Who is Jean Watson and what is her contribution to the nursing profession? Jean Watson is a Distinguished Professor of Nursing and holds the Murchinson-Scoville Endowed Chair in Caring Science at the University of Colorado, Denver College of Nursing and Anschutz Medical Center Campus. She earned undergraduate and graduate degrees in nursing and psychiatric-mental health nursing, and a Ph.D. in educational psychology and counseling. She has received several national and international honors and honorary doctoral degrees. She is a Fellow of the American Academy of Nursing and is Founder and Director of the Watson Caring Science Institute in Boulder, Colorado (www.watsoncaringscience.org a non-profit foundation established to further the work of Caring Science in the world. Dr. Watson has published numerous works on her philosophy and theory of human caring. Her theory is used to guide transformative models of caring and healing practices around the world (Cara 2003). This paper will explore the elements of Jean Watson’s theory of caring.
It will explain how her theory can be applied in the clinical setting, and how it has impacted the nursing profession and influenced healthcare. Nurses define caring in various ways depending on their level of education, professional experience, personal values and professional focus. The concept of caring is central to the nursing profession. As Jean Watson proposed, regardless of their specialty area, nurses have awareness of the interconnectedness of all beings and share the common goal in supporting healing from both scientific and philosophical perspectives. This goal is referred to as the caring-healing consciousness (Sitzman, 2007 p. 9). Jean Watson’s theory of Transpersonal Caring (or Theory of Human Caring) was originally developed in 1979 but has continued to evolve over the years.
The three major conceptual elements are: 1) transpersonal caring relationships 2) ten carative factors 3) caring occasion/caring moment. Through a transpersonal caring relationship, nurses help patients to achieve a higher degree of harmony within the mind, body, and soul. Transpersonal reaches beyond one’s ego and the present moment, and allows one to connect spiritually and promote patient comfort and healing. The transpersonal caring relationship depends on the nurse’s moral commitment in protecting human dignity and the nurse’s caring consciousness in preserving and honoring the embodied spirit. This caring consciousness is essential for the mutual relationship between nurse and patient (Cara 2003).
“The goal of a transpersonal caring relationship corresponds to protecting, enhancing, and preserving the person’s dignity, humanity, wholeness, and inner harmony” (Cara, 2003, p. 53). The ten carative factors developed by Watson in 1979 serve as a guide for the core of nursing. These factors later evolved into ten clinical “caritas” (meaning to cherish and give special loving attention) processes. While acknowledging medicine’s curative factors and nursing’s legitimate place in that process, Watson’s theory identifies nursing’s carative orientation in healthcare (Sitzman, 2007 p. 9). The ten carative factors are comprised of ten elements:
* Formation of a Humanistic-altruistic system of values
* Instillation of faith-hope
* Cultivation of sensitivity to self and others
* Development of a helping-trusting, human caring relationship
* Promotion and acceptance of the expression of positive and negative feelings and emotions * Creative, individualized problem-solving caring process
* Promotion of transpersonal teaching-learning
* Provision for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environments * Assistance with gratification of basic human needs while preserving human dignity and wholeness * The allowance for existential-phenomenological-spiritual forces of caring and healing Watson believes these carative factors are a guide to promoting harmony and dignity into relationships, and provide a structure in understanding nursing as the science of caring (Ryan, 2005). According to Watson, “a caring occasion occurs whenever the nurse and another come together with their unique life histories and phenomenal fields in a human-to-human transaction” (Watson, 2010).
Jean Watson’s ten clinical caritas were developed to describe fully engaged nursing practice and can be applied to any specialty area or during any nursing activity, or during any verbal exchanges between nurse and patient. As discussed in Ryan (2005), Jean Watson’s theory is being used by nurse recruiters in the selection processes of nursing staff. They inform potential candidates that their facility’s practice is based upon her theory of caring. The interview process may require a candidate to describe a caring moment from their past, and based upon their response, recruiters select candidates who best fit within the nursing culture of caring In addition, job descriptions now state that nurses must be competent in both technological skills and in the carative factors of the caring theory. Moreover, the clinical ladder process has integrated Watson’s theory by requiring the candidate applying for advancement to share a story from their professional practice that demonstrates how they positively influenced a patient outcome, and then identify and discuss the carative factors discussed in their story.
