1. Think of a surprising or challenging practice situation in which you felt
underprepared, unprepared, or uncomfortable.
2. Select an important nursing issue/topic that was inherent to the identified
situation.
3. Briefly explain the situation
4. Identify the nursing issue inherent in the identified situation
1. As a method of refection, use Carper's Patterns of Knowing to analyze the
situation. In your discussion, address ONE of the following Patterns of Knowing:
1. What do you think was the underlying reason for the situation?
(Esthetics)
2. What were your thoughts and feeling in the situation? (Personal)
3. What was one personal belief that impacted your actions? (Ethics)
4. What evidence in nursing literature supports the nursing importance
of the identified issue? (Empirical)
5. What new insights did you gain through this reflective practice opportunity? How
will this apply to your practice as a nurse practitioner? Be sure to use scholarly
literature to support your position.
As a registered nurse working on a med-surgical unit I have encounter many situations that I felt
underprepared and uncomfortable. One situation was a 23 year old young man admitting for severe
abdominal pain, He was away on campus his senior year getting ready to graduate that year. He was
having other symptoms but never really pay attention to them. He thought it was probably anxiety and
studying and not eating properly. He was experiencing abdominal pain for few months, but the pain
would come and go away until one day he couldn’t bare the pain anymore and called his parents to
come to pick him up to take him to the hospital. When he got admitted the doctors ran many different
test and blood work to find out what was going on with him. After several days the doctors diagnose him
with colon cancer. The scan of his abdomen had shown widespread metastatic to different organs. The
family wanted to do everything and decided to have surgery the next day while in surgery the doctors
could not do anything because the cancer had metastases to his major organs. The surgeon had to sew
him back up and told him he had only few months to live. I was his nurse that day when he return back
to the room. I had to words to explain the look on this young man face and his family. I couldn’t hold my
tears after the recovering nurse gave me report. I was so emotionally destroyed and heartbroken,
frightening, and the experience was beyond my understanding . I wasn’t prepared to face this young
man and his family. I was not prepared to handle something like that it was extremely upsetting. I didn’t
know how to proceed the hurt, and I was feeling helplessness for him and his family. I am a mother and
found this experience very difficult. I was stuck between being emphatic and being emotionally involved.
This young man was being sent home to prepare to die. Some find it natural to talk about death, while
for me it was the worst thing that can happen and I had difficulty coping with the need to talk about it. I
did not know how to answer the patients' questions, and I would try to change the subject when the
patient brought death up. At the same time, it was my responsibility as the nurse to be strong in front of
patient. According to the article Journal of Pain & Symptom Management “The findings highlight that
nurses’ current practice involves supporting patients’ hope by finding out what hope means to each
This study source was downloaded by 100000827506713 from CourseHero.com on 09-23-2023 08:53:32 GMT -05:00
https://www.coursehero.com/file/47625417/NR501-WEEK-2-WORKdocx/
, individual patient, focusing on quality of life needs and building trusting relationships with patients and
families” (2010).
Carpers (1978) Patterns of Knowing are one classification system of nursing knowledge. The purpose of
Carper's theory was to identify the specific patterns of knowing which contribute to the professional
identity of nursing as a profession. My thoughts and feeling in the situation is that nurses will work with
many patients living with a terminal illness, but receiving a terminal diagnosis and coping in the
aftermath is very emotionally challenging for a young person. I had a difficult time with that because I
am a mother who also had a child in college and knowing this young man had so much to live for,
finishing his education, having a family, being a productive man in society. I was emotionally touch by
this patient because of his age, being a mother, and never been through that situation was very tuff for
me and I was not prepared to have this difficult conversation. After the doctor break the bad news,
Nurses are the one who provide ongoing support to the patient and family, and Patients and families
often turn to the nurse for clarification and further information. I felt a lack adequate knowledge and
expertise when dealing with death and dying.
