occupational health Nursing Practice
through the human Caring Lens
by Dianne L. Noel, RN, BSN, COHN-S/CM, COHN(c)
Many health care and academic centers have adopted Watson’s Theory of Human Caring as their guiding principle; the theory is also used in other disciplines, such as library science. Human caring theory offers occupational health nurses a structure that not only defines a focus for practice, but also provides a basis for moral and philosophical practice analyses. In particular, nurses may find this theory useful in confirming the definition of “caring” and reconsidering what nursing is all about. More importantly, consideration and application of this theory may lead to research on its applicability to the field of occupational health nursing. This article presents the science and philosophy of human caring, specifically Watson’s Theory of Human Caring. Two case studies are presented that demonstrate how the theory could be used to evaluate occupational health nursing practice. To demonstrate its possible relevance as an occupational health nursing framework, an analysis of and comparison to existing occupational health nursing guidelines are detailed and discussed.
ontroversy exists over the emphasis of “nursing”
versus “public health” foundations of occupational health nursing. It is recognized that practice draws from many theoretical perspectives. The author
found that caring theory struck a chord in re-affirming
that relationships and connectedness with others form the
underlying basis of her profession.
Nurses use skills, experience, and intuition to deliver
safe care. Watson calls skills, experience, and intuition
the “trim,” much like a sailor trimming a sail. The nurse also uses standards, guidelines, policies, procedures, and
monitoring equipment to guide nursing decisions. Much
of what the nurse does is shaped by theory. Like the sailAbout the Author
Ms. Noel is an occupational health nurse, JP Morgan Chase, Columbus, OH.
The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
january 2010, vol. 58, no. 1
or’s chart course, theory provides direction and purpose,
guiding and inspiring nurses’ thoughts and actions. This
is called the “core” by Watson, the basic operating system of the nurse-person relationship.
humAN CAriNg theory DefiNeD
Caring includes physical, psychological, cultural,
spiritual, and existential aspects. Caring science moves
nurses from rigid health care doctrines to meaningful
patterns and new insights of human caring, the central
focus. The theory supports a new direction: developing preventive rather than reactive approaches to health problems. Watson (2005) describes caring science as a
“model that allows us to approach the sacred in our caring-healing work” (p. xi). Caring science promotes an interpersonal relationship based on respect, mutual learning, and giving and taking. In looking ahead to the future of nursing, Bent,
Moscatel, Baize, and McCabe (2007) state that “nurses
will remain the only practice to meet patients in their
Definitions of terms used to Describe
reflexive—relating to an action directed back upon
Interpretive—to explain the meaning of; act as an
interpreter or translate; understand according to
individual belief, judgment, or interest; represent
Empirical—based on observation; subject to verification by observation or experiment aesthetics—branch of philosophy addressing the
nature, creation, and appreciation of beauty
Intuition—quick and ready insight; the power or faculty of knowing things without conscious reasoning
technological, historical, cultural, biological, emotional, intellectual, social, spiritual, metaphysical, ethical whole” (p. 331).