Jean Watson http www watsoncaringscience org Theory of

Jean Watson http: //www. watsoncaringscience. org Theory of Human Caring Group 1 Ferris State University Names listed are in order of appearance of works: Amelia Taggart, Holley West, Deanna Warnock, Anita Riddle, Carolyn Zielinski, and Mary Bierlein

Jean Watson, Ph. D, RN, AHBBC, FAAN Evolution of Transpersonal Caring Theory

Margaret Jean Harman Watson was born and raised in a small West Virginia town in the Appalachian Mountains named Welch. Being the youngest of eight siblings, she was surrounded by a large extended family. She moved to Colorado after marrying Douglas, had two daughters and five grandchildren.

Watson established the Center for Human Caring at the University of Colorado in the 1980’s. It was described as the “first interdisciplinary center committed to using human caring knowledge that forms the moral and scientific bases for clinical practice, scholarship, and administration and leadership”. (Watson, 1986)

Watson’s first book, Nursing: The philosophy and science of caring (1979), developed from her notes for an undergraduate course taught at the University of Colorado (Alligood, 2010). Yaloms’ eleven curative factors stimulated Watsons’ thinking about her ten carative factors (Alligood, 2010). Caratives were described as the organizing framework for her book.

Her early work embraced the ten carative factors but has evolved to include “caritas” that make connections between caring and love (Alligood, 2010). She added “spiritual aspects and believes that the core of nursing is seen in those nurse-patient relationships that result in a therapeutic outcome (Alligood, 2010, p. 102).

Metaparadigms Nursing theories embrace the concept that they all have elements that address four major paradigms: Environment Person Health Nursing

Environment In her original caratives, she refers to the nurses role in the environment as “attending to supportive, protective, and or corrective mental, physical, societal, and spiritual environments” (Watson, 1979, p. 10).

In her later work, she describes that “healing space can be used to help others transcend illness, pain, and suffering” (Watson, 2003, p. 200). She also emphasizes that environment and person are connected: “when the nurse enters the patients’ room, a magnetic field of expectation is created” (Watson, 2003, p. 200).

Her broad view of environment is: The caring science is not only for sustaining humanity, but also for sustaining the plan et…Belonging is to an infinite universal spirit world of nature and all living things; it is the primordial link of humanity and life itself, across time and space, boundaries and nationalities. (Alligood, 2010, p. 99)

Person Watson uses the words human being, person, life, and self interchangeably. She views the person as “unity of mind/body/spirit/nature” (Alligood, 2010, p. 99). She feels that “personhood is tied to notions that one’s soul possess a body that is not confined by objective time and space. . ” (Alligood, 2010, p. 99).

Health Her definition of health is “unity and harmony within the mind, body, and soul”, “the degree of congruence between the self as perceived and the self as experienced” (Alligood, 2010, p. 99). She further states “illness in not necessarily disease; instead it is a subjective turmoil or disharmony within a person’s inner self or soul”

Nursing consists of “knowledge, thought, values, philosophy, commitment, and action, with some degree of passion” (Watson, 1988, p. 53). Nurses go beyond procedures, tasks, and techniques used in practice settings. (Watson, 1988, p. 53).

“Care for the Journey” Jean Watson http: //www. watsoncaringscience. org/media /caring_moment. mp 3

Uniqueness of Concepts v New to nursing in 1979 with “deep roots in philosophy and ethics and become more closely aligned with Rogerian science of unitary human beings” (Foster, 2006). v Basic assumptions of Caring Science. v Carative Factors to Caritas Processes.

Basic Assumptions Caring Science • Caring • Humanity • Carative Factors/Caritas Processes • Effective Caring • Acceptance • Relationship • Curing Science (Watson, 2008) •

Carative/Caritas #1 Factor Process Humanistic-Altruistic System of Values Cultivating the Practice of Loving-Kindness and Equanimity Toward Self and Other as Foundational to Caritas Consciousness (“Jean Watson’s Philosophy”, 2010) (Watson, 2008)

Carative/Caritas #2 Factor Installation of Faith and Hope (“Jean Watson’s Philosophy”, 2010) Process Being Authentically Present: Enabling, sustaining, and Honoring the Faith, hope, and Deep Belief System and the Inner-Subjective Life World of Self/Other (Watson, 2008)

Carative/Caritas #3 Factor Process Cultivation of One’s Own Cultivation of Sensitivity to Spiritual Practices and Oneself and Others Transpersonal Self, Going Beyond Ego-Self (“Jean Watson’s Philosophy”, 2010) (Watson, 2008)

Carative/Caritas #4 Factor Process Developing a Helping. Trusting Relationship Developing and Sustaining a Helping-Trusting Caring Relationship (“Jean Watson’s Philosophy”, 2010) (Watson, 2008)

