Jean Watson’s Theory of Human Caring

Jean Watson is a nursing theorist whose focus is human caring. Watson’s (2008) theory of human caring is widely used in nursing practice. Nursing is a caring science with ethical and theoretical associations. Human beings are linked to each other in the caring practice; a nurse’s humanity embraces the humanity of others to sustain the self-esteem of self and others. Nurses take care of patients’ physical needs as well as their minds and souls and, therefore, have an obligation to patients, families, communities, and the universe (Lukose, 2011). The caring nurse supports in the healing process, regards people as wholes, accepts them now and whom they will turn out to be later, cultivates trustworthy connections, and assists in humanity expansion.

People pick nursing as a profession because of their desire to care for others. Caring is such a vital part of nursing that is specifically identified in the Code of Ethics for Nurses, in that all professional nurses have a responsibility to care for patients under their care (ANA, 2001). In choosing the profession of nursing, I made a moral promise to care for all patients, which is a decision that I do not take lightly. Because of modifications in healthcare delivery within healthcare establishments and systems globally, the responsibilities and assignment of nurses have increased and become more multifaceted.

Quality nursing and health care, today, mandate respect for the functional unity of the human being. The new movement in healthcare is an individual style, focused toward the person that respects and incorporates all the segments into a united and significant whole. “Human caring conveys a deeper human-to human involvement and connections one to another, which goes beyond the most concrete notion of what can be implied with the term human care” (Watson, 2012, p. 35). Caring Moment:

A caring moment is defined as “Two persons (nurse and other) together with their unique life histories and phenomenal field in a human caring connection comprise an event” (Watson, 2012, p. 71). An actual caring moment occasion involves action and choice both by the nurse and the individual. The moment of coming together in a caring moment occasion presents the two persons with the opportunity to decide how to be in the relationship—what to do with the moment (Watson, 2012). As a nurse, I have had many “caring moments” with my patients. One of the most significant occasions that I remember was as a young nurse working on an Oncology unit with a terminally ill young man.

For three nights I was his nurse, he was in his early 30’s and had a wife and young child. In caring for him, I took the time to sit and talk to him and his wife, after the doctor came in to discuss his prognosis. As you can imagine, there were lots of tears shed that evening and the next two, as we walked thru the scenarios of what the future held and decisions to be made. I spent time with him after his wife left and my other patients were taken care of, and listened as he spoke of his wife and child, and what the impact of his dying would do to them. By allowing him to talk of his feelings with me, I felt I helped, in a small way, to see him thru part of the grieving process. We discussed his choices and developed a plan to live each day as it comes. One of the things I learned about myself during this time was that I could not distance myself from another human being, as much as I wished I could.

I felt that I was grieving as much as he and his wife were. I prayed with them, cried with them, and tried to assist where I could. Both the patient and his wife were very grateful with the care that I provided. Shortly after he was discharged home, I received a card from them both with a picture of the family and a short note letting me know how he was and what they plans they had with their child. At that point in time, I was not as spiritual as I am today and regret not bringing spirituality to the forefront of our discussions. I do believe they would have benefited from meeting with clergy and hope that they did after they went home. Carative Factors:

The four Carative processes that were utilized during this time were: 1. The practice of loving-kindness/compassion and equanimity with self/other. 2. Sustaining a loving, trusting, and caring relationship.

3. Allowing for expression of feelings: authentically listening and “holding another person’s story for them. 4. Creating healing environment at all levels: physical/nonphysical, subtle environment of energy, consciousness of touching the embodied spirit of another as a sacred practice, working with life force/life energy/life mystery of another. “Compassion asks us to go where it hurts, to enter into places of pain, to share in brokenness, fear, confusion, and anguish. Compassion challenges us to cry out with those in misery, to mourn with those who are lonely, to weep with those in tears. Compassion requires us to be weak with the weak, vulnerable with the vulnerable, and powerless with the powerless.

Compassion means full immersion into the condition of being human.” (Gustin & Wagner, 2013, p. 176). I find this quote to be so truthful of what we do as nurses. It applies to every level of the nursing profession. Nurses need to be compassionate to all, no matter who our patient is. Our past is a reflection of our experiences and we must be open to new experiences every day. All human beings dealing with the end of life issues are on the same level and go through the same grieving process. As nurses, we need to allow them time and assist them as best and as much as they will let us. People grieve in different ways, being able to assess where our patient is in the process is helpful. Our personal experiences can be invaluable in these moments.

Giving patients the space and time they need, but letting them know that you are available should they want to talk, can be far more helpful than having their physical needs met. Nursing care is more and more complex and requires all team members to be united with prioritizing patient safety while delivering a high level of quality care. The objective is to assimilate the theories of caring and nurture team actions that confidently influence nursing practice and promote shared associations among the healthcare team. The development of these relationships will lead to a decrease in adverse events for patients and the establishment of a culture of safety and caring (Sellars, 2011). Team work is vital to being able to develop a trusting relationship with patients who are going through a crisis. Trusting relationships do not only mean our patients, but our co-workers, as well.

