Watson’s Theory of Human Caring With many changes in our health care systems today I believe nurses and our patients are suffering as a result of all the financial restructuring. Despite the hardships of administrative numbers, hospital nurses continue to provide care, practice the core of nursing, and maintain the caring model. To assist us in providing quality care we have theorists like Jean Watson that will take us back to our roots of the ideal nurse and stellar patient care.
In this paper I will describe Jean Watson’s background of her theory, and provide concepts of her theory. In addition, I will relate her theory to person, health, nursing and environment of the caring moment and provide a transpersonal relationship and relate the factors within my experience. Background and concepts of Watson’s Theory Dr. Jean Watson was born in West Virginia and moved to Boulder, Colorado in 1962. She attended the University of Colorado and earned a bachelor of science in nursing and psychology. Jean continued and received her master’s degree in psychiatric-mental health nursing.
In addition, she earned her Ph. D. in education psychology and counseling. She taught at the University of Colorado School of Nursing and is the founder of the Center for Human Caring in Colorado. She has written many books discussing her philosophy and theory of human caring. The three major elements of Watson’s theory are the carative factors, the transpersonal caring relationship, and the caring occasion/caring moment (Cara, 2003).
The carative factors were developed in 1979, and last rewritten in 1988. They are the basic foundation and core of nursing today.
- Humanistic-altruistic system of value.
- Sensitivity to self and others.
- Helping-trusting, human care relationship.
- Expressing positive and negative feelings.
- Creative problem-solving caring process
- Transpersonal teaching-learning
- Supportive, protective, or corrective mental, physical, societal, and spiritual environment.
- Human needs assistance.
- Existential-phenomenological-spiritual forces.
The carative factors are used as a guide for nurses. They also are an attempt to “honor human demensions of nursing work and the inner life world and subjective experiences of the people we serve” (Cara, 2003).
The Transpersonal Caring Relationship is a nurse’s dedication to raise and maintain self worth and self regard. This relies on the “nurses caring consciousness to preserve and honor the embodied spirit, thereby not reducing the patient to a moral status of an object” (Favero, 2009). Within this relationship of the nurse/patient the caregiver goes beyond one’s won ego and reaches a deeper connection with the patient to promote a positive health outcome for the patient. While doing so the person being care for maintains dignity, harmony, and felt protected.
The third element of Jean Watson’s theory is the Caring Occasion/Caring Moment. According to Watson a caring moment starts as soon as the caregiver enters the room. A rapport is immediately formed with the one being cared for. Watson calls this the human-to-human transaction. At this immediate point the nurse/patient are influenced by their actions within the relationship thereby, acting upon and now becoming part of his/her own past events. When this transpires the mind, body, and spirit will expand the boundaries of openness in which offers human capabilities.
Jean Watson’s theory assumptions related to person, health, nursing, and environment Watson defines the person as of the world and using mind, body, and. This will impact the concept of self and the person who is unique and able to make choices. If the patient’s room is clean, soothing, and sacred, this will in turn promote wholeness and healing. Watson shares if the patient’s room is dirty and un-kept the mind, body, and spirit can not heal (Cara, 2003). Again, the mind, body and spirit shines through assumptions related to health as well.
Watson explains health is a subjective experience and parallels with harmony and balance through the mind, body, and spirit. Assess the patient’s thoughts on health and it is also important to ask him/her questions regarding their health, and possibly about their situation and discover what his/her priorities are. Watson defines health “as a human science of persons and human health. ” She views nursing as an art and science. Art because of the role we play as a nurse for our patients and his/her families.
We as nurses provide comfort measures as we implement our knowledge and expertise to provide healing and alleviate pain, stressors, and promote positive health outcomes. Watson’s carative factors and the personal reflection of the professional experience My personal reflection is a professional experience. However, I was the patient only wanting to be on the other side, as the nurse. As you read this personal experience all ten carative factors are wallpapered within this story of the caregiver and the person being cared for.
Here are the four I chose.
- Expressing positive and negative feelings.
- Creative problem-solving/caring process
- Human needs assistance
After five months of doctors appointments, antibiotics, inhalers, nebulizer treatments, xrays and kenalog shots, I had given up. During those five months I learned to live with shortness of breathe, night sweats, a chronic cough and went through an albuterol inhaler every four days.
On this particular night I had borrowed a friend’s nebulizer machine medicating myself and diagnosing myself with an acute case of bronchitis. The doctors could not figure it out. Exhausted, I told my friend, “if the doctors do not find out what is wrong with me I am going to die in the next 72 hours. ” The next morning while getting ready for work I finished my albuterol nebulizer treatment, took a mucinex pill, downed a couple of antibiotics, stuffed some prednisone in my scrub top for breakfast, and I was off to work. Later that morning I looked at my watch it was 10:30a.
I thought to myself, “ this is it. ” Should I call an ambulance or go to primary? I was fighting to make it through this colonoscopy for my patient. I could not catch my breath. Next thing I knew I was in an ambulance headed for the nearest hospital. After arriving to the emergency room I still, could not breathe after two solumedrol treatments and three nebulizer treatments. The pulmonologist was puzzled. Finally arriving to the step down unit I remember struggling to breathe. I watched a lady (in slow motion) with a white coat on walk by my room.
