Analysis of Pain Management-Nursing Care



Analysis of Pain Management and Nursing Care Using the Patterns of Knowing

Student Name

NUR 620-005 Theoretical Basis of Advanced Nursing

Harriet Rothkopf Heilbrunn School of Nursing

Long Island University Brooklyn

Dr. Julie Elting





Analysis of Pain Management and Nursing Care Using the Patterns of Knowing

In the last five years, my experience as a registered nurse (RN) has led me to witness

numerous situations that were worth reflecting on. As I grasp and familiarize myself with

Carper’s original four fundamental patterns of knowing and the addition of emancipatory

knowing (Chinn & Kramer, 2019), I can now compare my specific patient experiences to better

help me understand my practice and why I do what I do. The purpose of this paper is to explore

the five patterns of knowing through my personal experience of providing nursing care to a

post-operative patient who used medications for chronic pain and anxiety.

Description of the Patterns of Knowing

Chinn and Kramer (2019) identify the patterns of knowing as the way we perceive and

interpret knowledge we gain. The five patterns are personal, ethical, empiric, aesthetic, and

emancipatory. The idea of personal knowing is to be aware of one’s personal feelings and

thoughts to truly comprehend why you do what you do as a nurse in certain scenarios. To

develop ethical knowing we must ask ourselves as nurses, “Is this right? Or is this responsible?”

(Chinn & Kramer, 2018, p. 107). We must address situations and act ethically as the appropriate

thing to do considering our limitations, responsibilities, and scope of practice. Empiric knowing

is a combination of scientific knowledge, experience, research, and theories competently applied

to provide optimal care (Chinn & Kramer, 2018). Aesthetic knowing describes the art of nursing,

the unique moment-to-moment care we provide which is developed over time combining our

ability to be intuitive to the needs of our patients. Emancipatory knowing is the process in which

we ask ourselves what is wrong with the situation, who benefits from it, what are the barriers to

change, and how we create change in unjust situations (Chinn & Kramer, 2018).




Description of the Nursing Experience

As a Post Anesthesia Care Unit (PACU) nurse, I care for post-operative patients

throughout my day. Early in my career I cared for an African American man in his 40s who had

surgery to repair a leg fracture after an accident. He suffered from chronic back pain and anxiety,

for which he was taking prescribed opioids and anti-anxiety medications. He arrived from the

operative room moaning in pain with his heart and respiratory rate elevated. The

anesthesiologist whispered I should refrain from giving him too much pain medication because

he may be drug-seeking. When I asked what he meant by this, he said he thought the patient was

exaggerating and I would see for myself.

I was conflicted by the doctor’s comment and felt he was being insensitive to the patient’s

pain. I had only been an RN for a year and was also new to the unit so I did not feel comfortable

challenging the doctor’s assumptions. According to Chapman et al. (2017), guidelines for

prescribing opioids do not support the sudden stopping or instant reduction of opioids prescribed

to a patient because it may lead to withdrawal, pain, and psychological distress. Additionally, the

patient said he did not take his medications this morning because he was told not to take

anything after midnight. So the pain he was experiencing from the surgery was on top of the now

untreated chronic pain. I followed the prescribed dosing and helped the patient get comfortable,

but I do not know how he was treated when transferred from PACU.

Applying the Patterns of Knowing to Practice

As someone who has Sickle Cell Disease, my personal knowing on the topic of pain

management and the perception healthcare providers have of those suffering from chronic pain is

very real. I know pain is subjective and different for everyone, including me. My personal




knowing allows me not to judge someone’s chronic disease symptoms because I know how it

feels not being taken seriously about my pain.

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