Watson calls caring the ethical principle or standard by which curing interventions are measured (Alligood, 2006). Watson’s caring theory evolves in a global state no longer limited to facility settings. Watson’s theory is the development of a caring fluid experience expanding from the person to the community onward to society. Her six Caritas process uses creativity and a scientific problem-solving method for caring decision making, and preserving the “human caring model. Caring and healing bridges to form a complete relationship while developing and recognizing the transpersonal aspect of the relationship (Watson, 2007). Watson has refined her caring theory throughout the years; however, her basic concepts have remained unchanged. Her theory continues to focus on human caring and the subjective life experiences of self and other. This philosophy promotes the human dimension of the nurse and the person in the realm of one’s spirituality. Watson’s caring theory reflects on human values and revolves around caring and healing.
Her transpersonal teaching-learning undertakes the idea of encompassing more than teaching to invoke a compassionate and caring relationship between the patient and the nurse. Teaching and learning are in a caring manner, promoting a readiness to learn, thus reinforcing the human dimension of nursing. Nursing goals should direct and exhibit a benevolent act leading to a caring moment derived from self and delivered to other permitting a spiritual presence for both. Concepts of Watson Theory: Carative Factors I developed the “carative factors” in 1979 and revised them in 1985 and 1988b,” I viewed the “carative factors” as a guide for the core of nursing. I use the term carative to contrast with conventional medicine’s curative factors” (Watson, 1997b). Believing that care and love are essential to the patient’s healing environment as well as the nurses will certainly open a caring relationship for both patient and nurse. A spiritual wellness will provide each with a sense of wholeness and genuine embracement of faith and healing relationship.
Her carative factors attempt to “honor the human dimensions of nursing’s work and the inner life world and subjective experiences of the people we serve” (Watson, 2007, p. 130). Watson introduces a spiritual caring consciousness addressing the whole person. Caring transforms into an assessment tool that one can visualize, touch, hear, and verbalize, by interacting with the person in the direction of true human needs. Focus on the holistic attitude of caring will reveal an inspired and centralized bonding thereby creating a stronger understanding of human the experience.
When human needs are met the patient and nurse creation a fundamental awareness of spiritual wholeness; enveloping a positive and holistic entity. Each processes listed below enables a nurse to travel beyond the norm to pursue a “transpersonal” interaction delivering a human to human response, which is for the greater good of both patient and nurse. Not only does this concept promote faith and hope related to the “here and now” for the nurse, it is a fluid concept that embodies the soul and in essences continues to build many influencing caring moments.
The carative factors are inclusive of 10 elements of factors, in 2001 Watson refined the carative factors to clinical caritas processes and below are the original factors and the revised 2001 caritas process (Watson, 2007): • Humanistic-altruistic system of value- practicing loving – kindness and equanimity for self and others. • Instillation of faith-hope – Authentically present to/enabling/sustaining/honoring deep belief system and subjective world of self/other. • Cultivation of sensitivity to self and others – Cultivating of one’s own spiritual practices; deepening self awareness, going beyond “ego self. • Development of a helping-trusting, human care relationship – Developing and sustaining a helping-trusting, authentic caring relationship. • Promotion and acceptance of expressing positive and negative feelings – present to, and supportive of, the expression of positive and negative feelings as a connection with deeper spirit of self and the one – being-cared-for.
• Systematic use of a creative problem-solving caring process – Creatively using presence of self and all ways of knowing/multiple ways of Being/doing as part of the caring process; engaging in artistry of caring-healing practices. Promotion of transpersonal teaching-learning – Engaging in genuine teaching-learning experiences that attend to whole person, their meaning; attempting to stay within other’s frame of reference. • Provision for a supportive, protective, and corrective mental, physical, societal, and spiritual environment – Creating healing environment at all levels (physical, nonphysical, and subtle environment of energy and consciousness whereby wholeness, beauty, comfort, dignity, and peace, and potentiates. Assistance with gratification of human needs – Assisting with basic needs with an intentional, caring consciousness of touching and working with embodied spirit of individual, honoring unity of Being; permitting spiritual emergence. • Allowance for existential-phenomenological – spiritual forces- Opening and attending to spiritual-mysterious, unknown existential dimensions of life-death; attending to soul care for self and one- being- cared- for (Watson, 2007Nurse/patient interaction Received an assignment to care for Ms D 46 year- old African American female: diagnosed with a severe case of peripheral vascular disease and diabetes.
Admitted for left above knee amputation, several years ago she was admitted to the surgical floor for a right above knee amputation. I was assigned as her nurse at this time also on the surgical unit. I always like taking care of her as a patient and person (humanistic altruistic system value). Because I have taken care of her during her past admissions, we have a special relationship (helping trusting, human relationship). Seem as if we had developed this special bond or connect the first time I cared for her (trusting, human relationship).
She shares with me personal aspects of her personal life. This has allowed me to know her not just as a “client” but allowed me to know her as a person. I was happy to see her as she was admitted to the floor. Our eyes met and she produced a weak smile. I said “hello” to her and asked how she was doing. I mentioned to her that since I had last seen her I had some new creative ideas to share with her on the caring for her recent right above knee amputation, creativity is the art of nursing (creative problem-solving/transpersonal teaching learning).
