| Course | NR 520 Applied Theoretical Foundations, Scientific Inquiry, and Decision-Making |
|---|---|
| Week | 4 |
| Paper type | Ways of knowing essay |
| Length | About 1,120 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NR 520 Week 4
Ways of Knowing Essay: Five Things I Believe About the 0400 Blood Draw, Sorted by Carper's Patterns, and What It Would Take to Unseat Each One
Student Name
College of Nursing, Chamberlain University
NR 520: Applied Theoretical Foundations, Scientific Inquiry, and Decision-Making
Instructor Name
Month Day, Year
Ways of Knowing Essay: Five Things I Believe About the 0400 Blood Draw, Sorted by Carper's Patterns, and What It Would Take to Unseat Each One
Why Test My Own Claims
Carper (1978) proposed that nurses know in four distinct ways: through science (empirical), through the art of skilled practice (esthetic), through awareness of themselves in relation to patients (personal), and through judgment about right action (ethical). A common way to write about these patterns is to define each and give an example. This essay does something different. It takes five claims I hold about the 0400 blood draw on my medical unit, sorts each by the kind of knowing it rests on, and asks what would have to happen for me to give it up. Different kinds of knowing fail in different ways, and knowing how a belief could fail is part of knowing what kind of belief it is.
Claim 1: Most Daily Labs in Stable Patients Do Not Change the Plan
Pattern: empirical. This is a claim about frequencies that could be counted.
Basis: professional guidance recommends against repetitive blood counts and chemistry panels when a patient is clinically and biochemically stable (Bulger et al., 2013), and reviews of repetitive testing describe many daily labs as low value (Eaton et al., 2017). My own impression from eight years of nights agrees.
What would unseat it: data. If an audit of our unit showed that a large share of daily labs in patients stable for 48 hours led to a change in treatment, my claim would be wrong for our unit, whatever the guidance says. The claim is only as strong as the most recent good count, and I have not yet made that count on our own patients.
Claim 2: I Can Tell Which Patients Will Not Get Back to Sleep
Pattern: personal, mixed with empirical. It rests on my experience of many nights and my sense of individual patients.
Basis: over years, I have noticed that some patients, often older, anxious or confused, stay awake after a 0400 draw, while others fall back asleep within minutes.
What would unseat it: a simple test. If I wrote down my prediction for each patient before the draw and a colleague recorded who was awake at 0500, I would learn how often I am right. Personal knowledge of this kind falls to the shift where it did not hold, and more often than we admit. I suspect I am better at predicting the extremes than the middle, but I do not actually know.
Claim 3: Waking Someone for a Test Nobody Will Use Is Wrong
Pattern: ethical. It says how nurses should act, not what the numbers show.
Basis: it follows from respect for the person and from the nurse's duty to promote the patient's well-being, which the ANA Code of Ethics places at the center of practice (American Nurses Association, 2025). A test that will not change care imposes a harm, lost sleep and a needle, without a benefit.
What would unseat it: not a study. A better study could show that the test is used more often than I think, which would change whether the premise applies, but it would not change the ethical claim itself. What could unseat it is a stronger ethical argument, for example that the harm is so small and the protection from rare missed findings so large that routine testing is justified. That is an argument about values and risk, and it has to be answered in those terms.
Claim 4: How You Wake Someone Changes What Happens Next
Pattern: esthetic. It is knowledge expressed in how the act is done.
Basis: waking a patient by name, with a lamp rather than the overhead light, after putting in hearing aids, produces a different response from waking them with a bright light and a stranger's hand. I saw this with an 84-year-old woman who was confused after one kind of waking and calm after the other.
What would unseat it: very little, because esthetic knowledge is not a general claim that one study could refute. It could be refined by watching skilled colleagues and by noticing when my approach fails. Its weakness is the opposite of empirical knowledge: it is hard to test and easy to overrate.
Claim 5: A Patient Knows Their Own Sleep
Pattern: the patient's knowledge, which Carper's four patterns do not name directly but which personal knowing depends on.
Basis: when a patient says they always wake at 0600 and cannot sleep again once woken, that is knowledge about their life that neither I nor any study has.
What would unseat it: neither a study nor my experience. Research tells us that sleep in hospital is shorter and more disrupted than at home; in one study, patients slept 83 minutes less (Wesselius et al., 2018). But no study can tell a particular patient that her account of her own sleep is wrong. It can only be revised by the patient.
What Sorting the Claims Showed
Sorting my beliefs this way showed me that I defend them all in the same tone, as if they were equally solid, when they are not. The empirical claim is the one I am most confident of and have tested least. The personal claim is probably overconfident. The ethical claim is the most important and cannot be settled by data at all. The esthetic claim is the one I use most and describe least. And the patient's knowledge is the one I most often forget to ask for. The practical result is a plan: audit our daily labs, test my own predictions for a month, and ask every patient on the 0400 list when they usually wake. Each of those steps answers to a different kind of knowing, which is the point: no single source could have told me which of my beliefs to trust, and treating them as one kind of certainty was the habit I most needed to break.
Sorting also exposed a habit of argument. When I defended the ethical claim to a colleague, I reached for data; when I defended the empirical claim, I reached for my experience. Each time, I was answering a question with the wrong kind of evidence, and the colleague, reasonably, was not persuaded.
The plan is modest, and that is deliberate: each step tests one claim with the kind of evidence that claim can actually answer.
