Term Paper on "Watson's Caring Theory of Nursing"

Term Paper 7 pages (2441 words) Sources: 8

[EXCERPT] . . . .

Watson Theory of Nursing

Background and Fundamental Concepts of Watson's Caring Theory of Nursing

Jean Watson conceptualized and operationalized a notion that had always been fundamentally important as a defining purpose within the nursing field: caring. Generally, empathy and genuine concern for the welfare and health of others has always been a common motivating force of nurses. Watson introduced her Carative Theory of Nursing and outlined a framework of carative factors and fundamental assumptions to allow nurses to apply specific facets of caring to the nursing services that they deliver to patients.

In Watson's view, nursing has existed as long as human societies and involves the sharing of caring practices within the social environment and as part of human cultural adaptations necessary to survive in and cope with the challenges to human health in the external environment (Fawcett, 2005; Mixer, 2008). Generally, those caring practices are those that contribute to promoting health, preventing illness, providing care and comfort for the ill and restoring health. In that regard, Watson taught that one important measure of health in society and in the individual is the absence of illness and that, therefore, one of the most important goals of modern medicine and nursing is to promote and maintain human health through specific efforts designed to prevent and treat illness (Luna & Miller, 2008).

Watson taught that it is impossible to understand human behavior without understanding their root in and connection to emotions because feelings necessarily influence thoughts and behavior (Finfgeld-Connett, 2008; McKenna, 1997). According to Watson, every person represents a unique individual with values and perceptions relating to self and others, and those values and perceptions must be recognized, respected, and cared for within the context of the whole-person and integrated self (Reed, 2006). Even though many individual component elements of self are determined by society, every person is unique because the integrated whole persona cannot be fully described one-dimensionally, as a simple sum of component parts. Whereas inanimate machines made of identical parts are indistinguishable, that is not the case with human beings (Vandemark, 2005).

Watson defined nursing as a "human science" whose subject matter involved the entire range of personal and health-illness experiences addressed by interactions comprising professional, personal, scientific, aesthetic and ethical human components in an integrated approach (Delaune & Ladner, 2002). Carative Theory is unique in that it conceptualizes a scientific caring methodology that is based humanism and human philosophies rather than on empirical science. Her approach challenges nurses and other caretakers of others to learn about ourselves and about one another and to increase our respective understanding and appreciation of meaning in all of our lives and relationships as a means of improving our ability to deliver carative nursing services (Finfgeld-Connett, 2008; McKenna, 1997).

In principle, Watson's theory emphasizes the patient and humanistic principals as the focus of nursing practice. Her theory has not been tested as extensively as various other theories of nursing, because it does not lend itself as well to scientific measurement. While carative nursing could certainly be tested objectively and scientifically in relation to outcome, it is precisely because Watson's theory of nursing draws from so many unscientific disciplines that it is difficult to research empirically in clinical applications, particularly in a contemporary health care environment where so many unrelated (even conflicting) factors necessarily dictate crucial elements and parameters of nursing care that can be delivered.

Theoretical Assumptions of Watson's Theory

In its most fundamental principle, Watson's Caring Theory of Nursing attempts to meld the hard science of the medical aspect of nursing with the implications of the many broader aspects of human knowledge, drawing from the humanistic influences on human behavior and health (McKenna, 1997). Watson in no way sought to contradict the obvious importance and value of scientific medicine and nursing. On the other hand, Watson suggested that the greatest potential value of scientific medicine is limited by the narrow focus on the coldly scientific components of medicine and nursing care. Watson's perspective is simply that the ultimate value of medicine to human health and to human welfare are greatest and most capable of being realized when the empirical bases of medical science are supplemented by various humanistic concepts applied in the process of understanding patient needs and delivering optimally beneficial care in the medical setting (Fawcett, 2005).

Fundamental Assumptions

According to Watson, there are seven fundamental assumptions of carative nursing: Caring in the context of interpersonal human interaction; specific carative factors important to satisfying important human needs; caring in the context of individual patient health and family growth; caring in the context of the potential and current state of being of every individual; caring in the context of a balanced environment in terms of clinical needs and autonomous rights to self-determination and independent choice; caring in the context of a multidimensional concept rather than the narrow focus of curing illness and disease; and the essential complementary nature of the empirical scientific elements of curing caring and the humanistic nonscientific elements of caring (Vandemark, 2006).

Carative Factors

Watson introduced an outline of ten primary carative factors that defined her concept of carative nursing theory (Taylor, Lillis, & LeMone, 2007); they are: 1. Altruism and societal value systems; 2. Spirituality and faith; 3. Self-awareness and requisite sensitivity to others to cultivate human relationships consistent with mutual trust and the promotion of human welfare; 4. Acknowledgment, acceptance, and validation of positive and negative emotions alike; 5. Problem-solving based on scientific analysis and objective decisions; 6. Interpersonal teaching and learning; 7. Spiritual support, protection, and correction through environmental, cultural, societal, and physical modalities; 8. Providing a supportive, protective, and corrective environment across the mental, physical, cultural, and spiritual realms; 9. Recognition of and support for the satisfaction of a wide range of specific human needs; and 10. Recognition of and open-mindedness toward existential and phenomenological influences on human health (Hamric, Spross, & Hanson, 2009).

Application of Theory to a Caring Moment

As a divorced mother of two and a practicing RN for the last 25 years, I found myself caring for my father at the end of his life. My older sister is not in the medical field and was living in New York and I had no other family available to help me cope. As a nurse, I had always tried to care for my patients others as though each one of them was someone important to me and, naturally, I always expected that when the time came to care for my father at the end of his life, I would be able to count on my professional colleagues to demonstrate the same respect, compassion, and empathy that I have always provide for my patients. Unfortunately, this was not the case. He suffered confusion, partly as the result of losing his eyesight and the nursing staff made no effort to comfort or reassure him. They neglected to provide the most basic care, such as simply making sure that he received his meals and when he complained about his care, they moved his call light out of his reach.

The case manager complained to me that my father had been taking up too much of the floor nurses' time, and insisted that I obtain private care for him. The fact that she was obviously completely unaware that I had already arranged for private care indicated that she could not possibly have been acting responsibly to provide those nursing services that he still needed from her and her staff. After negative experiences in several rehabilitation facilities and bouts with hospital-acquired infections and medication errors attributable to clinical inefficiency and carelessness, his situation was dismal and my disillusionment with my profession so great that I worried I would never be able to return to being a nurse. Then, during one of his acute medical episodes, an ICU specialist demonstrated the way that Watson's carative factors advance the quality of nursing for patients and their families.

First, he exhibited the sensitivity to others necessary to cultivate human relationships and to establish mutual trust and the promotion of human welfare in the way that he explained to me sensitively but honestly that my father's failure to thrive and continued deterioration were irreversible and that aggressive treatment for his medical problems in isolation and without regard for the quality of his life amounted to prolonging his death rather than his life. In that process, he helped me acknowledge and accept my positive and negative emotions and he provided valuable validation of both of them. His approach to problem-solving incorporated both the objective, clinical, scientific analysis of my father's medical prognosis and its impact on his quality of life along with his conceptual understanding of the personal and spiritual values that I had expressed. He also helped me reconcile various potential contradictions between my socially and culturally learned views about life and death with my profound desire to make the best possible decision for my father that he could no longer make for himself and, especially, to minimize and prevent any… READ MORE

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