Carative/Caritas #5 Factor Process Being Present to, and Promotion and Acceptance Supportive of, the of the Expression of Positive and Negative Feelings (“Jean Watson’s Philosophy”, 2010) (Watson, 2008)

Carative/Caritas #6 Factor Process Creative Use of Self and Systematic Use of the All Ways of Knowing as Scientific Problem-Solving Part of the Caring Process; Method for Decision Engage in the Artistry of Making Caritas Nursing (“Jean Watson’s Philosophy”, 2010) (Watson, 2008)

Carative/Caritas #7 Factor Process Promotion of Interpersonal Teaching and Learning Engage in Genuine Teaching-Learning Experience That Attends to Unity of Being and Subjective meaning. Attempting to Stay Within the Other’s Frame of Reference (“Jean Watson’s Philosophy”, 2010). (Watson, 2008)

Carative/Caritas #8 Factor Process Attending to a supportive, Protective, and/or Corrective Mental, Physical, Societal, and Spiritual Environment Creating a Healing Environment at All levels (“Jean Watson’s Philosophy”, 2010). (Watson, 2008)

Carative/Caritas #9 Factor Assistance with Gratification of Human Needs (“Jean Watson’s Philosophy”, 2010). Process Administering Sacred Nursing Acts of Caring. Healing by Tending to Basic Human Needs (Watson, 2008) Intrapersonalinterpersonal need (self-actualization) ────── Psychosocial Needs (achievement, affiliation) ─────── Psychophysical Needs (activityrest, sexuality) ─────── Biophysical Needs (food, water, elimination, ventilation Watson’s additional needs: Knowledge, beauty-aesthetics, evolving self-actualization that is spiritually meaningful, and “need to connect with that which is greater than self--to surrender to a higher source with a sense of awe toward the mystery and wonder of life, whether humanity itself, nature, God, Spirit, or a Divine universe” (Watson, 2008, p. 147).

Carative/Caritas #10 Factor Process Allowance for Existential. Phenomenological Forces Opening and Attending to Spiritual/Mysterious and Existential Unknowns of Life-Death (“Jean Watson’s Philosophy”, 2010). (Watson, 2008)

Jean Watson Tik Tok � Please click on the following link: http: //www. youtube. com/watch? v=hcr. Tn. Kx. JEa 8

Watson’s theory in clinical practice.

The nurse considers the patient as a whole.

“The nurse makes a moral commitment and direct intentionality and consciousness to the protection, enhancement, and potentiation of human dignity, wholeness, and healing, such that a person creates or co-creates his or her own meaning for existence, healing, wholeness, and caring” (Kearney, 2008, p. 74).

The nurse is able to “connect with the inner condition (spirit) of another” (Kearney, 2008, p. 74) and create caring moments.

The nurse uses the healing modalities to help bring harmony to a patient. The healing modalities include: The use of auditory, visual and tactile therapies. Gustatory Mental/cognitive Kinesthetic Caring consciousness Understanding own life history

The nurse should “potentiate comfort measures, pain control, a sense of well-being or spiritual transcendence of suffering” (Kearney, 2008, p. 74).

Framework for patient assessment.

Watson’s theory challenges nurses to go beyond the tasks and procedures of nursing and really dig for the core of nursing (Tomey, 2010, p. 98)

Ways to incorporate Watson’s theory into nursing assessment Do an emotional and spiritual assessment Sit down while talking with patient and give them your undivided attention Actively listen to patient Ask open ended questions that will allow the patient to share their feelings on their views on things such as health and situation Instill hope and faith (Watson, 2007)

“TRANSPERSONAL CARING” In Nursing Education

Definition of Nursing Practice “ In the practice setting, nursing theory clearly defines the unique contribution of nurses to health care and helps distinguish nursing as a professional discipline with its own body of knowledge that is separate from the medical model of care” (Marckx, 1995, p. 49).

Carative-a Definition “Carative is the philosophy and theory of human caring. Dr. Jean Watson uses the term “carative” instead of “curative” to distinguish between nursing and medicine”. “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, 1979). The original theory developed in 1979, was organized around 10 carative factors: Source: Nursing: The Philosophy and Science of Caring by Jean Watson, RN, Ph. D. Boston: Little, Brown and Co. , 1979.

Abbreviations of Watson’s Carative Factors “They can be used as an expressive tool while directing the assessment, interventions, charting and full engagement of caring human dimensions of nursing practice” (Rosenberg, 2006, p. 55)

Implication to Nursing Education “The carative factors, which represent the core of nursing and the primary ingredients of effective nursing practice, provide a language, structure, and order for studying and understanding nursing education and practice” (Wade & Kasper, 2006, p. 163).