Educational offerings which previously focused on the physical nature of a medical condition are now focusing on the holistic nursing model instead of the disease-focused medical model. Clinical information system coordinators have revised computerized documentation screens to reflect theory-based nursing practice. Nursing diagnoses and interventions have become linked with the carative factors. Watson discusses the impact of her theory on nursing practice in “From Theory to Practice: Caring Science According to Watson and Brewer.” In this interview, she states that the increase in frequency and number of Magnet hospital’s use of caring theory is evidence of its impact on nursing. As a result of caritas nursing models, nurses honor their commitment to society and humanity to offer compassionate human caring. In addition to the initiatives of Magnet hospitals, developments in caring-theory guided practices are evident through the gatherings of the International Caritas Consortium (ICC).
The ICC is an invited network of hospitals, educational program representatives, and individuals who are committed to expanding and implementing caring theory/ caritas nursing. As Watson states, “These individuals explore and experiement in deepening the practices of the human dimensions of caring-healing, returning to heart-centered-loving practices” (Clarke, Watson, & Brewer 2009, p.340). Hospitals who are dedicated to implementing the caring theory and healing models sponsor these gatherings. Jean Watson states in her interview with Jacqueline Fawcett, RN; PhD; FAAN, (Fawcett 2002) that the value of the human caring theory is a foundational ethic and philosophy for any health professional. She states “the core of the human caring theory is about human caring relationships and the deeply human experiences of life itself, not just health-illness phenomena, as traditionally defined within medicine” (p. 215).
She goes on to state that “nurses and nursing working from a human caring philosophy bring a different consciousness and energy of wholeness to any setting, offering a counterpoint to the medicalizing-clinicalizing of human experiences in the conventional institutional industrial models of practice” (p. 216). In Fawcetts’s interview, Dr. Watson goes on to say that even though nursing is multiparadigmatic, “caring can and still must be honored as a core value, knowledge development and practices related to healing and wholeness” (p 216). She believes her theory of transpersonal caring is moving toward a unitary-transformative paradigm, bringing in consciousness, intentionality, energy, evolution, transcendence process, relativity, and things that transcend our conventional medical and modern conventional science models and thereby, more clearly seeing the intersection between arts and humanities and science.
In conclusion, Jean Watson’s Theory of Transpersonal Caring provides a foundational philosophy for health professionals. As Watson states “The core of the human caring theory is about human caring relationships and the deeply human experiences of life itself, not just health-illness phenomena, as traditionally defined within medicine” (Fawcett 2002, p. 215). Jean Watson’s theory affirms, guides and solidifies nursing practice.
Cara, C. (2003). A pragmatic view of Jean Watson’s caring theory. International Journal for
Human Caring, 7(3), 51-61. Retrieved from http://web.ebscohost.com.ezproxy.gardner-webb.edu Clarke, P., Watson, J., & Brewer, B. (2009). From theory to practice: Caring science according to Watson and Brewer. Nursing Science Quarterly, 22(4). doi:
10.1177/0894318409344769 Fawcett, J. (2002). The Nurse theorists: 21st-Century updates. Nursing Science Quarterly, 15(3), 214-219. doi: 10.1177/089431840201500307 George, J.B. (2002). Nursing theories the base for professional nursing practice (5th ed.). Upper Saddle River, NJ: Pearson Education, Inc. Ryan, L. (2005). The journey to integrate Watson’s caring theory with clinical practice. International Journal for Human Caring, 9(3), 26-30. Retrieved from http://web.ebscohost.com.ezproxy.gardner-webb.edu Sitzman, K. (2007). Teaching-learning professional caring based on Jean Watson’s Theory of Human Caring. International Journal for Human Caring, 11(4), 8-16. Retrieved from http://web.ebscohost.com.ezproxy.gardner-webb.edu Watson, J. (2010). Watson’s Caring Science Institute website. Retrieved from www. watsoncaringscience.org/j_watson/index.html