| Course | NU 700 Knowledge for Nursing Practice |
|---|---|
| Unit | Unit 6 |
| Paper type | Patterns of knowing reflection paper |
| Length | About 1,000 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN |
| Updated | October 2026 |
Free sample paper for NU 700 Unit 6
One Home Visit, Four Ways of Knowing: A Family's Request for Intravenous Fluids at the End of Life
Student Name
Department of Nursing, Herzing University
NU 700: Knowledge for Nursing Practice
Instructor Name
February 24, 2026
One Home Visit, Four Ways of Knowing: A Family's Request for Intravenous Fluids at the End of Life
The Episode
I was the nurse practitioner on a home hospice visit to Mr. E., a composite 79-year-old man with metastatic pancreatic cancer, three days after he had stopped eating and drinking more than sips. He was drowsy but rousable, his mouth was dry, and his urine output had fallen. His wife of 52 years and their son met me at the door. The son said, "He's dying of thirst. We want him on an IV. If you won't do it, we'll take him to the hospital." His wife said nothing but watched my face. Mr. E. had told the hospice nurse two weeks earlier that he wanted to die at home and did not want "tubes." The visit lasted 50 minutes, and I left without starting fluids, with the family's agreement.
The episode is left unresolved at this point on purpose. The four patterns of knowing described by Carper (1978) each read it differently, and each section below states what the pattern attends to, what it sees in this visit, and what it misses.
Empirical Knowing
What it attends to: evidence that can be generalized and tested. What it sees here: the question of whether parenteral hydration relieves symptoms in advanced cancer has been tested. In a multicenter, double-blind, placebo-controlled trial of patients with advanced cancer receiving hospice care, one liter of parenteral fluid daily did not improve dehydration symptoms, quality of life, or survival compared with 100 mL daily (Bruera et al., 2013). The dry mouth that troubled the family is common at the end of life and responds better to mouth care than to fluids. Empirical knowing therefore argued against starting an infusion, and it gave me something specific to offer instead: frequent mouth swabs, lip balm, and small ice chips if he could manage them.
What it misses: the trial measured outcomes in patients, not the distress of families. It could not tell me what this son meant by "dying of thirst," or what it would cost him to believe his father died that way.
Ethical Knowing
What it attends to: obligations and the conflicts between them. What it sees here: two defensible obligations pulled in opposite directions. Respect for Mr. E.'s autonomy, expressed in his earlier wish to avoid tubes and to die at home, pointed away from an infusion and away from the hospital. The obligation to care for the family, who are part of the unit of care in hospice, pointed toward taking their distress seriously rather than overriding it. A third obligation, to avoid harm, was also present: fluids at this stage can worsen secretions, edema, and breathlessness. The Code of Ethics for Nurses frames the nurse's primary commitment as to the patient while recognizing the family's role (American Nurses Association, 2015). The conflict was not between right and wrong, but between two goods.
What it misses: ethical knowing tells me what matters and who is owed what, but not how to say it at a doorway to a frightened son in a way he could hear.
Personal Knowing
What it attends to: the clinician's own self, and how it shapes the encounter. What it sees here: my father died in a hospital with an intravenous line running, and I remember believing at the time that it meant someone was still trying. When the son spoke, I recognized my own younger self in him, and I noticed an urge to agree with him quickly to spare him what I had felt. Naming that urge to myself, in the car before I went in and again during the visit, allowed me to use my experience to understand him rather than to act on it.
What it misses: personal knowing is unreliable when the clinician's experience is different from the family's, and it can mislead if it is taken as insight into another person's meaning rather than as a reason to ask.
Aesthetic Knowing
What it attends to: the perception of the whole situation and the art of responding to it. What it sees here: the wife's silence, her eyes on me, the son standing between her and the bedroom door. I sat down at the kitchen table rather than standing in the hall, asked the son to tell me what he had noticed, and asked the wife, directly, what she thought her husband would want. She said, "He told me no tubes. But I can't watch him suffer." That sentence was the center of the visit. Aesthetic knowing is what led me to invite her to speak, and to hear that the family's request was really a plea for evidence that he was not suffering.
What it misses: aesthetic knowing is hard to teach, hard to document, and hard to check, which is why it needs the other patterns alongside it.
Synthesis: What the Patterns Together Produced
No single pattern resolved the visit. Empirical knowing told me an infusion would not relieve his symptoms. Ethical knowing told me whose wishes came first and that the family's distress was also my responsibility. Personal knowing kept me from answering the son too quickly. Aesthetic knowing found the question underneath his demand. Together they produced a plan the family could accept: I explained that the evidence showed fluids would not make him more comfortable and could make his breathing harder; I showed his son how to moisten his father's mouth every hour; and I promised a nurse visit the next morning. The son helped with mouth care before I left. White (1995) argued that Carper's patterns should be joined by a fifth, sociopolitical knowing, and this visit shows why: the family's fear of "dying of thirst" reflects a widespread public belief, and changing that belief is work beyond a single visit. Mr. E. died at home four days later, with his wife and son beside him; at the bereavement call, his son said the mouth care had given him something to do.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association.
