Evolution of Nursing: Watson's Theory of Human Caring

Nursing has evolved and thrived over time to become the esteemed profession it is today. The profession has been influenced by the development of theories, shaping its practitioners into compassionate caregivers. 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). This article will provide a concise overview of Watson's background and her theory of human caring, including key concepts. It will also define a caring moment based on Watson's theory and incorporate four of her carative factors.

Additionally, the article will explain how an interaction between a patient and nurse can be seen as a caring moment, discuss personal insights gained from this interaction, explore how the patient perceived the care provided, suggest strategies to enhance such moments, and examine the nursing metaparadigm in relation to these moments.

According to Morris (2006), Watson's Theory of Human Caring serves as a comprehensive framework in nursing that establishes a moral and philosophical foundation (p.

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1). The creator of this theory, Jean Watson, was born in West Virginia (Current Nursing, 2012). She worked as a psychiatric nurse and obtained her doctorate in psychology and counseling. Watson firmly believed that caring is an essential aspect of nursing practice (Blaise & Hayes, p. 108, 2011). Current Nursing (2012) reports that Watson has been awarded six Honorary Doctoral Degrees and her research primarily centers around human caring and loss. Her Human Caring Theory was published in 1988 (para. 1). This theory by Watson incorporates both humanistic and scientific approaches to patient care, emphasizing the significance of comprehending human behavior and reactions towards health concerns.

The key components of this theory encompass carative factors, transpersonal caring relationship, and caring moment/caring occasion (Blaise & Hayes, 2011, p.108).

Watson's theory of human caring emphasizes the significance of offering care and affection that corresponds to an individual's morals, values, and ethics. Nurses are required to demonstrate genuine empathy and surpass expectations in fulfilling patients' needs while ensuring their safety. It is vital to provide comprehensive care by considering the patient's mental, physical, and spiritual well-being. Establishing trust and comprehension through self-disclosure plays a pivotal role in establishing a meaningful connection. Can you clarify what constitutes a caring moment and share your own personal experience?

Blaise & Hayes (2011, p. 109) state that a caring moment occurs when the nurse and another person interact in a human-to-human manner. It involves actions and choices from both parties involved. According to Cook & Cullen (2003), care is defined as actions aimed at assisting, supporting, or enabling individuals or groups with existing or anticipated needs for improvement or facing death (p. 192-7). I worked on the medical-surgical/Respiratory unit which was typically busy. While on duty one evening, I received information about an admission, an elderly male referred to as Mr. X who had been diagnosed with anemia and had a history of chronic obstructive pulmonary disease (COPD) despite being a daily smoker of one pack of cigarettes.

Mr. X was given Fresh Frozen Plasma (FFP) in the Emergency Department and will receive three more units urgently, along with three units of Packed Red Blood Cells. Oxygen administration was prescribed through a nasal cannula at a rate of 2L. During report, I learned about Mr. X's rude and condescending attitude, which initially affected my perception of him and made me apprehensive about our upcoming interaction.

After receiving report, we prepared the room for Mr. X's arrival. He arrived on a stretcher accompanied by the reporting nurse and pushed by a porter. I introduced myself and offered my hand, but he disregarded the gesture and barely acknowledged my presence with a muttered "Hi." Despite his dismissive response, I applied Watson's first carative factor by establishing a humanistic-altruistic system of values.

I helped transfer Mr. X onto the bed and tried to make him as comfortable as possible while accompanying him and the healthcare team to the room. At this point, anxiety raced through my heart based on what I had heard about Mr. X. Even though I offered him a drink, he declined it angrily. I explained the admission process to him and gave a brief overview of his plan of care, to which he responded angrily that he understood.

Mr. X appeared pale and breathless, so I administered oxygen therapy and advised him to stay in bed. I gave him a call bell and instructed him on how to use it for assistance. This initial interaction set the stage for our care and expectations. It was essential in shaping Mr. X's outlook on his current and future situation, as it established a connection between us. Building a trusting relationship takes time and requires trust and effective communication. Therefore, during the admission process, I focused on developing a supportive and caring bond with my patient, which allowed him to open up about his life. He revealed that he lived alone and lacked family support, leading to feelings of anger and pain. He also expressed disappointment with his life, which contributed to his smoking habit.

Mr. X shared that his child refuses to communicate with him and he has lost motivation for life. I sympathized with him and felt powerless. Despite this, I allowed him the opportunity to express his frustrations as I listened. At this point, I became even more concerned and understood the need to apply Watson's second carative factor, the instillation of faith-hope. To do this, I inquired about his spiritual beliefs and personal values. It turned out that he believed in a higher power but felt that his current circumstances were not worth fighting for. I encouraged him to reconcile with his child if possible and spoke to him about the mercy and love bestowed upon us by the Almighty. I also offered the option of speaking with the Chaplin, but he declined. Now, it was important to implement Watson's fifth carative factor, which promotes and accepts the expression of both positive and negative emotions.

During a conversation with Mr. X, I reassured him that it was acceptable to experience his emotions and I was pleased that he felt comfortable expressing himself. This allowed me to gain a deeper understanding of his personality. This particular moment presented him with choices as to how he wanted to engage with me, while I made an effort to establish a connection by accepting him. Throughout this moment, I acted as an attentive listener, both through my verbal and nonverbal communication, conveying my interest and concern. According to Finfgeld-Connett (2008), this presence and display of care represents a deliberate therapeutic process that embodies the expertise of nursing practices along with intimate interpersonal sensitivity. The outcomes of this process are enhanced well-being, both mentally and physically, for those receiving care, as well as improved mental well-being for nurses themselves (p. 111-9).