During my years of nursing I have learned to balance emotional support with professionalism. As a nurse
practitioner I will be dealing with many different challenges, or maybe have to break bad news regarding
a terminal diagnosis. Understanding that each patient will receiving information differently depending on
their emotional state and being there to answering all questions as truthfully as I can. I will use
Evidence-based education and training will that will improve effective communication and different
strategies that I had learned during nursing career for example having empathy, patience, attentive
listening, and understanding patients’ needs. Making sure patient getting the right pain medication,
helping patients understand what to expect in terms of the progression of their illness, helping patients
adjust to their new life and finding ways to move forward. Helping patients to find ways to make the
most out of their final days, whether that’s spending as much time as possible with family and friends, or
focusing on personal interests. Also helping love ones cope with they are angry, offering emotional
support and providing resources. According to Fanaroff, J. “The fact that a patient is dying does not
necessarily mean that “curative” measures are withdrawn. At the same time, comfort measures aimed
specifically at relief of pain and stress are critical. Indeed, caregivers must focus on relieving the four
domains of suffering: physical, spiritual, psychosocial, and emotional” (2015).
Carper, A. B. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing
Science, 38, 13-24.
Fanaroff, J. (2015). Dealing with Death and Dying. AARC Times, 39(7), 6–7. Retrieved from
https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?
direct=true&db=ccm&AN=109813816&site=ehost-live&scope=site
Reinke LF, Shannon SE, Engelberg RA, Young JP, Curtis JR, Reinke, L. F., … Curtis, J. R.
(2010). Supporting hope and prognostic information: nurses’ perspectives on their role when
patients have life-limiting prognoses. Journal of Pain & Symptom Management, 39(6), 982–992.
https://doi-org.chamberlainuniversity.idm.oclc.org/10.1016/j.jpainsymman.2009.11.315
This study source was downloaded by 100000827506713 from CourseHero.com on 09-23-2023 08:53:32 GMT -05:00
https://www.coursehero.com/file/47625417/NR501-WEEK-2-WORKdocx/
underprepared, unprepared, or uncomfortable.
2. Select an important nursing issue/topic that was inherent to the identified
situation.
3. Briefly explain the situation
4. Identify the nursing issue inherent in the identified situation
1. As a method of refection, use Carper's Patterns of Knowing to analyze the
situation. In your discussion, address ONE of the following Patterns of Knowing:
1. What do you think was the underlying reason for the situation?
(Esthetics)
2. What were your thoughts and feeling in the situation? (Personal)
3. What was one personal belief that impacted your actions? (Ethics)
4. What evidence in nursing literature supports the nursing importance
of the identified issue? (Empirical)
5. What new insights did you gain through this reflective practice opportunity? How
will this apply to your practice as a nurse practitioner? Be sure to use scholarly
literature to support your position.
As a registered nurse working on a med-surgical unit I have encounter many situations that I felt
underprepared and uncomfortable. One situation was a 23 year old young man admitting for severe
abdominal pain, He was away on campus his senior year getting ready to graduate that year. He was
having other symptoms but never really pay attention to them. He thought it was probably anxiety and
studying and not eating properly. He was experiencing abdominal pain for few months, but the pain
would come and go away until one day he couldn’t bare the pain anymore and called his parents to
come to pick him up to take him to the hospital. When he got admitted the doctors ran many different
test and blood work to find out what was going on with him. After several days the doctors diagnose him
with colon cancer. The scan of his abdomen had shown widespread metastatic to different organs. The
family wanted to do everything and decided to have surgery the next day while in surgery the doctors
could not do anything because the cancer had metastases to his major organs. The surgeon had to sew
him back up and told him he had only few months to live. I was his nurse that day when he return back
to the room. I had to words to explain the look on this young man face and his family. I couldn’t hold my
tears after the recovering nurse gave me report. I was so emotionally destroyed and heartbroken,
frightening, and the experience was beyond my understanding . I wasn’t prepared to face this young
man and his family. I was not prepared to handle something like that it was extremely upsetting. I didn’t
know how to proceed the hurt, and I was feeling helplessness for him and his family. I am a mother and
found this experience very difficult. I was stuck between being emphatic and being emotionally involved.
