The purpose of this paper is to describe Jean Watson’s Theory of Human Caring. Dr. Jean Watson is a highly distinguished individual in the field of nursing who advocates a philosophy and theory of human caring. She was born in West Virginia. She obtained her BSN in 1964, finished her MSN in 1966 and her PhD in 1973 at the University of Colorado.
As a respected professional, being a distinguished Professor of Nursing and the Murchinson-Scoville chair in caring Science at the University of Colorado, School of Nursing and the founder of the Center for Human Caring in Colorado, her theory of human caring has gained respect and admiration throughout the world (Cara, 2003). Jean Watson’s caring theory has been used as a guide and model in caring and healing practices for the nursing profession throughout the world.
Watson indicates that this is her initial attempt “to bring focus to nursing as an emerging discipline and distinct health profession with its own unique values, knowledge, and practices, with its own ethics and mission to society. ” (Watson, 1990). Watson wants to stress that nursing is a special calling and not just a job in which one simply works for wages. She points out that those in the nursing profession need to be deeply committed to care, to love, and to serve.
She compares nursing to teaching because both professions are life-giving and life- receiving careers which span to a lifetime (Foster, 2006). Watson’s caring philosophy or model requires one to “get it” to personally experience it. It is not just a theory that you have to read, study, learn about and research and you have it. One has to experiment doing it. One has to live it out in one’s personal and professional lives. Watson’s caring theory is a model intended to transform oneself and one’s nursing practice.
For a nurse to acquire this philosophy, she needs congruence between the belief in caring and herself, her group, the system she is in, and the setting she works in. She also has to understand what it means to be human, caring, healing, and transforming. The nurse has to seek authentic connections and establish the caring-healing relationships with herself and others. Watson’s caring theory has evolved to become “caritas process. ” Although the basic philosophy of caring still holds and is used, the original carative factors have transposed into “clinical caritas processes. I believe this process is the extension and expansion of Watson’s original caring theory. Dr. Jean Watson’s caring theory is characterized by three major elements namely; the carative factors, the transpersonal relationship and the caring occasion or caring moment. The carative factors as distinguished from curative factors refer to those subjective elements that consider not only the physical condition but also affective aspect of the human being. Curative factors, on the other hand are those medical practices and cures that basically treat the physical condition of a patient.
Carative factors include 10 basic tenets namely: Formation of a humanistic-altruistic system of values; Instillation of faith-hope; Cultivation of sensitivity to one’s self and others; Development of a helping-trusting, human caring relationship; Promotion and acceptance of the expression of positive and negative feelings; systematic use of a creative problem-solving process; Promotion of transpersonal teaching-learning; Provision for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment; Assistance with gratification of human needs; Allowance for existential-phenomenological –spiritual forces (Watson, 1999). Transpersonal caring considers the whole person and beyond the given moment.
It’s a caring that transcends beyond the physical being to the spiritual. It’s the caring and healing that tries to connect with the spirits of the cared for. It’s the authentic relationship of caring. Transpersonal caring is present when the caregiver possesses the caring consciousness and intentionality as she gets into the world of the patient, mind, body, and spirit. Transpersonal caring is evident when both the caregiver and the cared-for focus on their own uniqueness and the uniqueness of the moment. It is evident when the nurse consciously and intentionally focuses on caring, healing, and wholeness, rather than on disease, illness, and pathology.
A caring occasion or caring moment refers to an occasion or a moment or a focal point whenever the nurse and her patient come into a human-to-human transaction and both are presented the opportunity to decide the kind of relationship they want to be in. At this moment, the nurse should consciously establish caring-healing-loving relationships. In discussing Watson’s theory of human caring and it’s application to nurse-patient interaction, this author will quote some Watson’s theories and relate them to how this author believes they are applied based on this author’s personal nursing experience. Watson advocates the idea that caring is the core of nursing. Which this author fully agrees.
Take away the aspect of caring from nursing and all that is left is dehumanizing patient care. Watson extends her advocacy of caring to all aspects of nursing that includes clinical, administrative, educational, and research practice. Therefore, caring should not be limited to the nurse’s face-to-face areas and facets of nursing. Watson defines 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. The nurse who provides care has to consider the makeup of a human being and be supportive of the needs of the three spheres of being.
