Theory of Human Caring - Essay Example

?Watson's Theory of Human Caring: Reflective Essay Introduction All over the world, several health care systems are restructured and this has increased the risk of dehumanisation of care of patients (Cara, 2003). Hence, appropriate nursing care is possible only through deliberate and conscious efforts on the part of of nurses to not only enhance, but also preserve human caring in various clinical practice areas. Several caring theories have been developed to enhance and preserve caring; some of which are Watson's theory, Leininger's Theory, Roach's theory and Boykin's theory. Watson theory, proposed by Jean Watson, is basically philosophy of caring and science and examines relatedness of various aspects of nursing like human science, human experiences, human caring, phenomena and human processes. According to Watson (2009), "nursing is a lifetime journey of caring and healing, seeking to understand and preserve the wholeness of human existence, and to offer compassionate, informed, knowledgeable human caring to society and humankind." Thus, nurses play an important role in the healing of human suffering. In this essay, role of Watson's theory in caring of patients in nursing profession will be discussed through review of a particular case and reflection. Case scenario 55 year James was transferred to the neurology ward from neurosurgical ICU to which he was admitted one week ago with right sided hemiplegia following stroke. Besides right sided hemiplegia, the patient had bladder and bowel incontinence, pneumonia and depression. I was one of the nurses assigned to take care of the patient. The patient stayed in the stroke rehabilitation ward for 4 weeks. During the first week in the ward, I found James to be depressed and frustrated. His only family member with him was his wife. I found out from the couple that they had 2 sons, who were married and stayed in different countries. They had not come down because the parents did not want to trouble them and hence did not deliver proper information. During my sessions of nursing care I convinced the patient that their sons be asked to come down as it would make the patient feel a lot better. I finally managed to convince them to do so in the second week and when their sons came down, the patient was a lot better psychologically. The patient was a spiritual person and believed in Christianity. He missed attending church regularly. I allowed him to offer prayers by arranging a father to meet him every week. This uplifted the psychological and spiritual morale of the patient. As he improved, I asked his wife and sons to contact a few friends of James and asked them to meet him in the rehabilitation center. James was very much upset about his physical deficiencies because of stroke, especially the bowel and bladder incontinence. I instilled lot of confidence and hope in the patient and told him that recovery occurs with good positive outlook and physiotherapy. The patient got discharged after 4 weeks. When he came for review after 4 weeks of discharge, he was a lot more improved physically and psychologically and confident person. Jean Watson and her theory Jean Watson, an eminent nurse educator and theorist has contributed significantly to the profession of nursing through her famous theory, the Theory of Transpersonal Caring, which is also known as the Theory of Human Caring. Watson was born in West Virginia and is currently settled in Colarado (Cara, 2003). She graduated from the University of Colarado and did her Master's degree in psychiatric-mental health nursing (Cara, 2003). She further achieved Ph.D degree in psychology and counseling. She is the founder of the Center for Human Caring located in Colarado and is currently a distinguished professor at the University of Colarado (Cara, 2003). The theory was developed by the nursing scholar based on her experiences in the field of mental health, psychology and counseling. This theory is very important for the nursing profession because it emphasizes the role of humanistic perspective of profession based on appropriate scientific knowledge that is acquired through education and training. An understanding of such nursing theory is critical for the practice of nursing so that the nurse can apply the knowledge base of the theory not only in practice but also in nursing research. According to Watson (2009), "the ability to resolve conflicts between what nursing is and what nurses supposedly do, may be the most critical challenge for the discipline and for the profession’s survival into this millennium." It is critical to resolve conflicts because they can affect health care at all levels of society. Jean Watson developed the Theory of Human Caring in the year 1979 (Cara, 2003). Watson considered nursing as a profession distinct from other health professions and through this theory she ascertained and projected the distinct roles of the noble profession. She described the role of a nurse through this theory. According to the theory, nurses have a role in establishing a good caring