Assignment: Pain Management Efforts
Assignment: Pain Management Efforts
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Assignment: Pain Management Efforts
in a specific situation, skill development,
and anything one can touch or observe
scientifically in time and space. The
inextricable links between the internal
and external aspects of clients’ integral
environment shape the context in which
the client exists and help frame the meaning
of the reality of the client.
Patterns of Knowing
Rooted in Carper’s (1978) depiction of
the four fundamental ways of organizing
nursing knowledge and nursing’s pattern
of knowing—personal, empirics, aesthetics,
and ethics—the additional pattern of “not
knowing” proposed by Munhall (1993)
and the pattern of “socio-political knowing”
described by White (1995) create the six
patterns of knowing applied in the theory
of integral nursing. These six patterns are
superimposed on the quadrants of reality
and work to bring nurses to the fullness of
knowing and expression of being in each
caring experience. By acknowledging the
Exploring the Theory of Integral Nursing
292012, Vol. 16, No. 1
integration of science and aesthetics,
knowing and not knowing, and the influence
of socio-political knowing, nurses confirm
the value of patterns of knowing in clinical
practice. Through the patterns of knowing,
nurses are encouraged to develop a flow of
ethical experience through thinking and
acting in ways that promote self-assessment
and self-healing while generating a sacred
space for care that promotes client healing.
Quadrants
Quadrants in the theory of integral
nursing can be understood as dimensions
of reality that are permeable, integrally
transforming, and empowering to all other
quadrant experiences. Each quadrant is
intricately linked and bound to each other
quadrant, carrying along its own truths and
language. The language of “I,” “We,” “It,”
and “Its” that characterizes the concept
Exploring the Theory of Integral Nursing
Table 1
Dimensions of Reality within Quadrants in Pain Management
Dimension or perspective
Focus of the dimension Aspects included in the dimension Sample pain management questions by dimension
Individual Interior
Personal/intentional
The “I” space—the individual’s internal sense of reality
Self-consciousness
Self-care, self-esteem
Feelings, beliefs, values
Moral development
Cognitive capacity
Emotional maturity
Personal communication styles
Am I feeling stressed? Thinking clearly?
Am I open to the client’s assessment of their own pain?
Am I ethically assessing the client’s pain and making moral decisions about options for pain management?
Am I communicating clearly and compassionately?
Individual Exterior
Physiology/behavior
The “IT” space—objective or tangible aspects of the individual that influence reality
Brain and organisms
Pathophysiology
Physical sensations
Neurotransmitters
Chemistry and biochemistry
Behaviors and skill development
Am I able to envision by bodily presence changing?
Can I fully describe the sensations I feel?
Can I feel my open presence changing my client’s responses to my pain management efforts?
Do I feel more able to do my pain management work skillfully?
Collective Interior
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