In practice, it translates into providing physical cure, having uninterrupted caring moments and having occasions to promote patient’s understanding of life (Watson, 1999). Watson (1999, p 102-103) has outlined several major theory assumptions related to person, health, nursing, and environment. As related to person, caring is based on an ontology and ethic of relationship and connectedness. Caring consciousness, in relation becomes primary, caring can be most effectively demonstrated and practiced interpersonally and transpersonally. Caring consists of “caritas” consciousness, values, and motives. It is guided by carative components (carative factors). Based upon Watson’s assumptions, this author surmise that Watson expects every nurse to provide a caring relationship with her patients.
It’s a relationship based on love and caring, where a patient is viewed as a person with mind, body, and spirit, and not merely an object that requires treatment. She expects every nurse to treat patients with respect and with a positive regard for her well-being. Watson’s assumptions demand caring moments from nurses and not just finishing a task or a job. As related to health, caring promotes self-growth, self-knowledge, self-control, and self- healing processes and possibilities. Caring accepts and holds safe space for people to seek their own wholeness of being and becoming, not only now but in the future, evolving toward wholeness, greater complexity and connectedness with the deep self, the soul and the higher self.
It’s Watson’s assumption that when a patient is given loving care, it will contribute greatly to the person’s motivation to self-heal not only physically but also spiritually. Watson likewise assumes that caring results in a person’s desire to seek balance in life, combining his personal and spiritual life into one. As related to environment, the environment includes things that produce or reduce stress, comfort, safety, privacy, and a clean aesthetic surrounding. It is supporting, protecting, and/or correcting mental, physical, social, spiritual, and energetic vibration fields integral with the person. The environment includes places where nurses work and how nurses are perceived (Watson, 2001, p. 80).
This assumption requires that the room, or the physical environment of the patient need to be clean, tidy, organized, and safe to provide comfort and feeling of peace and relaxation to patients. This kind of environment promotes the mental, physical and spiritual well-being of the patients. In addition to physical environment, Dr. Watson establishes an assumption that; “a caring relationship and a caring environment attend to soul care. The spiritual growth of both the one caring and the one-being-cared-for. To Watson, a caring relationship and a caring environment preserve human dignity, wholeness, and integrity. They offer an authentic presencing and choice.
As related to nursing, it is the profession that has an ethical and social responsibility of both individuals and society to be the caretaker of care and the vanguard of society’s human care needs now and in the future,” (Watson, 1999, p. 32). “As a human rather than a traditional science, nursing can view human life as a gift to be cherished-a process of wonder, awe, and mystery. Nurses can choose methods that allow for subjective, inner world of personal meanings of the nurse and patient” (Watson, 1999, p. 7).
This author believes theses assumptions of Dr. Watson as to how nursing profession should be viewed stem from Watson’s work exposure in the East and the Pacific Islands where the emphasis of healing s not only on the physical but also the spiritual side of men. Watson advocates that those in the nursing profession need to assume ethical and social responsibility for those in the profession and those they care for. This responsibility requires nurses to view human life as a gift to cherish, not an object to be treated. On account of this responsibility, nurses need to be more understanding in allowing methods of healing that will give meaning to the individual’s life. Nursing is expected to be more affective rather than technological. While competence in technology is required for better management, it should never take precedence over the primary role of caring.
Transpersonal relationship is describes by Watson as one where the caring of one person goes across or beyond oneself. Caring resulting from this relationship “seeks to connect with and embrace the spirit or soul of the other through the processes of caring and healing. ” She further states that the transpersonal caring relationip moves beyond ego-self and radiates to spiritual, even cosmic concerns and connections that top into healing possibilities and potentials (Watson, 1999). In a transpersonal relationship, “the one caring and the one cared-for connect in their search for meaning and wholeness (Watson, 1999). To give meaning and fulfillment to transpersonal; caring relationship is to adhere and utilize some of Watson’s carative factors.
The formation of a humanistic-altruistic system of values directly results in a transpersonal caring relationship. When a caregiver develops an unselfish devotion to the well-being of his patients, transpersonal caring relationship is created. Transpersonal caring acknowledges that life is interconnected and that it moves in concentric circles from the nurse and the doctor to the patient and his family, to their communities and to the world at large. This type of caring results in the healing of the patient’s mindbodyspirit, his whole being. In this relationship, the nurse deeply commits herself to protect and enhance the dignity of the patients as well as raise her level of selflessness.
