Assignment: Pain Management Efforts

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Assignment: Pain Management Efforts

Assignment: Pain Management Efforts

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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 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


The “I” space—the individual’s internal sense of reality


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


The “IT” space—objective or tangible aspects of the individual that influence reality

Brain and organisms


Physical sensations


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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