Bruera, E., Hui, D., Dalal, S., Torres-Vigil, I., Trumble, J., Roosth, J., Krauter, S., Strickland, C., Unger, K., Palmer, J. L., Allo, J., Frisbee-Hume, S., & Tarleton, K. (2013). Parenteral hydration in patients with advanced cancer: A multicenter, double-blind, placebo-controlled randomized trial. Journal of Clinical Oncology, 31(1), 111-118. https://doi.org/10.1200/JCO.2012.44.6518
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
White, J. (1995). Patterns of knowing: Review, critique, and update. Advances in Nursing Science, 17(4), 73-86. https://doi.org/10.1097/00012272-199506000-00007
What the NU 700 Unit 6 instructions ask for
The Unit 6 assignment asks you to analyze a clinical situation through multiple patterns of knowing, usually Carper's empirical, ethical, personal and aesthetic patterns. Expect to describe the episode briefly, then devote a section to each pattern, explaining what that kind of knowing attends to and what it revealed in the situation. Many versions add later patterns such as sociopolitical or emancipatory knowing, so check your instructions. A synthesis section usually asks how the patterns worked together or conflicted. First person is generally allowed because the episode comes from your own practice. Even so, the paper still needs scholarly support, at minimum Carper's original article and evidence for the empirical section. Keep the patient unidentifiable by changing details that do not affect the analysis.
Inside the NU 700 Unit 6 example
The paper opens with the visit in a single paragraph, enough detail to make the request and the tension clear. Each pattern section follows the same two-part structure, first naming what the pattern attends to and then what it showed in this home. That repetition helps the grader compare the sections. The empirical section stands on a specific randomized trial rather than general claims about hydration. The ethical section names two competing obligations rather than one rule. The personal section is the most exposed and is kept short, showing self-awareness without turning into memoir. The aesthetic section shows the clinician's response through actions, like sitting down and offering mouth care. The synthesis ties the four together, explaining that no single pattern produced the decision to decline the infusion while offering other comfort.
Where the points sit in the NU 700 Unit 6 rubric
Herzing rubrics for a patterns of knowing paper usually score the description of the situation, the analysis of each required pattern, the synthesis, and scholarly writing. The situation earns points when it is concise and clearly involves more than one kind of knowing. Each pattern is typically its own criterion, with full points for an accurate definition supported by Carper or later theorists and a specific application to the episode. Personal and aesthetic knowing are the patterns graders read most closely, because they are hardest to write without slipping into narrative. Synthesis points go to papers that show interaction among the patterns rather than a closing summary. The writing criterion covers organization, appropriate use of first person, APA 7 citations and protection of patient identity.
NU 700 Unit 6 help before you submit
The most frequent Unit 6 problem is describing each pattern in general terms without saying what it showed in this particular episode. Another is a personal knowing section that tells the student's life story instead of examining how their history shaped their judgment. Aesthetic knowing is often confused with being kind; the pattern concerns perceiving the whole situation and responding with skill. Students sometimes rely on evidence claims without a source in the empirical section, which undercuts the pattern that most needs one. A synthesis that repeats each section briefly earns less than one that shows the patterns correcting each other. Choose an episode with real tension, because a routine visit gives the patterns little to do. Finally, remove details such as dates, towns or rare diagnoses that could identify the family.
Get a NU 700 Unit 6 example written to your instructions
Send the Unit 6 instructions and the rubric from your NU 700 classroom, plus the framework your instructor named and a rough outline of the episode you want used. We write a custom example against those instructions, with one episode read from every direction, and return it in 24 to 48 hours. The first one is free.
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NU 700 Unit 6 questions, answered
Do I have to use Carper's patterns?
Check your instructions, because some sections name them, some allow later accounts that add an emancipatory pattern, and some leave the framework open. Whichever you use, cite the original source rather than a summary page, and apply every pattern the framework contains. Naming four and analyzing three is a visible gap when the rubric lists the framework by name.
How personal is this paper allowed to be?
Personal enough to show what you perceived and how it changed the encounter, and no further. First person is normal in this piece. What costs points is emotion with no analytic use, since the pattern is about the clinician as an instrument of perception rather than about how the situation felt. Tie each personal observation to something that happened next.
Can I use an episode from my own practice?
In many sections yes, and real episodes usually produce stronger papers because the tension is genuine. Remove every identifier, including dates, facility, unusual diagnoses and anything that would let a colleague recognize the person. Your obligations under your own access and your employer's policy stay with you when you write for a course, so a composite is safer when the case is unusual.
Where can I find a free NU 700 Unit 6 sample paper?
You can read the entire NU 700 Unit 6 hospice visit paper here free of charge, all four patterns and the synthesis. If you need a different episode or added patterns such as emancipatory knowing, ask for a custom paper built from your situation.
What is aesthetic knowing in nursing, with an example?
Aesthetic knowing is the perception of the whole situation and the art of responding to it. In this sample the nurse practitioner notices the wife's silence and the son's position in the doorway, sits down at the table and offers mouth care instead of explaining trial data.