Theory of Human Caring

1. Jean Watson Group 1Ferris State UniversityNames listed are in order of appearance of works:Amelia Taggart,Holley West, Deanna Warnock,Anita Riddle, Carolyn Zielinski, andMary Bierlein Theory of Human Caring http://www.watsoncaringscience.org

2. Jean Watson, PhD, RN, AHB-BC, FAAN Evolution of Transpersonal Caring Theory

3. Margaret Jean Harman Watson was born and raised in a small West Virginia town in the Appalachian Mountains named Welch. • Being the youngest of eight siblings, she was surrounded by a large extended family. • She moved to Colorado after marrying Douglas, had two daughters and five grandchildren.

4. Watson established the Center for Human Caring at the University of Colorado in the 1980’s. • It was described as the “first interdisciplinary center committed to using human caring knowledge that forms the moral and scientific bases for clinical practice, scholarship, and administration and leadership”. (Watson, 1986)

5. Watson’s first book, Nursing: The philosophy and science of caring (1979), developed from her notes for an undergraduate course taught at the University of Colorado (Alligood, 2010). • Yaloms’ eleven curative factors stimulated Watsons’ thinking about her ten carative factors (Alligood, 2010). • Caratives were described as the organizing framework for her book.

6. Her early work embraced the ten carative factors but has evolved to include “caritas” that make connections between caring and love (Alligood, 2010). • She added “spiritual aspects and believes that the core of nursing is seen in those nurse-patient relationships that result in a therapeutic outcome (Alligood, 2010, p. 102).

7. Metaparadigms • Nursing theories embrace the concept that they all have elements that address four major paradigms: • Environment • Person • Health • Nursing

8. Environment • In her original caratives, she refers to the nurses role in the environment as “attending to supportive, protective, and or corrective mental, physical, societal, and spiritual environments” (Watson, 1979, p. 10).

9. In her later work, she describes that “healing space can be used to help others transcend illness, pain, and suffering” (Watson, 2003, p. 200). • She also emphasizes that environment and person are connected: “when the nurse enters the patients’ room, a magnetic field of expectation is created” (Watson, 2003, p. 200).

10. Her broad view of environment is: The caring science is not only for sustaining humanity, but also for sustaining the plan- et…Belonging is to an infinite universal spirit world of nature and all living things; it is the primordial link of humanity and life itself, across time and space, boundaries and nationalities. (Alligood, 2010, p. 99)

11. Person • Watson uses the words human being, person,life, and self interchangeably. She views the person as “unity of mind/body/spirit/nature” (Alligood, 2010, p. 99). • She feels that “personhood is tied to notions that one’s soul possess a body that is not confined by objective time and space..” (Alligood, 2010, p. 99).

12. Health • Her definition of health is “unity and harmony within the mind, body, and soul”, “the degree of congruence between the self as perceived and the self as experienced” (Alligood, 2010, p. 99). • She further states “illness in not necessarily disease; instead it is a subjective turmoil or disharmony within a person’s inner self or soul”

13. Nursing • Nursing consists of “knowledge, thought, values, philosophy, commitment, and action, with some degree of passion” (Watson, 1988, p. 53). • Nurses go beyond procedures, tasks, and techniques used in practice settings. (Watson, 1988, p. 53).

14. “Care for the Journey”Jean Watson http://www.watsoncaringscience.org/media/caring_moment.mp3

15. Uniqueness of Concepts • New to nursing in 1979 with “deep roots in philosophy and ethics and become more closely aligned with Rogerian science of unitary human beings” (Foster, 2006). • Basic assumptions of Caring Science. • Carative Factors to Caritas Processes.

16. Basic Assumptions • Caring Science • Caring • Humanity • Carative Factors/Caritas Processes • Effective Caring • Acceptance • Relationship • Curing Science (Watson, 2008)

17. Carative/Caritas#1

18. Carative/Caritas#2

19. Carative/Caritas#3

20. Carative/Caritas#4

21. Carative/Caritas#5

22. Carative/Caritas#6

23. Carative/Caritas#7

24. Carative/Caritas#8

25. Carative/Caritas#9 ────── ─────── Psychophysical Needs (activity-rest, sexuality) ─────── Biophysical Needs (food, water, elimination, ventilation Watson’s additional needs: Knowledge, beauty-aesthetics, evolving self-actualization that is spiritually meaningful, and “need to connect with that which is greater than self--to surrender to a higher source with a sense of awe toward the mystery and wonder of life, whether humanity itself, nature, God, Spirit, or a Divine universe” (Watson, 2008, p. 147). Intrapersonal-interpersonal need (self-actualization) Psychosocial Needs (achievement, affiliation)

26. Carative/Caritas#10

27. Jean Watson TikTok • Please click on the following link: http://www.youtube.com/watch?v=hcrTnKxJEa8

28. Watson’s theory in clinical practice.

29. The nurse considers the patient as a whole.

30. “The nurse makes a moral commitment and direct intentionality and consciousness to the protection, enhancement, and potentiation of human dignity, wholeness, and healing, such that a person creates or co-creates his or her own meaning for existence, healing, wholeness, and caring” (Kearney, 2008, p. 74).

31. The nurse is able to “connect with the inner condition (spirit) of another” (Kearney, 2008, p. 74) and create caring moments.

