Nursing Knowledge: The Ways of Knowing

By Stephanie Black Brugger, RN, BS and Holly Evans Madison, PhD, RN

Professionals define themselves in terms of what knowledge they possess and seek to acquire. Have you ever considered how bachelor’s and master’s degree registered nurses add to their knowledge base? Barbara Carper (1978) identified four fundamental patterns of knowing that form the conceptual and syntactical structure of nursing knowledge. These four patterns include: personal, empirical, ethical, and aesthetic knowing. Let’s look at how these ways of knowing can assist you in your pursuit of knowledge as a nursing student.

The Four Patterns of Nursing Knowledge

Personal Knowing

PERSONAL knowing refers to the knowledge we have of ourselves and what we have seen and experienced. This type of knowledge comes to us through the process of observation, reflection, and self-actualization. It is through knowledge of ourselves that we are able to establish authentic, therapeutic relationships as it propels us towards wholeness and integrity (Chinn & Kramer, 2015). When you began to study nursing, what knowledge did you possess? Consider what you have learned since–in your personal life, in school, and through practice.

Empirical Knowing

We gain EMPIRICAL knowledge from research and objective facts. This knowledge is systematically organized into general laws and theories. One of the ways we employ this knowledge is through the use of evidenced-based practice (EBP). This way of knowing is often referred to as the “science” of nursing (Chinn & Kramer, 2015). Can you relate how study findings have changed your nursing practice?

Ethical Knowing

ETHICAL knowing helps one develop our own moral code; our sense of knowing what is right and wrong. For nurses, our personal ethics is based on our obligation to protect and respect human life.  Our deliberate personal actions are guided by ethical knowing . The “Code of Ethics for Nurses” (American Nurses Association, 2015) can guide us as we develop and refine our moral code. Can you think of an occasion that you needed to make an ethical decision? If you are like many practicing nurses, you make several every single day.

Aesthetic Knowing

The final way of knowing identified by Carper (1978) is AESTHETIC Knowing.  Aesthetic knowing makes nursing an “art.” It takes all of the other ways of knowing and through it creates new understanding of a phenomenon. Aesthetic knowing is that “aha” moment that we have when we uncovered something new; and just as an artist creates a painting, you are afforded the opportunity of new perspective. Consider a time when you had an “aha” moment. How did you come to that discovery?

The practice of nursing is a holistic, human discipline. The ways of knowing allow us to understand ourselves and nursing practice at a much deeper level; to appreciate nursing as both an art and a science. Consider how the ways of knowing can assist you in being a better person, a better student, and a better nurse.


American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author.

Chinn, P. L., & Kramer, M. K. (2015). Knowledge development in nursing theory and process (9th ed.). St. Louis, MI: Elsevier.

Carper, B. A. (1978). Fundamental patterns of knowing in nursing. ANS Advances in Nursing Science(1) 1, 13-23.