Bureaucratic Caring Theory

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Ray’s Theory of Bureaucratic Caring illustrates the importance of spiritual and ethical caring in relation to organizational cultures. Watson’ theory of Human Caring illustrates the fact that caring is central to the discipline of nursing. The paper will elaborate on Watson’s theory, Ray’s theory and then compare both theories. The theory of human caring was developed in 1975 and 1979 by Jean Watson. Watson is also the founder of the Center for Human Caring. The theory is used to guide new models of caring and healing practices in diverse setting and in several countries. (Parker, 2006) If we are to consider caring as the core of nursing, nurses will have to make a conscious effort to preserve human caring within their clinical, administrative, educational, and/or research practice. Nurses must now deal with patients’ increased acuity and complexity in regard to their health care situation. Despite such hardships, nurses must find ways to preserve their caring practice and Jean Watson’s caring theory can be seen as indispensable to this goal. Care and caring as described by Benner and Wrubel (1989, Benner, 1994), is a requirement of human being, a part of ‘what it is’ to be human. So caring is ontological. Caring endorses our professional identity within a context where humanistic values are constantly questioned and challenged (Duquette & Cara, 2000). According to Watson (2001), the major elements of her theory are the carative factors, the transpersonal caring relationship, and the caring occasion/caring moment. The carative factors were developed in 1979; Watson views the “carative factors” as a guide for the core of nursing. She uses the term carative to contrast with conventional medicine’s curative factors. Her 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). In all, the carative factors are comprised of 10 elements:

1.Humanistic-altruistic system of value.
3.Sensitivity to self and others.
4.Helping-trusting, human care relationship.
5.Expressing positive and negative feelings.
6.Creative problem-solving caring process.
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. (Parker, 2006) As she continued to evolve her theory, Watson introduced the concept of clinical caritas processes, which have now replaced her carative factors. The reader will be able to observe a greater spiritual dimension in these new processes. Watson (2001) explained that the word “caritas” originates from the Greek vocabulary, meaning to cherish and to give special loving attention. The following are Watson’s (2001) translation of the carative factors into clinical caritas processes: •Practice of loving kindness and equanimity within context of caring consciousness.

Being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and the one-being-cared-for. •Cultivation of one’s own spiritual practices and transpersonal self, going beyond ego self, opening to others with sensitivity and compassion. •Developing and sustaining a helping-trusting, authentic caring relationship.

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-cared-for. •Creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices. •Engaging in genuine teaching-learning experience that attends to unity of being and meaning, attempting to stay within others’ frames of reference. •Creating healing environment at all levels (physical as well as non-physical), subtle environment of energy and consciousness, whereby wholeness, beauty,...
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