THEORIES IN NURSING

-continuation-

Dr. Jean Watson

The Power of Caring: The Power to Make a Difference

emphasize that it is possible to read, study, learn about, even teach and research the caring theory; However, to truly "get it," one has to personally experience it; thus the model is both an invitation and an opportunity to interact with the ideas, experiment with and grow within the philosophy, and living it out in ones personal/professional life. Jean Watson
www.watsoncaringscience.org

Maybe this one moment, with this one person, is the very reason were here on Earth at this time.
- Jean Watson, The Caring Moment

Dr. Jean Watson at a glance

The goal of nursing is to help a person gain a higher degree of harmony with the mind, body and soul.
- Jean Watson, Nursing as Human Science and Human Care

Dr. Jean Watsons theory of caring

Dr. Jean Watsons theory

Watsons Concern
To make known: Inner healing process Experiencing the person

Three major elements of her theory:

Ten Carative Factors The Caring Occasion / The Caring Moment Transpersonal Caring

Dr. Jean Watsons theory

The Basics
The philosophy of caring and science examines the relatedness of everything, including: Human Science Human Caring Processes Experiences Phenomena Watsons Caring Science and Human Caring Theory blends the sciences and humanities Watson likes to cite Eastern Philosophy and the foundations of Buddhism Focus on holism

Dr. Jean Watsons theory

A Three Part Foundation

3. The Caring occasion or Caring event

According to Watson (2001), there are three main conceptual elements comprising her theory:

2. The development & Utilization of the Transpersonal Caring Relationship

1. The Caractive Factors/The Carative Process

Dr. Jean Watsons theory

Carative Factors
Goal was to guide the core of nursing In contrast to medicines curative factors Interdependent Used to honor the human dimensions of nursings work and the inner life world and subjective experiences of the people we serve First three factors are the philosophical foundation for the science of caring
The final seven build upon these

Transitioned to the caritas processes, expanding on the original factors

It is when we include caring and love in our work and our life that we discover and affirm that nursing, like teaching, is more than just a job; it is also a life-giving and life-receiving career for a lifetime of growth and learning (Parker, 2001)
Dr. Watson

Dr. Jean Watsons theory

Nursing
Starts with an authentic presence
Connection with another person

A spiritual practice, a calling Both a science and an art

Acknowledges science, art, intuitive, cultural, and spiritual knowledge Like Carper, also acknowledges and places high value on aesthetic, ethical, and personal ways of knowing

Caring is just as valuable and essential to our patients as curing

Nursing is complimentary to curing You can have caring without curing, but you cannot have true curing without caring

Dr. Jean Watsons theory

Nursing
Caring affects self and others
Bidirectional relationship, we also benefit, learn

The transpersonal care/transpersonal relationship is central to Watsons theory and what she calls of nurses
A true presence Moving toward a unitary-transformative perspective from a more general, multiple paradigm view

Dr. Jean Watsons theory

Nursing
Nursings tasks according to Watson
Healing our relationship with self and other/s, and our place in the wider universe; Finding meaning in our own life and health-illness concerns, as we re-awaken to our profound compassionate, caring and healing service in the world; Understanding and transforming our own and others suffering; Deepening our understanding and acceptance of impermanence, the expanding-contracting of all life cycles (birthing-dying/the dark and light), including preparing for our own death (Watson, 2002)

Watsons definition of caring is often incongruent with current hospital systems and policy

Dr. Jean Watsons theory

Transpersonal Caring Relationship

Occurs during the caring event, central to Watsons view of nursing Calls the nurse to go beyond the objective, physical assessment with concern for the persons deeper, subjective well-being The nurse [] seeks to connect with and embrace the spirit or soul of the other, through the process of caring and healing and being in authentic relation, in the moment

Dr. Jean Watsons theory

Transpersonal Caring Relationship

Goal is to protect, enhance, and preserve the persons dignity, humanity, wholeness, inner harmony, and overall well-being Can be nurtured by movements, gestures, facial and bodily expressions, the sharing of information, touch, sound, etc.

In a transpersonal caring relationship, a spiritual union occurs between two persons, where both are capable of transcending self, time, space, and the life history of each other. In other words, the nurse enters into the experience (phenomenal field) of another and the other person enters into the nurses experience. This shared experience creates its own phenomenal field and becomes part of a larger, deeper, complex pattern of life.
Dr. Watson

Dr. Jean Watsons theory

The Caritas Process:

Caritas comes from the Latin word meaning to cherish, to appreciate, to give special attention, if not loving, attention to; it connotes something that is very fine, that indeed is precious Both postmodern and traditional Invites nurse to explore the intersection between personal and professional

The Caritas Process:

Caritas comes from the Latin word meaning to cherish, to appreciate, to give special attention, if not loving, attention to; it connotes something that is very fine, that indeed is precious Both postmodern and traditional Invites nurse to explore the intersection between personal and professional