Through my experience with Mr. X, I have discovered how patients perceive my level of caring and ways to improve it. As humans, we often form opinions quickly based on personal experiences or hearsay. However, spending time with Mr. X allowed me to confront my fear - the fear of feeling inadequate in providing quality care to my patients. This encounter ultimately increased my gratitude for life, health, and family. It also made me realize the significance of not hastily judging others based on their perceptions.

Instead, it is crucial to take the time to comprehend the factors that influence a person's attitude. This specific experience taught me that I do not always need complete control; sometimes, it is better to dedicate a few minutes to listen and learn. At that moment, I felt content knowing that I had pursued my calling as a nurse.

The discussion with Mr. X had a positive impact as he expressed his appreciation for my willingness to listen. He also agreed to make efforts to repair his relationship with his child. Despite his failing health, his spirit was visibly brightened, evident from the smile on his face and his receptiveness to touch. This time, he was the one holding my hands. Upon reflecting on Mr. X's situation, I realized that discussing the involvement of a case manager would have been beneficial. This would ensure follow-up on his needs and provide him with necessary counseling services and referral information, if required. Additionally, it would enable him to join a support system that could assist in rebuilding his family structure.

The Nursing Metaparadigm, in relation to the concept of caring moments.

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 inquire 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, I incorporated Watson's viewpoint on nursing. As stated by Cara (n.d.), Watson defines nursing as a human science that involves offering care for individuals and their experiences with health and illness through professional, personal, scientific, aesthetic, and ethical interactions (para.20). I applied this perspective in my nursing practice by recognizing my emotions and the lessons learned from my encounter with Mr. X, while tending to his needs in mind, body, and spirit to enhance the situation. The provision of nursing care to maintain health must be suitable and efficient. According to Watson's definition, health goes beyond mere absence of disease; it is a subjective sensation that encompasses all aspects of an individual's well-being (Cara,n.d.).

Based on Watson's definition, it became apparent that Mr. X's health issues extended beyond superficial observations. Not only was he facing emotional distress, but he also exhibited a pessimistic attitude towards life as evidenced by his belief that life lacked value and his suppressed anger. Furthermore, he lacked a support system. Nevertheless, there is still room for optimism. Sitzman (2002) proposes that care and love are influential cosmic forces that form the foundation of nursing practice from Watson's perspective. With this in mind, a multitude of new opportunities may emerge, ultimately paving the way for Mr. X's recovery.

References

The text originates from a book called "Professional Nursing Practice: Concepts and Perspectives" authored by Blais, K. K., & Hayes, J. S. in 2011 (6th ed.). It is available in the University of Phoenix eBook Collection database.

The authors of this book are nurses, and its intended audience is also nurses. The primary objective of the book is to equip nurses with the essential skills and qualities required for continuously enhancing their healthcare environment (Cara, C. (n.d.)).

The website www.humancaring.org provides a summary of Jean Watson's Caring Theory.

This document is designed to offer nurses crucial information regarding the importance of caring, according to Jean Watson, the creator of the human caring theory. It places great emphasis on the significance of preserving individuals' dignity and well-being by addressing their physical, mental, and spiritual needs.

Cook, P. R., and Cullen, J. A. (2003).

The importance of caring is essential in the field of nursing education.

The article "Nursing Education Perspectives" is found in volume 24, issue 4, on pages 192-7.The main objective of this journal is to emphasize the significance and benefits of incorporating the concept of caring into the nursing school curriculum. It aims to raise awareness among nursing students about the importance of caring in providing nursing care.

Current Nursing (2012, January 26) provides a companion to nursing theories and models. The website offers an overview of Jean Watson's life and contributions. It includes the seven assumptions that define the concept of caring and identifies the ten carative factors, with their corresponding expected actions for each.

Finfgeld-Connett, D. (2008).

A qualitative evaluation and combination of nursing presence and caring.

The article citation is from the International Journal of Nursing Terminologies and Classifications, with volume 19, issue 3, and pages 111-9.

This article examines the significance of nursing presence and caring, emphasizing the importance of skills and building a connection with the recipient. Ultimately, both the nurse and patient will experience improved mental and physical well-being through this process.

The book "Watson's theory of human caring" was written by Morris, D. L. in 2006 and published by Springer Publishing Company, located in New York.

In this article, Watson's theory of human caring assumptions are outlined by Watson herself. The criteria for determining effectiveness in caring is discussed, as well as the significance of incorporating carative factors into care to achieve satisfaction. Additionally, the importance of self-care as a prerequisite for extending care to others is acknowledged. Overall, caregivers can find this article beneficial in understanding the advantages of caring.

The article titled "Interbeing and Mindfulness: A Bridge to Understanding Jean Watson's Theory of Human Caring" was published in Nursing Education Perspectives in 2002 (Vol. 23, Issue 3, p. 118).

This article examines the utilization of mindfulness in comprehending and applying Jean Watson's Theory of Human Caring within nursing. It underscores the significance of grasping the essence of caring as a prerequisite for providing care to others. Once this comprehension is attained, it must be put into practice in one's personal life before extending it to others.

The article "Caring Science and Human Caring Theory: Transforming Personal and Professional Practices of Nursing and Health Care" by Watson, J. (2009) is published in the Journal of Health and Human Services Administration, volume 31(4), pages 466-82.

This article examines the basis of nursing and the impact of caring science on the evolution of professional practice. It suggests that by incorporating theory-driven philosophical approaches and nurses' personal growth, the fundamental purpose of nursing has been reinstated.