Theory of Human Caring: Jean Watson

1. Theory of Human Caring:Jean Watson Christina Shoemaker & Holly Smith MSN 6501 Advancement of Nursing Science

2. Jean Watson • 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 care transactions” (Watson, 1988, p. 54)

3. Major Elements of the Caring Theory • Carative factors, evolving into Caritas factors • Transpersonal Caring Relationships • Caring occasion/Caring moment

4. Carative Factors • Guides the core of nursing • Carative factors 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). • Contrasts the curative factors of medicine (curative means to cure a disease) • Carative factors evolve into Caritas factors

5. Caritas • Caritas has a greater spiritual dimension • In Greek, caritas means “to cherish and to give special loving attention”

6. The Carative Factors Evolve into Caritas Factors Carative • Faith and hope • Helping-trusting, human care relationship Caritas • Being authentically present and enabling the beliefs of the one being cared for and the one giving care • Developing and maintaining a trusting, authentic, caring relationship (Watson, 1999, p.62)

7. The Carative Factors Evolve into Caritas Factors, cont. Carative • Creative problem solving caring process • Expressing positive and negative feelings • Transpersonal teaching- learning Caritas • Creative use of self • Being present to and supporting the positive and negative feelings with a connection of a deeper spirit • Engaging in genuine teaching-learning experience (Watson, 1999, p.62)

8. Transpersonal Caring Relationship Transpersonal means to go beyond one’s own ego and reach a deeper spiritual connection while comforting a patient. The transpersonal relationship depends on: • A commitment from the nurse to enhance and protect human dignity • An awareness from the nurse that they have the ability to heal • The nurse must go beyond the objective role

9. The Goal of Transpersonal Relationships • To preserve and protect a person’s humanity, and dignity • Preserve a patients spirit to ensure the patient does not become an object • This relationship allows the nurse and the patient to to mutually seek out meaning and in turn lead to a transcendence of suffering (Watson, 2001).

10. Caring Occasion/Caring Moment • Watson (1998, 1999) stated that when human caring is created the nurse and patient come together to create a moment, this is known as the caring occasion/caring moment • Watson (1999) feels as though the nurse and the patient must be aware of the caring moment so as to make appropriate choices and actions, thereby the nurse without knowing becomes a part of the patients “life history”

11. Research • Watson (1988) suggested that to study the effects of caring (which is quite difficult to effectively measure), qualitative studies are more fitting, with an emphasis on phenomenological research, such as open-ended interviews that focus on the experience of the individual. • Watson's theory was applied in the development of a group discussion: six women, with two volunteers, met once a week and shared stories or thoughts in a circle format, which was then followed by positive feedback from the members.

12. Clinical Application of the Caring Theory The Caring Theory is one of the few theories in nursing that apply to both the patient and the nurse. To accomplish and utilize the theory requires a coordinated effort from all staff. It exists to provide: • To provide each person with a caring environment • Assist with basic needs • Always practice loving kindness • The use of creative self • Going beyond self • Engaging in genuine teaching learning experience • Openness to others • Being present to support positive and negative feelings • Soul care for the one being cared for (Watson, 2001)

13. How does the theory apply to our nursing practice? • We question the ease of comprehension on the theory and whether the theory is applicable to nursing practice in today's world of advanced technology and budget cuts. • We agree with Watson and feel that the contact and the bond between two individuals is the foundation of nursing. We provide this caring and thoughtful approach to promote holistic health and prevent illness. • A “good” nurse cannot be defined solely by her ability and skills but also by how well she interacts with the client and family while providing that care.

14. How does the theory apply to our nursing practice?, cont. • Throughout nursing history, the public image of nursing is this: a woman giving sponge baths and cleaning bed pans. These stereotypes are ones that are negative to our profession and the need to instill a new image is vital. The need is to harmonize and seek a balance between a professional image of nurses yet maintain our caring/nurturing image. In Watson’s (2001) words, nurses “are searching for the way to care in a society that refuses to value caring, and the way to serve without being subservient”.

15. How does the theory apply to our nursing practice?, cont. • “The central task of health professions education - in nursing, medicine, dentistry, public health, psychology, social work, and the allied health professions - must be to help students, faculty, and practitioners learn how to form caring, healing relationships with patients, and their communities, and with each other, and with themselves…the knowledge, skills, and values necessary for effective relationships… Developing practitioners mature as reflective learners and professionals who understand the patient as a person, recognize and deal with multiple contributions to health and illness, and understand the essential nature of healing relationships.” (Pew-Fetzer Task Force Report, 1994, p. 39) • The need to make caring a greater part of educational practice and continuing practice is apparent. Each year nurses must perform educational tasks to maintain their licenses but we have yet to incorporate caring into a educational task.

16. Conclusion “Nursing can expand its existing role, continuing to make contributions to health care within the modern model by developing its foundational caring-healing and health strengths that have always been present on the margin.” (Watson, 1999, p. 45) Watson (1997) feels as though the most important, vital aspect of nursing is spirituality. Nurses must be at one with the past, present and future to attain this ultimate of caring. For example, you are reading this theory, pondering how it has pertained to patients in the past and how it may effect your patients in the future. You must grow as nurse and seek out the essence of nursing: caring.

17. A Thought to Ponder for Discussion • How do you share and express your consciousness of caring and your commitment to caring to a patient and their family members? To other health care professionals?

18. References • Watson, J. (1988). Nursing: Human science and human care. A theory of nursing (2nd printing). New York: National League for Nursing. (Original work published in 1985.) • Watson, J. (1997). The theory of human caring: Retrospective and prospective. Nursing Science Quarterly, 10(1), 49-52. • Watson, J. (1999). Postmodern nursing and beyond. Toronto, Canada: Churchill Livingstone. • Watson, J. (2001). Jean Watson: Theory of human caring. In M.E. Parker (Ed.), Nursing theories and nursing practice (pp. 343-354). Philadelphia: Davis.