Over the years, nursing has evolved and blossom into the noble profession that exist today. With the development of theories, members of the profession have been molded and fashioned to be givers of care who operates with bowels of mercy and compassion. According to Watson (2009) “Caring is a professional ethical covenant that nursing has with the public to sustain human caring in instances where it may be threatened” (p. 469). In this paper, I will give a brief description of Watson’s background, and concepts of the theory of human caring. I will also define a caring moment reflecting Watson’s theory of human caring and incorporate four of her carative factors. I will also explain how my patient-nurse interaction may be described as a caring moment, explain what I learned about myself during this interaction, explain how my caring was perceived by the patient, explain what I could do to enhance the caring moment, and describe the nursing metaparadigm as it relates to the caring moment. Background and major concepts of Watson’s theory of human caring.
According to Morris (2006) “Watson’s Theory of Human Caring can be called a treatise, a conceptual model, a framework, or a middle-range theory, which seeks to provide a moral and philosophical basis for nursing” (p.1). Jean Watson, the founder of the human caring theory was born in West Virginia (Current Nursing, 2012). She was a psychiatric nurse who obtained her doctorate in psychology and counseling. She believed that caring is essential and central to nursing practice (Blaise & Hayes, p. 108, 2011). According to Current Nursing (2012), “Jean hold, six Honorary Doctoral Degrees and her research has always focused on human caring and loss. In 1988 her Human Caring Theory was published” (para. 1). Watson’s theory of human care laid the premise for nursing by combining humanistic and scientific approach to patient care. The theory is created around the caring process that requires nurses to be knowledgeable about human behavior and responses to health issues. “The major conceptual elements of the theory are carative factors, transpersonal caring relationship, and caring moment/caring occasion” (Blaise & Hayes, 2011, p. 108).
The major concepts of Watsons theory of human caring is to ensure that each individual and self receive care and love based on each person’s moral, value and ethics. Nurses are expected to care from the heart with the willingness to extend themselves to care for and protect patients. Each patient should be cared for holistically, with acknowledgement of the mind, body, and soul. There should be self-disclosure as this allows understanding, leading to new discoveries and the creation of a trusting relationship. Define a caring moment and share experience
“Caring moments/caring occasion occurs whenever the nurse and another come together in a given moment for human-to-human transaction. It involves action and choice by both nurse and other” (Blaise & Hayes, 2011, p. 109). According to Cook & Cullen (2003) care is “actions and activities directed toward assisting, supporting, or enabling another individual or group with evident or anticipated needs to ameliorate or improve a human condition or lifeway, or to face death” (p. 192-7). The medical-surgical/Respiratory unit on which I worked is usually busy. One evening while, on duty, I was told that I had an admission, an elderly male whom I will refer to as Mr. X. Mr. X was diagnosed with anemia, and has a history of chronic obstructive pulmonary disease (COPD) but smokes a pack of cigarette per day.
In the Emergency Department, he was transfused with Fresh Frozen Plasma (FFP), and he will continue to get an additional three units stat, plus three units of Packed Red Blood Cells. Oxygen 2L via nasal cannula was also ordered. During report, I was also warned about his rude, condescending attitude. Immediately I formulated my opinion of Mr. X and with fear, I was ready to face my challenge. After report, the room was prepared, and Mr. X arrived to the unit. He came to the unit on a stretcher, pushed by the porter accompanied by the reporting nurse. I met him in the passage way, introduced myself, and extended my hand. He never shook my hand, barely glanced at me, and under his breath he mumbled “Hi.” I ignored his bashful response and implemented Watson’s first carative factor, the formation of humanistic-altruistic system of values. I accompanied him and the other health-care workers to the room and assisted in transporting him onto the bed, then made him as comfortable as possible. By this time, my heart was pounding with fear based on the information that I received about Mr. X. I offered him a drink which he refused. I explained the admission process to him and gave him a brief insight about the plan of care. In an angry tone, he expressed that he understood.
