Introduction
To understand nurses’ approaches to work, it is critical to analyze the philosophical considerations that inform these specialists’ decision-making in both work-related and educational contexts. This essay is aimed at explaining the theory that underpins my professional practice with patients in intensive care units and emergency departments. The paper is focused on the human science ontological tradition and its connections with Jean Watson’s theory of human caring.
Watson’s Theory and Professional Experience
The theory that explains the essence of nursing care in a way that aligns with my personal values and attitudes to patients is the theory of human caring proposed by Jean Watson. This theorist’s claims concerning the need to go beyond the scientific approach and support patients through the development of personal connections always inspired me (Cook & Peden, 2017). The decision to select this theory is linked to the fact that I have managed to fully understand the benefits of this approach to care when working with older adults in the intensive care unit. Since many geriatric patients have complex psychological needs apart from medical issues, seeing caring “as a moral ideal” helps me to focus on clients’ unobvious care needs that may relate to their life circumstances (Cook & Peden, 2017, p. 16). I have heard about the selected theory even before the start of my experience with patients, but it was the period of my theoretical training when I explored Watson’s views more thoroughly.
Objective/Subjective Recall
My practical experience with the theory of human caring involves attempts to develop trust-based relationships with patients to make them feel safe and welcome to express their concerns. During my work at the ICU, there was an interesting case when I applied it to manage the care needs of a lonely senior abandoned by her children and grandchildren. The situation involved me, the patient, and other nurses who had cared for the woman before. The patient’s condition required close monitoring since she had spine trauma and heart disease.
When visiting the patient, I noticed that she was extremely upset. I asked the woman about her mental condition, trying to lift her spirits. Sometimes, such interviews help to identify the causes of abuse (Registered Nurses’ Association of Ontario, n.d.). To my surprise, she burst into tears and explained that everyone focused too much on her physical condition, whereas she had severe emotional pain because of her lonely life. I tried to make use of emotional intelligence, listened to the woman’s short monologue about her life, and inspired her by referring to recent improvements in her condition, thus implementing Watson’s first, second, and fourth creative factors (Ozan, Okumus, & Lash, 2015). That conversation calmed the woman down, allowing me to observe interactions and links between the provision of holistic care and patient well-being.
To maximize benefits for healthcare consumers, the use of the creative factors should be individualized and tailored to clients’ cultural and spiritual characteristics. As an example, the understanding of privacy varies depending on the culture, and some patients may recognize increased attention to their inner experiences as attempts to cross their personal boundaries. At the same time, maintaining professional boundaries is critically important (College of Nurses of Ontario, 2019). Also, Watson’s theory seeks to ensure “the harmony between health and illness experiences of a person” (Ozan et al., 2015, p. 26). To provide holistic care and promote health, it is critical to understand a client’s illness and the degree to which body-, spirit-, and mind-related factors contribute to it.
The subjective experiences associated with the case helped me to solidify personal beliefs and professional values associated with caring. During my conversation with the patient, I was thinking about people’s psychological needs that do not become secondary even in the presence of life-threatening conditions. The patient’s positive reaction to my questions filled me with a sense of relief, and I intuitively felt that the opportunity to express concerns was helpful to her and could give her hope. My values associated with the mentioned event are patient-centered care, human relationships, and support. Specifically, the need to adhere to them arises when I work with clients that experience psychological stress apart from physical illnesses since they require holistic care to recover.
Analysis, Revision, and New Perspectives
With its focus on subjective experiences and relationships, my theoretical framework does not have obvious connections with the post-positivist school of thought. The latter is associated with reliance on logical reasoning and the accuracy of knowledge (Clark, 1998).
As a professional, I value evidence and precision in medical recommendations, but nursing care is much more complex than achieving health improvement at the physical level. The critical theory involves mediating between subjectivism and objectivism to produce meaningful knowledge, whereas the theory of human caring that underpins my practice relies on abstract, subjective, and non-measurable concepts, such as love and compassion (Cook & Peden, 2017; Mill, Allen, & Morrow, 2001). Contrary to the basic assumptions of the critical theory, my approach to fulfilling my primary responsibilities is based on developing meaningful and productive relationships with clients, but the success of this process is usually dependent on subjective factors, including mood, emotional state, and so on.