The development of a helping-trusting human caring relationship is also utilized to form transpersonal caring relationship. When one cared-for believes that she could sincerely trust the caregiver, this feeling facilitates healing of mind, body, and spirit. A trusting relationship fosters wholeness, beauty, dignity, and peace for both the caregiver and the cared-for. Cultivation of sensitivity to one’s self and to others is another carative factor that sustains transpersonal relationship. A nurse needs to have sensitivity to the feelings, emotions, and well-being of the cared-for. This sensitivity is part of mutual respect expected in a transpersonal caring relationship. Watson states, “Caring and compassionate acts of love beget healing for self and others.
The caring person has sensitivity to wholeness of a person but “the uncaring person is by contrast insensitive to another person as a unique individual, non-perceptive of the other’s feelings. And does not necessarily distinguish one-person from another in any significant way” (Watson, 1999, p. 34). One other carative factor that promotes transpersonal caring is the promotion and acceptance of the expression of positive and negative feelings. When an individual is cared-for, there are occasions when that person expresses negative feelings as he is trying to find answers to his pain and suffering. He seems to have a hard time finding meaning in his life of pain and miseries.
How he is able to find balance and meaning in his life and have positive feelings is attributed to the caregivers caring relationships. When the nurse is able to transcend her own ego and seek to go deeper in promoting the patient’s comfort and healing, then a deeper spiritual connection, a transpersonal relationship is formed between her and her patient. As this author reflects on her personal experiences with patients for the past 12 years, this author couldn’t agree more with Dr. Watson that the care of the patient is not limited to physical cure. A patient is not just an object lying in bed. A patient is mind, body, and spirit, all in which need attention and healing.
Furthermore, this author shares Dr. Watson’s view that “the care of the soul remains the most powerful aspect of art of caring in nursing” (Watson, 1997). This author in her nursing practice will enter her patient’s room with a smile, conscious that she will need to be a nurse who will heal not with prescription medication but with loving care. I remember one of my patients who were very ill. She had diarrhea and she was vomiting a lot. Nobody wanted to go above and beyond their job description. All she needed was an emesis basin, some washcloths, and somebody to assure her she will be fine. She needed some touch to feel that the nurses truly care.
When I gave her all the things she needed, I spent a few minutes with her, rubbing her back and asking her for any concerns and gave her the call light within reach. The patient then thanked me for all the little things I did for her. As I keep on reading publications and writing this report on Watson’s caring theory, I also keep on asking myself if I have lived up to the nursing role as Watson advocates. Did I acknowledge caring as the essence of nursing? Did I assist my patients to find meaning in their illness and suffering? Did I practice caring intentionally and consciously? I ask myself. I believe that for the most part I have been a caring nurse to my patients. In this age of technology, it is easy to view patients as numbers.
Being in the nursing profession I believe that I have to reflect from time to time to make sure that I am a nurse who helps patients live a balance and meaningful life. From time to tine, I get personal satisfaction in receiving notes and commendations from patients who acknowledge my competent services and loving care during their stay in the hospital. Patients deal with nurses differently. Some are nice and some are rude. Regardless of attitude, I still show my unconditional care and acceptance of them. I have my own limitations but one thing I guarantee is my caring when I visit my patients. This report makes me aware that I still have to work harder to be another Florence Nightingale.
While I perceive myself as a caring nurse, I know I have to set goals not only to maintain it but also enhance my transpersonal relationship with patients, It is my goal to continue to treat patients as holistic beings and to continue to spend uninterrupted time with the patients. Due to the number of patients assigned to a nurse, the vast paperwork a nurse has to complete, the nurse has the tendency to rush with everything to finish her job on time and not run into unnecessary overtime. I will never forget that nursing is just a job. It is a calling for me to establish caring relationship with patients. It’s a calling for me to treat my patients with a positive attitude.
Finally, it is my goal to create that caring occasion or caring moment to establish transpersonal caring relationship with my patients. With time and conscious effort on my part, I know I can do it and my patients can do it too.
References
Cara, C. (2003). A pragmatic view of jean watson’s caring theory. International Journal for Human Caring. 7(3), 51-61. Foster, R. (2006). A perspective on watson’s theory of human caring. Nursing Science Quarterly. 19(2), 5-11. Watson, J. (1999). Nursing: Human science and human care, a theory of nursing. Sunbury, MA: LN Press, Jones and Bartlett. Watson, J. (1990). Caring knowledge and informed moral passion. Advances in Nursing Science, 13(1), 15-24. Watson, J. (1990). The moral failure of the patriarchy. Nursing Outlook, 28(2), 62-66.
