Theory of Human Caring by Jean Watson - Research Paper Example

Theory of Human Caring by Jean Watson Several health care systems all over the world have undergone restructuring and this has lead to dehumanization of patient care in several situations (Cara, 2003). From this point it is evident that caring, which is the core principle of nursing is possible only by conscious effort by the nursing staff to not only preserve, but also enhance caring through various aspects of professional and nursing practice. It would be appropriate to say that the profession of nursing has escalated to the present level because of immense contributions from several nursing theorists. One such theorist is Jean Watson who developed and conceptualized the "Theory of Human Caring". 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." In this essay, application of Watson's theory to clinical nursing practice will be exercised for better understanding of the concepts of the theory. Context of development of theory Jean Watson, an imminent theorist and nurse educator has contributed immensely to the nursing profession. Her most popular conceptualization of nursing profession is the Theory of Transpersonal Caring which is commonly known as the Theory of Human Caring. The nurse educator was born in West Virginia. She graduated from the Colarado University and completed Master's degree from the same University. Her specialty was psychiatric-mental health nursing. She did her Ph.D in counseling in psychology. She is currently a distinguished professor at the Colarado University. She is the founder of the Center for Human Caring located in the same city as the University she is employed at (Cara, 2003). The theory is the output of the professor's experience in the field of psychology, mental health and counseling, her specialty subjects during her post graduation and doctorate degrees. This theory emphasizes the humanistic aspect of the noble profession of nursing based on principles of scientific knowledge acquired through education, learning, research and training. Thus, this theory is very important for the profession of nursing both theoretically and practically. Watson (2009) opined that "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." Watson strongly believed that resolution of conflicts at all levels of society is crucial, because; such conflicts can affect health care at any level (Cara, 2003). The theory of Human caring was brought out in 1979. According to Watson, nursing is a profession that is distinct from other health related professions. Based on this distinct nature of the profession, she defined, ascertained and opined about the distinct role of the profession in the caring for humans who are sick. Infact, this theory defined the role of nurse. According to the theory of Human Caring, nurses impart care by establishing a good relationship with the patients and also their relatives (Sitzman, 2007). Nurses have to treat patients by including all aspects of life, the mind, body and spirit and not just deal with physical ailments of the body. Thus, nurses are expected to provide holistic care to the patient. It is because of holistic care that various needs of the patient like spiritual, emotional, psychological, economical and physical needs of the patient are met. The theory strongly upholds the fact that nurses must display acceptance towards patients and their relatives in an unconditional manner and whatever treatment is instituted is done with positivism. Nurses are expected to cause health promotion and well-being through appropriate knowledge concerning the medical condition of the patient and also through medical interventions. Above all, it is expected that nurses provide care in an uninterrupted manner. The theory of human caring emphasizes on the importance and the gravity of moments spent by the nurse with the patient. Watson opined that the first interaction between the patient and the nurse is when the nurse enters the room of the patient. This is a very important milestone in the contact between the nurse and the patient (Cara, 2003). This is because the patient experiences a feeling of expectation when he or she meets the nurse. thereafter, the interaction and relationship between the nurse and the patient depends upon the attitude and competence of the nurse (Cara, 2003). The end-result is strongly dependent on the interaction. The journey of association between the nurse and patient starts from here on. At the time when Watson conceptualized the theory, she was not happy with the way human relationships had materialized. Thus, she felt that this theory was useful in the era when "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). Watson opined that such a culture was detrimental for humans, especially patients, because; it contributed to "even more safety violations and increases in medical errors" (Watson, 2009). Conceptualization This theory is nothing but philosophy of caring and science of healing through caring. It examines, evaluates, ascertains and assimilates various aspects of nursing like human experiences, caring of human being, human sciences, human phenomena and processes of human beings. The theory plays around the idea that caring is one of the important moral ideals that involves mind, body and spirit, without separating them. In the initial stages of conceptualization, 10 carative factors were developed and they 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, assistance with gratification of human needs and allowance for existential-phenomenological-spiritual forces" (Chinn and Krammer, 2008), which 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). Over several years, the theory has evolutionized and undergone many changes. Evolution has caused replacement of the carative factors by caring process (Chinn and Krammer, 2008). Principles evolving from