Insight in to Jean Watson’s Caring Theory

1 January 2017

In this paper, I will apply Watson’s theory to one specific nurse-patient interaction, which I encountered during my experience as a nurse. I will also describe how Watson’s carative factors were utilized in the transpersonal relationship. I will also give a personal reflection on my professional experience that is basis of this paper. The term theory has many definitions, but generally it refers to a group of related concepts, definitions, and statements that propose a view of nursing phenomena from which to describe, explain, or predict outcomes (Chitty, 2005).

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Theories are important because it help guide nurses in the direction to provide the best care to patients’. A benefit of having a defined body of theory in nursing allow the nurse to provide efficient patient care, promote nursing status as a professional, improved communication amongst caregivers and patients, and guidance for nurses to engage in research to further their education . Dr. Jean Watson is an American nursing scholar born in West Virginia. Dr. Watson attended the University of Colorado where she earned her Bachelor’s of Science degree in nursing and psychology.

Watson later earned her master’s degree in psychiatric-mental health nursing and continued to earn her Ph. D in education psychology and counseling (Chantal, 2003). In 1979, Dr. Watson’s theory of science of caring was first published in Nursing: The Philosophy and Science of Caring. In the publication, she issued a call for a return to the earlier values of nursing and emphasized the caring aspects nursing. Watson’s work addresses the philosophical question of the nature of nursing when viewed as a human-human relationship (Chitty, 2005).

There are three major concept of Watson’s theory: a) the carative factors, b) the transpersonal caring relationship, and c) the caring occasion/caring moment. The carative factors provide a focus for nursing phenomena. Carative factors specify the meaning of the relationship of the nurse and patient as human beings. Transpersonal caring relationships describe how the nurse goes beyond an objective assessment, showing concerns towards the person’s subjective and meaning regarding their health care situation.

The goal of transpersonal caring relationship is to protect, enhance, and preserve the person’s dignity, humanity, wholeness, and inner harmony(Cara, 2003). Caring occasion/caring moment occurs whenever the nurse and another come together in a given moment for human-to-human interaction. Watson believes that both nurse and patient can be influenced by caring moments depending on their action and choice within the relationship. Dr. Watson’s carative factors consist of 10 elements: 1. The formation of a humanistic-altruistic system of values. 2. Instillation of faith-hope. . The development of a helping-trusting, human care relationship. 4. The cultivation of sensitivity to one’s self and to other’s 5. The promotion and acceptance of the expression of positive and negative feelings 6. Creative problem solving caring process 7. The promotion of transpersonal teaching and learning 8. The provision for a supportive, protective and/or corrective mental, physical, socio-cultural and spiritual environment. 9. Assistance with the gratification of human needs 10. The allowance for existential-phenomenological forces. (Cara, 2003, p. 52).

As Watson continued to develop her theory, she developed clinical caritas processes, which replaced the carative factors. Clinical caritas processes were: 1. Practice of loving kindness within context of caring consciousness. 2. Being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and one-being-cared for. 3. Cultivation of one’s own spiritual practices and transpersonal self, going beyond ego self, opening to others with sensitivity and compassion. 4. Developing and sustaining a helping-trusting caring relationship. . Being supportive of, the expression of positive and negative feelings to connect with a deeper spirit of one self. 6. Creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices 7. Participate in genuine teaching-learning experience that promote unity of being and meaning, attempting to stay within others; frames of reference. 8. Creating an environment that is conductive to healing at every level, subtle environment, which potentiates the ability to sustain or develop dignity, comfort, and peace. . Ensuring basic needs are met, with a caring conscious, providing “human care essentials”, which tends to the individual’s mindbodyspirit. 10. Allowing the expression one’s spirituality and attending to spiritual needs as it relates to ( Cara, 2003). According to Suliman, Welmann, Omer, and Thomas (2009), transpersonal relationship depends on the nurse moral commitment in protecting and enhancing human dignity. It also depends on the nurses’ caring conscious communicated to preserve and honor the embodied spirit.

The nurse caring conscious and human-to-human relationship potentiates a healing process that is based on the nurses’ intentional connection, perception, and experience. Dr. Watson’s carative factors can be utilized in the transpersonal relationship in the clinical setting in many ways. When developing a nurse-patient relationship, it is very import to establish a helping-trusting, human care relationship with the patient. Establishing a relationship that is genuine in nature, which goes beyond working nurse-patient relationship is necessary to build a transpersonal relationship.

Transpersonal relationship can develop from the nurse-patient incorporating spiritual matters in the healing process. The nurse ability to instill hope and faith to patients who are in distress, exhibit a sense of the nurse caring conscious. Promoting hope when modern medicine have nothing else to offer, the nurse can continue to give faith-hope to provide a sense of well-being through belief’s which are meaningful to the individual (Holland Wade, & Kasper, (2006). Assisting with the gratification of human needs could also be utilized in the transpersonal relationship.

