Introduction
Jean Watson’s theory of caring epitomizes paradigm shifts as healthcare systems undergo reconstitution. As a result, this theory has spurred controversy and immense debates since its instauration. It is important to note at this point that, the core purpose of nursing is to offer care and not anything short of patient care defines nursing appropriately. As nursing institutions go through administrative changes among other changes, the focus may shift from patient care to other issues, and this risks the possibility of dehumanizing patient tending. It would be risky to watch as patient caring shrivel and fade away from nursing heritage. Jean Watson probably had this worry of a fading caring heritage in the nursing profession when she joined the ‘Theory of Human Caring.’ Patient needs are in the increase and nurses face the challenge of increased workload and responsibilities (Cara, 2006). Despite these increased demands, nurses should adopt a strategy that will ensure the maintenance of professional nursing roots and values – caring.
Watson’s caring theory typifies the archetype of a paragon nurse (Cara, 2006). This theory shifts nursing from ‘a job’, to a professional entity where people enjoy what they do. By upholding Watson’s caring theory, nurses not only exercise the art of caring but also expand their actualization. This theory tries to strike a balance between the cared and the caregiver hence tackling the health issues of the two parties and offering a tributary channel for nurses to discover meaning in their exploits.
Background
Jean Watson hinges her theory of human care on caring science whereby, philosophical and ethical fundaments are part of professional nursing. This theory incorporates both science and art and offers a model that espouses liberal arts, mind-body-spirit medicine, and spirituality in the nursing profession. According to Watson (2007), trans-personal caring recognizes the oneness of life. This chain of caring emanates from an individual and moves to others, society, and eventually to the universe. Caring science studies essentially encompass reflective, objective, subjective and interpretative derivatives (Watson, 2007). Moreover, these studies embrace ontological, historical, ethical, and philosophical researches. Caring science is a growing field that has found its way into the nursing profession among other multidisciplinary fields of study.
Major Concepts in this Theory
According to Cara (2006), elements of Jean Watson’s theory on care entail three major elements, that is, creative factors, transpersonal caring relationships, and the caring moment.
Creative Factors
Watson uses causative factors as a pathfinder to the gist of nursing, which is caring. She deliberately uses the word ‘creative’ to counterpoint formal medicine’s term ‘curative.’ These creative factors seek to acknowledge human attributes of nursing, inner lives, and immanent experiences of patients (Favero, Meier, Lacerda, Mazza and Kalinowski, 2009). There are ten creative factors, which include a humanistic-selfless system of value, personal and other’s sensitivity, faith and hope, help-trust care relationship, expression of positive and negative feelings, proactive problem-solving relationship, assistance to human needs, wholesome supportive environment, experiential-philosophical-spiritual powers and transpersonal teaching and learning (Cara, 2006). However, as Watson continued to work on her theory, she premised the construct of clinical Caritas. What do they entail? Clinical Caritas incorporate greater spiritual attributes into the existing factors. This entails the development of one’s spiritual patterns that supersedes ego and opening to others with sensibility and compassionateness. It also espouses the development and sustenance of help-trust relationships between patients and nurses. According to Favero et al (2009), this new construct also contains the creation of a healing environment whereby wholeness, comfort, beauty, peace, and dignity are potential.
Transpersonal Caring Relationship
In Watson’s view, this relationship qualifies a peculiar case of human care where the line between the cared and the caregiver is very thin (Cara, 2006). The consciousness of these two people comes together in terms of experience in the past, feelings in the present, and expectations in the future. This relationship entails the entirety of human experience including feelings, spiritual beliefs, environmental considerations, and one’s perception among others. This is a two-way system whereby, the shift is not on the care alone, but also the caregiver (Favero et al, 2009). The nurse realizes his or her cognizance and veritable presence of being in a caring instance with the patient. This moment influences both the caregiver and the cared regarding the choices and actions taken within the relationship. Actions from this relationship may become part of one’s life history. A transpersonal relationship incorporates caring moments when it countenances the presence of the spirits of both parties going beyond the limits of receptiveness and trust (Pilkington, 2005).
Caring Moment
Caring occasion also known as the caring moment is the occasion where a nurse and patient associate in space and time, creating a human caring moment (Watson, 2007). Regardless of the differences between these two people, they form a human-to-human relationship. This relationship borrows heavily from creative factors that define this stage.
The first creative factor here is sensitivity to self and others. In this context, a nurse’s moral commitment is towards protecting the patient and upholding human self-worth. The nurse’s caring cognizance is geared towards preserving honor thus preventing the reduction of the patient’s status to a moral position of an object (Favero et al, 2009). Due to sensitivity to self and others, a nurse seeks to identify with the patient and offers the best to take care of the patient’s needs. This drives the nurse’s caring consciousness to connect him or her with the patient’s needs including spiritual, psychological, and physical among others. The other creative aspect here is the help-trust human care relationship. According to Favero et al (2009), forming trust between a patient and a caregiver (nurse) is the first fundamental step inefficient care provision. A caring moment here means going beyond ego to identify with the needs of a patient and it becomes important for a nurse to create this relationship with the patient.