If I had not been able to trust my team members to take care of my other patients, I would not have been able to provide the care I did. Trust is also vital in our interpersonal relationships. Developing trusting relationships takes work and honesty between the people involved. Keeping a patient safe, giving them the prescribed care, teaching and educating patients, letting them know if you don’t know the answer to a question, all goes into developing a trusting relationship. At many points throughout a life, people are confronted with existential/spiritual concerns about their existence and the meaning of their lives. These concerns tend to be more urgent when the person’s existence is threatened. It is when nurses are able to genuinely listen to another’s story, to hold their sorrow for and with them that may be the greatest healing gift.

It is the nurse at that moment who may be the only one who is there to listen to and hold the other’s story so he or she can explore their own meaning and thus own self-directed option (Watson, 2012). End of life issues are important to discuss with the patient and families. Allowing the patient and families to express concerns, verbalize feelings and know it is okay to feel them, is vital in helping families to cope with the end of life. The role of the nurse in this aspect of care is important. Some nurses have not been confronted with death and dying of a younger patient and have not yet explored their own autonomy, this makes the care of the patient more difficult . As nurses, we must explore our own feelings in regards to death and dying.

It is difficult to come to terms with the young dying, when an older patient dies we feel they have lived a good life and it is more acceptable than a young person or child dying. Nurses build a healing environment by generating a feeling of safety, trust, and openness that allows for compassion, clearness, and truth. To successfully do this, nurses must sustain nonjudgmental interactions to invite those same qualities to flow from others. A beneficial association allows for focused, goal-directed contacts to guide the best interest and results for patients. This creates a united environment that supports the self-healing ability of both the patient and the nurse. The healing environment must reflect the values, beliefs, and philosophies of the patients served (Bednarski, 2009).

We need to foster an environment that is soothing and curative for everyone. Allowing the patient to be in the best “place” for him, which was for him to be able to express every emotion he had and not be judged for it. At the same time, the nurse must understand the emotions are not directed towards her or reflect badly on the care received, but on the patient themselves expressing their grief the only way they know. Occasionally that means blaming the nurse or others for things that have gone wrong and the patient has no control over. Unfortunately, the nurse is usually the one who walks into the room after a doctor has given the patient news they did not want to hear. Conclusion:

Jean Watson has given the nursing profession the basis of which all nursing professionals should become deeply familiar with. As nurses, we do the ten Carative factors every day with each interaction we have with our patients. This theory should be so ingrained in us that compassion, caring, healing, loving-kindness, trust, dignity, and spirituality are the daily mantra of the nurse. This theory applies not only to the nurse-patient experience, but should be applied to all aspects of our lives, in the way we treat our family, friends and those we meet in passing. Everyone has a fundamental need to be loved and cared for.

Before starting this paper, I thought a lot about the experiences that I have had over the past 29 and a half years of nursing, I think this gentleman stood out the most because of when it happened in my career. I have since learned to be compassionate and allow myself to help the person grieve without getting caught up in their grieving process. I also have developed more of my own sense of spirituality over the years, which I did not have then. My hope is for the remainder of my career to always remember and instill this theory into everyday living, not just in my work life, but also my personal life.

Annotated Bibliography:

American Nurse Association (ANA): Code of Ethics for Nurses. (2014). Retrieved from This website is maintained by the American Nurses Association to promote, teach and guide nurse in their responsibility to carry out their duties with quality care. Exceptional resource for the code of ethics development and interpretive data.

Bednarski, Donna, (2009). The healing environment. Nephrology Nursing Journal, 36(5), 463- 463, 495. Retrieved from http://search.proquest.com/docview/216535689?accountid=458

Discusses the healing environment and what part the nurse plays in it. Environment in relationship to current theories, what can be done to promote a healthier, safer environment. Gustin — L. W., & Wagner — L. (2013). The butterfly effect of caring – clinical nursing teachers .’ Scandinavian Journal of Caring Sciences, 27(1), 175-183. doi:doi: 10.1111/j.1471-6712.2012.01033.x This article is about a study done to understand participant’s perception of compassion. Based on the 10 Carative factors from Watson’s theory, the authors developed a teaching–learning model that develops the students’ ability to be compassionate towards self and others while learning caring theory. Lukose, A. (2011, January). Developing a Practice Model for Watson’s Theory of Caring. Nursing Science Quarterly, 24(1), 27-30. doi:DOI: 10.1177/0894318410389073

This article focuses the four elements of Watson’s theory. It is reflective of how these elements focus on the importance using them for patient care. It also discusses how we can implement them in regards to our nursing students and educational programs. Nursing management and administration can benefit from implementing them into their everyday lives and develop the healthcare teams with this theory in mind. Sellars, B. B. (2011, December). The Impact of Caring on Transforming Culture. Nurse Leader, 9(6), 46–48. doi:http://dx.doi.org/10.1016/j.mnl.2011.04.001 This article is speaks to the new work environment and the impact it is having on the dehumanizing of patient care, due to the developing technology nurses have to deal with.

The impact and responsibilities that nurse leaders have to utilize Watson’s theory and institute the ten Carative factors. Watson, J. (2012). Human caring science: a theory of nursing (2nd ed.). Retrieved from The University of Phoenix eBook Collection database.. This is a course textbook used as required reading for this course. Watson’s theory is broken down and explained well in each of the chapters. Pertinent chapters are devoted to the recent changes in the theory with in-depth reasons why.