This young man was being sent home to prepare to die. Some find it natural to talk about death, while
for me it was the worst thing that can happen and I had difficulty coping with the need to talk about it. I
did not know how to answer the patients' questions, and I would try to change the subject when the
patient brought death up. At the same time, it was my responsibility as the nurse to be strong in front of
patient. According to the article Journal of Pain & Symptom Management “The findings highlight that
nurses’ current practice involves supporting patients’ hope by finding out what hope means to each
This study source was downloaded by 100000827506713 from CourseHero.com on 09-23-2023 08:53:32 GMT -05:00
https://www.coursehero.com/file/47625417/NR501-WEEK-2-WORKdocx/
, individual patient, focusing on quality of life needs and building trusting relationships with patients and
families” (2010).
Carpers (1978) Patterns of Knowing are one classification system of nursing knowledge. The purpose of
Carper's theory was to identify the specific patterns of knowing which contribute to the professional
identity of nursing as a profession. My thoughts and feeling in the situation is that nurses will work with
many patients living with a terminal illness, but receiving a terminal diagnosis and coping in the
aftermath is very emotionally challenging for a young person. I had a difficult time with that because I
am a mother who also had a child in college and knowing this young man had so much to live for,
finishing his education, having a family, being a productive man in society. I was emotionally touch by
this patient because of his age, being a mother, and never been through that situation was very tuff for
me and I was not prepared to have this difficult conversation. After the doctor break the bad news,
Nurses are the one who provide ongoing support to the patient and family, and Patients and families
often turn to the nurse for clarification and further information. I felt a lack adequate knowledge and
expertise when dealing with death and dying.
During my years of nursing I have learned to balance emotional support with professionalism. As a nurse
practitioner I will be dealing with many different challenges, or maybe have to break bad news regarding
a terminal diagnosis. Understanding that each patient will receiving information differently depending on
their emotional state and being there to answering all questions as truthfully as I can. I will use
Evidence-based education and training will that will improve effective communication and different
strategies that I had learned during nursing career for example having empathy, patience, attentive
listening, and understanding patients’ needs. Making sure patient getting the right pain medication,
helping patients understand what to expect in terms of the progression of their illness, helping patients
adjust to their new life and finding ways to move forward. Helping patients to find ways to make the
most out of their final days, whether that’s spending as much time as possible with family and friends, or
focusing on personal interests. Also helping love ones cope with they are angry, offering emotional
support and providing resources. According to Fanaroff, J. “The fact that a patient is dying does not
necessarily mean that “curative” measures are withdrawn. At the same time, comfort measures aimed
specifically at relief of pain and stress are critical. Indeed, caregivers must focus on relieving the four
domains of suffering: physical, spiritual, psychosocial, and emotional” (2015).
Carper, A. B. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing
Science, 38, 13-24.
Fanaroff, J. (2015). Dealing with Death and Dying. AARC Times, 39(7), 6–7. Retrieved from
https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?
direct=true&db=ccm&AN=109813816&site=ehost-live&scope=site
Reinke LF, Shannon SE, Engelberg RA, Young JP, Curtis JR, Reinke, L. F., … Curtis, J. R.
(2010). Supporting hope and prognostic information: nurses’ perspectives on their role when
patients have life-limiting prognoses. Journal of Pain & Symptom Management, 39(6), 982–992.
https://doi-org.chamberlainuniversity.idm.oclc.org/10.1016/j.jpainsymman.2009.11.315
This study source was downloaded by 100000827506713 from CourseHero.com on 09-23-2023 08:53:32 GMT -05:00
https://www.coursehero.com/file/47625417/NR501-WEEK-2-WORKdocx/