relationship with the patients and their relatives (Sitzman, 2007). They have to treat patients is a holistic manner handling issues of all the 3 aspects of human being, namely. mind, body and spirit and not just take care of the physical aspects of health. Nurses must display acceptance that is unconditional in nature and treatment of patients must be instituted with positivism. Nurses must cause promotion of health and well-being of their patients through appropriate knowledge and medical interventions. Above all, the care to the patient must be provided in an uninterrupted manner. Watson's theory specially enhances the importance and gravity of moments of caring spent with the patient by the nurse. The first and foremost interaction in any caring moment in the contact between the patient and the nurse (Cara, 2003). At the time when the nurse enters the room of the patient there is creation of feeling of expectation and thereafter the interaction between the nurse and patient progresses based on the competence and attitude of the nurse (Cara, 2003). The end result of the interaction can be rich or dull, secure or threatening, bright or drab and large or small. And from here on, the journey of relationship between the nurse and patient starts. The theory of Watson becomes essential in the wake of "a culture which has lost its way: a culture void of humanity and authentic human caring relationships, and void of meaningful communication and connections" (Watson, 2009) which have paved the way for "even more safety violations and increases in medical errors" (Watson, 2009). Principles of Watson's theory Watson's theory proposes that caring is a moral ideal involving mind, body and soul without separating them. Originally, the theory of Watson consisted of 10 carative factors (Cara, 2003). The ten factors were "formation of a humanistic-altruistic system of values, instillation of faith-hope, cultivation of sensitivity to one's self and to others, development of help-trusting, human caring relationship, provision for a supportive, protective, and/or corrective mental, physical, societal and spiritual environment, assisstance with gratification of human needs and allowance for existential-phenomenological-spiritual forces" (Chinn and Krammer, 2008). The ten carative factors were developed by "structuring a number of beliefs, concepts, a body of knowledge, and principles, all foundational to human behavior in health and illness, from a metaphysical, phenomenological, existential and spiritual orientation that draws on eastern philosophy" (Sourial, 1996). Evolution of the theory over many years has caused replacement of these carative factors into a caritas process (Chinn and Krammer, 2008). Thus, the principles which evolved from the caring process were “practice of love-kindness and equanimity within context of caring consciousness, being authentically present, and enabling an sustaining the deep belief system and subjective life world of self and one-being-cared for, cultivation of one's own spiritual practices and transpersonal self, going beyond ego self, developing and sustaining a help-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, engaging in genuine teaching-learning experience that attends to unity of being and meaning attempting to stay within others frame of reference, creating healing environment at all levels- be it physical, non-physical, subtle environment of energy, consciousness, whereby wholeness, beauty, comfort, dignity and peace; 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; opening and attending to spiritual-mysterious, and existential dimensions of one's own life-death; soul care for self and the one-being-cared-for” (Chinn and Krammer, 2008). Reflection on application of Watson's theory Reflection is the process by which a person evaluates and examines one's own thoughts and actions. Reflective practice is very essential for nursing clinical practice because it helps the nurse to understand, assess and learn through the experiences during clinical practice (Burns and Grove, 2005). On reflection on this incident, it is clear that Watson's theory of nursing has been applied effectively to enhance human caring. The carative factors which were used for nursing are cultivation of sensitivity to one's self and to others, intillation of hope, human caring relationship and provision for a supportive and spiritual environment. I developed a sense of empathy and listened patiently to James because I cultivated sensitivity to the patient. I developed a strong trust worthy and human caring relationship with the patient and convinced him to take help of his sons and friends. Thus, social environment was created for the patient to thrive and heal. I allowed spritual environment that was satisfiable to the patient by allowng him to offer prayers through a father. The main assumptions of Watson's theory are that effective practice and demonstration of care can be done only interpersonally and that caring mainly involves several caring factors as illustrated above. The end result of