Theory provides professional independence by guiding the practice, education, and research functions of the profession. The study of theory helps to develop analytical skills, challenge thinking, clarify values, and assumptions, and determine purposes for nursing practice, education, and research (Reed, Shearer, and Nicoll, 2004). According to Reed, Shearer, & Nicoll (2004) Jean Watson presents the most current nursing theories. She is the only nursing theorist to support the concept of soul and to emphasize the spiritual dimension of human existence (p. 310).
According Suliman, Welmann, Omer, and Thomas (2009) Jean Watson theory addresses caring relationships among people and the deep experiences of life itself.
Background and Major Concepts of the Theory According to Alligood (2010) “Watson’s theory of caring can be traced back 30 years from its earliest beginnings as a textbook for nursing curriculum to a transformation of the health care system by bringing new meaning to the world of nursing and patient care.
The relationship of human caring and nursing laid the foundation for what was to become the theory of human caring” (p.
11). Jean Watson bases her theory for nursing practice on 10 care factors. Each has a forceful phenomenological component relative to the individuals involved in the relationship as encompassed by nursing. The first three care factors serve as the foundation for the science of nursing (Watson, 2011). Jean Watson Care factors are •Formation of a humanistic-altruistic of values, which is the satisfaction through giving and extension of the sense of self (Watson, 2011).
This means to be intentionally present with the patient and to focus on what is going on in the present; making the patient feel that he or she matters. •Instillation of faith and hope, which is the promotion of holistic nursing care and positive health within the patient population. The nurse’s role is to develop an effective nurse patient interrelationship and promote wellness by helping the patient to adopt health-seeking behavior (Watson, 2011). Cultivation of sensitivity to self and others, in other words as the nurse acknowledge his or her sensitivity and feelings, he or she becomes more genuine, authentic, and sensitive to others (Watson, 2011). •Development of a helping-trust relationship, which is crucial for transpersonal caring because this promotes the expression of positive and negative feelings. This involves being real, honest, and authentic with the patient and family (Watson, 2011).
Any nurse can be with a patient but a providing a caring relationship, which cultivates healing is a conscious choice for healing to occur •Promotion and acceptance of the expression of positive and negative feelings •Promotion of interpersonal teaching-learning; this allows the patient to be informed and shifts the responsibility for wellness and health to the patient •Provision for supportive, protective, and corrective mental, physical, sociocultural, and spiritual environment.
The nurse should recognize what effects the internal and external environments have on health and illness of the patient (Watson, 2011). Assistance with gratification of human needs through intentional caring and assisting patient with basic needs •Allowance for existential phenomenological spiritual forces; Jean Watson believes that the nurse have the responsibility to go beyond the care factors in dealing with one’s own life and death so that he or she can deal with the patient that is cared for. Nurse and Patient Interaction Transpersonal caring can be read about, but to truly understand it a person has to experience it personally, interact, and grow within this intentional experience.
I worked in the intensive care unit, and it was my turn to receive the next admission. In walked a tall very handsome 34-year-old young man. He has a wife and twin daughters. He worked as a Wayne County Sheriff. He was admitted with diagnosis of cancer of the throat and was going to surgery the next day. At this point, he was ill and needed help, according to Alligood (2010) Watson views health and illness functioning simultaneously as a way to stabilize and balance a person’s life. Illness is turmoil and an interruption in a person’s life. There is a healing potential within the transpersonal caring relationship.
With this the nurse can assist the patient to realize his or her internal, mental-spiritual consciousness allowing him or her to accept healing or the positive on his or her life (p. 123). When he came to the unit it was time to get off duty, but I introduced myself, and the very first thing he said was “I will not see you after surgery. ” With that statement I had to delay my leaving and talk with him. This is the caring moment, the moment in which this patient and myself come together and being with the patient at his time of need. I talked with this patient to try to get him to turn his negative thinking into a positive one (Watson, 2011).