According to the complexity ontological perspective, knowledge is produced when systems are studied with attention to complexity and diversity. This approach helps to achieve this goal instead of overemphasizing the role of particular components (Thompson, Fazio, Kustra, Patrick, & Stanley, 2016). I would accept this position when studying care at the systems level, but in the case of nurse-patient relationships, it would probably make the process of research overcomplicated and unfocused. Watson’s theory that I support also contains the elements of systems thinking since a human being is believed to be greater than the sum of his/her parts (Ozan et al., 2015).
At the same time, it is still oriented toward understanding human beings and the meaning of holistic care.
The ontological approach that accurately describes the selected theoretical framework is a human science. According to the founders of this school of thought, human beings present the sources of knowledge in themselves, which does not allow studying their experiences with the help of natural science methods (Mitchell & Cody, 1992). Both Watson’s theory and my understanding of the art of caring align with the human science approach due to the recognition of people as a whole and free-willed beings whose lived experience is critically important (Mitchell & Cody, 1992).
As for the key issues and reinterpretation, when an analysis lens is applied, contradictions between Watson’s definitions of free will and the way it is understood in the human science approach become obvious, which has implications for the practical case. In Watson’s theory, the nurse is allowed to “correct” the patient’s condition to achieve harmony, and the patient’s involvement in decision-making is desirable, not obligatory (Mitchell & Cody, 1992). Such points limit the patient’s free will, thus running counter to the principles of the human science approach (Mitchell & Cody, 1992). As far as I can remember, this issue was present in the practical case discussed earlier since I focused on distracting the client from her negative thoughts instead of enabling her to exercise her freedom of expression.
Based on the new knowledge, to make sure that the patient’s autonomy is never compromised, I may need to improve the use of the fifth carative process (expression of feelings). For instance, it can be done by encouraging clients to behave openly and share their worst thoughts if they feel that it can be helpful. Because of their effectiveness and connections with the human science approach, other caring practices, including the recognition of patients’ wholeness and paying attention to their experiences, are to be preserved (Mitchell & Cody, 1992). To preserve them, it is critical to practice a patient-centered approach and encourage all clients to enjoy their decision-making power.
Overall, the recommendations include continuing the use of the patient-centered approach to care and enabling patients to exercise their free will through the expression of both positive and negative emotions. My understanding of myself as a nurse has been affirmed since the way that I communicate with clients who have complex needs aligns with the human science approach that I value. The positive outcomes of practicing holistic and patient-centered care and its links to the human science tradition also confirm my practice context, but I am still going to improve skills linked to some aspects of communication with patients.
Conclusion
To sum it up, Watson’s theory of human caring that I value aligns with the human science tradition. As a professional, I have experienced the benefits of this ontological approach by focusing on my client’s unique experiences and concerns to improve care. However, as certain weaknesses have been identified, I am planning to polish my communication skills to enhance patients’ free will when working with individuals and their families and collaborate with peers.
References
Clark, A. M. (1998). The qualitative-quantitative debate: Moving from positivism and confrontation to post-positivism and reconciliation. Journal of Advanced Nursing, 27(6), 1242-1249.
College of Nurses of Ontario. (2019). Practice standard: Code of conduct. Toronto, ON: CNO. Web.
Cook, L. B., & Peden, A. (2017). Finding a focus for nursing: The caring concept. Advances in Nursing Science, 40(1), 12-23.
Mill, J. E., Allen, M. N., & Morrow, R. A. (2001). Critical theory: Critical methodology to disciplinary foundations in nursing. Canadian Journal of Nursing Research Archive, 33(2), 109-127.
Mitchell, G. J., & Cody, W. K. (1992). Nursing knowledge and human science: Ontological and epistemological considerations. Nursing Science Quarterly, 5(2), 54-61.
Ozan, Y. D., Okumus, H., & Lash, A. A. (2015). Implementation of Watson’s theory of human caring: A case study. International Journal of Caring Sciences, 8(1), 25-35.
Registered Nurses’ Association of Ontario. (n.d.). Addressing abuse of older adults ? An RNAO initiative. Web.
Thompson, D. S., Fazio, X., Kustra, E., Patrick, L., & Stanley, D. (2016). Scoping review of complexity theory in health services research. BMC Health Services Research, 16(1), 1-16.