Watson’s View Entry Level of Practice ADN Ø BSN Ø MSN Ø Doctorate “Although the bachelor’s degree is considered still the [unresolved and impossible to implement] minimal entry level into the professional practice of nursing, the mature practice of nursing, as a career health professional, ideally should be at the professional doctorate level, or at least the graduate level. ” (Fawcett, 2002, p. 217). Ø

“TRANSPERSONAL CARING” In Nursing Research

Current Research Ø Unitary-Transformative Paradigm > unity of mind, body, soul, nature and the universe > spirit to spirit connection (Watson & Smith, 2002, p. 458). “We are to realize that we have to pay attention to what is happening in the universe; we are not separate from the environment, nature and other humans” (Fawcett, 2002, p. 216).

The Watson Caring Science Institute Dr. Jean Watson, Founder, created her international nonprofit Watson Caring Science Institute in 2007 with the mission to restore the profound nature of caring-healing in today’s healthcare systems and to retain its most precious resource, caring professional nurses and transdisciplinary care team members http: //www. watsoncaringscience. org/

Million Nurse Global Caring Field Project http: //www. watsoncaringscience. org/jea nmedpop. htm (Right click, select open hyperlink) Goal: “Connect simultaneously with a million nurses (or more) around the globe: to create and radiate an energetic Caring Field of Heart. Centered Love for Self, Others, and the Planet Earth. This intentional focused experience honors and extends the human caring vibration of nurses into the universal energy field of humanity facilitating healing and health for all” (Watson, 2010)

Heart. Math “Thousands of health professionals in clinics, hospitals, military facilities, coaching, couples therapy, and private practice are using the em. Wave technologies with clients. They have found that with consistent practice, clients can learn to reduce stress, manage the emotions associated with stress, expand their coping skills, and create a greater sense of wellbeing. ” http: //www. heartmath. com/

Jean Watson’s Philosophy and Theory Strengths of this Model a) Jean Watson’s theory is similar to the nursing process and follows a similar path as the scientific research process. 1. Assessment 2. Plan 3. Intervention 4. Evaluation, so it is familiar for nurses to follow. b)Watson’s work does follow logical steps. c) Using the science of caring or the carative factors, shows how nursing differs from other professions. d)It advocates for the healing of the patient as opposed to the technology needed. e) Her philosophy is based on love/caring of the human being which is why many nurses chose their profession.

Jean Watson’s Philosophy and Theory Limitations of this Model a) Watson’s theory is first and foremost a psychosocial model. (Andrews, 2008. ) b)With shorter hospitalization stays it is difficult to evaluate the effectiveness of the model in the hospital (Andrews, 2008). c) It is a relatively new theory (published in 1979) and hasn’t been utilized a lot; it needs more nursing research to determine it’s effectiveness in nursing practice. d) Her theory “language “can be difficult to understand.

*Evaluation of Jean Watson’s Theory of Human Caring *Is about much more than giving care to a person. *Is about caring for a person’s body, mind, and spirit (soul) (Ryan, 2005). *Is about the person giving care as well as the one being cared for (Sitzman, 2011). *Is a moment to moment experience. *Is holistic

* Forgiveness * Compassion * Love * Mind * Body * Soul * Harmony * Spiritual * Mystical *Caring Relationship

*Evolved in the 1970’s *Florence Nightingale *Caring leads to healing *“love, compassion, and forgiveness…. ” *

* Carative Factors *Caritas Processes *Curative Factors *Aspects of Theory of Caring

*Transpersonal caring relationship *Caring moment *Caring healing modalities. *Transpersonal Caring Relationship

*Recent Studies *What patients view as important in caring *Least important aspects of care *Caring for Patients

References Alligood, M. R. , Tomey, A. M. (2010). Nursing theorists and their work (7 th ed. ). St. Louis, MO: Mosby Elsevier. Andrews, M. (2008). Jean Watson’s Philosophy and Science of Caring, Retrieved from www. slideshare. net/Sac. State 35/jeanwatson-presentation? from=shar_email-logout Caruso, E. , Cisar, N. , & Pipe, T. (2008). Creating a healing environment, an innovative educational approach for adopting Jean Watson’s theory of human caring. Nursing Administration Quarterly. 32(2). Clark, P. , Watson, J. , & Brewer, B. (2009). From theory to practice: caring science according to Watson and Brewer. Nursing Science Quarterly, 22(4), 339 -345. doi. 10. 1177/0894318409344769 Jean Watson’s philosophy of nursing (2010, June 27). Retrieved from http: //currentnursing. com/nursing_theory/Watson. html Fawcett, J. (2002). The nurse theorists: 21 st century updates-Jean Watson. Nursing Science Quarterly, 15(3), 214 -219. Foster, R. (2006). A perspective on Watson’s theory of human caring. Nursing Science Quarterly, 19(4), Retrieved from 332 -333. EBSCOhost. Heart. Math. (2011). Retrieved from http: //www. heartmath. com/ jeanwatsonrox (2010, March 07). Jean Watson Tik Tok. Retrieved from http: //www. youtube. com/watch? v=hcr. Tn. Kx. JEa 8

