nursing theory on care

Dr. Margaret Jean Harmon Watson, Phd, RN, AHN-BC, FAAN 1

Dr. Jean Watson

Nursing Concepts

October 24, 2012


Abstract


Born under the name Margaret on July 21, 1940 in the small town of

Welch, West Virginia; Dr. Jean Watson spent most of her time surrounded by

her seven older brothers and sisters and a community environment in the

Appalachian Mountains (Alligood, 2012). With her hard work and dedication to

make a positive difference in nursing, she has changed the way of many

nurses with the attribution of her Philosophy and Theory of Transpersonal

Caring, helping to develop trusting, caring, and patient centered relationships.

Dr. Watson attended High School in her small hometown of West

Virginia, then continuing her education at the Lewis Gale School of Nursing

in the town of Roanoke, Virginia, graduating in 1961. After graduating,

Watson married Douglas, whom she described as not only her spiritual

partner, but also her best friend (Alligood, 2012). She and Douglas then moved

west to Colorado where her two daughters, Jennifer and Julie, were born.

Watson continued her nursing education and graduate studies at the University

of Colorado, where she earned her baccalaureate degree in nursing in 1964.

She then went on to earn her master’s degree in psychiatric-mental health

nursing at the Health Sciences Campus of Colorado in 1966. In the year 1973,

at the Graduate school of Boulder, Colorado, Watson earned her doctorate in

educational psychology and counseling. Once her doctoral degree was in

completion, she joined the School of Nursing faculty, serving in both faculty

and administrative positions at the Health Sciences Center of the Denver

campus, University of Colorado (Alligood, 2012). During the 1980’s,


colleagues and Watson began the Center for Human Caring, the nation’s first

center dedicated learning center for human care knowledge using moral and

scientific basis for the clinical practice and leadership in the nursing field.

The Center for Human Caring sponsored projects on human care, educational,

and community scholarship activities involving national and international

scholars; connecting colleagues from all around the world. These activities

still continue to this day at the University of Colorado’s International

Certificate Program in Caring-Healing, here Watson offers her courses on

theory for doctoral studies (Alligood, 2012). Studying here will only boost

excellence in any nursing career considering Watson’s 10 Honorary Doctoral

Degrees, including her seven International Honorary Doctorates in Sweden,

the United Kingdom, Spain, British Columbia, Japan, Canada, and Quebec

(Watson, 2012). Watson then began her sabbatical and international traveling

studies, starting with New Zealand, Australia, India, Thailand and Taiwan in

1981-1982, earning her nickname, “Global Jean” (Watson, 2012). At the

School Of Nursing, Colorado campus, Watson devoted her time to serving as

a chairperson along with assistant dean of the apprentice program. Her time

serving in these positions involved her in the planning and actions of the PhD

program allowing her place of coordinator and director during 1978-1981.

Watson then gained the title of Dean of the University Of Colorado School Of

Nursing and the title of Associate Director of Nursing Practice at University

Hospital in the years 1983 to 1990. During her reign as Dean, Watson


developed post baccalaureate nursing curriculum in human caring, health, and

the healing that leads to a Nursing Doctorate (ND); a professional and clinical

doctoral degree. This program was converted to the Doctor of Nursing

Practice (DNP) in 2005 and still is in existence (Alligood, 2012). In the year

1992, Watson was honored by the University of Colorado by declaring her as

a Distinguished Professor of Nursing, receiving six honorary degrees from

United States Universities and three Honorary Doctorates at international

Universities. Watson was once again honored in the year 1993 when she

received the Martha E. Rogers award, recognizing nursing scholar’s

substantial offerings in advancing knowledge in nursing and in other health

sciences. Watson then began to serve as a member of the Executive

Committee and the Governing Board, elected as president from the years 1995

to 1996, leading to her honorary lifetime certificate as a holistic nurse in 1997

(Alligood, 2012). The year 1998 marked another achievement for Dr. Watson,

but also a period of great sadness when her husband, Douglas, passed away.

