The Jean Watson Philosophy and Science of Caring

1. The Jean Watson Philosophy and Science of Caring Carl Fulton Irma Gomez Dorothy Onyeise Jaime Valles November 17, 2013

2. Overview The discipline of nursing requires one to become educated in many academic fields, including the anatomical, biochemical, behavioral, the social sciences and the humanities. This facilitates an educated and holistic view of a person’s wellness or illness. Nursing also requires understanding health, illness, and patient environment, and how these factors relate to human behavior (and deliberate nursing intervention). Finally, a nurse must have excellent interpersonal skills. Keeping these ideas in mind, Jean Watson focuses on the philosophy and science of caring as the core to nursing practice. Jean Watson (1996) states “Caring is acknowledged as the highest form of commitment to self, to others, to society, to environment, and at this point in human history, even to the universe” (p. 146). This presentation will explain how Jean Watson’s philosophical Science of Caring incorporates the four nursing metaparadigm concepts: person, health, environment and nursing. By understanding and utilizing the theoretical proposals of Watsons’ Science of Caring, one could improve nursing practice and assessment skills, improve patient rapport, and improve patient outcomes (by facilitating effective communication, and thereby empowering the patient). By utilizing Watson’s Philosophy and Science of Caring in practice, one may promote the roles, functions, and values of America’s most-trusted professional, the nurse (Gallup, 2010).

3. Caring Behaviors

4. Person Body-Mind-Soul Caring, which Watson sees as a moral ideal rather than a task-oriented behavior, is central to nursing practice and includes aspects of the actual caring occasion and the transpersonal caring relationship. An interpersonal process, caring results in the satisfaction of human needs. The ultimate goal is to “help persons gain a higher degree of harmony within the mind, body, and soul which generates self-knowledge, self-reverence, self-healing, and self-care processes, while allowing increasing diversity” (Watson, 1988). By emphasizing care of the mind, body, and soul, Watson’s Science/Theory of Caring uses a Holistic approach to healthcare (in other words, care of the whole human being).

5. Subjective Experience • The concept of Health is a subjective experience, and perception of health may vary among individuals according to their environment, baseline health status, mental health status, social status, and other variables. Health is more than the absence of illness: “Health refers to unity and harmony within the mind, body, and soul” (Friberg, 2011, p. 107). • Illness may be defined as disharmony of the mind, body, or soul (Friberg, 2011). Health

6. Environment Family, Culture, Community & Society When changing the client’s environment, the nurse should take into consideration both internal and external variables that may influence perception of the environment. (Friberg, 2011). Maintain a quiet environment so that the patient can achieve optimal rest. Create a healing environment for the physical and spiritual self, while respecting human dignity. The aim is to help the client feel safe and free to make the best decision at that specific occasion.

7. Jean Watson views nursing as not only a science, but also an art as well. In her 1988 book Nursing: Human Science and Human Care / A Theory of Nursing, Watson defines nursing as “a human science of persons and human health—illness experiences that are mediated by professional, personal, scientific, aesthetic, and ethical human care transactions”(1988, p. 54) • Watson’s theory provides a conceptual model to facilitate the goal of “promoting health, preventing illness, caring for the sick, (and) restoring health” (Watson, 1979). • Jean Watson teaches the use of a caritas model; or a model in which caring and love becomes the perspective (and basis) for providing compassionate human care. “…love becomes the energetic basis for sustaining humanity.” (Brewer, Clarke, & Watson, 2009). Nursing

8. Nursing Good Communication is the Key to Good Nursing • The carative factors elaborated upon in Watson’s Science of Caring, attempt to “honor the human dimensions of nursing’s work, and the inner life-world and subjective experiences of the people we serve” (Watson, 1997, p. 50). • The nursing and curing aspects of the healthcare profession are different, but intricately interrelated. Nursing is an interpersonal art with defined goals and interventions that are both self-directed and directed by the interdisciplinary team, in conjunction with the will of the patient and family. • The nurse-patient relationship can be used as a tool to help the patient gain a higher degree of wellness by facilitating personal growth, healing, and adaptation using good communication with the patient.