This patient and myself talked for an hour and by the tome I left he was positive that he was going to come through this surgery without problems. According to Jean Watson theory of caring both the patient and myself came together in a meaningful, authentic, intentional way to help him discover new possibilities such as living for the future. The nurse in this instance becomes the environment because we promote the intentional and conscious attention to healing. By talking to the patient about his concerns, I was creating caring, which like a pebble thrown across the water crates a circle outward to be felt by the patient.
This patient went to surgery and when he returned to the intensive care unit he was in a coma, the physician was not sure if he would wake up. I cared for this gentleman by talking to him no matter what I was doing. I would tell him about the weather, about his daughters, the pictures that his wife had brought to the room as well as pray with him. According to Parker (2006) “the transpersonal caring relationship is where the nurse seeks to recognize, detect, and connect with the inner condition with the person while seeking to sustain caring in the midst of threat and despair” (p. 299).
This gentleman woke up after three weeks and as we talked he told me he heard everything I said. He stated that he felt as if he was outside in the dark but could hear what was being said. We developed a trusting relationship because I had a moral commitment to protect him and care for him as well has enhance human dignity and intentional caring for him because he was in need. We watch over the patients as they struggle against their disease, and are there, too, if they decline, beginning their slow embrace with death. The changes in health care around the world have increased nurse’s responsibility as well as workloads.
We must deal with patients increased acuity levels in regard to his or her health care situation. Despite this we find ways to preserve our caring practice and even though I did not know it at the time Jean Watson’s caring theory can be seen as indispensable to this goal. I developed a helping-trusting relationship with his wife. By promoting a caring relationship, I created space for this patient to generate his own healing. His wife was very positive that his healing environment was a positive one. The patient was transferred out of the intensive care unit to a regular floor.
He required suctioning because of an ostomy in his neck. I place a bag over the hole to keep his clothing from getting wet; the saliva would be caught in the bag. Within one-week this man was readmitted to the intensive care unit because he was not being suctioned frequently. He died an hour after admission. My heart went out to the wife as well as the children. I had to meet the wife need of caring and allowing her to grieve. Personal Reflection When I made the conscious decision to become a nurse, I also made the moral decision and commitment to care for all patients I come in contact with.
Caring endorses our professional identity and upholding these caring values in our daily practice helps to transcend us from a state where nursing is perceived as a just a job to that of a gratifying profession. Upholding Jean Watson’s caring theory (which is embedded within me) not only allows me to practice the art of caring, to provide compassion to ease a patient’s suffering as well as his or her family suffering, and promote his or her healing and dignity, but it will also expand my actualization.
Allowing this patient to verbalize his thoughts was a way for him to find his voce as well as his own lived experience to allow him introspection and meaning (Alligood, 2010). I cried with his wife when he expired because when you care for a patient and become involved with the family it is as if they become a part of you. When they expire it is as if you have lost that personal part of yourself. By talking with his patient I feel that I applied Jean Watson’s care factors by providing the patient and his wife respect, instilling hope by taking the time to talk over his concerns.
I discussed the patient feelings and perceptions about his quality of life and management of care within the intensive care unit. I provided a trusting relationship, which enabled the patient to discuss negative feelings about his current health situation. Conclusion Caring and nursing are so intertwined that nursing always appeared on the same page in a Google search for the definition of caring. Caring is “a feeling and exhibiting concern and empathy for others; showing or having compassion” (The Free Dictionary, 2013, p. 1). Caring is as old as humankind.
There is someone in the family or close social network that was given the responsibility to take care of those not able to care for himself or herself. The concept of transpersonal caring developed by Watson who built her theory on caring, which is a moral ideal of nursing stating caring is the protection, enhancement, and preservation of human dignity (Watson, 2011). Watson also states that caring is a characteristic of the nurse, a response, and behavior of the nurse on behalf of the patient. The carative factors make up the core of nursing and provide a structure and order or nursing theory.
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