Marilyn Ray and Jean Watson's Theories Compared

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Marilyn Ray and Jean Watson’s Caring Theories Compared
Winifred Hernandez
National American University

How is caring defined? In nursing, caring is an essential part of our profession. It is the foundation and initial approach used in our daily practice. There are many belief systems in which caring is examined. The two theories discussed in this paper are Marilyn Anne Ray’s Theory of Bureaucratic Caring and Jean Watson’s Theory of Human Caring. The Theory of Bureaucratic Caring was generated in a complex organization, while The Theory of Human caring defines caring in more of a scientific way. The definition of caring for each have some similar characteristics, but these two theorist methodologies are quite different. This paper will interpret these two theories of caring, apply them to practice, and then explore both their similarities and their differences.

Marilyn Ray and Jean Watson’s Caring Theories Compared
Have you ever wondered why you went into nursing? Is it because of the salary? Is it because you needed a change? Is it because you wanted to put your best foot forward and utilize your positive energy to help others? Whatever the reason, caring is an integral part of nursing that cannot be ignored. Nursing today, is more complex than ever. The constant change in technology and increased duties in patient care can be quite overwhelming. One must have a beneficial understanding of what caring is in order to be an effective nurse.

Caring, as a central concept, has led to the development of several theories. Marilyn Anne Ray’s Theory of Bureaucratic Caring originated as a grounded theory first (caring in a complex organization), then as a holographic theory, which showed the growth and development of the nature of nursing over time. "The purpose of Ray's dissertation study was to generate a theory of the dynamic structure of caring in a complex organization" (Turkel, 2007). Ray spent approximately 8 months in a local hospital studying caring in all aspects; from nutrition to materials handling, nursing clinical units to administration. This study involved 200 participants. The key question asked of participants was, "What is the meaning of caring to you?" (Turkel, 2007). The study performed involved observation of patient care, direct questioning and interviews. Ray’s research exposed the dilemma that these health care workers battled with between the corporate “red tape” and serving the caring needs of their patients. Caring within the corporation had its constraints and differences. Caring was perceived very different throughout the hospital and in their practice settings. For instance, administrators expressed caring in terms of economics. They believed that patient satisfaction was viewed as a return on investments. ICU nurses expressed caring in more vulnerable way. Their patients were very sick not able to care for themselves. Patients were in need of the highest quality and quantity of care. Physicians saw caring for their patients in a more technological way. Hospice staff members conveyed caring as a part of the compassion and spirituality given to their patients (Turkel, 2007). Substantive Theory called Differential Theory was born. Later, the Theory of Bureaucratic Caring was established. The Theory of Bureaucratic Caring denoted the changing caring structure within this complex organization. Many variables affected nurse- patient relationships. Political and economic elements were dominant; followed by education and the relationship itself (Parker & Smith, 2010). The nursing staff was also influenced with the culture within the complex organization. This culture contained political, economic, legal and technological bias. Later, Ray revisited this theory and then revealed it as holographic. Not only was caring at the center, but spiritual and ethical considerations must be also. Holographic is best described as the whole and part being interconnected (p. 473, Parker...
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