SPRTL Care in Nsg Mar 2012

THEORIESTHEORIESIN NURSINGIN NURSING

-continuation--continuation-

Dr. Jean WatsonDr. Jean WatsonThe Power of Caring: The Power of Caring: The Power to Make a The Power to Make a

DifferenceDifference

“I emphasize that it is possible to read, study, learn about, even teach and research the caring

theory; However, to truly "get it," one has to personally experience

it; thus the model is both an invitation and an opportunity to

interact with the ideas, experiment with and grow within the philosophy, and living it out in one’s personal/professional life.” -

Jean Watson

www.watsoncaringscience.org

““Maybe this one moment, Maybe this one moment, with this one person, is the with this one person, is the very reason we’re here on very reason we’re here on

Earth at this time.”Earth at this time.”

- Jean Watson, The Caring Moment- Jean Watson, The Caring Moment

Dr. Jean Watson at a glance …Dr. Jean Watson at a glance …

““The goal of nursing is The goal of nursing is to help a person gain a to help a person gain a

higher degree of higher degree of harmony with the harmony with the

mind, body and soul.” mind, body and soul.” - Jean Watson, Nursing as Human Science and Human - Jean Watson, Nursing as Human Science and Human

CareCare

Dr. Jean Watson’s theory of caring Dr. Jean Watson’s theory of caring ……

Watson’s ConcernWatson’s ConcernDr. Jean Watson’s Dr. Jean Watson’s theorytheory

• To make known: • Inner healing process• Experiencing the person

Three major elements of her theory:

• Ten Carative Factors• The Caring Occasion / The Caring Moment• Transpersonal Caring

The Basics The Basics Dr. Jean Watson’s Dr. Jean Watson’s theorytheory

•The philosophy of caring and science examines the relatedness of everything, including: Human Science Human Caring Processes Experiences Phenomena •Watson’s 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

A Three Part A Three Part FoundationFoundation

Dr. Jean Watson’s Dr. Jean Watson’s theorytheory

According to According to Watson (2001), there Watson (2001), there are three main are three main conceptual elements conceptual elements comprising her comprising her theory:theory:

Carative FactorsCarative FactorsDr. Jean Watson’s Dr. Jean Watson’s theorytheory

•Goal was to guide the “core” of nursing•In contrast to medicine’s “curative factors”•Interdependent•Used to “honor the human dimensions of nursing’s work and the inner life world and subjective experiences of the people we serve”•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

Dr. WatsonDr. Watson

““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)” ”

NursingNursingDr. Jean Watson’s Dr. Jean Watson’s theorytheory

• 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


• Caring affects self and others Bidirectional relationship, we also benefit, learn

• The transpersonal care/transpersonal relationship is central to Watson’s theory and what she calls of nurses

A true presence Moving toward a unitary-transformative

perspective from a more general, multiple paradigm view


• Nursing’s 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 other’s 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)

• Watson’s definition of caring is often incongruent with current hospital systems and policy

Transpersonal Transpersonal Caring Caring RelationshipRelationship


• Occurs during the ‘caring event’, central to Watson’s view of nursing

• Calls the nurse to go beyond the objective, physical assessment with concern for the person’s 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”

Transpersonal Transpersonal Caring Caring RelationshipRelationship


• Goal is to protect, enhance, and preserve the person’s 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.

Dr. WatsonDr. Watson

“In a transpersonal caring relationship, a spiritual union occurs between two persons, where both are capable of transcending self, time, space, and the life history of each other.

In other words, the nurse enters into the experience (phenomenal field) of another and the other person enters into the nurse’s experience. This shared experience creates its own phenomenal field and becomes part of a larger, deeper, complex pattern of life.”

The Caritas Process:


• Caritas comes from the Latin word meaning to cherish, to appreciate, to give special attention, if not loving, attention to;

• it connotes something that is very fine, that indeed is precious Both postmodern and traditional Invites nurse to explore the intersection between personal and professional

The Caritas Process: Caritas comes from the Latin word meaning to cherish, to appreciate, to give special attention,

if not loving, attention to; it connotes something that is very fine, that

indeed is precious Both postmodern and traditional

Invites nurse to explore the intersection between personal and professional


• Caritas comes from the Latin word meaning to cherish, to appreciate, to give special attention.

• Invites nurse to explore the intersection between personal and professional

The 10 Carative The 10 Carative FactorsFactors


1. Humanistic-altruistic system of values2. Faith-hope3. Sensitivity to self and to others4. Helping-trusting, human care relationships5. Expressing positive and negative feelings 6. Creative problem solving caring processes7. Transpersonal teaching-learning8. Supportive, protective and or corrective

mental, physical, societal and spiritual environment

9. Human needs assistance10.Existential-phenomenological-spiritual forces


Consider the situation:

Mrs. Smith, a 78 year old widow, is experiencing acute onset of severe back pain

She feels panicky, depressed and confused about her ability to now manage her life

Using the basis of the 10 carative factors, what would a Watson nurse do?


