In this paper I would like to discuss important interactions I had with different nursing staffs and how these nurses showed esthetics knowing and personal knowing in the treatment of my grandmother and how these two patterns of knowing are intertwined. This hospital experience and the nursing I witnessed has definitely impacted me and has guided me to where I am today in the nursing program. Esthetics knowing can be defined “as the art of nursing which is based on the direct feeling of experience. ”(Mantzorou & Mastrogiannis, 2011, p.253)
While “personal knowing is encountering and actualizing the concrete, individual self. This type of knowing provides the cornerstone for nursing practice and pervades all patterns of knowing. ” (Jacobs, 1998, p . 24) My grandmother was diagnosed with breast cancer eight years ago. During surgery to remove the tumour in her breast, cancer was also detected in her lymph nodes. Her treatment plan consisted of chemotherapy followed by radiation. Unfortunately after her first chemo treatment , she experienced severe reactions to the chemo and refused further chemo treatments.
She continued with the radiation treatments and then went on estrogen suppressant medication. Two years later she experienced some difficulty walking and pain in her back. After some tests it was discovered that her cancer had metastized to her bones and liver. A rapid decrease in her health began. She was hospitalized because she was unable to walk and hypercalcemia developed. Her hospitalization included three different nursing areas-chronic care, palliative and acute care over the course of five months before she died.
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Chronic care was the first nursing area that my grandmother was placed. Nurses showed Personal knowledge nursing (Carper, 1978, p. 13) They were aware of difficulty of her diagnosis and her lack of mobility. They went out of their way to be pleasant and upbeat. There were number examples where they displayed great empathy. Esthetics Knowledge was displayed when the nurses recognized when the hpercalcemia rate was becoming too high and my grandmother became delirious, paranoid and difficult. These nurses also saw the effect of my grandmother’s change in health and how it affected family members.
They reassured us that once the hpercalcemia rate came down my grandmother’s behavior would change back to its previous state. Palliative chemo did help the hypercalcemia symptoms. A few months later my grandmother was transferred to the Palliative care area of the hospital (a hospice was not available in our city).
The nurses in plaintive care displayed many wonderful examples of personal knowledge. They knew at different times in this process when to ask if a social worker or a clergyman could visit my grandmother or one of her family members.
They were extremely sensitive to the needs of not only my grandmother but anyone in the immediate family. They were also very upbeat and respectful. Esthetic knowledge was displayed in numerous ways as well. At one point my grandfather was trying to get my grandmother to eat in the belief that she would live longer. Unfortunately it became a battle between the two of them until the nurses explained that my grandmother could not help her lack of appetite. They were able to get my grandfather to assist my grandmother with the food she could tolerate like Ensure and make him still feel he was still helping my grandmother.
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The last nursing area that my grandmother was placed was Complex Continuing Care. She was moved there out of Palliative care because at the time she was in the hospital, the government was going through a funding cutback. The Personal knowledge of the nurses was constantly displayed because each of the patients in this area had very complex and often unusual conditions. Esthetics Knowledge was evident on the last day of my grandmother’s life. We were called in the middle of the night to come to the hospital for the nurses were aware that the end was near.
The nurses moved my grandmother to a private room on the floor and we were able to have a quiet and meaningful visit with her before she passed away. In my follow up paper I would like to go more in depth how many forms of Knowing work together for one positive experience. To say that only some forms of Knowing were being shown at one time would go against my own perceived experiences. I would like to investigate a theory of combined Knowledge and its positive effects on patients and family members in end of life caring.
