Jean Watsons theory of caring - Essay Example

? Research Paper on Jean Watson’s Theory of Caring ID Number: of School Word Count: Research Paper on Jean Watson’s Theory of Caring Abstract This paper talks on Jane Watson's theory of nursing. Her theory is based on the belief that a caring attitude among the nurses for their patients is an essential part of getting well. Moreover, a real and heart-felt caring attitude develops from a humanistic personal value system that comes from a liberal arts background in college. She calls this caring attitude as composed of “carative” factors (from the word care) and is encapsulated in her seven major assumptions as contained in her theory of nursing. Furthermore, she elaborated on this theory in her ten “carative” factors that should serve as a guide in today's complex world of nursing. The major point of her theory is to re-emphasize the caring factors which are somehow lost in the current focus on technological and technical factors in medicine and nursing care. People seem to have forgotten how crucial caring is because of the rapid commercialization of the health care industry. Patients are now viewed or termed as clients and no different from a regular sales transaction in which the health care nurse or any medical professional is the seller and the patient is the customer. Jane Watson's theory has great significance today in view of emphasis that patients should be treated first and foremost as human beings who have feelings which can either send them back to either good or ill health depending on the attitude exhibited by their nurses. Profound changes in the medical and scientific technologies should not diminish the patient as a person. Keywords: altruism, carative, caring, humanistic, nursing, personal, theory, values Introduction Nursing today is a recognized profession and forms a crucial part of the health care team. Nurses have their own code of ethics to guide them through the challenges and ethical issues that they often encounter in their practice. It has gone a very long way since the days of Ms. Florence Nightingale whose original philosophy was limited to caring of the wounded and the sick as she had witnessed during a war. Nursing has since expanded to many specialties such that nurses are to be trained academically as well as acquire practical skills through learning by experience. The big part of nursing practice is anchored on certain theories about proper care in all aspects of the human life. Nursing has since expanded to include important components in human life: ranging from the conception of life itself, the entire birth-death cycle, personal relationships, good health, healing, pain, suffering, loss, grieving and caring (Watson, 2008, p. 2). Nursing practice is based on a number of competing theories about caring for the sick and how to promote good health in general. It has evolved since and is still evolving even today. This paper discusses Jean Watson's own theory of nursing as opposed to the other nursing theories in current practice. Nursing as a distinct profession has its unique focus for knowledge acquisition and development through the totality of its philosophy, research, theories and practical wisdom. The knowledge so acquired is used to guide actual nursing practice but obviously, this can also change from time to time depending on which nursing theory seems plausible and workable. The theories of Jean Watson are remarkable in one respect which is to bring back humanity to a side of nursing which had been criticized in some quarters of society as being too cold and clinical for forgetting that patients are people who have feelings that can get hurt if not handled well. Discussion Background of Theory – Jean Watson had a doctorate degree in nursing and so was able to develop her theory based on extensive knowledge together with equally impressive working experiences. She has both undergraduate and graduate degrees in nursing and psychiatric health nursing as well as another doctorate degree in educational psychology. She also has three other honorary doctorate degrees conferred by Canada, Sweden and the United Kingdom. Her theory has gained widespread acceptance among major nursing schools as well as in actual practice in various medical institutions because of the return to an emphasis on caring in nursing. The trend in nursing practice today is towards an impersonal and cold clinical setting which makes patients worse off than before because their feelings are not recognized and they are not treated well. Essentially, Jean Watson's theory of nursing centers on the belief that nurses must at all times be aware how a patient feels about the entire medical process and give due course to their patient's opinion, suggestions and feelings by establishing a good rapport with the patient. Nurses of today must not get distracted by all the seeming technical tasks of their job as nurses and focus back on the caring factors that patients expect and crave from their health care providers. A good example would be learning all about a patient's personal background such as the patient's race or nationality, the native language, his beliefs, his culture and even his superstitions if necessary to go beyond the normal rendition of standard medical care and establish a good personal rapport or relationship with the patient to gain his trust and perhaps give him encouragement and hope. The nurse must not appear to