References
American Nurses Association. (2025). Code of ethics for nurses. https://codeofethics.ana.org/
Bulger, J., Nickel, W., Messler, J., Goldstein, J., O'Callaghan, J., Auron, M., & Gulati, M. (2013). Choosing wisely in adult hospital medicine: Five opportunities for improved healthcare value. Journal of Hospital Medicine, 8(9), 486-492. https://doi.org/10.1002/jhm.2063
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23. https://doi.org/10.1097/00012272-197810000-00004
Eaton, K. P., Levy, K., Soong, C., Pahwa, A. K., Petrilli, C., Ziemba, J. B., Cho, H. J., Alban, R., Blanck, J. F., & Parsons, A. S. (2017). Evidence-based guidelines to eliminate repetitive laboratory testing. JAMA Internal Medicine, 177(12), 1833-1839. https://doi.org/10.1001/jamainternmed.2017.5152
Wesselius, H. M., van den Ende, E. S., Alsma, J., ter Maaten, J. C., Schuit, S. C. E., Stassen, P. M., de Vries, O. J., Kaasjager, K. H. A. H., Haak, H. R., van Doormaal, F. F., Hoogerwerf, J. J., Terwee, C. B., van de Ven, P. M., Bosch, F. H., van Someren, E. J. W., & Nanayakkara, P. W. B. (2018). Quality and quantity of sleep and factors associated with sleep disturbance in hospitalized patients. JAMA Internal Medicine, 178(9), 1201-1208. https://doi.org/10.1001/jamainternmed.2018.2669
What the NR 520 Week 4 assignment asks for
The Week 4 essay asks you to explore ways of knowing in nursing, usually Carper's patterns and sometimes later additions, and to relate them to your practice. Prompts typically ask you to describe each pattern, give examples and reflect on how they shape clinical decisions. A stronger essay goes beyond examples by examining your own beliefs: which pattern each rests on, and what would make you change your mind. That shows you understand how the patterns differ, not just what they are called. Cite Carper and any other theorists directly. Use first person where it fits. Required length and whether additional patterns must be included depend on your section.
How this NR 520 Week 4 example is built
The example explains why it tests claims instead of defining patterns. Five sections follow, each with the claim, its pattern, its basis and what would unseat it. The empirical claim about daily labs rests on guidance and could fall to a local audit. The personal claim about predicting sleep could fall to a simple test. The ethical claim cannot be overturned by data, only by a stronger ethical argument. The esthetic claim about waking resists general testing. The patient's knowledge of her own sleep can be revised only by her. The closing section notes that the writer defends all claims in one tone and sets a plan matched to each.
Reading the NR 520 Week 4 grading rubric
The rubric for the ways of knowing essay usually rewards accurate description of the patterns, meaningful personal application, depth of reflection and scholarly support. Graders look for examples that clearly illustrate each pattern and for reflection that goes beyond description. An essay that examines how each kind of knowledge could be wrong shows the depth graders reward. Correct citation of Carper's original work matters. Writing should be clear and well organized, with first person used appropriately. A conclusion that turns reflection into a concrete change in practice often lifts the score, and references belong in APA 7 format throughout. Essays that tie each pattern to a real belief the writer holds, rather than to a textbook example, tend to reach the top band.
NR 520 Week 4 help from the desk
The most common weakness is an essay that defines four patterns and gives one example of each, with no reflection. Examine your own beliefs instead. Another is treating all knowledge as if it could be settled by research, which misses the point of the patterns. Students also misclassify examples, calling a rule of thumb empirical when it is personal or esthetic. Check each against Carper's definitions. Include the patient's knowledge, which the patterns can overlook. Finally, end with something you will do differently. A reflective essay that changes nothing reads as an exercise, while one that leads to a test of your own claims reads as learning.
Get a NR 520 Week 4 example written to your instructions
Send the prompt, the page count, and the earlier paper whose claims you plan to sort. A custom Week 4 essay is written to your prompt and comes back inside 24 to 48 hours, the first one free. If you would rather not send the original, list the claims as three or four sentences and that is enough.
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NR 520 Week 4 questions, answered
Do I have to name a published set of knowing patterns?
Most sections expect you to work with a named set, and using one is straightforward. What earns the marks is the sorting, not the recitation, so the categories should appear as labels you apply to your own sentences rather than as a section explaining what each pattern means. Two lines of definition and then straight into the claims.
Can experience be the source and the claim still stand?
Yes, and treating experience as automatically inferior is a common way to lose points here. A claim about how a particular unit behaves, held because you have watched it for years, is well founded for that unit. It becomes overreach only when it gets applied to a population it never observed, and naming that boundary is the mark of a careful essay.
How personal is this supposed to get?
Personal in the sense that you wrote the claims, not in the sense of confession. The essay wants your reasoning on the table, not your feelings about a difficult shift. Where a story is needed to explain why you believe something, keep it to the detail carrying the belief and let the rest go unwritten.
Where can I find a free NR 520 Week 4 sample paper?
The five-claim ways of knowing essay above is a complete NR 520 Week 4 sample, available to read at no charge. Share your own practice area through the request form for an essay built on your claims.
Do I have to use Carper's four patterns in NR 520 Week 4?
Most sections start with Carper, and some add later patterns such as unknowing or sociopolitical knowing. The sample uses Carper's four and adds the patient's own knowledge, explaining why it matters.