Jean Watson, PhD, RN, AHN-BC, FAAN

1. WISDOM FORGIVENESS Jean Watson, PhD, RN, AHN-BC, FAAN COMPASSION LOVE CARING

2. BROUGHT TO YOU BY: FRANCINE NESHEIM HILARY EDMONDSON LISA SNIDER WILLIAM RUSSELL

3. Jean Watson's Theory of Nursing Theory of human caring and the art and science of caring in nursing "Dr. Watson’s caring philosophy is used to guide transformative models of caring and healing practices for nurses and patients alike, in diverse settings worldwide" (Watson, 2012) Provides many useful concepts for professional nursing today Many theories tied together and utilized in today’s nursing education A detailed description of the 'carative factors have given guidance to nurses who wish to utilize them in their own nursing practice (Watson, 2012)

4. Who is Jean Watson? Born in West Virginia Attended the University of Colorado BSN in 1964 MS in 1966 PhD in 1973 Published her first book ‘The Philosophy and Science of Caring’ While at the University of Colorado, Dr Jean Watson held the title of Distinguished Professor of Nursing, one of the highest honors awarded to a faculty member for their scholarly work. In 1999, Dr Watson assumed the Murchinson-Scoville Chair in Caring Science, the nation’s first endowed chair in Caring Science at the University of Colorado Denver & Anschutz Medical Center (Watson, 2012)

5. Dr Watson founded her international nonprofit Watson Caring Science Institute in 2007 Her mission is “to restore the profound nature of caring healing in todays health care systems and to retain it’s most precious resource, caring professional nurses and transdisciplinary care team members” (Watson, 2012) Dr Jean Watson developed the 10 Carative Factors which defines the relationship of nurse and patient as human beings (Black, 2011). Watson's Caring Institute

6. Dr Jean Watson’s 10 Carative FactorsDefines the relationship of nurse and patient as human beings (Black, 2011) The formation of a humanistic- altruistic system of values The installation of faith-hope The cultivation of sensitivity to one’s self and to others The development of a helping-trust relationship The promotion and acceptance of the expression of positive and negative feelings The systematic use of the scientific problem-solving method for decision making The promotion of interpersonal teaching-learning The provision for a supportive, protective and /or corrective mental, physical, socio-cultural and spiritual environment Assistance with the gratification of human needs The allowance for existential-phenomenological forces

7. Carative Factor #1 The formation of a humanistic-altruistic system of values Begins to develop at an early age with values shared with the parents. Mediated through ones own life experiences, the learning one gains and exposure to the humanities. Perceived as necessary to the nurse’s own maturation which then promotes altruistic behavior towards others(Watson, 2012)

8. Carative Factor #2 Essential to the carative and curative processes. Sometimes modern medicine has nothing further to offer the person, the nurse can use faith-hope to provide a sense of well-being through beliefs which are meaningful to the individual. The instillation of faith-hope

9. Carative Factor #3 The needs of the nurse are explored in order for an emotion to be able to present itself. One’s own feelings are developed as needed to interact genuinely and sensitively with others. The nurse striving to become sensitive, becomes more authentic, thus encouraging self-growth and self-actualization, in both the nurse and those with whom the nurse interacts The nurse promotes health and encourages higher level functioning only after they form person to person relationships (Watson, 2012). Cultivation of sensitivity to one’s self and others

10. Carative Factor #4 • Communication is the strongest tool which establishes rapport and caring attitudes • Characteristics needed in the nurse to aid in the helping-trust relationship are: • Congruence,Empathy, and Warmth • Different forms of communication includes verbal, nonverbal and listening in a manner which represents empathetic understanding • (Watson, 2012) The development of a helping-trust relationship

11. Carative Factor #5 Feelings can alter thoughts and behavior, and need to be considered and allowed for in a positive caring relationship. Awareness of the patients feelings assists nurses to help understand the certain behaviors (Watson, 2012). The expression of positive and negative feelings

12. Carative Factor #6 The scientific problem-solving method is the only method that allows for control and prediction, and that permits self-correction. The science of caring should not be always neutral and objective (Watson, 2012). The systematic use of the scientific (creative) problem-solving caring process