When developing a transpersonal relationship one must remember to protect the dignity of the patient at all times. Assisting the patient with basic needs with intentional caring consciousness, while administering “ human care essentials,” which potentiate alignment of mindbodyspirit and unity of being in all aspect of care (Cara, 2003). The promotion of transpersonal teaching and learning is also useful in the development of transpersonal relationships. Engaging in meaningful and intentional caring process allows the nurse to establish transpersonal relationship with the patient.

This encounter also allows the nurse and patient to communicate in a way where each one’s perspectives are evaluated for understanding. Understanding the person’s perception of the situation can assist the nurse to prepare a cognitive plan. This interaction promotes mutuality between both nurse and patient, which is essential in developing a meaningful relationship. Dr. Watson define the person as a being-in-the-world who holds three spheres of being-mind, body, and spirit that are influenced by the concept of self and who is unique and free to make choices (Cara, 2003).

Dr. Watson’s assumption of caring as it relate to the person states “ …a caring person is that the person is somehow responsive to another person as a unique individual, perceives the other’s feelings, and sets one person apart from other”. Dr. Watson’s believes that a person’s health is subjective. Health corresponds to the person’s harmony, or balance, within the mind, body, and spirit. Dr. Watson’s assumption of health states that caring promotes health more than curing and effective caring promotes health to an individual as well as family growth (Cara, 2003).

According to Dr. Watson nursing is defined as a “human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, aesthetic, and ethical human care transactions” (2008a, p. 54). Dr. Watson’s assumption as it pertains to nursing states that human caring in nursing is not just an emotion, concern, attitude, or benevolent desire, but rather a personal response (Cara, 2003). Dr. Watson believe the person’s environment could expand awareness and consciousness, while promoting the healing of the, mind, body, and spirit. Dr.

Watson’s assumption of caring as it relates to the environment states that “a caring environment offers the development of potential while allowing the person to choose the best action for the self at a given point in time” (Alligood, 2010, p. 109). To better understand Dr. Watson’s theory, I will apply her theory to a specific nurse-patient encounter. When using clinical caritas process (CCP), I will also attach the corresponding numbers to denote its use within my clinical story. While working in Post Anesthesia Care Unit (PACU), I was assigned a patient by the name of Ms.

Anderson. Ms. Anderson was 1 day post-op of having a vaginal hysterectomy. Upon getting report regarding Ms. Anderson’s condition, I was informed that the patient was “very needy” and didn’t want to go home”. When I went into Ms. Anderson’s room, I introduced myself and told her that I will be her nurse for the day. I proceeded to ask Ms. Anderson if there is anything I could do for her at that time. She told me that see just want the lights off and the curtains closed. After an hour I went back into Ms.

Anderson’s room informing her that she will be discharged that day. She appeared very anxious and apprehensive. I held her hand as I asked “Ms. Anderson you seem a little upset is there a reason you do not want to go home’’(CCP#4). Ms. Anderson began to cry and I assured her that everything will be ok, but she had to believe that I was there to try to help her (CCP#2). Ms. Anderson proceeded to tell me that she does not live in this state and she thought that she would be hospitalized for at least three days. Ms.

Anderson said she had a train ticket back to her home state of Atlanta, but the train ticket was for the following day. I acknowledged Ms. Anderson’s concerns and informed her that she need not to worry (CCP#5). I informed Ms. Anderson’s doctor and notified the hospital social worker regarding her situation (CCP#6). After collaborating with the doctor and social worker, we were able to accommodate Ms. Anderson for another night. I inform Ms. Anderson that she could stay in the unit and I will continue to assist in any way until her departure the following day (CCP#1).

Allowing Ms. Anderson to stay in the hospital an additional night, eliminated her anxiety. Dr. Watson’s theory has personally expanded my perception regarding how patients’ should be managed as a whole. When using Watson’s theory in practice, it allows me to place focus mainly on the patients needs by the use of having a caring conscious rather the use of technology or medication. In conclusion, Watson’s caring theory provides a guide for nurses to practice nursing by way of having a caring conscious.

Nursing theories provide a guide for nurses to administer evidence-base nursing to provide best care to patients’. The major concepts of Watson’s theory, which are carative factors, transpersonal relationships, and caring moment allow the nurse to provide a foundation for nurses to use within the clinical setting. Dr. Watson’s theory assumptions provide a guide for nurses’ to establish human-to-human relationships, which could be applied during a caring moment. The nurse ability to establish a caring relationship with the patient is the focal point of Watson’s theory.

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