the caring process include “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). Overall significance of the theory According to Watson's theory, demonstration of nursing of nursing care and effective clinical practice can be done only interpersonally and that caring can be done only through the caring process as mentioned above. Watson opined that the end-result of the caring is satisfaction of the various human needs of the patient, expected from the nurse. Watson proposed that such a satisfaction led to health promotion and growth of the 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. Watson also opined that an environment becomes caring whenevever there is good scope for potential development of oneself, in coherence with allowing the individual to act in his best manner at a given point of time and place (Cara, 2003). Thus, it is evident that health promotion occurs through and halth promotion is not just curing of physical illness. This is clear from the WHO definition of health promotion. Thus caring is the cornerstone of nursing. Strengths of the theory In view of the concept of caring, Watson's theory has a crucial place in the nursing practice. The theory is based on several phenomenological studies which are understanding and analysis based and have questioning attitudes. The theory stresses on the fact that nursing care must be imparted through a humanistic approach. From the nurses point of view, such a care gives the nurses practice of satisfaction and helps the nurse provide holistic care. The theory is applauded and supported by several developmentalists, humanists, psychologists and philosophers. The kind of care described is "soul-satisfying care." The concentration in this type of care is nurse-patient interaction and the main aim of care is enhanced quality of life of the patient. However, such application of care is not practical in an acute care setting. Watson believes that this theory is the need of the hour 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). Weaknesses of the theory Though Watson's theory is very useful in nursing practice, it is criticized often because of the complex caring processes and sophisticated language. Another main source of criticism is the fact that the theory is based on several arts (Sourial, 1996). The theory is general and it is difficult to access in all scenarios. 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." Nursing situation 32 year old Jill Gomes, married to a mechanical engineer Jack Gomes came to the out patient department with history of amenorrhea since 8 months and leaking per vaginum since few hours. Jill was diagnosed to be pregnant and her scans were suggestive of twin pregnancy. On admission, Jill was tired and worried. On one side she was apprehensive about the leaking per vaginum which could affect her twins, both in terms of infection and premature delivery. On the other hand, she was concerned about her other kids, who are, 2, 5 and 7 years old. When the nurse who was taking care of Jill was informed that her children had not eaten at home, she gently and promptly made arrangements for their food. She also took phone numbers of her husband and parents who were called and informed about the situation. The carative processes involved in the patient care were human caring relationship, cultivation of sensitivity to one self and to others and assistance with gratification of human needs. Through these carative factors, Jill was nursed in the hospital for seven days. She was then discharged home. Jill was very happy about her stay in the hospital. She was overwhelmed about the the confidence and optimism she received from the nursing staff. She was also happy about the way her children were taken care at the time of admission. Utilization of Watson's theory to practice Watson's theory can be incorporated into nursing practice by establishing a caring relationship with patients being taken care of. This can be done by being receptive and open to the needs of the patient. The patients must be aware of the fact that the nurse is thoroughly interested in taking care of the patient. This can be done by effective communication and listening to the patients with patience. The patients must be treated as holistic beings and nurses must be aware of their mental and also emotional health other than just physical health. The patients must be treated with a positive regard and they must be respected and encouraged. They must be sensitive to the insecurities of the patient because of their vulnerable position. Promotion of health of the patients must be done through appropriate knowledge and evidence based intervention. The patients also must be encouraged to understand their health position and explore his condition through research. Nurses must also spend uninterrupted time with them and maintain eye-to-eye contact. On the whole holistic nursing care must be provided to the patient. Conclusion The Theory of Human Caring was developed by Jean Watson, a famous nurse educator and an imminent theorist, in the year 1979. Since then, the theory has evolutionized gradually. The fundamental principles of care in the initial theory were based on 10 carative factors which were later modified to 10 caring processes. The need for application of Watson's theory which is basically based on humanist approach to nursing care has arisen because of the structural modifications of health care in which humanistic approach is lost. 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. Though the theory has several benefits, inconsistent definitions, complex language and incoherent concepts confuse the readers and defer practical application. However, despite these negative aspects, the theory has an important place in nursing leading to soul-satisfying patient care. References 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