Dr. Jean Watsons theory

Carative Factors
Caritas comes from the Latin word meaning to cherish, to appreciate, to give special attention. Invites nurse to explore the intersection between personal and professional

Dr. Jean Watsons theory

The 10 Carative Factors

1. 2. 3. 4. Humanistic-altruistic system of values Faith-hope Sensitivity to self and to others Helping-trusting, human care relationships 5. Expressing positive and negative feelings 6. Creative problem solving caring processes 7. Transpersonal teaching-learning 8. Supportive, protective and or corrective mental, physical, societal and spiritual environment 9. Human needs assistance 10.Existential-phenomenological-spiritual forces

Dr. Jean Watsons theory

Carative Factors
Consider the situation: Mrs. Smith, a 78 year old widow, is experiencing acute onset of severe back pain She feels panicky, depressed and confused about her ability to now manage her life

Using the basis of the 10 carative factors, what would a Watson nurse do?

Dr. Jean Watsons theory

Carative Factors
RESEARCH ARTICLE: Caring for Older Adults: Practice Guided by Watsons Caring-Healing Model The nurse develops a sense of hope (factor 2) and trust (factor 4) through genuine caring, listening and responding to the unique seriousness of Mrs. Smiths experience (factor 1) Acknowledgement of Mrs. Smiths expression of disharmony (factor 5) between her usual perceived self and this encounter
The nurse, along with family, other health professionals and community services can help Mrs. Smith meet her basic needs (factor 9) of pain management, arrangements for check ups, support with ADLs and reconnecting with old friends.(Bernick, 2004)

Dr. Jean Watsons theory

Carative Factors
Within the caring-healing model, the approach included one that attended to the interconnectiveness between Mrs. Smiths mind-body-soul as influenced by her personal experience Mrs. Smiths pain was better controlled, she was able to control her fears of her life management, and was able to reintegrate her life with others and feel supported
(Bernick, 2004)

Dr. Jean Watsons theory

Carative Factors
Benefits: Transferable to current practice environments, meaning of health through the patients perspective, considers the complexity of each individual experience

Limitations: Time

Dr. Jean Watsons theory

As Jean developed her theory over time, she came to change these carative factors into clinical caritas processes.
THESE INCLUDED: 1- HUMANISTIC-ALTRUISTIC SYSTEM OF VALUES, becomes: "Practice of loving-kindness and equanimity within context of caring consciousness 2 - FAITH-HOPE, becomes: "Being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and one-being-cared- for

Dr. Jean Watsons theory

3 - SENSITIVITY TO SELF AND TO OTHERS, becomes: "Cultivation of one's own spiritual practices and transpersonal self, going beyond ego self 4- HELPING-TRUSTING, HUMAN CARING RELATIONSHIP, becomes: "Developing and sustaining a helpingtrusting, authentic caring relationship"

Dr. Jean Watsons theory

5 - EXPRESSION OF POSITIVE AND NEGATIVE FEELINGS, becomes: "Being present to, and supportive of the expression of positive and negative feelings as a connection with deeper spirit of self and the one-being-caredfor" 6 - CREATIVE PROBLEM-SOLVING CARING PROCESS, becomes: "creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices"

Dr. Jean Watsons theory

7 - TRANSPERSONAL TEACHINGLEARNING, becomes: "Engaging in genuine teaching-learning experience that attends to unity of being and meaning attempting to stay within other's frame of reference" 8 - SUPPORTIVE, PROTECTIVE, AND/OR CORRECTIVE MENTAL, PHYSICAL, SOCIETAL, AND SPIRITUAL ENVIRONMENT, becomes: "Creating healing environment at all levels, (physical as well as non-physical, subtle environment of energy and consciousness, whereby wholeness, beauty, comfort, dignity, and peace are potentiated";

Dr. Jean Watsons theory

9 - HUMAN NEEDS ASSITANCE, becomes: "assisting with basic needs, with an intentional caring consciousness, administering human care essentials', which potentiate alignment of mind-body-spirit, wholeness, and unity of being in all aspects of care"; tending to both embodied spirit and evolving spiritual emergence; 10 -EXISTENTIAL-PHENOMENOLOGICAL - SPIRITUAL FORCES, becomes: "opening and attending to spiritualmysterious, and existential dimensions of one's own life-death; soul care for self and the one-being-care-for.

Purposeful To be intentional To pause and slow down Mindful Grounded on firm surface while Feeling the breeze and warm sun Presence In a world of one Shared with another Organized Creativity, context and knowledge Primacy being care Central to all Reverence and respect Connecting Listening Being understood Caring Supporting Healing
(Bernick, 2004)

References
Bernick, L. (2004). Caring for older adults: practice guided by Watsons caring-healing model. Nursing Science Quarterly, 17(2), 128-134.