References continued Jean Watson's Theory of Nursing (2010, December 21). In Current Nursing: Nursing Theories. Retrieved February 1, 2011, from http: //currentnursing. com/nursing_theory/Watson. html Kerney-Nunnery, R. (2008). Advance your career: Concepts of professional nursing. Philadelphia, PA: F. A. Davis Company Lukose, A. (2011). Developing a practice model for Watson’s theory of caring; Nursing Science Quarterly; 27 -30. doi: 10. 1177/0894318410389073 Magee, P. (2009, September 9). Journaling My Caritas Journey. In http: //pattymageeart. blogspot. com/. Retrieved February 5, 2011 Marckx, B. (1995). Watson’s theory of caring; a model for implementation in practice. Journal of Nursing Care Quality, 9(4), 43 -54. Mc. Cance, T. V. , Mc. Kenna, H. P. and Boore, J. R. (1999), Caring: theoretical perspectives of relevance to nursing. Journal of Advanced Nursing, 30: 1388– 1395. doi: 10. 1046/j. 1365 -2648. 1999. 01214. x Raile, M, & Marriner-Tomey, A. (2010). Nursing theorists and their work. Maryland Heights, MO: Mosby. Rosenberg, S. (2006). Utilizing the language of Jean Watson’s caring theory within a computerized clinical documentation system. CIN: Computers, Informatics, Nursing, 24(1), 53 -56.

References Ryan, L. (2005). The journey to integrate Watson’s caring theory with clinical practice International Journal for Human Caring, 9(3), 26 -33. Retrieved from EBSCOhost. Sitzman, K. Teaching-learning professional caring based on Jean Watson’s Theory of Human Caring. International Journal for Human Caring, 11(4), 8 -16. Suliman, W. , Welmann, E. , Omer, T. , & Thomas, L. (2009). Applying Watson’s nursing theory to assess patient perceptions of being cared for in a multicultural environment. Journal of Nursing Research (Taiwan Nurses Association). 17(4), 293 -300, doi: 10. 1097/JNR. 0 b 013 e 3181 c 122 a 3. Tomey, A. M. , & Alligood, M. R. (2006). Nursing theorists and their work (6 th ed. ). St Louis: Mosby Elsevier. Vanguard. Health Systems. (December, 2010) Overview of Jean Watson’s Theory. Retrieved from http: //www. innovativecaremodels. com/uploads/File/caring%20 model/Overview%20 JW%20 Theory. pdf Wade, G. , & Kasper, N. (2006). Nursing student’s perceptions of instructor caring: an instrument based on Watson’s theory of transpersonal caring. Journal of Nursing Education, 45(5), 162 -168. Watson, J. (1979). Nursing: the philosophy and science of caring. Boston, MA: Little, Brown and Co. Retrieved from http: //www. carative. com/carative. html Watson, J. (1979). Nursing: The philosophy and science of caring. Boston, MA: Little, Brown.

References Watson, J. (1986, Dec. ). The dean speaks out: Center for human caring established. The University of Colorado School of Nursing News. Watson, J. (1988). Nursing: Human science and human care-A theory of nursing. New York, NY: National League for Nursing. Watson, J. (1999). Postmodern nursing and beyond. Edinburgh: Churchill Livingstone. Watson, J. (2001). Jean Watson: Theory of human caring. Nursing theories and nursing practice. pp. 343 -354. Philadelphia, PA: Davis. Watson, J. (2003). Love and caring: Ethics of face and hand. Nursing Administration Quarterly, 27(3), 197 -202. Watson, J. (2008). The philosophy and science of caring. Boulder, CO: University Press of Colorado. Watson, J. (2009). Watson’s caring science institute international caritas consortium. Retrieved from: http: //www. watsoncaringscience. org/ Watson, J. (2009). Care for the journey (audio recording). http: //www. watsoncaringscience. org/media/caring_moment. mp 3 Watson, J. (2010). The million nurse global caring field project. The Caring Science Institute. Retrieved from http: //www. watsoncaringscience. org/jeanmedpop. htm Watson Caring Science Institute (2010). Jean Watson (Photogragh). Retrieved from http: //www. watsoncaringscience. org Watson, J. (2011). The caring science institute. Retrieved from http: //www. watsoncaringscience. org/