RESEARCH ARTICLE: Caring for Older Adults: Practice Guided by Watson’s Caring-Healing Model

The nurse develops a sense of hope (factor 2) and trust (factor 4) through genuine caring, listening and responding to the unique seriousness of Mrs. Smith’s experience (factor 1)

Acknowledgement of Mrs. Smith’s expression of disharmony (factor 5) between her usual perceived self and this encounter

The nurse, along with family, other health professionals and community services can help Mrs. Smith meet her basic needs (factor 9) of pain management, arrangements for check ups, support with ADL’s and reconnecting with old friends.(Bernick, 2004)


Within the caring-healing model, the approach included one that attended to the interconnectiveness between Mrs. Smith’s mind-body-soul as influenced by her personal experience

Mrs. Smith’s pain was better controlled, she was able to control her fears of her life management, and was able to reintegrate her life with others and feel supported

(Bernick, 2004)


Benefits: Transferable to current practice

environments, meaning of health through the patient’s perspective, considers the complexity of each individual experience

Limitations: Time

As Jean developed her theory over time, she came to change these carative factors into clinical caritas processes.

Dr. Jean Dr. Jean Watson’sWatson’stheorytheory

THESE INCLUDED: • 1- HUMANISTIC-ALTRUISTIC SYSTEM OF

VALUES, becomes: "Practice of loving-kindness and equanimity within context of caring consciousness

• 2 - FAITH-HOPE, becomes: "Being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and one-being-cared- for”

Dr. Jean Dr. Jean Watson’sWatson’stheorytheory

• 3 - SENSITIVITY TO SELF AND TO OTHERS, becomes: "Cultivation of one's own spiritual practices and transpersonal self, going beyond ego self“

• 4- HELPING-TRUSTING, HUMAN CARING RELATIONSHIP, becomes: "Developing and sustaining a helping-trusting, authentic caring relationship"

Dr. Jean Dr. Jean Watson’sWatson’stheorytheory • 5 - EXPRESSION OF POSITIVE AND

NEGATIVE FEELINGS, becomes: "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"

• 6 - CREATIVE PROBLEM-SOLVING CARING PROCESS, becomes: "creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices"

Dr. Jean Dr. Jean Watson’sWatson’stheorytheory • 7 - TRANSPERSONAL TEACHING-LEARNING,

becomes: "Engaging in genuine teaching-learning experience that attends to unity of being and meaning attempting to stay within other's frame of reference"

• 8 - SUPPORTIVE, PROTECTIVE, AND/OR CORRECTIVE MENTAL, PHYSICAL, SOCIETAL, AND SPIRITUAL ENVIRONMENT, becomes: "Creating healing environment at all levels, (physical as well as non-physical, subtle environment of energy and consciousness, whereby wholeness, beauty, comfort, dignity, and peace are potentiated";

Dr. Jean Dr. Jean Watson’sWatson’stheorytheory • 9 - HUMAN NEEDS ASSITANCE, becomes:

"assisting with basic needs, with an intentional caring consciousness, administering ‘human care essentials', which potentiate alignment of mind-body-spirit, wholeness, and unity of being in all aspects of care"; tending to both embodied spirit and evolving spiritual emergence;

• 10 -EXISTENTIAL-PHENOMENOLOGICAL - SPIRITUAL FORCES, becomes: "opening and attending to spiritual-mysterious, and existential dimensions of one's own life-death; soul care for self and the one-being-care-for.

PurposefulPurposefulTo be intentionalTo be intentional

To pause and slow downTo pause and slow downMindfulMindful

Grounded on firm surface whileGrounded on firm surface whileFeeling the breeze and warm sunFeeling the breeze and warm sun

PresencePresenceIn a world of oneIn a world of one

Shared with anotherShared with anotherOrganizedOrganized

Creativity, context and knowledgeCreativity, context and knowledgePrimacy being carePrimacy being care

Central to allCentral to allReverence and respectReverence and respect

ConnectingConnectingListeningListening

Being understoodBeing understoodCaringCaring

SupportingSupportingHealingHealing

(Bernick, 2004)(Bernick, 2004)

Bernick, L. (2004). Caring for older adults: practice guided by Watson’s caring-healing model. Nursing Science Quarterly, 17(2), 128-134.

ReferencesReferences

SPRTL Care in Nsg Mar 2012

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