9. MODEL UNIVERSE Patient (Body, soul and mind) •  Transpersonal Caring Relationship •  Authentic relationship  • Caring Moment / Occasion  • Sacred SPACE • % • ( • Healing • Environment Nurse 6 Forgiveness Compassion Love 9 Forgiveness Compassion Love 8 uses carative factors  Becomes Caritas Process  Love/Care (Lukose, 2011)

10. Watson’s Science of Caring Can Be Used To: Watson’s science of caring can be used to improve assessment skills, by utilizing communication skills highlighted by Jean Watson: Listening, Being Responsible, Being Honest, Showing a Comfortable Attitude, Having Patience, Providing Information to the Patient for Informed Decision Making, Being Respectful, Exhibiting the Caring Touch, Addressing the Patient by Name, and Being Sensitive. Improved communication and assessments increase the nurse’s familiarity of the patient and their situation. By taking time to get to know one’s patient, the nurse will be able to effectively identify variations in patterns that are pertinent to patient safety. This can help to identify side effects, toxicities, or complications when a patient initially becomes symptomatic. Knowing our patients will also help with patient advocacy, by intervening while problems are small rather than waiting until they become complex.

11. Watson’s Science of Caring Can Be Used To: Utilizing effective communication skills (as elaborated by Watson) improves the nurse-patient rapport, empowers the patient to take an active role in their health, and improves patient outcomes. Effective communication can facilitate patient education (especially of the disease process and necessary interventions). This helps (and encourages) the patient to participate in the self care process, and in any decisions that affect them.

12. Watson’s Science of Caring Can Be Used To: Improve and change the patient’s care, and to change the impression that the public have regarding nursing. The public will see nursing as a profession, as opposed to an occupation. By utilizing Watson’s Philosophy and Science of Caring, one may promote the roles, functions, and values of America’s caring professional, the nurse.

13. References: Brewer, B.B., Clarke, P.N., & Watson, J. (2009). From Theory to Practice: Caring Science According to Watson and Brewer. Nursing Science Quarterly, 22(4), 339-345. Accessed November 13, 2013, from OVID SP Database/ Wolters Kluwer Health. Friberg, E.E., & Creasia, J.L. (2011). Conceptual Foundations: The Bridge to Professional Nursing Practice (5th ed.). St. Louis: Mosby. Jones, J.M. (2010). Nurses Top Honesty and Ethics List for 11thYear. Gallup Economy. Obtained November 17, 2013, from the Gallup Poll Website: http://www.gallup.com/poll/145043/nurses-top-honesty-ethics-list-11-year.aspx Lukose, A. (2011). Developing a practice model for watson's theory of caring. Nursing Science Quarterly, 24(1), 27-30. doi: AN:00006236-201101000-00009 Rafael, A. (2000). Watson's Philosophy, Science, and Theory of Human Caring as a Conceptual Framework for Guiding Community Health Nursing Practice. Advances in Nursing Science, 23(2), 34-49. Obtained November 14, 2013, from the EbscoHost Database. Vance, T. (2003). Caring and the Professional Practice of Nursing. Retrieved November 17, 2013, from http://rnjournal.com/journal-of-nursing/caring-and-the-professional-practice- of-nursing

14. References: • Watson, J. (1979). Nursing: The Philosophy and Science of Caring. Boston: Little, Brown & Company. • Watson, J. (1988). Nursing: Human Science and Human Care-- A Theory of Nursing. New York: National League for Nursing. RetrievedNovember 13, 2013, from the EbscoHost Database. • Watson, J. (1996). Watson's Theory of Transpersonal Caring. In P. H. Walker & B. Neuman (Eds.), Blueprint For Use of Nursing Models (pp. 141–184). New York: NLN Press. • Watson. J. (1997). The Theory of Human Caring: Retrospective and Prospective. Nursing Science Quarterly, 10(1), 49-52. Obtained November 14, 2013, from the EbscoHost Database. • Watson, J. (2005). Caring Science as Sacred Science. Philadelphia: F.A. Davis.