Mr. X was very pale and appeared to be short of breath. I initiated his oxygen therapy, and encouraged him to remain in bed. I handed him the call bell, and I showed him how to operate it should he need assistance. This was the beginning of my caring moment. The initial interaction between Mr. X and me allowed the laying of the foundation for care and expectations. During this moment, my approach laid the foundation for Mr. X’s outlook on the current and anticipated situation. This caring moment had the power to either make or break him because it created the link between him and me. I am aware that relationship takes time to be built, and its survival is dependent on the existence of trust and effective communication. So during the admission process, I incorporated Watson’s fourth carative factor, which is the development of a helping-trusting (human caring) relationship. During this time, my patient opened up to me. The information he volunteered made me realize that he lived alone and was lacking family support. I could sense anger and pain in his voice when he speaks about his life. He expressed how disappointed he was with his life, and it was one of the reasons he smokes.
He also stated that he has one child who does not speak to him, and he does not feel like bothering with life. My heart went out to Mr. X and at that moment, I felt powerless; however I gave him the opportunity to vent, and I listened. By this time, my fear had increased, and I realized that Watson’s second carative factor, instillation of faith-hope has to be implemented. I asked him about his spiritual beliefs and his values for life. Turned out he did believe in the Almighty, but he expressed that his current quality of life was not worth fighting for. I encouraged him to make peace with his child if it is possible and I spoke to him about the Almighty’s mercy and love for us. I asked if he would like to speak with the Chaplin, but he refused. It was now time to use Watson’s fifth carative factor, promotion and acceptance of the expression of positive and negative feelings.
I told Mr. X it was okay to feel the way he did, and I was happy he was able to express his feelings. In that moment, I got to know him has a person. That moment offered him choices with the opportunity to decide how to be in the moment with me while I made efforts to connect with him through acceptance. During that moment, I was an attentive listener whose nonverbal and verbal language communicated interest and care. According to Finfgeld-Connett (2008) “Presence and caring comprise an intentional therapeutic process that involves expert nursing practice and intimate interpersonal sensitivity. Outcomes of the process are improved mental and physical well-being among recipients and improved mental well-being among nurses” (p. 111-9).
What I learned about myself, how patient perceived the caring, what could be done to enhance the caring. As human beings, we tend to quickly formulate opinions based on experiences or what we are told by others. However, the time spent with Mr. X gave me the opportunity to face my fear, the fear of not being able to administer quality care to my patient. That moment made me more appreciative of life, health and family. It made me realized that I should not be quick to judge based on others perception; instead it is better to take the time to identify the stimuli that trigger a person’s attitude. My experience, in that moment, taught me that I do not always have to be in control, it is sometimes better to take the few minutes to listen, and a lot can be learnt. At that moment, I was happy that I obeyed my calling to become a nurse.
I could tell that discussion with Mr. X had a positive impact because he expressed how much he appreciated the fact that I was willing to listen to him. He even agreed to extend efforts to repair his relationship with his child. I could tell that inspite of his failing health his spirit was brightened, this time he was smiling and was very receptive to touch, now he was the one holding my hands. Reflecting on Mr. X’s situation, I should have discussed with him the involvement of a case manager. This would allow follow up on his needs, and he would be able to obtain the necessary counseling services and referral information if needed. He would also be able to join a support system that could help with the rebuilding of his family structure.
Nursing Metaparadigm as it relates to caring moment
According to Cara (n.d.), “Watson (1988b) defines the person as a being- in- the-world who holds three spheres of being – mind, body, and spirit – that are influenced by the concept of self and who is unique and free to make choices”(para. 15). Using Watson’s view of person, my moment with Mr. X allowed me to enquire about his family, lifestyle and environment and not just his diagnosis. Nightingale’s concept of environment was adopted by Watson who saw the importance of having the patient’s room clean and neat as this would aid with healing (Cara, n.d.). As evident in my initial approach, before Mr. X’s arrival I ensured that the room was clean, water pitcher filled; drinking cups, facial tissue, disposal bag and urinal were at his bedside. The bed was properly made and adequate blanket available.