32. The healing modalities include: • The use of auditory, visual and tactile therapies. • Gustatory • Mental/cognitive • Kinesthetic • Caring consciousness • Understanding own life history The nurse uses the healing modalities to help bring harmony to a patient.

33. The nurse should “potentiate comfort measures, pain control, a sense of well-being or spiritual transcendence of suffering” (Kearney, 2008, p. 74).

34. Framework for patient assessment.

35. Watson’s theory challenges nurses to go beyond the tasks and procedures of nursing and really dig for the core of nursing (Tomey, 2010, p. 98)

36. Do an emotional and spiritual assessment • Sit down while talking with patient and give them your undivided attention • Actively listen to patient • Ask open ended questions that will allow the patient to share their feelings on their views on things such as health and situation • Instill hope and faith (Watson, 2007) Ways to incorporate Watson’s theory into nursing assessment

37. “Transpersonal Caring” In Nursing Education

38. Definition of Nursing Practice “ In the practice setting, nursing theory clearly defines the unique contribution of nurses to health care and helps distinguish nursing as a professional discipline with its own body of knowledge that is separate from the medical model of care” (Marckx, 1995, p. 49).

39. Carative-a Definition “Carativeis the philosophy and theory of human caring. Dr. Jean Watson uses the term “carative” instead of “curative” to distinguish between nursing and medicine”. “Whereas curative factors aim at curing the patient of disease, carative factors aim at the caring process that helps the person attain (or maintain) health or die a peaceful death” (Watson, 1979). The original theory developed in 1979, was organized around 10 carative factors: Source: Nursing: The Philosophy and Science of Caring by Jean Watson, RN, Ph.D. Boston: Little, Brown and Co., 1979.

40. Abbreviations of Watson’s Carative Factors “They can be used as an expressive tool while directing the assessment, interventions, charting and full engagement of caring human dimensions of nursing practice” (Rosenberg, 2006, p. 55)

41. Implication to Nursing Education “The carative factors, which represent the core of nursing and the primary ingredients of effective nursing practice, provide a language, structure, and order for studying and understanding nursing education and practice” (Wade & Kasper, 2006, p. 163).

42. Watson’s ViewEntry Level of Practice • ADN • BSN • MSN • Doctorate “Although the bachelor’s degree is considered still the [unresolved and impossible to implement] minimal entry level into the professional practice of nursing, the mature practice of nursing, as a career health professional, ideally should be at the professional doctorate level, or at least the graduate level.” (Fawcett, 2002, p. 217).

43. “Transpersonal Caring” In Nursing Research

44. Current Research • Unitary-Transformative Paradigm > unity of mind, body, soul, nature and the universe > spirit to spirit connection (Watson & Smith, 2002, p. 458). “We are to realize that we have to pay attention to what is happening in the universe; we are not separate from the environment, nature and other humans” (Fawcett, 2002, p. 216).

45. Dr. Jean Watson, Founder, created her international nonprofit Watson Caring Science Institute in 2007 with the mission to restore the profound nature of caring-healing in today’s healthcare systems and to retain its most precious resource, caring professional nurses and transdisciplinary care team members Dr. Jean Watson, Founder, created her international nonprofit Watson Caring Science Institute in 2007 with the mission to restore the profound nature of caring-healing in today’s healthcare systems and to retain its most precious resource, caring professional nurses and transdisciplinary care team members. The Watson Caring Science Institute http://www.watsoncaringscience.org/

46. Million NurseGlobal Caring Field Project http://www.watsoncaringscience.org/jeanmedpop.htm (Right click, select open hyperlink) Goal: “Connect simultaneously with a million nurses (or more) around the globe: to create and radiate an energetic Caring Field of Heart-Centered Love for Self, Others, and the Planet Earth. This intentional focused experience honors and extends the human caring vibration of nurses into the universal energy field of humanity facilitating healing and health for all” (Watson, 2010)

47. HeartMath “Thousands of health professionals in clinics, hospitals, military facilities, coaching, couples therapy, and private practice are using the emWave technologies with clients. They have found that with consistent practice, clients can learn to reduce stress, manage the emotions associated with stress, expand their coping skills, and create a greater sense of well-being.” http://www.heartmath.com/

48. Jean Watson’s Philosophy and Theory Jean Watson’s theory is similar to the nursing process and follows a similar path as the scientific research process. 1. Assessment 2. Plan 3. Intervention 4. Evaluation, so it is familiar for nurses to follow. Watson’s work does follow logical steps. Using the science of caring or the carative factors, shows how nursing differs from other professions. It advocates for the healing of the patient as opposed to the technology needed. Her philosophy is based on love/caring of the human being which is why many nurses chose their profession. Strengths of this Model

49. Jean Watson’s Philosophy and Theory Limitations of this Model Watson’s theory is first and foremost a psychosocial model. (Andrews, 2008.) With shorter hospitalization stays it is difficult to evaluate the effectiveness of the model in the hospital(Andrews, 2008). It is a relatively new theory (published in 1979) and hasn’t been utilized a lot; it needs more nursing research to determine it’s effectiveness in nursing practice. Her theory “language “can be difficult to understand.

50. Is about much more than giving care to a person. • Is about caring for a person’s body, mind, and spirit (soul) (Ryan, 2005). • Is about the person giving care as well as the one being cared for (Sitzman, 2011). • Is a moment to moment experience. • Is holistic Evaluation of Jean Watson’s Theory of Human Caring