Barbara A. Carper Reflects on Her Career in Nursing and 'Ways of Knowing'
Influential Article in Advances in Nursing Science Introduced Wholistic View of Nursing
In the late 1970s, nursing professor Barbara A. Carper outlined a philosophy that helped nursing broaden its
focus from scientific knowledge alone to a broader range of "patterns of knowing" that form the foundation of
the care nurses provide. She discusses her formative experiences and ideas in a special interview article in the
April/June issue of Advances in Nursing Science. The journal is published by Wolters Kluwer Health.
Dr. Carper's paper "Fundamental Patterns of Knowing in Nursing"—published in the very first issue of Advances in
Nursing Science in October, 1978—has been a touchstone of nursing science ever since. In conversation with
Elizabeth R. Eisenhauer, RN, MLS, a doctoral student in nursing at the University of Michigan, Dr. Carper talks
about her background, the trajectory of her career and work, and her perspective on the current state of nursing.
Foundational Paper Led to 'A Paradigm Shift in Nursing'
Dr. Carper's article "arguably created a paradigm shift in nursing," according to Elizabeth Eisenhauer. Their wideranging discussion provides new insights into Dr. Carper's life and career, including the inspiration and influences
that lead her to develop her ideas about "patterns of knowing" in nursing.
While teaching in the 1960s, Dr. Carper felt concerns about the nursing curriculum's strict focus on "science and
the science of nursing." "For me, developing the patterns of knowing was a response to intellectual and personal
concerns to clarify and express that nursing practice was more than science," she tells Elizabeth Eisenhauer.
"Carper's insights unleashed a critical moment in the history of the development of nursing by demonstrating that
nursing practice is based on wholistic nursing that includes empirics, but also privileges personal, ethical, and
aesthetic knowing," according to an editorial comment by Peggy Chinn, RN, PhD, FAAN, Editor-in-Chief of Advances
in Nursing Science.
Dr. Carper describes the ways of knowing as a "cultural or intellectual philosophy of nursing, not a theory." She
shares her views on how her ideas have been incorporated into nursing training, and on the importance of
incorporating the arts and humanities into nursing education.
The conversation touches on Dr. Carper's early influences, her training and teaching experience, and the factors
and people contributing to the rapid development of nursing theory in the late 1970s and early 1980s. Dr. Carper
also voices concern over the encroaching role of technology—she sees some doctors and nurses paying more
attention to the information on their computer screen, rather than listening to what patients are trying to tell
them.
Asked to sum up her influence, Dr. Carper responds, "I would say my major contribution was not just to nursing
science, but was to the practice of nursing…to get nurses, and those who taught nurses, to think about something
more than the science, in terms of what is the practice of nursing." She believes her ideas resonated with
experienced clinicians, who "agreed that we do require different kinds of knowing...all of value but different
ways...it's not 'either or,' but all of them."
Cited more than 1,800 times since its publication, Dr. Carper's foundational paper "extended the possibilities for
future development of nursing knowledge, theory, research and practice," according to Dr. Chinn. She adds, "For
many, the revelation of the wholistic nature of knowing in nursing has affirmed and encouraged nursing's historic
commitment to the wholistic nature of human experience."