13. Carative Factor #7 A caring nurse should focus on the learning process as much as the teaching process. In assisting to prepare a cognitive plan, the nurse should understand the person’s perception of their situation (Watson, 2012). The promotion of interpersonal teaching-learning

14. Carative Factor #8 Watson divides these into eternal and internal variables, in which the nurse can manipulate in order to provide support and protection for the person’s mental and physical well-being. The external and internal environments are interdependent. The nurse provides comfort, privacy and safety as a part of this carative factor(Watson, 2012). The provision for supportive, protective, and/or corrective mental, physical, sociocultural, and spiritual environment

15. Carative Factor #9 It is based on a hierarchy of need similar to that of the Maslow’s. Each need is equally important for quality nursing care and the promotion of optimal health. All the needs deserve to be attended to and valued. Examples of needs Biophysical needs: Ventilation, food and fluid, and elimination Psychophysical needs: activity, inactivity, and sexuality Psychosocial needs: achievement, affiliation, and self actualization (Watson, 2012). Assistance with the gratification of human needs

16. Carative Factor #10 Phenomenology is a way of understanding people from the way things appear to them, from their frame of reference. Existential psychology is the study of human existence using phenomenological analysis. This factor helps the nurse to reconcile and mediate the incongruity of viewing the person holistically while at the same time attending to the hierarchical ordering of needs. The nurse assists the person to find the strength or courage to confront life or death (Watson, 2012). The allowance for existential-phenomenological forces http://currentnursing.com/nursing_theory/Watson.html

17. Information and Concepts The content of this grand theory includes the four major metaparadigm concepts of : Human Being Environment Health Nursing

18. Human Being Watson views the person as a being consisting of mind, body, and spirit, and she acknowledges the importance of the unity of the mind, body, and spirit. A human being refers to a valued person to be cared for, respected, nurtured, understood, and assisted. "There is a need to develop methods that retain the human context and allow for advancement of knowledge about the lived world of human experience" (Watson, 1999).

19. Environment According to Watson, the environment includes the physical space in which the caring occasion occurs and when the nurse and patient come together in a human transaction (Cara, 2003). The environment must be healing in all ways physically and non-physically, and attention is on wholeness, comfort, dignity, and peace. A caring attitude is not transmitted from generation to generation, it is transmitted by the culture of the profession as a unique way of coping with its environment. • http://jalyon.wordpress.com/scholarly-works/watsons-human-caring-theory/

20. Health Health is a subjective experience that is defined by the person. "Health corresponds to the balance between mind, body, and spirit, and is influenced by how one perceives and experiences the situation and self "(Cara, 2003). Watson uses three elements to define health: 1. A high level of overall physical, mental and social functioning. 2. A general adaptive-maintenance level of daily functioning. 3. The absence of illness.

21. Nursing Nursing is defined as both an art and science in Watson's theory, with caring as the essence of nursing. It is the role of the nurse to assist the person in finding meaning to illness and suffering. Watson defines nursing as, "A human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions" (Watson, 1999). Nursing focuses on health promotion and treatment of disease using a holistic approach.

22. INTERPRETATION & INFERENCE Watson's theory focuses on the nurse-patient relationship first and foremost. Spirituality is a key focus of this relationship. This theory infers that a patient must be willing and able to participate in the type of patient to nurse sharing of feelings required to be therapeutic. Chitty(2011) Social support is also very important in Watson's theory. This infers the nurse must be able to identify the patient's idea of social support is most beneficial

23. Implications and Consequences This theory has implications in that they may need to find the willingness to participate in this type of relationship. Some patients and their family and friends may choose not to participate.Consequences may include patients feeling uncomfortable with this level of sharing. Some nurses, including new nurses, may be uncomfortable in sharing some of their own feelings with patients.

24. Evaluation of the nursing model Jean Watson’s philosophy is unique to nursing because it focuses more on the emotional aspect of nursing rather than the previous focus of the physical aspects. It brought more light to the importance of truly caring for our patients rather than just performing actions like a robot. Jean Watson’s model of caring accurately encompasses the four global concepts of human beings, environment, health, and nursing. Her theories explain how all four concepts are related and the impact they have on one another.