effective caring is satisfaction of various human needs and such a satisfaction ensues in the promotion of health and growth of family (Cara, 2003). Also, the responses of caring are such that a person is accepted as of how he is now and as of how he may become in future. An environment becomes caring when there is scope for development of one's potential in coherence with allowing the individual to act in his best manner at a given point of time and place (Cara, 2003). Watson's theory also indicated that caring is what that improves health than just curing the patient of illness and that caring is the crux and cornerstone of the profession of nursing. Watson's theory has an important place in the practice of nursing because of its caring concept. Watson's theory is basically based on various phenomenological studies that have a questioning attitudes and the intention of the studies are analysis and understanding. Watson's theory is useful in the guidance and practice of nursing and emphasizes humanistic approach of care of patients. The theory provides the nurse with satisfaction in practice and assists in provision of holistic care to the patient. The work of Watson is supported by innumerous numbers of developmentalists, psychologists, humanists and philosophers. The theory is is based on various theories of development, humanistic psychology, existential phenomenology, teaching-learning and communication. The theory enables soul-satisfying care. It concentrates mainly on nurse-patient interaction and the ultimate aim is quality of life of the client. The theory is however impractical in acute care setting. The theory of Watson becomes essential in the wake of "a culture which has lost its way: a culture void of humanity and authentic human caring relationships, and void of meaningful communication and connections" (Watson, 2009) which have paved the way for "even more safety violations and increases in medical errors" (Watson, 2009). Critical view of Watson's theory Watson's theory is mainly criticized for the complexity and sophistication of language and that fact that the principles are drawn from various aspects of arts (Sourial, 1996). Also, the theory is a general one because it covers all aspects of health and illness and accessibility of the theory is difficult. Critics often view Watson's theory as a complicated theory with difficult terminologies, phrases and concepts. Also, some concepts are better defined than others (Sourial, 1996). Another important defect noted in the theory is the interchangeable usage of words (Sourial, 1996). All these lead to confusion and mislead the reader, and make the understanding of the theory a tedious process (Sourial, 1996). The predictive power of the theory is weak (Sourial, 1996). Also, during an actual caring occasion, even when there is human care process, it is not necessary that intersubjective caring will occur and even such a caring occurs, harmony and healing may not be the end result. Thus Watson's theory fails in meeting goals despite applying it (Sourial, 1996). However Watson (1989, cited in Sourial, 1996) explained this as "the process allows for combinations of expressions of human caring in different moments and contexts, and with different outcomes, that can never be fully explained or predicted." Conclusion Jean Watson developed the Theory of Human Caring in the year 1979 and since then it has been modified regularly. Initially the fundamentals of the theory were based on 10 carative factors which were later modified into 10 caring process. The need to deploy Watson's theory in nursing practice sessions and actions arises because of the changing structure of health care in which care is not given preference, thus affecting health care delivery. Watson's theory emphasizes on delivery of deliberate, willful and conscious care by the nurse, thus triggering a positive nurse-patient interaction resulting in optimal health outcome. The theory by Watson has many benefits. However, the complexity of language, inconsistency in definitions and complex and incoherent concepts have lead to confusion of the readers. Despite all this criticism, Watson's theory has an important place in the care of patients and when applied, leads to soul-satisfying patient care. References Burns, N., and Grove, S. K.. (2005). The Practice of Nursing Research: Conduct, Critique and Utilisation, 3rd ed.. Philadelphia: W. B. Saunders Co. Cara, C. (2003). A Pragmatic View of Jean Watson's Caring Theory. International Journal of Human Caring, 7(3), 51- 59. Chinn, P.L., and Krammer, M.K. (2008). Theory and Nursing: Integrated Knowledge Development (7th Edition), St.Lois, MO: Mosby. Sitzman, K.L. (2007). Teaching-Learning Professional Caring, International Journal of Human Caring, 11(4), 8-15. Sourial, S. (1996). An analysis and evaluation of Watson's theory of human care. Journal of Advanced Nursing, 24, 400- 404. Watson, J. (2009). Caring Science and Human Caring Theory: Transforming Personal and professional Practices of Nursing and Health Care. JHHSA Spring, 466-481. Read More