She must have seen the look on my face because she turned around and put her head in the door. She stepped into my room and introduced herself as the house supervisor. I remember thinking, if one more person asks me another question that is it! I am outta [sic] here. She said, “hi, my name is Marrieta, if you need anything let me know. ” I then thought, oh, she is here to help. Hypoxia must have set in because I asked her for a sledge hammer. She asked me what was wrong. I told her I have been in the emergency room since 1100 a. m. nd that it is midnight and I still can not breathe.
My respirations were 38 and my heart rate on the monitor was 176. The last thing I remember is her calling rapid response, shoving a culture down my nose to my lung bifurcation, then the code team running into my room. A long 12 hour-day I had landed myself in the intensive care unit with a diagnosis of H1N1, Methicillin-resistant Staphylococcus aureus in both lungs, followed with pneumonia. As a nurse I have had many patients with pneumonia and MRSA; however, I had never experienced a patient with H1N1.
The Center for Disease Control (CDC) has estimated that between 7,880 and 16,460 2009 H1N1 – related deaths occurred between April and December 12, 2009 and 5,000 in San Diego County (CDC, 2009). Refusing intubation, I succumbed to a bi-pap machine with sedation for the first three to five days. The first few days as an inpatient was the week the local newspapers starting debriefing the public and implementing ways to stop the pandemic of the Swine Flu. I laid there in ICU for 12 days and heard code blue ICU over and over. I would touch myself to make sure I was alive. There were three other swine flu patients in the icu with me.
By the eighth day of my stay I was the only one left. I was told by my nurse one lady was 36 years of age and the doctors delivered her baby before she died. When the two others died I remember feeling so guilty. As a nurse I was not happy being, “on the other side. ” On one particular day I heard the doctors tell my friends, “we should notify her family, there’s nothing we can do. ” The nurses gave stellar care and provided loving kindness, respect, and positive energy was all around me (CR#9). They gave me hope each day and with my faith I was determined to make it out of there.
I had so many goals in life I still wanted to accomplish, so many places to see, and many people I just wanted to say, “I love you. ” I decided right then my new short- term goal in life was to get out of that bed and live. I called my sister in Alabama, who I never talk to and with a bi-pap mask on my face under sedation I said, “ text , text, text. ” I was not sure if she had text. She said, what about nine times. My heart rate was up to 176, machines were beeping, and the nurses were running into my room as I was yelling text to my sister in the phone.
In which I felt like I had a garbage bag over my head. I was suffocating. The nurses took my cell phone. I remember talking loudly, “tell my sister, it’s [sic] my sister. ” The nurse put the bipap mask back on, threatened me with intubation and administered more sedation. I remember them telling my sister what had happened before I went off to sleep. I woke up hours later, grabbed my phone, and saw a text from Alabama. It was my sister. It said, “I called and got text [sic] is that what you were saying? The nurse told me everything (CF#6, 9). ” She texted me and it read, Call me when you can talk.
We are coming to California. My father had two cardiac stents placed the day after I went into ICU so I had asked my friends not to call home. A cardiac patient cannot fly after stent placement for a month. I also did not want to change the outcome of his health. I had several thoughts I wanted to share with her one in which I may not make it through this and what if I were actually going to die here. My nurse came in later that night and sat down on my bed. I remember wondering how she had time to talk with me when she was so busy. She said, “Tammy, you are very lucky.
How are you dealing with this situation as your family is not here? ” (Transpersonal caring relationship). We talked for an hour as she listened to my feelings of denial, anger, and thankfulness at the same time. She will probably never remember me for those few minutes, however; I will remember her for a lifetime. Conclusion In writing this continuing education paper, I could dissect Jean Watson’s theory, and the three elements that make up her human care theory. I was able to learn about her goals and how she has preserved our human caring heritage for decades.
This paper offered new knowledge and new goals for myself regarding the core of nursing. In addition, I will be able to offer my experience with this paper to my patients by providing Jean Watson’s carative factors. Nurses will continue to make contributions in health care. Studying Jean Watson’s theory assumptions related to person, health, nursing, and environment will again have much impact on the concept of self and the person which unique and able to make choices. For example, maintaining a patient’s environment whether soothing or sacred can improve healing of the mind, body, and spirit.
Embracing the carative factors of Faith-Hope, Expressing positive and negative feelings, Creative problem-solving caring process, and Human needs assistance and was able to apply those four elements mentioned in my personal reflection. The other six elements of Jean Watson’s guide of the core of nursing were also implemented in my personal experience as a patient. I was able to interact with them as the person receiving the care and to the caregiver as well who provided a perfect example of Jean Watson’s ideal nurse.
- CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April – December 12, 2009 (2010). Retrieved from http://www. cdc. gov/h1n1flu/estimates_2009_h1n1. htm
- Cara, C (2003). A pragmatic view of Jean Watson’s caring theory. International Journal for Human Caring, 7 (3), 51-61
- Favero, L. , Meier, M. , Lacerda, M. , Mazza, V. , & Kalinowski, L (2009). Jean Watson’s Theory of Human Caring: a decade of Brazilian publications [Portuguese]. Acta Paulista de Enfermagem, 22(2), 213-218.