During my caring moment, Watson’s view of nursing was implemented. According to Cara (n.d.), “Watson defines nursing as a human science of persons and human health- illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human care transactions” (para.20). My practice of nursing was utilized when I came to grip with my feelings, acknowledging what I learnt from the encounter with Mr. X and having the ability to make the situation better by attending to the needs of his mind, body, and soul. For health maintenance, nursing care has to be appropriate and effective. Watson defines health as more than just the absence of disease. Health is a subjective feeling that includes every aspect of the individuals’ wellbeing (Cara, n.d.).
Using Watson’s definition, I realized that Mr. X’s health issues were beyond what the eyes could see. Emotionally he was ill, and his value on life was lost as evident by his verbalization of “life was not worth fighting for,” his pent up anger and the lack of family structure. However, all hope is not lost because through the eyes of Watson, according to Sitzman (2002) “Care and love are the most universal, the most tremendous and the most mysterious of cosmic forces: they comprise the primal universal psychic energy ….Caring is the essence of nursing and the most central and unifying focus for nursing practice” (p. 118). With this in mind, a whole world of new possibilities could be opened leading to the healing of Mr. X.
Blais, K. K., & Hayes, J. S. (2011). Professional Nursing Practice: Concepts and Perspectives (6th ed.). Retrieved from University of Phoenix eBook Collection database
This book was written by nurses for nurses. Its main purpose is to inform and educate members of the profession who are striving to achieve a higher degree of learning, about the necessary skills and characteristics that are needed to enable the growth of the health care environment of which they belong. Cara, C. (n.d.)
A Pragmatic View of Jean Watson’s Caring Theory. Retrieved from www.humancaring.org
This is a very informative and educational document. Its main purpose is to educated nurses about the importance of caring as through the eyes of the Jean Watson the founder of the human caring theory. Great emphasis is placed on maintaining the dignity and health of the individuals that are cared for by attending to the needs of the mind, body and soul.
Cook, P. R., & Cullen, J. A. (2003).
Caring as an imperative for nursing education.
Nursing Education Perspectives, 24(4), 192-7.
This journal speaks about the significance of caring in the delivery of nursing care. Its main objective is to ensure that the concept of caring is incorporated in the nursing school curriculum so that nursing students will not be denied the knowledge about the importance and benefits of caring.
Current Nursing. (2012, January 26). Nursing theories: A companion to nursing theories and models. Retrieved from http://currentnursing.com/nursing_theory/Watson.html
This website gives a quick insight into the life and work of Jean Watson. It outlines the seven assumptions that tell what caring should be. It also lists the 10 carative factors and explains the actions that are expected when each is practiced.
Finfgeld-Connett, D. (2008).
Qualitative comparison and synthesis of nursing presence and caring.
International Journal of Nursing Terminologies and Classifications, 19(3), 111-9.
This article is about understanding the concepts of nursing presence and caring. Being in the presence and having the ability to care requires skills and the ability to connect with the recipient. The positive outcome of the process will eventually improve the mental and physical well-being of the nurse and the patient.
Morris, D. L. (2006). Watson’s theory of human caring. New York: Springer Publishing Company.
This article outlined major assumptions of Watson’s theory of human caring as stated by Watson. It states the ways in which caring would be considered effective. It explained that caring has to include the carative factors before satisfaction is obtained, however, the care for self is a priority before it can be extended to others. This article serves as a guide so that individuals who are caregivers will understand the benefits of caring.
Sitzman, K. L. (2002). Interbeing and mindfulness: A bridge to understanding jean watson’s theory of human caring. Nursing Education Perspectives, 23(3), 118.
This article explains the understanding and implementation of Jean Watson’s Theory of Human Caring in nursing through the use of mindfulness. It highlights that before one is able to care for others it is important to understand what caring means. When the understanding is obtained, it has to be applied in the life of the individual before it can be extended to others.
Watson, J. (2009). CARING SCIENCE AND HUMAN CARING THEORY: TRANSFORMING PERSONAL AND PROFESSIONAL PRACTICES OF NURSING AND HEALTH CARE. Journal of Health and Human Services Administration, 31(4), 466-82.
This article explores the foundation of nursing and the effect that caring science has on the transformation of the professional practice. It implied that through theory-guided philosophical practices and nurses taking the step to advance themself the core function of nursing have been restored.