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Henry-Emancipatory Knowing
Emancipatory Knowing-Quality Nursing Care & Leadership
Barb Henry
University of Cincinnati
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Henry-Emancipatory Knowing
Emancipatory Knowing-Quality Nursing Care & Leadership
Emancipatory knowing involves critical analysis of the status quo and leading the way to
practice change (Chinn & Kramer, 2008). Though all ways of knowing provide a foundation for
advanced practice, emancipatory knowing is most important to quality care and leadership in the
nursing profession.
Florence Nightingale built the foundation for empiric, ethical, personal, and aesthetic
knowing in nursing (Chinn & Kramer, 2008). Her emancipatory knowledge helped improve
sanitary conditions, healthcare for soldiers, and establish schools of nursing (Nightingale, 1969).
Nursing leaders who followed: Sanger, Wald, Dock, Taylor, Walking Bear Yellowtail,
Staupers, and Thoms possessed emancipatory knowledge (Chinn & Kramer, 2008). Because of
these leaders, the underserved of the time: women, children and families, Native Americans, and
African Americans received equal access to healthcare and respect, a battle still fought by
current nursing leaders.
Emancipatory knowing is necessary to provide adequate healthcare services for Iraq and
Afghanistan combat veterans who are expected to exceed the high post traumatic stress disorder,
suicide, and addiction statistics of Vietnam era veterans (TransWorldNews, 2009). Nurses like
Ruth Malone, PhD, RN, use emancipatory knowledge to battle big tobacco companies and assist
Americans with smoking cessation to reduce healthcare costs and chronic illness (Shwarz, 2004).
A case from this authors practice illustrates why emancipatory knowing is most
important. A patient with paranoid schizophrenia stable on a long acting injectable antipsychotic
medication was denied the medication by a managed care administrator due to cost. The author
provided clinical data documenting multiple hospitalizations and incarcerations due to
noncompliance with oral medications in previous years. Despite the data, the appeal was denied.
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Henry-Emancipatory Knowing
Oral medications were prescribed despite ethical and empirical knowledge that this was not the
right course of action (Chinn and Kramer, 2008). The patient was eventually admitted for
inpatient psychiatric treatment after an incarceration for menacing acts committed during a
psychotic state. The author notified the mental health board and the National Alliance for the
Mentally Ill (2010) of the problem. The managed care group is no longer an Ohio Medicaid
provider due to similar incidents reported by other providers and patients. This type of
experiential learning (Benner, 1982) increases emancipatory knowledge.
Emancipatory knowing builds on all four Carper model ways of knowing (Zander, 2000).
Novice, advanced beginner, and competent nurses possess empiric and ethical knowing, but lack
the personal and aesthetic knowing seen in proficient and expert nurses capable of holistic
decision making and emancipatory knowing (Benner, 1982). Education and experiential
learning provide opportunities to develop proficiency in recognizing patterns, similarity,
common sense understanding, skilled know how, sense of salience, and deliberative rationality
required for complex healthcare and emancipatory knowing (Benner, 1987).
According to Schultz & Meleis, nursing epistemology is: “the study of knowledge shared
among the members of the discipline, the patterns of knowing and knowledge that develops from
them and the criteria for accepting knowledge claims” (1988). Understanding ways of knowing
that make nursing unique from medicine and other professions is an important theoretical
framework for advanced practice (Chinn & Kramer, 2008).
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Henry-Emancipatory Knowing
References
Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407.
Benner, P. C. (1987). Clinical judgment: How expert nurses use intuition. The American Journal
of Nursing, 87(1), 23-31.
Chinn, P. L., & Kramer, M. K. (2008). Integrated theory and knowledge development in nursing
(7th ed.). St Louis, MO: Mosby Elsevier.
National Alliance on Mental Illness. (2010). Retrieved from http://www.nami.org/
Nightingale, F. (1969). Notes on nursing: What it is and what it is not. New York: Dover
Publications, Inc. (Original work published 1860.)
Schultz, P.R. & Meleis, A.F. (1988). Nursing epistemology: Traditions, insights, questions.
Journal of Nursing Scholarship 20(4), 217-221.
Schwarz, T. (2004). Nightingales vs. big tobacco: Nurses confront the nation’s greatest public
health threat. American Journal of Nursing 104(6), 27.
TransWorldNews. (2009). Drug problems among Iraq, Afghan vets could dwarf Vietnam.
Retrieved from http://www.veteransforcommonsense.org/index.php/archives/751transworldnews
Zander, P. E. (2000). Ways of knowing in nursing: The historical evolution of a concept. The
Journal of Theory Construction and Testing, 11(1), 7-11.