Standards of Proficiency. Having realized that she did not want to take about her family matters, I knew my boundaries and avoided issues to do with family life. My decision to do this created another dilemma considering the requirements of Domain 1 and 5 of the PCF, which obliges me to act professionally and inform others concerning the care plan that was being created for Mrs. Williams (British Association of Social Workers, 2012).   When coming up with a plan for care or intervention, social workers are expected to discuss it with family members of the patient to make sure that their wishes are taken into consideration.

By removing the family contacts from the notes, this was made impossible. However, I believed that the wishes of the patient come before the views of the family members. As indicated earlier, Mrs. Williams was a smoker despite her health concerns. This was her personal choice and I respected it in accordance with the call to appreciate diversity by domain 3 of the PCF.

However, I advised her about the effects that smoking can have on her health. I did this with her best interest being considered. When I visited her to help out with the tenancy forms, I advised her to let me know when she is overwhelmed with questions regarding the form.   I allowed her time for tea to come back to fill the form.   It was okay when I couldn’ t complete the form and reschedule for the next meeting. This decision was guided by Domain 5 and 7 of PCF.

Domain five calls on the social workers to understand the various psychological as well as social and cultural influences that may affect the behaviors of an individual, and apply the appropriate knowledge when intervening. Various psychological elements may have been influencing Mrs. William’ s communication skills and methods. Domain 7, on the other hand, promotes the use of judgment and authority to intervene and also providing support which will prevent any kind of harm to the patient. I did this by ensuring that a non-formal environment was created.

In addition, The Standard of Proficiency also calls for the nurse and practitioners to understand the need for effective communication throughout the service provision period (Trevithick, 2012). This requires the use of interpersonal skills which will allow for active participation and create service provider-patient partnerships (Schon, 1991). It also influenced me to adopt a more informal approach when working on the tenancy forms with the patient. When I went to see Mrs. Williams a few days ago, she was showing signs of depression due to the debt she had incurred during the four months stay in the hospital.

I offered to call the various service providers she owed but she kept screaming and yelling that she wanted to talk to them personally. Applying the PCF domain 1 and 2, I was able to act professionally and ignored her shout while at the same time reassuring her that everything will be fine. She has also been complaining about my English and since PCF 3 stresses the importance of recognizing diversity, I strived to speak slowly and more clearly so that I do not hamper communication. From this scenario, I realized that views, beliefs, and family competencies influence the nature of communication that takes place between patients and caregivers and how a relationship will be developed between the two individuals.

Thus, I believe that practitioners should be sensitive to the unique needs and believes of the people they are serving.


British Association of Social Workers (2012), The Code of Ethics for Social Work: Statement of Principles. Available at: http://cdn.basw.co.uk/upload/basw_112315-7.pdf (Accessed 18 March 18 2015)

HCPC 2012, Standards of Proficiency. Available from http://www.hpc-uk.org/assets/documents/10002963sop_practitioner_psychologists.pdf. [Accessed from 18 March 2015]

Johns, C 1995, ‘Framing learning through reflection within Carper’s fundamental ways of knowing in nursing’, Journal of Advanced Nursing, vol. 22, pp. 226-34

Schon, D 1991, The Reflective Practitioner: How Professionals Think in Action. Ashgate Publishing, Farnham.

Trevithick, P 2012, Social Work Skills and Knowledge, A Practice Handbook. Open University Press, Maidenhead.

Urdang, E 2010, ‘Awareness of self—a critical tool’. Social Work Education, vol. 29, no. 5, pp. 523–538. Available from: http://www.bu.edu/ssw/files/2010/10/Awareness-of-Self-A-Critical-Tool.pdf [Accessed 18 March 18 2015].

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