In 1998, she was recognized by New York University as a Distinguished

Nurse Scholar, and in 1999 she received the Fetzer Institute’s National

Norman Cousin’s Award. This was awarded in acknowledgment of her pledge

to evolving, preserving, and demonstrating relationship centered care

practices. In my own opinion, her greatest recognition was given in the year

1999 when Watson assumed the nation’s very first Murchison-Scoville

Endowed Chair of Caring Science (Alligood, 2012). Of her higher


achievements, she later was also awarded an International Kellogg Fellowship

in Australia, following with a Fulbright Research Award in Sweden (Watson,

2012). Watson shares her nursing theory and knowledge as the author and co-

author of over eighteen books and her features in at least twenty different

videotapes and audio tapes. Watson’s achievement list is ongoing and is fully

credited to her thirst for learning and determination for changing nursing care

for the better, even generations later. Distinguished Professor and Dean

Emerita Dr. Jean Watson retired on July 1, 2012 after standing as Endowed

Chair in Caring Science for sixteen years at the University of Colorado

Denver College of Nursing and Anschutz Medical Center (Watson, 2012).

Since then she has built Watson Caring Science where she continues to polish

her theory and remains dedicated to the future of nurses and their care for

patients. Her sole stated mission for the Watson Caring Science is to restore

the profound nature of caring-healing in today’s healthcare systems and to

retain its most prized resource, caring qualified nurses and trans-disciplinary

care team memberships (Watson, 2012).

Watson’s theory is based on using care as a sacred science. She is

responsible for the Caring Science Ten Caritas (care) Processes. The first

process, Humanistic-Altruistic Values, is performing selfless acts. Taking the

time to act humanely, putting the patient first. The second process, Faith-

Hope, is most necessary helping to instill faith and hope into the patient about

his or her illness providing a sense of comfort and well-being to the patient


(yesensain, 2011). The third process, Sensitivity to Self and Others, is to make

sure the nurse remains sensitive to what is going on with the patient. The

nurse should not pass judgment and should interact compassionately with the

patient, assessing him or her in a genuine way, promoting health and higher

levels of functioning for the patient. The fourth process, Helping-Trusting

Relationships, is forming a sense of trust between the patient and the nurse.

An example would be to make sure that the nurse answers the call light in a

timely matter so a caring empathetic bond is created (yesensain, 2011). The

fifth process, Positive and Negative Feelings, is the nurse’s use of therapeutic

communication, acknowledging the feelings of not only the patient but also

the patient’s family leading to an understanding by the nurse as to why they

may feel this way. The nurse should encourage both positive and negative

sharing of feelings by the patient as well as the patient’s family members

(yesensain, 2011). The sixth process, Problem Solving, provides the nurse with

the way of thinking that her job isn’t done with just the physical aspects of the

patient; her job also includes acting as a mediator when necessary. The nurse

should assess for the causes of the particular dilemma and help the patient and

family throughout the problem solving process by providing all resources

available, such as information on what the dilemma might include by

providing literature to read, or helping the patient and family contact outside

sources for help (yesensain, 2011). The seventh process, Interpersonal

Teaching-Learning, this is where the nurse understands and learns the patients


point of view on his conditions and decisions, not trying to direct the patient

in any way, but following the patients choices. The eighth process,

Environment, is to make sure the nurse creates a safe, healing, comfortable,

and supportive environment allowing the ease of the patients suffering

(yesensain, 2011). The ninth process, Gratification of Human Needs, is to

make sure that all of the patient’s needs are of equal importance allowing for

the health and well-being of the patient. The tenth and final process,

Existential-Phenomenological, means being open and sensitive to the spiritual

views of the patient, meaning understanding others from the way things

appear to them. Including this in patient care allows the nurse to assist the

patient in finding strength and courage to confront their condition according to

their own spiritual preference (yesensain, 2011). Watson encourages nurses to

use the task of hand washing as a ritual to pause and “wash” all of their

thoughts of their mind to become more in the moment for their interactions

with their patients, encouraging patient centered care. She encourages nurses

to use the sense of caring touch to let their patients know they are in the

moment and centered fully on the patient alone, leading to a trusting

patient/nurse relationship and working towards more of an open conversation

that could be used as a way to correctly form a nursing diagnosis. She

encourages nurses to sit down bedside, focus purely on the patient and ask the

patient what he or she needs to make their situation more comfortable,

offering every option possible. This theory and the above mentioned ten


processes have not only helped to shape the future of nursing care, but have

made the process of caring more manageable within the nursing field helping

to promote excellence.

