The core concepts of nursing theories are the building blocks of any nursing theory model, which include the fundamentals views of person, environment, health and nursing. Incorporating the general ideologies of nursing principles and practice, the four concepts display the way nursing examines and treat persons within the nursing continuum. While these four concepts are interdepended with one another, each one stems from the formation of the idea that comes before. These concepts guides nurses in their everyday practices. According to Brilowski and Wendler (2005), nurses embody the ideas as they assess, plan, and deliver care. This paper will identify the core concepts from theorist Jean Watson and Sister Callista Roy, as well as comparing the two theories and how nursing’s implication and application to nursing practice is based on them. Nursing has been based on the practice of delivering care, insuring the welfare of humans and assisting them in meeting their needs whilst providing education on how to care for themselves.
Accountability lies with the nursing profession that they promote good health, disease prevention, and providing care to the ill and dying patient. Nursing has been known to be an art as well as a science that is ever evolving. Science, theories and nursing practice has been the foundation to elevating nursing as a profession. Sister Callista Roy’s Adaptation Model (RAM) implies that nursing is a scientific discipline that focuses on practice (Andrews & Roy, 1991). RAM describes nursing as the promotion of adaptation and health that involves intervention; the fifth step of the nursing process that describes the best method to support the patient in reaching their goals. According to Andrews and Roy (1991), Roy’s nursing objective is “the promotion of adaptation in each of the four modes, thereby contributing to the person’s health, quality of life and dying with dignity”. Nurses need to discover ways to maintain a compassionate practice regardless of the professional difficulties and Jean Watson’s caring theory is key to obtaining this goal. Jean Watson (1988) shares nursing as a social science of human health and disease experiences adjudicated by scientific, professional, personal, esthetic, and ethical personal care communications.
According to Watson (1988), working as an artist is characteristic of the nurse’s role, and is a crucial part of providing care to patients and their families. The goal of nursing is health promotion, disease prevention, caring for the sick and the restoration of health (Watson, 1988). Watson goes on to say that holistic care is crucial to the practice of the caring nurse. Jean Watson’s Theory of Human Caring also known as The Caring Model has gone through revisions since its origination in 1979. Watson’s principles of theory are the carative factors, which include the transpersonal caring relationship, and the caring moment (2001). Watson constructed the model in order to define nursing as a well-developed profession, which emphasizes on quality and caring. She proceeds to introduce seven assumptions about the science of caring and theorizes that caring encompasses carative factors with the intent sequel to be fulfilling to specific personal needs, which supports health, and personal/family growth. According to Watson (1988), the science of caring compliments the science of curing in which the practice of caring is fundamental to nursing.
According to Watson (2014), transpersonal caring relationships are the foundation and send a “concern for the inner life world and subjective meaning of another who is fully embodied”. Watson (2014), “transpersonal seeks to connect with and embrace the spirit or soul of the other through the process of caring and healing and being in authentic relation, in the moment”. Transpersonal caring calls for the nurse to be genuine, and in the moment and have the ability to focus on caring, healing and wholeness rather than on the disease and illness (Watson, 2014). The link between nursing and caring can heal due to increased knowledge, experience and purposeful contact. This contact describes how the nurse transcends a neutral evaluation, and the expression of interest towards an individual’s personal and profound essence relating to his/her own personal health. According to Watson (2001) the providing person and the person receiving care connect in support of pursuing meaning, wholeness, and possibly for the spiritual existence of suffering.
The focus of transpersonal caring is to conserve, improve, and sustain the morality of an individual’s humanism, integrity and tranquility. Watson uses the carative factors as a standard for nursing’s concentration and applies the expression carative factors to differentiate from traditional medicine’s curative factors. The emphasis of her carative factors is to “honor the social dimensions of nursing’s work and the inner life world and subjective experiences of the people we serve” (Watson, 1997b). “Whereas curative factors aim at curing the patient of disease, carative factors aim at the caring process that helps the person attain (or maintain) health or die a peaceful death” (Watson, 1985, p. 7). Watson’s framework on the science of caring is constructed around ten carative factors, and benefits nurses with the delivery of care to patients. Jean’s first three Caritas sets the theoretical tone for the science of caring and lays the foundation for the remaining seven processes. The humanistic-altruistic system of values is crucial to the nursing process and toward the maturation of nurses.