25. Evaluation of the nursing model Jean Watson’s work opened up the doors for further development of the transpersonal caring process. Watson developed ten Carative Factors that are specific to describe the relationship between the nurse and the patient and how to enhance healing through trust, love, faith, acceptance, and support. This model can be used in all practice situations from a doctors office, to the different units in the hospital, to end of life care. No matter what situation the patient is receiving care in, it is important for the nurse to use carative factors whenever possible.

26. Conclusion Jean Watson’s theory of caring science is a much needed reminder to nurses that patients require more than medical interventions and procedures to heal. We must care for each individual patient and be authentically present with him or her to develop a relationship conducive to healing. We must treat the holistic health of the patient and remember that caring is at the center of nursing and our words and actions must reflect that (Nyberg, 2010).

27. 1. You are caring for a patient in a nursing home post stroke who has lost the ability to perform the activities of daily living on her own. You assist the patient to get out of bed, use the toilet, brush her hair and teeth, and dress her for the day, then feed her. Which of the 10 Carative factors are most prominent in this situation? 2. You are taking care of a middle aged patient who has been undergoing cancer treatment for 4 months with little results. In talking to the patient it seems that he is beginning to give up the fight. You know that he is christian so you talk to him about his religion and how it has helped him get through experiences in the past. You encourage the patient that the fight is not over and there are still other treatments to try. After your conversation he seems uplifted and has a new outlook on his health. Which of the Carative factors was best used in this situation? CASE STUDIES JEAN WATSON'S CARATIVE FACTORS

28. JEAN WATSON'S CARATIVE FACTORS CASE STUDIES 3. You are caring for a gentleman who recently transferred to your unit and became very angry with you and revealed his negative thoughts related his current hospitalization. You remained calm, kind and tolerant of his occasional venomous attacks and his outburst became less frequent. Which one of the 10 Carative factors are most prominent in this situation? 4. You are caring for a young man diagnosed with advanced colon cancer. You assist him and his family by assessing his physical and social environment and evaluating where he is spiritually. Was there anything he’s always wanted to do that you as his nurse could assist in arranging. Was he currently planning a wedding and was unable to leave the hospital or even did he recently develop a relationship with God and want to get baptized? What carative factor would be prominent for this situation?

29. CASE STUDIES 5. A nurse finds a 52 year old male patient in his room crying following removal of his prostate. Which of Watson's Carative Factors do you employ? 6. A 52 year old nurse finds a 17 year old female with a new right arm amputation worried she will never be able to apply make-up again. What factor should he employ?

30. CASE STUDIES Jean Watson's Carative Factors 7. You are caring for a patient who has been in labor for 24 hours and who has been pushing for almost three hours and still is having difficulty with progressing to deliver her baby vaginally. Fetal heart tones are reassuring on the monitor. You are talking with your patient to help her decide which form of delivery will be best for her. Using a controlled situation and prediction, the two of you come up with a decision. Which one of the ten carative factors does this case study represent? 8. You are caring for a post-partum mom and her baby and going over newborn teaching. In reviewing prevention strategies to reduce the risk of SIDS (Sudden Infant Death Syndrome), you understand the patient's perception of the situation and know to focus on the learning process as much as the teaching process. Which carative factor does this case study represent?

31. References Cara, C. (2003). A pragmatic view of Jean Watson's caring theory. International Journal for Caring Nursing. 7(3), 51-61. Retrieved from:http://jalyon.wordpress.com/scholarly-works/watson-human-caring-theory Chitty, K.K., & Black, B. P. (2011). Nursing theory: The basis for professional nursing. Professional nursing: concepts and challenges (6th ed.) (pp 308-310) Maryland Heights, MO: Saunders Nyberg, J. J. (2010).A Caring Approach in Nursing Administration. Boulder, Colorado: University press of Colorado. Watson, J. (1999). Nursing: Human Science and Human Care. Sudbury, MA:Jones and Bartlett. Watson, J. (2008). Nursing: The philosophy and science of caring (pp. 30-31) Boulder, CO: University Press of Colorado Watson, J. (2012). Jean Watson's theory of nursing. Current nursing. Retrieved from http://currentnursing.com/nursing_theory/Watson.html Watson, J. (2012). Watson caring science institute & international caring consortium. Retrieved from http://watsoncaringscience.org/about-us/jean-bio/Mcurrent

32. Thank You!