Did you see nurse that you can know me-- The part that is me, my mind and soul is in my eyes These tubes that are everywhere-that is not me. The one in my throat is the worse of all-- Now my whole being, the essence of me I must reflect through my hands but they are tied down, movements of my head but did you realize that uncomfortable for me or through my eyes and you do not notice them-- except once today during my bath. You speak to me and look at the tubes-- Don't you know my thoughts are all over my face Don't you realize your thoughts are on your face-- In your touch and your tone of voice. I wrote a request on paper and you said "I'll take care Of it for you" your tone said "Why can't this woman Do anything for herself?" You positioned your hand to count my pulse but I Can't say you touched me-you wouldn't hold my hand that I may touch you. You walked in for the first time today with a grin on your face but your mouth is now tight you grimaced a lot as you bathed me. Don't you see nurse that you can know me--I'm not A chart or tubes of medication, monitors or all the other things you look at so intensely--I'm more than that I'm scared--just look in my eyes. --S. Carr, 1991 Carper's (1978) patterns of knowing offer a framework for organizing the content for studying this nursing situation. PERSONAL KNOWING Who are the nurse and nursed as caring persons in the moment? How are the nurse and nursed expressing caring in this moment? What is the meaning of this situation to the nurse and nursed in terms of present realities and future possibilities? What is the meaning of vulnerability and mortality? What is the value of intuition in practice? Empirical Knowing What nursing and related research exists on modes of communication, the meaning of presence in practice, touch, objectification, recovery of cardiac patients, technological caring, understanding the experience of fear and loneliness? What factual knowledge is needed to be competent in this particular situation--e.g. knowledge of monitors, chest tubes, medications, cardiac care, diagnostic data? ETHICAL KNOWING If nursing is practiced from the perspective of Nursing as Caring, what obligations are inherent in this situation? How is the nurse demonstrating the value that all persons are caring? Respect for person-as-person? Interconnectedness? What dilemmas are present in this story? AESTHETIC KNOWING