Jean Watson’s Caring Theory
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The Implementation of Jean Watson’s Caring Theory in Nursing Dr. Jean Watson defined nursing as a “Human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human“(Watson, 1988, p. 54). The Caring Theory of Nursing is a relational caring for self and others based on a moral, ethical, and philosophical foundation of love and values (Watson Caring Science Institute, 2010). Watson‘s core concepts formulate the practice of loving-kindness, enabling the authentic presence of deep belief and cultivating one’s own spiritual practice towards’ wholeness (Butts & Rich, 2011). This is better worded as a holistic approach to mind, body, spirit, and beyond the ego which releases the “being’ in the caring healing environment allowing miracles to flow from the openness of the unexpected (Watson Caring Science Institute, 2010).
The major elements allow the nursing world to take focus on Carative factors, grasp onto transpersonal caring relationships, and in doing so provide what is known as a critical “caring moment”(Watson Caring Science Institute, 2010). The caring theory and tools are practiced in every aspect of nursing in today’s modern medical world and are supported by ethical research that celebrates the healing environment. Watson truly applied a clinical practice that has grown the nursing world into a genuine and loving atmosphere for the sick, lamed, and broken. The Components of Human Caring Theory (Jean Watson)
The human caring theory birthed by Dr. Jean Watson derived from a solid background founded in education counseling, nursing and psychology (Butts & Rich, 2011). Watson’s theory took shape around 1979, as a response to wide gap she witnessed in health care, which was technology oriented and simply focused on diagnosis and treatment of disease overlooking the art of healing recognizing humanity as a whole and scope of individual relation between patient and health care provider (“Jean Watson’s theory of Human Care”, 2010). Watson was motivated to write the theory as she pursued to develop an integrated baccalaureate curriculum in a school of nursing (Butts & Rich, 2011). Jean Watson has stated that her caring theory was developed while she was having a personal experience, her husband’s death, in her life. She molded her professional and personal life in order to develop her theory. According to Jean Watson’s definition of metaparadigm, a person is a human being whose needs should be respected, supported, and cared for.
The environment should be contributing to holistic healing. Health was examined by Watson holistically, where a human being should be able to function mentally, physically, spiritually, and socially to its full aptitude (Jean Watson, 1988). Watson’s theory was developed on a foundational approach which focused on both deductive and inductive methods. The inductive approach was set out to prove theory through research and in contrast the deductive approach was developed based on experience (Tomey and Alligood, 2006). The central theme of the caring theory is allowing an individual to encompass their approach to nursing through loving-kindness and equanimity (Watson Caring Science Institute, 2010). Major elements in this theory according to Watson are the carative factors, the transpersonal caring relationship, and the caring occasion or caring moment. It is said that “Jean Watson is one of the few nursing theorists who considers not only the cared for but the caregiver”, which is supported by her core concepts of the caring theory (Tomey and Alligood, 2006).
Carative factors are considered the guide of the nursing core which attempt to honor all human dimensions. The nurse’s work and the intimate world are idiosyncratic experiences of the individuals they serve and contrast the curative factors of medicine. Carative literally means “to cure a disease;” and in the caring theory the carative factors evolve into the caritas factors (Watson, 1997). There are ten carative factors that Watson considers foundational to the theory: “Formation of humanistic-altruistic system of values, Instillation of faith and hope, Cultivation of sensitivity to oneself and to others, Development of a helping-trusting, human caring relationship, Promotion and acceptance of the expression of both positive and negative feelings, Systematic use of a creative problem-solving caring process, Promotion of transpersonal teaching-learning, Provision for supportive, protective and corrective mental, physical, societal, and spiritual environment, Assistance with gratification of human needs, Allowance for existential-phenomenological-spiritual forces” (Butts and Rich, 2011, Pg. 510).
