jean watson

• 1.Jean Watsons Caring Science and Human Caring Theory
  Emily Becker
  Laura Dryjanski
  Kristen Neigebauer
  

2. A Brief Background
The Theory of Human Caring was developed between 1975 and 1979, first published in 1979
According to Watson, It was my initial attempt to bring meaning and focus to nursing as an emerging discipline and distinct health profession [] (Parker, 2001)
[] I tried to make explicit that nursings values, knowledge, and practices of human caring were geared toward subjective inner healing processes and the life world of the experiencing person, requiring unique caring-healing arts and a framework called carative factors which complemented conventional medicine but stood in stark contrast to curative factors (Parker, 2001)
3. The Basics
The philosophy of caring and science examines the relatedness of everything, including:
Human Science
Human Caring Processes
Experiences
Phenomena
Watsons Caring Science and Human Caring Theory blends the sciences and humanities
Watson likes to cite Eastern Philosophy and the foundations of Buddhism
Focus on holism
4. A Three Part Foundation
According to Watson (2001), there are three main conceptual elements comprising her theory:
1.) The Carative Factors/Caritas Process
2.) The development and utilization of the transpersonal caring relationship
3.) The caring occasion or caring event
5. Carative Factors
Goal was to guide the core of nursing
In contrast to medicines curative factors
Interdependent
Used to honor the human dimensions of nursings work and the inner life world and subjective experiences of the people we serve (Watson,2007)
First three factors are the philosophical foundation for the science of caring
The final seven build upon these
Transitioned to the caritas processes, expanding on the original factors
6. It is when we include caring and love in our work and our life that we discover and affirm that nursing, like teaching, is more than just a job; it is also a life-giving and life-receiving career for a lifetime of growth and learning (Parker, 2001).
7. Original 10 Carative Factors
Formation of a humanistic-altruistic system of values
Instillation of faith-hope
Cultivation of sensitivity to ones self and to others
Development of a helping-trusting, human caring relationship
Promotion and acceptance of the expression of positive and negative feelings (Watson, 1985)
8. Carative Factors Continued
Systematic use of a creative problem-solving caring 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, 1985)
9. Moving Forward
As Watson continued her work, the 10 Carative Factors transitioned to the 10 Caritas Processes
Caritas meaning to cherish (Greek)
The processes allow for the intersecting of the personal and professional aspects of nursing care
Gives us clues as to who/what Watson views as the person, health, environment, and nursing
10. 10 Caritas Processes
Practice of loving kindness and equanimity within the context of caring consciousness
Being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and one-being-cared-for
Cultivation of ones own spiritual practices and transpersonal self, going beyond ego self, opening to others with sensitivity and compassion (Parker, 2001)
11. 10 Caritas Processes Continued
Developing and sustaining a helping-trusting, authentic caring relationship
Being 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
Creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices (Parker, 2001)
12. 10 Caritas Processes Continued
Engaging in genuine teaching-learning experience that attends to unity of being and meaning, attempting to stay within others frames of reference
Creating healing environment at all levels
Assisting with basic needs, with an intentional caring consciousness, administering human care essentials, which potentiate alignment of mindybodyspirit, wholeness, and unity of being in all aspects of care, tending to both embodied spirit and evolving spiritual emergence (Parker, 2001)
13. 10 Caritas Processes Continued
Opening and attending to spiritual-mysterious, and existential dimensions of ones own life-death; soul care for self and the one-being-cared-for (Parker, 2001)
14. The Person
A complex, holistic being; an evolving soul
People have value, meaning
Not an object, and cannot be separated from self, other, nature, or the larger universe
Impacted and influence by the surrounding environment
A human being has complex needs including physical, psychological, psychosocial
A person is to be cared for, nurtured, and both valued and respected
15. The Person Continued
Comprise of three spheres of being: mind, body, and spirit
[] a valued person in and of him or herself is to be cared for, respected, nurtured, understood, and assisted; in general a philosophical view of a person as a fully functional integrated self.He, human is viewed as greater than and different from the sum of his or her parts (Watson, 1985)
The core of human caring theory is about human caring relationships and the deeply human experiences of life itself, not just health-illness phenomena, as traditionally defined within medicine (Fawcett, 2002).
