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Jean Watson

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Michelle Lee

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Transcript of Jean Watson

Major Assumptions of Watson's Theory of Caring


American nurse theorist and nursing professor who is best known for the birth of the “Theory of Human Caring”


Born on June 10, 1940 in Williamson, West Virginia
Graduated with an MS in Psychiatric and Mental Health Nursing and received her Ph.D in Educational Psychology and Counseling in 1973
Fellow of The American Academy of Nursing
Research primarily focuses in the area of human caring and loss
Theory of Caring Science was published in 1988
President of The National League for Nursing



1. Caring consists of 10 carative factors ("caritas processes") that result in the satisfaction of certain human needs.

2. Effective caring promotes health and individual or family growth.

3. Caring responses accept person not only as he or she is now but as what he or she may become.

4. A caring environment is one that offers the development of potential while allowing the person to choose the best action for himself or herself at a given point in time.

5. Caring is more “ healthogenic” than it is curing. A science of caring is complementary to the science of curing.

6. The practice of caring is central to nursing.
Introduction to Jean Watson
Higher Order Needs
• Psychosocial needs
Lower Order Needs
Psychophysical needs
Biophysical needs
Nursing Theoretical Perspective

“The perspective is spiritual-existential and phenomenological in orientation, but it also draws on some indigenous practices, Eastern philosophy, evolved Western beliefs, and ancient wisdom traditions across time. Many of the principles and premises are consistent with the blueprint of Nightingale, which have yet to be actualized in this 21st century.”
(Watson, 2012 p. 91)
Jean Watson
Statement of Purpose
The purpose of this presentation is to conduct a theory critique of Jean Watson’s Theory of Caring and to investigate its application to nursing practice.
Jean Watson
Human Caring Science
A Theory of Nursing

Preview of Presentation
Brief Intro of Jean Watson
Human Caring Science as a Nursing Theory
Major assumptions
Definition of Metaparadigm
3 Elements of Watson's theory
Application to Practice
Model Case
Reason for choosing this theory

Watson's Metaparadigmatic Elements
Health: High level of overall physical, mental, and social functioning. Unity and harmony within the mind, body, and soul. Degree of congruence between the perception of one's health and the real life experience

Human Being: Philosophical view of a person as fully functional integrated self
Environment: Caring has existed in every society. It is transmitted by the nursing profession through coping with its environment
Nursing: A human science of persons and human health illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human transactions
Understanding Watson's Theory
Major Elements
Carative Factors (Caritas Process)

Transpersonal Caring Relationship

The Caring Occasion/Caring moment
Carative Factors
Guide for the core of nursing
Term used to contrast with conventional medicine's curative factors
Attempt to honor the human dimensions of nursing work with the subjective experiences of patients
10 elements comprise the carative factors
In 2001, Watson introduced the concept of "Clinical Caritas processes"
Caritas is a greek word which means "To cherish and give special loving attention"

Transpersonal Caring Relationship
The Caring Occasion/Caring moment
Focal point in space and time when a nurse and another person come together in a way that an occasion for human caring is created

Human to human transaction is born

Phenomenal fields come together, which consists of one's human experience with bodily sensations, thoughts, spiritual beliefs, goals, expectations, and perceptions
Strengths Limitations
• This theory places client in the context of the family, the community and the culture.
• It places the client as the focus of practice rather than outcomes and objectives.

Nursing Practice Guided by this Theory
• Biophysical needs of the individual are less important.
• Time consuming.
• A diverse nursing staff, many of whom have no previous exposure to nursing theoretical concepts



Model Case:
“depicts all of the defining characteristics of a concept
(Walker & Avant, 2011)”

Contrary Case:
“represents a situation that does not depict the concept
(Walker & Avant, 2011)”
Goal of Nursing from The Theoretical Perspective
Help persons gain a higher degree of harmony that fosters self-knowledge, self-reverence, self-caring, self-control, and self-healing processes while allowing increasing diversity
Help individuals find meaning in their existence, disharmony, suffering, and turmoil
Help restore humanity and nourish the human heart and soul in an age of technology, scientism, loneliness, rapid change, and stresses
Characterized by a special kind of human relationship
Depends on the nurse's moral commitment in protecting and enhancing human dignity as well as to preserve and honor the embodied spirit
Important to not reduce the moral status of a person to an object
A nurse goes above and beyond the objective assessment, shows concerns toward a person's subjective thoughts
Caring consciousness becomes essential between the connection and understanding of the other person's perspective
A mutual understanding between the pair occurs
vs.
Requirements needed to practice this theory
Model Case
knowledge and understanding of individual needs
knowledge of how to respond to others’ needs
knowledge of our strengths and limitations
knowledge of who the other person is, his or her strengths and limitations, and the meaning of the situation for him or her
knowledge of how to comfort and offer compassion
authentic presence to hold another in his or her wholeness, while he or she is vulnerable, hurt, wounded and suffering
enabling actions that allow another to seek creative solutions to life situations, to grow, evolve, and transcend the here and now
caritas processes become actualized in the moment-to-moment


transforming human suffering and/or finding meaning in suffering
deepening our understanding of meaning of life and acceptance of all its ups and downs with compassion and composure
deepening our understanding and acceptance of impermanence, of death/dying as part of the sacred circle of life
preparing for our own death