This pathway of thinking emphasizes the connection of spirituality and human love in the patient-nurse relationship that are held in high respect and considered equally important to both parties (Butts and Rich, 2011). Caritas carry grand spiritual dimension into the heart of this theory. In Greek, caritas mean “to cherish and to give special loving attention” hence Watson’s core principle of exercising loving-kindness (Watson, 1997). The caritas field is the center for the conscious healing presence which has evolve into a clinical process: “Embrace altruistic values and practice loving kindness with self and others, instill faith and hope and honor others, be sensitive to self and others by nurturing individual beliefs and practices, develop helping-trusting-caring relationships, Promote and accept positive and negative feelings as you authentically listen to another’s story. Use creative scientific problem solving, share teachings and learning, create a healing environment, assist with basic physical, emotional, and spiritual human needs. Be open to mystery and allow miracles to enter” (Butts and Rich, 2011, Pg 511-512).
The Transpersonal caring relationships go beyond the human ego into a more “spiritual” caring environment. This type of caring allows moral commitment to protect and enhance human dignity. This creates a respect and true love for the person which honors their “needs, wishes, routines, and rituals (Watson Caring Science Institute, 2010). The concept of the Caring consciousness allows the caregiver to place themselves in the similar situation as the patient, allowing deep connection between the two. This also allows the giver to manifest an honest heart-centered spirit that practices and honors the wholeness of mind, body, and spirit (Watson Caring Institute, 2010). When these core concepts are practiced in unity they form what is known as equanimity or inner harmony that maintains the balance of the environment. Harmoniously, the principles agree together and the intention of “doing” for another and “being” with another who is in need, providing the skills and a formula to properly care for a specific need (Watson, 1999). Subsequently, this enables the caregiver to be open “to the unexpected and inexplicable life events, “birthing what is called the “Authentic Presence (Watson Caring Science Institute, 2010). In this particular presence or moment there is an assembling and joining to the patient at the heart of their treatment, painting an atmosphere for the “Caring Moment” (Watson Caring Science Institute, 2010).
Heart-centered encounter with another person is known as the “Caring Moment” or “Caring Occasion.” Essentially, when two individuals meet, they link together their own personal backgrounds which in turn creates a “human-to human transaction that is meaningful, authentic, intentional, honoring that person, and sharing human experience that expands each persona’s worldview” (Watson Caring Science Institute, 2010, Pg 1). This union provides new discoveries and new possibilities that are expanded by the spirit of caring and the art of knowing the needs of your patient. The Impact of Human caring theory in Practice
Implementing Dr. Jean Watson’s caring theory into practice has significantly impacted nursing world as we know it. Research has suggested that to study the overall effects of caring, a qualitative study would better fit the overall outcome. For example, phenomenological research that conducted interviews with open-ended questions gives attention to the individual who experienced the theory first hand. This enables an appropriate analyzing of the major elements focused on the carative factors; Transpersonal caring relationship, and the caring occasion or moment. What better way to investigate a theory of loving-kindness than to sit and grasp a painted picture from the patient themselves. One illustration of this theory in practice was focused on six women, with two volunteers, who met once a week, and shared stories or thoughts in a circle format (Watson, 1988). This was followed by positive feedback from the members. There is a certain ease of comprehension on this theory and it seems applicable to the nursing practice.
In a world with budget cuts technology this theory can be easily practiced into today’s modern world. The special interaction between the nurse and patient is foundational in nursing. This is caring and sympathetic approach to holistic health which enables the nurse to see the patient as a whole being and not just illness or brokenness. Viewing the individual in the holistic sense allows the patient to feel justified and promotes awareness for all current needs during their experience. The family can also feel validated in knowing the spirit of the caregiver is loving and bringing forth the art of caring openly with no limits. In Watson’s words nurses “are searching for the way to care in a society that refused to value caring, and the way to serve without being a subservient”(Watson, 2001). Harmonization is needed to balance the professional image of nurses and maintain a nurturing image. The changes in the health care world has produced an increase in acuity and complexity of the medical field which require an enormous sense of caring. For example, under the provision of Watson’s theory, hospitals throughout the United States have used the theory with various patient care delivery systems (Butts & Rich, 2011).
Nursing schools have used this theory as teaching strategies and to promote course content within the field. Research studies have used Watson’s famous principles as foundation in human caring that are both “reflective and subjective, and as well as objective-empirical” (Butts & Rich, 2011, pg 512). The effectiveness of Watson’s Caring Model on the quality of life and blood pressure of patients with hypertension (Watson, 2001) “demonstrated a relationship between care given according to Watson’s Caring model and increased quality of life of the patients with hypertension” (Watson, 2001).