16. The Environment
Driven by Curative Factors/ Caritas Process 8 and 9
Should be conducive to holistic healing
Designed to be comfortable, not the typical hospital environment
An open system containing both internal (mental, spiritual, and cultural) and external (physical, environmental, and safety) variables that we as caregivers can manipulate
Can serve to expand the persons awareness and consciousness, to promote mind-body-spirit healing, wholeness, and well-being (Watson, 1999)
Is comprised of[] noise, privacy, light, access to nature, color, space and smells that can have an impact on the caring-healing process (Watson, 1999)
17. Environment Continued
The person is split apart and the soul is replaced with narcissism of self or denied all together.The human soul is further destroyed with a depersonalized, manmade environment, advanced technology, and robot treatment for cure, delivered by strangers in a strange environment (Watson, 1988)
The typically employed medical model reduces humans to body systems, individual cells or atoms, in order to treat and cure
Calls for a balance between the high tech environments of the typical hospital setting with a high touch environment
To [] transform the environment into one in which healing can occur (Ryan, 2005)
18. Health
Holistic- When the human being is considered from a holistic perspective, health implies harmony and balance among the various dimensions of human experience- physical, emotional, mental, spiritual, and so on (Parker, 2001)
defined as a high level of overall physical, mental, spiritual, and social well-being and functioning
Can be defined as the absence of illness, but health can be obtained even when physical wholeness cannot be obtained
Adaptive-maintenance in daily functions, harmony
19. Nursing
Driven by most Curative Factors/ Caritas Process
This caring science seeks to honor the depth, humility, connection, compassion, responsibility, and concern for human welfare and optimal human development/evolution (Watson, 2008)
Watson defines as A human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human transactions (Watson, 1985)
[] being present, attentive, conscious, and intentional as the nurse works with another person (Fawcett, 2002)
Nurses and practitioners who are literate with caring relationships are capable of having loving, caring, kind, and sensitively meaningful, personal connections with an increasingly enlightened public: a public seeking wholeness and spiritual connections for their wellbeing, not just sterile, depersonalized medical technological interventions, void of human-to-human caring relationships (Watson, 2009)
Comprised of loving kindness, caring, compassion, gentleness, calmness, wholeness/healing
Occurs during the caring event
20. Nursing Continued
Starts with an authentic presence
Connection with another person
A spiritual practice, a calling
Both a science and an art
Acknowledges science, art, intuitive, cultural, and spiritual knowledge
Like Carper, also acknowledges and places high value on aesthetic, ethical, and personal ways of knowing
Caring is just as valuable and essential to our patients as curing
Nursing is complimentary to curing
You can have caring without curing, but you cannot have true curing without caring
21. Nursing Continued
Caringaffects self and others
Bidirectional relationship, we also benefit, learn
The transpersonal care/transpersonal relationship is central to Watsons theory and what she calls of nurses
A true presence
Moving toward a unitary-transformative perspective from a more general, multiple paradigm view
22. Nursing Continued
Nursings tasks according to Watson
Healing our relationship with self and other/s, and our place in the wider universe;
Finding meaning in our own life and health-illness concerns, as we re-awaken to our profound compassionate, caring and healing service in the world;
Understanding and transforming our own and others suffering;
Deepening our understanding and acceptance of impermanence, the expanding-contracting of all life cycles (birthing-dying/the dark and light), including preparing for our own death (Watson, 2002)
Watons definition of caring is often incongruent with current hospital systems and policy
23. The Transpersonal Caring Relationship
Occurs during the caring event, central to Watsons view of nursing
Calls the nurse to go beyond the objective, physical assessment with concern for the persons deeper, subjective well-being
The nurse [] seeks to connect with and embrace the spirit or soul of the other, through the process of caring and healing and being in authentic relation, in the moment (Parker, 2001)
Goal is to protect, enhance, and preserve the persons dignity, humanity, wholeness, inner harmony, and overall well-being
Can be nurtured by movements, gestures, facial and bodily expressions, the sharing of information, touch, sound, etc.
24. The Caring Event
Two persons (nurse and other) together with their unique life histories and phenomenal field in human care transaction comprise an event (Watson, 1985)
An event, such as an actual occasion of human care, is a focal point in space and time from which experience and perception are taking place, but the actual occasion of caring has a field of its own that is greater than the occasion itself (Watson 1985)
Implementation of nursing actions
Every encounter has the opportunity to be a caring occasion
25. Implications for Nursing Practice
Need for an extensive understanding and appreciation of the caritas process
Very complex, can be difficult to understand
No defined parameters
Reality:
Nurses generally like her theory, emphasis on care and compassion
Values aspects of nursing central to why nurses become nurses and not doctors
How realistic is the implementation of this theory in current practice with constrains such as
Working conditions that inhabit caring are lack of accountability for nurses, poor staffing, unreasonable workloads, and poor patient care (Quinn et al 2003)
26. Implications for Nursing Practice Continued
Person:
Our healthcare system acknowledges that humans are holistic beings, but often treats them more as objects
Environment:
Sterile, non-home-like, not conducive to healing
27. Implications for Nursing Continued
Health:
Generally accepted as overall physical, emotional, psychosocial, psychological, etc.
Implementing practices to better achieve this
Ex: Child Life, complimentary medicine, music therapy
Still falling short, placed on back burner, first to be forgotten
Nursing:
Congruent with how most nurses feel about nursing care
Grounded in the discipline of nursing and nursing science
Incongruent with current institution standards, policy, and how nursing is actually implemented
28. Discussion of Implications for Nursing
29. References
Bevis, E. O., & Watson, J. (1989).Toward a caring curriculum: a new pedagogy for nursing.New York, New York: National League for Nursing Press.
Fawcett, J. (2002) The nurse theorists: 21st century updates- Jean Watson.Nursing Science Quarterly, 15(3), 214-219)
Parker, M. E. (2001).Nursing theories and nursing practice.Philadelphia, PA: F. A. Davis Company.
Quinn, J., Smith, M., Swanson, K., Ritenbaugh, C., Swanson, K., & Watson, J. (2003) Research guidelines for assessing the impact of the healing relationship in clinical nursing.Alternative Therapies, 9(3). A65-A79.
Ryan, L. (2005).The journey to integrate Watsons Caring Theory with clinical practice.International Journal of Human Caring, 9(3), 26-30.
Watson, J. (1979). Nursing: The philosophy and science of caring. Boston: Little Brown.
Watson, J. (1985). Nursing: Human Science and Human Care. Connecticut, USA: Appleton-Century-Crofts.
Watson, J. (1997). The theory of human caring: Retrospective and prospective. Nursing ScienceQuarterly, 10(1), 49-52.
Watson, J. (1999). Postmodern nursing and beyond. Toronto, Canada: Churchill Livingstone.
Watson, J. (2000). Via negativa: Considering caring by way of non-caring. The Australian Journal of Holistic Nursing, 7(1), 4-8.
Watson, J. (2001). Jean Watson: Theory of human caring. In M.E. Parker (Ed.), Nursing theories and nursing practice (pp. 343-354). Philadelphia: Davis.
Watson, J. (2002). Guest editorial: Nursing: Seeking its source and survival.ICU NURS WEBJ Issue 9, pp 1-7 Spring.