Instilling hope and faith to the patient is a vital component to the caring and curing model. When a patient education has run its course, what is left is instilling hope and faith in order to cultivate a sense of wellness, which may become instrumental to them. The nurturing of information to oneself and others examines the nurses’ need to initiate experiences and emotions as it displays. When nurses practice sensitivity, it brings on a more genuine and trustworthy impression, which motivates self-maturity and self-actualization. So as nurses who articulate person-to-person relationships, health and sophisticated behavior is promoted. Good communication skills which entails verbal and non-verbal as well as listening, exhibits a caring personality and creates caring and rapport with the patient. The ability to acknowledge affirmative and negative connotations increases level of understanding and the awareness of such emotions helps understand the behavior that is being conveyed.
Watson (1990) insinuates that feelings modify thoughts and behaviors for deliberation and allowance in a caring connection. She continues to elevate the individual character of nursing and advocates the necessity to evaluate and formulate further methods of practice to implement a holistic approach. The caring nurse should also include an emphasis on the learning process in addition to teaching. When a nurse can accept and understand a person’s attitude regarding his/her status, it lends the ability of the nurse to create a cognitive plan. While considering the requirements for a caring, protecting, and curative emotional, physical, socio-cultural, and spiritual environment, Watson segregates the factor into two variables; internal and external interdependent. Nurses utilize these variables in an effort to gain support and protection for the person’s emotional and physical well-being. Offering assistance of fulfilling the human need is a hierarchy of need that is comparable to Maslow.
Watson constructed a hierarchy that is important to the science of caring and for the quality of nursing care whilst promoting optimal health. The way in which human existence comprehends each other allows the nurse to incorporate and reconcile inconsistencies of how the perception of the person as a holistic being, while focusing on the hierarchical arrangement. This enables the nurse to assist the patient in discovering strengths and courage when facing life or death. At the moment of caring, the nurse and the patient connect in such a way that creates an opportunity for humanistic caring (Watson, 1985). Both persons connect exclusively in a person-to-person interaction. Watson (1999) eludes to the fact that caring time becomes transpersonal when it affirms the appearance of the spirit of both and the opportunity to expand the confines of openness and personal capabilities transpires.
An individual is identified as a person who has biophysical, psychophysical, psychosocial and intrapersonal needs that requires respect and care. Watson (1988) lends an explanation that a person is an existence within the world that embraces three realms of being, mind, body, and soul that is inspired by the self-concept, and who is free to make choices. Spirituality upholds a leading importance in the nursing profession and ascertains that the care of the soul is the most prominent characteristic in the art of nursing (Watson, 1997a).
In conclusion, the concept of nursing as a science that is the culmination of personal behaviors, practices, proficiency, and experiences through a holistic approach. This approach enables the nurse to develop an approach that is effective in providing optimal care. Implementation of The Roy Adaptation Model enhances the role of nurses by clarifying and increasing interdisciplinary involvement. Watson’s theory encourages nurses to base their nursing process on her caring model and implement the art of caring by providing compassionate care. Caring out the delivery of Watson’s theory will augment the nursing process and the delivery of care that are both gratifying and stimulating.
Andrews, H., & Roy, C. (1991). The Adaptation Model. Norwalk, CT: Appleton & Lange. Brilowski, G., & Wendler, M. (2005). An evolutionary concept analysis of caring. Journal of Advance Nursing, 50(6), 641-650. Watson, J. (1985). Nursing: Human Science and Human Care, a Theory of Nursing. Norwalk, CT: Appleton-Century-Crofts. Watson, J. (1988). Nursing: Human Science and Human Care. A Theory of Nursing (2nd printing). Norwalk, CT: Appleton-Century-Crofts. Watson, J. (1990). Caring knowledge and informed moral passion. Advances in Nursing Science, 13(1), 15-24. Watson, J. (1997a). Artistry of caring: Heart and soul of nursing. In D., Marks-Maran & P. Rose (Eds.), Nursing: Beyond art and sciences. Boulder, CO: Colorado Associated University Press. Watson, J. (1997b). The theory of human caring: Retrospective and prospective. Nursing Science Quarterly, 10(1), 49-52. Watson, J. (2001). Jean Watson: Theory of human caring. In M.E. Parker (Ed.) Nursing theories and nursing practice. Philadelphia, PA: Davis. Watson, J. (2014). Caring Science Theory and Research. Retrieved from http://watsoncaringscience.org
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