Moreover, the patients who received this type of caring model practice appeared to demonstrate a relationship between the Caring model and a decrease in patient’s blood pressure (Watson, 2001). As a result of this research, Watson’s model was recommended as a benchmark to nursing patients with hypertension, “as one means of decreasing blood pressure and increase in quality of life” (Watson, 2001). Unfortunately, this theory is not useful in some aspects of the medical field such as biomedical, bureaucratic health system, and sometimes presents problems for nurse’s work in the sense that it requires deeper evaluation of self. The strengths, is that the theory places the client in the context of the community and culture which is a focus of practice rather than technology. The limitations are that the biophysical needs of the patient are put the back burn and the ten carative factors primarily delineate the psychosocial needs of the person. How to Implement Caring Theory
The caring theory strengthens our practice by providing a structure of common caring and linking with the patient through holistic wellness. The theory allows the practitioner to affirm their personal beliefs, values, and to paint the very picture of why they became nurses. Their deep roots of caring are manifested forward and provide a profound joy in the caring of their patients. Caring as we know it personally is the continuous healing of relationships, friendships, wounds, and emotions just to name a few. Patients are the center of our caring hands and focus, therefore produced is a good quality treatment and healing encompassed in one. Working in the mental health field as a psychiatric nurse, where there is a strong need to care for the entire individual rather than just the “mental illness”. This enables a personal growth in handling, caring, and loving honorably the entire individual while they are under my care for a short period of time. To fully engage with my patients, I incorporate Watson’s first and second caritas into my regular nursing routine. Her first caring process is, “practicing loving-kindness within the context of an intentional caring consciousness “and the second, “being fully present in the moment and acknowledging the deep belief system and subjective life world of self and other” (Watson, 1988).
When I enter the room for the first time, I make eye contact as I introduce myself with a touch on their hand and a warm smile. This action lets the patient to know that I genuinely care. This loving and caring environment opens the ability to instill faith and hope into my patient’s existing condition. The caring theory disables the ability to pass judgments, enabling to all patients the same respect and level of care (Watson, 2001). I instill hope to my patients with mental illness or chemical dependency issues that helps them to get through a rough time. Caring allows me to discuss the patient’s feelings and perception of their quality of life and managing their conditions. Moreover, I can advocate for my patients through our established rapport developed throughout their treatment. Importantly, the mind, body, and spirit are extremely important to observe and consider in psychiatric treatment to develop a treatment plan beneficial for acute care. A high quality nurse is not defined simply by her ability and skills but rather how well she interacts with the client and family while implementing care. Transparency is imperative and can only be discernible by the caring process wrapped in the best interest of the patient.
After reviewing several theories on human caring it is concluded that Jean Watson’s and Kristen Swanson’s theories have some similarities. Their philosophy of nursing is similar in some aspects of nursing metaparadigm. Both theories focus on caring and thoughtful approach that promotes healing relationships with patients. I would incorporate both theories in my nursing practice in order to provide holistic care (Butts and Rich, 2011). Conclusion
In conclusion, Watson’s human caring theory allows nursing to embrace the positive energy that flows from an incorporated mind, body, and spirit and is equally rewarding to both the patient and the nurse. Jean Watson asserts that caring restores life energies and potentiates our abilities. The benefits are beyond measure and promote self-actualization on both personal and professional level. Caring is a mutually beneficial experience for both the patient and the nurse, as well as between all health team members. It improves patient outcomes and customer satisfaction.
Butts, J. B., & Rich, K. L. (2011). Philosophies and Theories for Advanced Nursing Practice. Ontario, Canada: Jones & Bartlett Learning. Tomey, A. M., & Alligood, M. R. (2006). Nursing Theorists and Their Work (6 ed.). St. Louis: Mosby. Watson, J. (1988). Nursing: Human science and human care. A theory of nursing. New York: National League for Nursing. Watson, J. (1997). The theory of human caring: Retrospective and prospective. Nursing Science Quarterly, 10(1), 49-52. Watson, J. (2001). Jean Watson: Theory of human caring. In M.E. Parker (Ed), Nursing Theories and nursing practice. Philadelphia: Davis Watson Caring Science Institute, 2012