the patient as too much in a hurry to go to the next patient. The nurse is expected to spend quality time with the patient whenever possible despite a hectic schedule. Major Concepts – the major principles of her theory are that nursing first and foremost is a profession that demands a caring attitude and that this attitude develops from a humanistic type of personal values which is being threatened by today's commercial environment in the industry. This is a very basic concept which originated from Ms. Nightingale herself but was somehow in a process of being lost due to the numerous advances in the health care industry in which all the technological innovations are being given more emphasis and attention instead of caring for the patient in a way that humanizes them instead of an impersonal, cold and “inhuman” treatment. A good number of nurses today go about their rounds hurriedly sometimes without even taking the time to talk to the patient in a civilized manner or engage them in polite conversation. Nursing today is exposed to increased pressure and workload but nurses must at all times strive to be a professional ideal nurse by not forgetting their primary role which is to care for the patient that treats each patient as a person and living human being deserving of respect and care. Nurses should still give proper attention to the essential elements of health recovery such as the cleanliness of the patient's surroundings, proper ventilation, adequate lighting, clean water, soap, correct diet, warm beddings, reduction of noise and clean air but must not forget the other types of elements which are social, psychological, emotional and religious aspects of nursing care. A good nurse, based on Jean Watson's theory of caring, must be able to establish a good personal relationship with a patient by understanding his or her worldviews without any apparent bias on the nurse's part (Fortinash & Holoday-Worret, 2004, p. 66). The idea is to avoid the very common mistake of ethno-centrism in which the nurse judges the patient based on a nurse's own personal beliefs and become judgmental or subjective and disregard the patient's opinions. The Caring Moment – perhaps no other moment in a person's life is he or she in the most vulnerable position as in the last stages of an incurable disease (such as cancer) and is just for the moment awaiting the final and inevitable death to occur. The nurse attending to that patient must all times exercise extreme care and sensibility to show compassion, empathy and understanding. This caring moment does not come very often and this is the most opportune time to show what is known as human dimensions of the nurse's work by establishing a direct personal relationship with the patient in a humane and respectful way without sacrificing professionalism at all. Many patients who are terminally ill often become grouchy, sad, irritable or angry at their situation and in some cases, might even be suicidal and fatalistic already about their health values in life which in turns makes them turn into a negative person who is bitter at God and at everyone. A caring nurse is immediately aware of these negative emotions and tries to turn them around to make the patient cheerful, happy and have a positive outlook in their remaining days on Earth. The Context of the Moment – the caring nurse assumes the role of a very close relative or friend of the patient and no longer as just a health care professional who is rendering the service. There is genuine concern for the feelings of the patient who might be hurt in some ways due to feelings of abandonment or futility about struggling against the disease any further and may be resigned to his or her eventual fate despite the advances in modern scientific medicine. The nurse will try to ease the transition and a caring moment is often encountered in geriatrics departments of major hospitals where patients are either terminally ill or very old and suffering from the usual ailments accompanying old age such as Alzheimer's disease or dementia. With people living a bit longer today, end-of-life palliative nursing care is a special challenge (Johnson, 2005, p. s37). This portion of the paper discusses some of the major theory assumptions which are the basis of Jean Watson’s theory of caring in nursing. The various areas covered are related to the patient as a person, views on health and well-being, the philosophy of nursing care and the total environment in which the caring moment is placed in its proper context. The patient – Watson’s caring in nursing must transcend the expected human feelings of pity and sadness to the greater heights of spirituality. This is to satisfy the patient’s need for the guidance on how to face death itself and prepare him or her for it. The caring factor can only be manifested, demonstrated and practiced by the nurse in an interpersonal way. Watson’s theory is a contrast to the other popular nursing theories such as those espoused by Patricia Benner which puts emphasis on the technical skills of a nurse, from being a novice to that of an expert. Theory of Benner can sometimes give the patient a feeling of being de-humanized because the technical aspects of caring and curing are given focus instead of being treated decently as a person such as the respect for the patient’s privacy, personal religious beliefs or cultural practices. Based on her theory, a nurse can be a technically expert nurse but