Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Differing Kinds and Field of Knowledge
  1. Background knowledge. This is knowledge the nurse brings with him/her before meeting the client. This includes education, the readings he/she has engaged in, and one’s life experiences.
  2. Knowledge of interpersonal, caring and development theory. This includes knowledge of theories, which provide an understanding of the development of the sense of self (who we are), and how that self influences our way of being in the world with others. There are different theoretical approaches such as:
    • Interpersonal (Orlando, 1961; Peplau, 1952)
    • Object relation theory (Lego, 1980; Winnicott, 1965)
    • Developmental (Erickson, 1963; Freud, 1912; Stern, 1985)
    • Gender/developmental (Gilligan, 1987; Miller, 1985; Stiver, 1985)
    • Caring Theories (Benner, 1989; Leininger, 1988; Watson, 1999; Watson, 2005)
  3. Knowledge of diversity influences and determinants. Knowledge about the relationship of social justice to social, cultural and racial diversity is essential. The nurse needs to be aware of the effects of “differences” and how these influence the therapeutic relationship.
  4. Knowledge of person. This knowledge refers to the particular narrative of the client which includes:
    • Understanding of the client’s particular world;
    • Identifying and confirming what is meaningful and concerning to that client; and
    • Hearing the client’s life history.
    • Awareness of ways and patterns of knowing: empirical (evidence based), personal, ethical, aesthetic and political.
    • Knowledge of health/illness. The nurse requires specific knowledge of the client’s presenting issue so that he/she can engage effectively in a therapeutic relationship. For example, if a young man presented with a diagnosis of schizophrenia, the nurse would need to know about:
      • Explanatory models including multi-determinants of health/illness which would be biological, psychological and/or socio-contextual;
      • Symptoms;
      • Standard interventions and issues of rehabilitation;
      • Pharmacology-in order to administer, monitor, and instruct; and
      • Knowledge of best practices.
  5. Knowledge of the broad influences on health care and health care policy.The nurse needs to have knowledge of the forces that may influence the context of the client’s care:
    • Social and political forces;
    • The client’s expectations of the health care system;
    • How the health care professional functions; and
    • Changes in the health care system such as accessibility, resources, etc.
  6. Knowledge of systems. The nurse needs knowledge of the system and how it operates so that he/she can provide instrumental assistance to the client. Through the therapeutic relationship, the nurse can help the client navigate the system and obtain access to services.