Aug 8th, 2013
Watson's Theory of Human Caring
Background and major concepts of Watson’s Theory of Human Caring Dr. Jean Watson is considered a theorist, a philosopher, and a healer. She directed her life works to the science of human caring and proposed a new and innovative approach to the nurse-patient interaction. Dr. Watson resumed her life career as “devoted to the phenomena of human caring, and inner subjective feelings, emotions and experiences” ("Dr. Jean Watson," n.d.). Her theory, introduced in 1970, was originally based on Nightingale’s concepts of nursing (Fitzpatrick & Whall, 2005). However, her view of caring as a vital part of nursing care continues to be developed nowadays. Watson’s theory focuses on the benefits of the caring relationship between the nurse and the patient. According to her view, the patient and nurse join in a spiritual and trans dimensional perspective in their interaction. (Blais, 2011). George (2011), proposes a concrete description of Watson’s theory: “The essence of Watson’s theory is caring for the purpose of promoting healing, preserving dignity, and respecting the wholeness and interconnectedness of humanity.” (p. 454). According to Blais (2011), Watson’s theory of caring includes three major concepts: the nurse-patient transpersonal caring relationship, the carative factors and the caring moment. In a transpersonal caring relationship, both the spirit of the person and the nurse interact in a caring moment following the carative factors (Fitzpatrick & Whall, 2005). During this process, a “human-to-human connectedness” occurs (George, 2011). On the other hand, the carative factors are based on human values that promote a successful nurse-client interaction. According to George (2011), Watson proposed these factors as a “philosophical and conceptual guide to nursing” (p. 458). Although these factors originated in 1979, they were further expanded and redefined in 2008 (Watson, 2012). A caring moment occurs when nurse and patient “come together with their unique life histories and phenomenal field in a human-to-human transaction” (George, 2011, p. 459). Put differently, a caring moment defines the unique interaction between patient and nurse from a humanistic perspective. To put it on Watson’s words: “An emphasis is placed in helping a person gain more self-knowledge, self-control, self-caring, and inner healing of self, regardless of the external health condition. The nurse is viewed as a coparticipant in the human caring-healing process. Therefore, a high value is placed on the relationship between nurse and other” (Watson, 2012, p. 46).
As nurses, we use Watson’s theory on a daily basis without realizing the influence of our actions in our patients’ recovery and well-being. Since I had the opportunity to study Watson’s theory of caring in this class, I can relate to her view of nursing with a philosophical approach. If I had to select a caring moment in my nursing career, I would think immediately about my experiences as a hospice nurse. Although it was an emotional job position, I enjoyed my role because I provided care with compassion and respect. Every day I learned something interesting about human relationships and emotions, and most of the days I helped my patients die in peace. However, one particular case comes to my mind as a perfect example of a caring moment and transpersonal relationship: the case of Mr. A. Mr. A. was a Hispanic elderly male recently diagnosed with a terminal disease. He was very weak and needed moderate assistance to complete his Activities of Daily Living. Mr. A had intermittent pain that was relieved only by morphine, but his family had conflicting views regarding the administration of this medication. I came to know Mr. A and his family very well because we spent four nights in a row together. In the mornings, I left their home to rest and then came back in the evening ready to stay until the next morning. Mr. A’s family opened their doors and their hearts to me during those days, and at the same time I offered my complete being to them. I was not only there physically present as a nurse, but also spiritually present as a human being. I witnessed their suffering and fears and provided emotional support when they needed the most. We discussed the benefits versus the side effects of morphine, their wishes for the care of Mr. A and their individual concerns and feelings regarding the dying process. However, the peak of those moments was the night that Mr. A past away. Mr A. became weaker every day and, on the 4th night, he began to show signs of impending death. Although he knew he was about to die, Mr. A always remained calm and relaxed. It looked like he did not want his family to suffer, or he was ready to go. I remained next to him and his family until his last breath providing my most sincere care. My interaction with Mr. A and his family constitutes an example of a caring moment because we shared an interconnection that transcended a usual nurse-patient relationship. In addition, I applied specific carative factors such as the presence of a humanistic-altruistic system of values, the fostering of faith and hope, the promotion of a helping-trusting relationship and the facilitation for the expression of feelings. By identifying and acknowledging their own cultural views, I was able to obtain a clear perspective of the concepts of person, nurse, health and environment for Mr. A’s family. Since we shared the same ethnic background, I was able to understand their particular points of view. For them, health was not only the absence of disease, but it has a specific religious and spiritual meaning. On the other hand, nurse and patient interact in an environment that is controlled by forces outside of human understanding. If I can live that same experience again, I think I would provide more information to the family before death is approaching. Unfortunately, health care professionals do not provide enough teaching and guidance to patients and families about what to expect during this difficult time, leaving hospice nurses with a huge amount of information to teach at the end of life. This creates an extra burden for the family and nurse at a time when a vulnerable interaction is taking place. I will always remember Mr. A and his family because I could connect with them in a special way. I learned that death is not a failure and should not be treated as one. Mr. A’s relaxed demeanor and braveness when he was approaching death allowed me to view life with a different meaning. In addition, I am satisfied with my role as a nurse because of the response of Mr. A’s family. At the same time, they were extremely grateful with my assistance and the care that I provided.
Blais, K., & Hayes, J. S. (2011). Professional nursing practice: Concepts and perspectives. Upper Saddle River: Pearson Education, Inc.
This textbook summarizes the main concepts of multiple theories including Watson’s theory of caring. It explains the major elements in Watson’s theory and provides an explanation on what is a caring moment. Chitty, K. K., & Black, B. P. (2010). Professional nursing: Concepts and challenges. Maryland Heights: Elsevier, Inc.
This textbook provides an overview of Watson’s theory and discusses the importance of the concept of caring to nursing care. In addition, this textbook discusses why Watson considers Caring as the basis for nursing practice and how she formalized and developed her theory. Dr. Jean Watson | Watson Caring Science Institute & International Caritas Consortium. (n.d.). Retrieved from http://watsoncaringscience.org/about-us/jean-bio/ This webpage provides a detailed biography of Dr. Jean Watson. It is the official page for Watson Caring Science Institute, which was originated by Dr. Jean Watson. It includes Watson’s Curriculum Vitae and updated information on her latest activities. This is a trustworthy source because it provides reliable scientific information. Fitzpatrick, J. J., & Whall, A. L. (2005). Conceptual models of nursing: Analysis and application. Upper Saddle River, N.J: Pearson Prentice Hall.
This book provides a detailed background on Watson’s theory of caring. It compares the similarities between Nightingale and Watson’s views. Also, it defines the metaparadigm of nursing from Watson’s perspective. In addition, this book explains how Watson’s theory can be applied to nursing practice, research and education. Foster, R. L. (2007). Tribute to the theorists: Jean Watson over the years. Nursing Science Quarterly, Vol. 20 No. 1.
This article is a tribute to Watson. It discusses the influence of her theory not only in the development of a new vision for nursing, but also in society in general. It also discussed how caring relates to basic human values such as respect, dignity and compassion.
George, J. B. (2011). Nursing theories: The base for professional nursing practice. Upper Saddle River: Pearson Education, Inc.
This book dedicates a complete chapter to the theory of transpersonal caring (Chapter 18). It provides a detailed philosophical background of the theory and provides a thorough explanation of the carative factors and caritas. It also provides a concrete definition of what constitutes a caring moment. Watson, J. (2012). Human caring science (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
This book constitutes a primary source because it was written by the original author. In it, Watson provides a detailed explanation of her theory of caring. In addition, she discusses the future of nursing from her perspective and provides an explanation of her own value system as it relates to nursing and caring.