may have very poor interpersonal skills in dealing with patients who are more sensitive than healthy people (Benner et al., 2010, p. 1). Another theory of note is that of Ms. Virginia Henderson which emphasizes self-care to lead to faster recovery of the patient. She believes people are the best providers of their own care if they are assisted in doing so. The whole idea of Henderson’s theory of nursing is to give back to patients their cherished independence in performing their activities-of-daily living (ADL) and this is accomplished by the nurse becoming a substitute (doing for the patient), supplementary (helping) and complementary by working with the patient (Henderson, 1997, p. 12). Watson’s Theory on Health – Jean Watson believed that people are affected by their own feelings. This is why her theory emphasized making people happy, upbeat and positive on life. It is possible to achieve this even if people are sick if the nurse caring for them has empathy toward their feelings, opinions, beliefs, culture, language and values in life. This is done by the effective communication channels with the patient either verbally, non-verbally and listening skills which show genuine empathy and warmth. The end results of open and honest communication lines are to establish a helping and trusting relationship between the nurse and the patient. Further, there is also the added benefit of offering the patient faith and hope, especially for those terminally ill. In general, her theory states feelings can alter thoughts and behavior patterns and so the nurse must take care not to inadvertently or unconsciously hurt the feelings of the patient. Awareness to the feelings of a patient makes the nurse sensitive to changes in a patient’s behavior or attitude. Nursing Principles – Jean Watson brought back the original purpose of nursing which is to take care of the sick and bring them back to health and well being in the shortest time possible. This is done through a humanistic approach that treats each patient as an individual and not just a health care statistic who needs to be dealt with in a perfunctory manner. Patients today are more activist with regards to their health care delivery and want to participate more in their care and treatment. They are also more sensitive with greater emotional acuity in how they are treated by their health care providers, especially the nurses who perform the daily tasks for their care. Environment and Context – during the caring moment, the nurse must exhibit to a patient that no one else is more important than him or her. Jean Watson thinks nursing can be very good supplement to scientific medical care as long as it is practiced in a warm, personal manner to all. Personal Experience – I had once cared for a terminally-ill patient with a cancer of the liver and the patient is quite bitter at the turn of events. The patient had expected a recovery from all the expensive chemotherapy she had undergone but her cancer was discovered a bit quite late already (Stage IV) and the doctors do not hold out much hope for her survival. A caring moment that I experienced was spending the rounds which turned out to be her last day as she died in the early afternoon. I spent that last time discussing with her some spiritual things, that death is just a matter of different consciousness, from the physical body to that of the spiritual awareness. She had seemed happy to accept death at last because she had resigned herself to it and started to accept the inevitable in a more open-minded way than to keep on struggling against it. If done in a different way, I should have spent the last few hours with her until her dying moment instead of going to the next round of patients in the other wings of the hospital. Maybe I could have been warmer to her by embracing her on her death bed one last time while she was still alive. Nurses are supposed to be detached professionals but I got deeply affected by her death. Conclusion Although still not clearly understood by medical science, feelings and emotions have a big bearing on our health and well being. People who have a positive outlook in life rarely get sick and often recover much faster if ever they go down with an illness (Siegel, 2005, p. 153). I think the four carative factors applied to my caring moment experience were development of a humanistic personal value system, instilling in her hope in life eternal, having a trusting and a loving relationship with my patient (who was like my mother) and providing a very spiritual and transpersonal type of psychological support to the said patient in her last days on Earth. References Benner, P., Sutphen, M., Leonard, V. & Day, L. (2010). Educating Nurses: A Call for Radical Transformation. San Francisco, CA, USA: Jossey-Bass. Fortinash, K. M. & Holloday-Worret, P. A. (2004). Psychiatric Mental Health Nursing. Florence, KY, USA: Mosby. Henderson, V. (1997). Basic Principles of Nursing Care. Geneva, Switzerland: International Council of Nurses. Johnson, S. H. (2005, Nov-Dec). Making Room for Dying: End of Life Care in Nursing Homes. Hastings Center Report, 35 (6), Supplement: s37-s41. Siegel, B. (2005). 101 Exercises for the Soul: Divine Workout Plan for the Body, Mind and Spirit. Novato, CA, USA: New World Library. Watson, J. (2008). Nursing: The Philosophy and Science of Caring. Boulder, CO, USA: University Press of Colorado (note: this is a re-publication of original in 1979). Read More