Care is such a colossal aspect of nursing; some even consider

the words “nursing” and “care” to be synonymous. Care is the essential and

core element of nursing itself. Caring as the central aspect of nursing has led

to many care theories, including that of Dr. Jean Watson who describes

nursing as a human science with the major focus on the process of human care

(Vance, 2003). Without the focus of care within the nursing field, patients

would be without help in their conditions and would lack the correct nursing

diagnosis. Care in nursing can be classified as the holistic outlook of the

patient beginning in the assessment phase of the nursing process. Jean

Watson declares caring as a science. She states; caring is the science that

incorporates a humanitarian, human science direction, human caring practices,

phenomena, and experiences (Vance, 2003). Transpersonal caring is the

acknowledgement of the unity of life and connections that move in concentric

circles of caring from individual, to the others, to the community, to the

world, to the planet earth, then to the universe (Vance, 2003). The process of

care begins when you care for individuals; it is only when you are done caring

for the individual that you can care for others, and so on. Caring behaviors

are defined by nurses in ways such as consoling, active listening, touch,

sympathy, admiration, morality, persistence, accountability, patience, helping


the patient make informed decisions, and determination to help the patient

overcome their individual obstacles. All of these caring behaviors are present

in the nurses individualized care plan for the patient; the nurse will continue

the care plan until it is successful, proving the important aspect of care within

the nursing field.

After researching Dr. Watson and her theory on caring, my own

concept of caring has expanded from basic care of the patient to caring for not

just the patient, but the person as a whole. Caring for the patients basic needs

are mandatory, but caring for the patient’s soul and mind can lead to a positive

health outlook and a spiritual well-being during the hospital stay of the

patient. Caring of the patient as a whole, addressing their spiritual needs, soul

needs, mind needs, along with basic needs, has proven to help the patient as

well as the families of the patient remain positive and hopeful; this can even

lead to a quicker healing time. For instance, a newly diagnosed cancer patient

is full of helplessness and anxiety. The proper care for this patient includes

the basics, the assessment, the diagnosis, the explanation of procedures, the

procedure, the patients coping, etc. If this patient’s care were built on just

more than the basics and viewed holistically, it would help the patient remain

positive and hopeful. Staying positive will help the patient within his own

condition, remaining hopeful and prepared to battle his illness (Master Thesis,

2011). This would help the patient feel better, have more will power and can

also inspire the patient to appreciate those things that are meaningful in the


present as opposed to focusing on what may be lost in the future (Master

Thesis, 2011). This will also allow the patient to work with a strong support

system; he or she will be more probable to involve their friends and family.

Their support system will need to stay strong; especially at times they may

feel extra down. Eliminating some of the stress of the patient by talking to

them, giving them options, offering ways to get the extended care they may

need, and focusing on the patient in completion will ultimately help the

patient and his or her support system to have an understanding of the illness;

helping them to explore options and scenarios together with a positive

attitude.