The third creative factor is the confirmative, corrective, and protective mental, societal, physical, and spiritual environment. From Watson’s point of view, a person consists of three dimensions namely: body-mind, and spirit (Pilkington, 2005). This implies that the person-in-the-world cannot be complete without one’s environment, which may imply culture, family, community among others. This definition emphasizes the connection between oneself and the environment. Watson (2007) posits that the healing environment can stretch a patient’s consciousness and elevate mind-body wholeness thus promoting the healing process. This calls for making the patient’s room more consoling, sanative, and sanctified.
The fourth and final creative factor employed here is human need assistance. Watson’s theory seeks to create an interpersonal relationship that would go beyond conventional caring. For instance, a nurse may seek to know about a patient’s goals and expectations in life. There should be space to allow patients to share their dreams and objectives even fantasies in life. This creates a warm environment that would enhance healing. Cara (2006) posits that these deeper connections bring comfort and healing to the sick. The ultimate purpose of a caring moment is to conform to the need of protecting, preserving, sustaining, and uphold one’s gravitas, wholeness, humanity, and inner concordance.
Application of this Theory to Caring Moment
In January 2009, I am deputed to care for Mrs. Randy, an old woman poised to undergo 3rd amputation. The last amputation did not heal decently and this time around she has to undergo left knee amputation. We have known each other for I met her during past hospitalizations and have always liked her. The moment we met, we connected immediately and she shared a lot about her past, making me know her at a personal level. As I welcome her, she realizes me and gives a fading smile and immediately an urge to tend her grips me from within. I apply my creativity (the art part of nursing) and ask her how she has been doing and whether she remembered to take drugs appropriately. She answers that she has been fine and immediately seeks to know how I have been doing too. In a retrospect, she calls me her nurse. At this moment, I realize that I am not just ‘another nurse’ but also ‘her nurse.’ She appreciates that I have come to take care of her once more. This gives my job meaning and I feel satisfied that someone is benefiting from my services.
Although I can sense depression in her sound, I do not make any assumptions; instead, I offer to discuss her perceptions and feelings about this experience. As we enter the room, I arrange it to make her comfortable and at peace. Meanwhile, she talks about her hospitalization and tells me that she want to be home for Easter because her three grandchildren are visiting. I assure her that we are going to plan the hospitalization according to her schedule. I know that her involvement will speed up her recovery. Then unexpectedly, she breaks a bombshell. She asks me if I think this surgery will be successful or it is a waste of resources. She adds that, before amputation, people respected her but they no longer do that given her situation. I realize the significance of Watson’s caring principles about upholding and honoring human dignity. This throws in another Watson’s caring principle; people are connected to their environment. I cannot believe that people make decisions based on what they can see. Watson’s principle of spiritual connectedness resonates well here. I tell her that I will be back in a moment and believing that I will be back, she appreciates my help with another fading smile. As I leave I feel vulnerable, I want to help Mrs. Randy to recover from her situation.
Reflection
I realize that I am vulnerable but this reminds me that Watson concurs that, the vulnerability enables us not to reduce people’s status to mere objects hence, dehumanizing human care. Mrs. Randy perceived by caring well. Given the fact that we have been together in past, we relate well. She opens up to me as I open up to her. We create a rapport that I believe has become part of my life history. As I leave the unit, she smiles and I see the trust on her face that I will return. However, how I wish I could become more creative and give more hope and faith to this woman.
Assumptions in Context of Caring Moment
Watson assumes that caring is based on systems and ethics of relationship and consciousness and relationship and connectedness (Cara, 2006). According to Watson (2007), within the caring moment, caring consciousness becomes elementary. This assumption is in line with what happens in nursing. Nursing is a vocation and this factor qualifies this assumption. However, in some instances, people may take up nursing because of pressures from parents, and this assumption may not be true in such cases.
The other assumption that, is Caritas like cognizant, motives and values define and guide caring. This premise ties well with the first one. Watson assumes that soul care for both cared and caregiver results from a caring relationship. This assumption may be ideal and relates well with the clinical application given above. The other assumption is that a caring relationship upholds human dignity and integrity and brings about self-healing. This is true in part but may not apply in all caring instances. Given the fact that people are different and react differently, it would be difficult to say that these assumptions apply in all caring moments.
Conclusion
Jean Watson’s theory of human caring typifies a paradigm shift towards the provision of better caring services. The core of nursing is to care and Jean Watson’s theory offers nurses an opportunity to make their profession more gratifying. Based on caring science prospects, Watson presents nursing as an art and science whereby creativity meets research work to come up with an enthralling profession where one actualizes himself or herself. Interestingly, from the caring relationship developed between a patient and a nurse, life histories are made as people get to know each other during the caring moment.
References List
Cara, C. (2006). A Pragmatic View of Jean Watson’s Caring Theory. Web.
Favero, L., Meier, M., Lacerda, M., Mazza, V., & Kalinowski, L. (2009). Jean Watson’s Theory of Human Caring: a Decade of Brazilian Publications.
Pilkington, F. (2005). The Concept of Intentionality in Human Science Nursing Theories. Nursing Science Quarterly.
Watson, J. (2007). Jeans Watson’s Theory of Human Caring. University of Colorado Denver College of Nursing.