55 year old Caucasian
Gangrene ravaged both feet and legs
Scheduled for an above knee amputation of right leg
shared life story which allowed nurse to know patient on a more person level
Patient returns a faint smile (caring occasion takes place)
Nurse thought of new creative ways of how he could remember to take his medicine (According to Watson, the nurse's creativity contributes to making nursing an art)
Patient reveals he is happy to discuss the methods and asks nurse how she is doing
(Reveals patient sees the nurse as "his nurse" and knows that she is committed to help him through his ordeal) (Watson's example of the meaning "relationship becoming a part of both life stories."
Nurse arranges patient's room so he can feel at ease
Uses the time together to discuss feelings and priorities for his care plan and hospitalization
Patient reveals that he wants to be home by Christmas and care plan is centered around that priority

Examples of common human tasks that parallel human caring experiences
Cara, C. (n.d.). A Pragmatic View of Jean Watson’s Caring Theory. Internal Association for Human Caring . Retrieved February 13, 2014, from http://www.humancaring.org/conted/Pragmatic%20View.pdf

Jean Watson's Theory of Nursing. (n.d.). Current Nursing. Retrieved February 8, 2014, from http://currentnursing.com/nursing_theory/W

Walker, L. O., & Avant, K. C. (2011). Strategies for theory construction in nursing (5th ed.). Upper Saddle River, NJ: Prentice Hall.

Watson, J. (2009). Caring science and human caring theory: transforming personal and professional practices of nursing and health care. Journal Of Health & Human Services Administration, 31(4), 466-482.

Watson, J. (2012). Human caring science: a theory of nursing (2nd ed.). Sudbury, Mass.: Jones & Bartlett Learning.

Watson, J. (1988). Nursing, human science and human care. New York: National League for Nursing.

Watson, J. (n.d.). Watson caring science institute & international caritas consortium. Retrieved February 2, 2014, from http://watsoncaringscience.org/

Watson, J. (2007). Watson’s Theory Of Human Caring And Subjective Living Experiences: Carative Factors/caritas Processes As A Disciplinary Guide To The Professional Nursing Practice. Texto & Contexto - Enfermagem, 16(1), 1-13.
Examples of caring-in-action in a clinical setting
Intentionally pausing and breathing, preparing yourself to be present before entering a patient's room
Engaging in centering exercises and mindfulness practices, either individually or collectively
Placing magnets on patient's door with positive affirmations, and reminders of caring practices
Engaging in caring rounds at bedside with patients
References
Synopsis of APN's utilizing this theory
Type of nursing:
Qualifications, education, & certifications
Practice opportunities and settings
Political, legal, and marketplace issues
Practice Opportunities and Settings
Any type of nurse can utilize the theory, including CNA, LPN, RN, APN, PhD, or DNP.

Masters prepared and doctoral degree nurses most often implement Watson's Theory of Caring into their workplace since they have been exposed to evidence based practice.

"Nurses realized that although they might have been from different cultures, with different educational backgrounds, working in different nursing specialties, they did share with other nurses a common mission and purpose as described by this nursing theory."
Magnet hospitals (as seen in the class reading) are adopting the Theory. They must demonstrate criteria that recognize and also assure quality of care to consumers

Nursing homes, Assisted Living Facilities, Rehabilitation Centers, Hospitals, Schools, Patient homes, Churches, and Nursing Schools

Important in caring for morbidly obese, HIV positive, the elderly, and people suffering from wounds as a result of recent military duty
Type of nursing using this theory
"Watson's Theory of Human Caring is one prominent theoretical, ethical, philosophical frameworks in which nurses and administrators are engaged to inspire and transform nursing and health care."
Human caring science differs from other theoretical perspectives in that
Political, Legal, and Marketplace Issues
Marketplace: Heavy patient load and medication pass time constraints make it difficult for nurses to spend quality time with individual patients

Magnet Hospitals: Adopt the Theory to prove that they value patient care. Political issue because reaching "Magnet" status may be more about power and finances than it is about patient care

Legal Issues: Nurses taking the time to develop relationships may make some patients uneasy; can come off as being too personal and unprofessional
the theory incorporates a metaphysical view of nursing
there is a distinction between caring and healing
the theory was a response to the biomedical model which Watson views as sometimes threatening to humanity and human dignity
nurses and patients are coactive and coparticipants in the caring-healing process
human caring defines both nurse and person and a level of time and space
includes overlapping ideas between philosophy and theory
Reason for choosing theorist
Relevance to clinical practice experience
Impact on Health and Quality of Life
addresses the spiritual side of human nature
restoring humanity and nourishing the human heart and soul
finding work meaningful and important
stronger nurse-client relationships
strengthening inter-professional collaboration through universal caring goals
Full transcript