Caring in nursing has evolved from mandatory care, to adapted

care, to a vested individualized way of caring. The American Association of

Colleges of Nursing and the National League for Nursing have identified

caring as a foundational value of nursing (Rhodes, 2011). Caring today has

become the moral average by which nursing is measured. How a nurse cares

for a patient demonstrates the ability to maintain and continue the caring

nature by which nurses have been defined. Dr. Jean Watson reminds us that

before we can care for a patient, we must first care for ourselves (Rhodes,

2011). The quality of nursing care is based on the nurses themselves and how

one cares for his or her patient and therefore affecting the quality of nursing

care. If a nurse walks into a patient’s room to initiate care and he or she is

obviously agitated, tired, or overwhelmed, the patient will sense this and


assume the nurse is not willing to help the patient how he or she needs to be

helped. In a recent study on nursing care implementing Dr. Jean Watson’s

method at Adventist Hillsdale Hospital in November of 2011, the nurses

gathered for a one day retreat learning the methods of Watson’s theory and

how to implement them into their own personal care of their patients. The

result of the workshop study on Watson’s methods proved to be successful

with not only the nurses but also the patients. The hospital made important

changes to better serve their patient’s needs. Some of which included a

harpist coming into the hospital to provide soothing music for patients,

encouragement of twenty-four hour visitation, providing a bible in each room,

and offering each patient the CARE channel which provides meditative music

along with beautiful scenery (Clegg, 2012). The nurses implemented Watson’s

methods and took the time to sit and talk with the patient, building patient

relationships, and instilling trust with the sense of touch and active listening.

Linda Ryan, a nurse at the Adventist Hinsdale Hospital stated:

“Lately, when I am making my rounds, patients have told me there is

definitely a difference now, that they can sense a more caring

environment than it was like ten years ago. And some of the nurses,

too. They said that they really stop to think about their encounters

with patients. It’s not just route care, just going in and doing tasks.


Now, they are more intentional about making that person-to-person

connection with the patients and the families.” “You can’t just assume

caring is taking place. You need to have some dialogue about it to

increase awareness about it to make it more intentional.”

(Clegg, 2012)

This hospital has been implementing Watson’s methods since November of

2011; continuing to hold Watson workshops for their employee’s. Once

again, Watson’s theory proved to be successful in the quality of nursing care.

Watson’s work has often been described as blueprint, ethic, paradigm,

treatise, frame work, and model. Her hard work, dedication, and successful

theory on caring will continue to pave the way for many to come.

“We are the light in institutional darkness, and in this model we get to return

to the light of our humanity.” (Watson, 2012)

Dr. Jean Watson

Reference


Alligood, M. R. (2012). Nursing theorists and their work. (7th ed., pp. 91-94).

Maryland Hts, Missouri: Mosby Elsevier.

Clegg, T. (2012, Sept 24). Nurses see results from caring theory. Local Beat,

10. Retrieved from

http://watsoncaringscience.org/index.cfm/category/55/press-

releases.cfm

Rhodes, M. K. (2011). Nursing at its best: Competent and caring. The Online

Journal Of Issues In Nursing, 16(2), doi:

10.3912/OJIN.Vol16No02PPT01

(Master's thesis, Columbia University Medical Center, 2011) Retrieved from

http://pancreasmd.org/ed_coping_be.html

yesensain. (Performer) (2011). Jean watsons theory, theories 304 [Web].

Retrieved from http://www.youtube.com/watch?v=-

pBiQKjyeWM&feature=related

Vance, T. (2003). Caring and the professional practice of nursing. RN Journal,

Retrieved from

http://www.rnjournal.com/journal_of_nursing/caring_and_the_professi

onal_practice_of_nursing_-part_3.htm

Watson, M. J. (2012). Watson caring science institute. Retrieved from

http://watsoncaringscience.org/index.cfm

http://watsoncaringscience.org/index.cfm/category/55/press-%20%09releases.cfm

http://watsoncaringscience.org/index.cfm/category/55/press-%20%09releases.cfm

http://pancreasmd.org/ed_coping_be.html

http://www.youtube.com/watch?v=-%20%20%09pBiQKjyeWM&feature=related

http://www.youtube.com/watch?v=-%20%20%09pBiQKjyeWM&feature=related

http://www.rnjournal.com/journal_of_nursing/caring_and_the_professi%09onal_practice_of_nursing_-part_3.htm

http://www.rnjournal.com/journal_of_nursing/caring_and_the_professi%09onal_practice_of_nursing_-part_3.htm


Paper is on Caring, Front Page and reference page do not count as content. Rubric

APA 5 5 Jean Watson Nurse theorist Bibliography 10 10 Theorist concept on caring 10 10 Is caring an import aspect of nursing, support finding.

10 10

What are your own concepts of caring 10 10 How does caring effect the quality of nursing care

10 10

References 5 5

60/60 = 100%

nursing theory on care

Documents

patient remain positive

support system

watsons theory

distinguished professor

active listening

human care

nursing field

encourages nurses