She said she was happy to see me and hoped that I would be her nurse; she wanted to know how I was doing. Ms. D knew me as a person and not just a nurse; she feels as if I am “her friend and nurse. ” Ms. D knows that she is special to me and that I care about helping her doing this hospitalization (helping and trusting, human relationship). From her weak smile and flat affect I could sense she was depressed. I would not assume that and will need to speak to her about what she is feeling and her perception related to her right above knee amputation (sensitivity to self and others/expressing positive and negative feelings).
As, I was preparing her to rest I did my best to make her environment as pleasant as possible (supportive, protective/corrective mental, physical, societal, and spiritual environment) (Watson, 1997b). As, I helped her to get comfortable I used this time to inquire about her feelings and her main concerns about her care plan and admission (expressing positive and negative feelings). Ms D explains that she wants to be home to care for her eight year-old daughter; this is a priority to her, so I know that we as a team must focus on her priorities, I know that this may help her to participate in her healing process more actively.
Before I left her room, I asked if I could get her anything. She said, “Yes,” I could get her an extra pad because of her incontinence, and inability to use the bedside commode without assistance now. “At this moment I feel helpless, I cannot do anything for myself now, the one leg I had is now gone. ” “Do you think this will be the last surgery or will there be a need to cut on me again? ” “I just don’t know what or how to feel these days. ” I asked her to clarify what she was feeling and exactly what she meant by what she had said (expressing positive and negative feelings). I could no longer care for her daughter,” and must now depend on family members to help me. ” She feels as if she is a failure and no one respects her because she is a bilateral amputee. I could not even speak. I am left to think of caring factors related to dignity and respect; I now realize how important it is to preserve ones’ dignity. She made me also realize how and what others thought of her affected her emotionally. “I am not the same person I use to be, before they starting cutting on me. ” As Ms. D continues to talk as she expresses her sadness over her recent surgery. I wish you could have seen me when I was working and getting around on my own. ” I asked if losing her leg made that greater difference and how did it make her feel different (existential phenomenology spiritual focus, expressing positive and negative feelings and human needs assistance). She believes she no longer had a reason for living except for her daughter as her social life was non- existent. Hard to understand how people could not respect her because she was different; I looked at her physical body and focused on her mind and soul.
At this point, I sensed she wanted to be quiet and alone, so I honored, and respected her privacy. I told him I would be back to check on him in 30 minutes, I quietly closed the door. Sensing she may have needed quiet time for self reflection of life experiences, maybe even spiritual reflection; as from past sharing she has expressed her deep Christian and religious foundation (faith-hope). After leaving her room I wondered if could have done more, I felt as if I had failed her. Being caring can sometimes make one vulnerable.
I want to help her reach wholeness in her mind, body, and spirit and maintain some peace and harmony in her life (human needs assistance). I will do everything in my power to provide some hope to her by using creativity because I know hope and peace are essential elements in one’s ‘life (creative problem-solving, caring process). Motivated by positive deeds and my ability to motivate the spirit, accentuate mind, foster hope, and value dignity, advocate caring, and respect mankind. Passion and caring drives me to establish transpersonal caring relationships with the person, family, community, and societal.
An informed nurse is a caring nurse representing humanistic values, therefore respecting the person and the profession Major Theory Assumptions Person is a human being, to be nurtured, respected, and cared for holistically and understood each functioning as a whole in, mind, spirit, and body. Interaction with Ms. D’s story symbolizes a concept of human caring, building, bonding, and forming a transpersonal relationship, existing in the immediate environment with complete adaptation.
Health is the promotion of being of a sound mind and body, functioning physically, mentally, and socially with the absence of disease or illness. Ms. D verbalizes that there may be future surgeries; several caring factors are applied to enhance the promotion of optimal holistic caring experience. Environment influences ones’ unique coping and Adaptative skills as the whole person is a focus. When implementing the caring factors nurses focus on the person also achieving a positive and pleasant relationship with the environment.
Watson addresses the significance of environment and healing, the person’s room should be organize, comfortable, and easy on the eye, more related to a home away from home with peace and harmony in a secret place spiritually. Nursing promotes health, prevention of illness by assisting in restoring the persons’ health. Through research based on scientific validation, development to implement critical thinking through the nursing process, imploring creative, spiritual, and supportive caring system.
Transpersonal Caring Relationship. Nurse to patient relationship is a substantial connection and understanding of humanity in the assessment of the human experience in its wholeness. It is essential that the person and nurse initiate a deeper sense and appreciation for a caring environment. The transpersonal caring concept revolves around the nurse and person connecting at all levels. Transpersonal relationships develop into a protection mode and the delivery of a deeper sense or meaning of the person and nurse dignity, inner harmony, wholeness, and produce a powerful nurturing relationship.
Person and nurse can connect with a caring spirit therefore supplying a unique environment for healing in harmony for both person and nurse. The nurse at these times must assess and address a caring conscious of the past, present, and future. Each will examine and inventory their humanistic values and belief systems of self. Nurses can promote a focus on human caring while respecting the person for sharing life experiences and promoting enhancement the human dimension.
Conclusion. Nurses’ utilization of Watson’s caring theory as a clinical application in nursing practice often promotes a unique and positive healing experience for self and other. Application of the caring theory in the workplace can assist nurses in the expansion of theories, models, and concepts providing scientific modules while continuing to implement caring healing entities that have been present and shall always be present. The foundation of Watson’s caring philosophy continues to advance the nursing profession
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