OVERVIEW OF WATSON: THEORY OF HUMAN CARING
Overviewof Watson: Theory of Human Caring
Nursing Theory and AdvancedPractice
Nursing has invested many yearsof work to be identified as a profession. Many of the nursingleaders have conducted research towards identifying the sharedknowledge of nursing. Many nursing theories have been developed fromthe conducted research. A basic definition of theory is a systematicexplanation of an event in which constructs and concepts areidentified and relationships are proposed and predictions made.(McEwen & and Willis, 2014).
Earlier theorist such as FlorenceNightingale dedicated their research to identifying the role of thenurse. As time progress nurses, saw the need to identify how wecare. The theorist research conducted by these nurses sought toidentify that individuals are not only constituted by their diseaseprocess or illness. Each individual has spiritual and emotional partof their being that also needs the care of the nurse.
This school of thought led todevelopment of the theory based on interactive process. Dr. JeanWatson developed Theory of Human Caring. This theory is based onincorporating the spiritual dimension of nursing. (McEwen &andWillis, 2014). Withenactment of the Affordable Care Act, it is important the wholeperson. The theory of human caring is essential to nursing in agewhere customer service is key component to healthcare.
Often times nurse do notrecognize the need to apply research to nursing practice. (Roberts,2013)This paper will define and review the theory of human caring. The theory will also be applied to nursing patient interaction toevaluate its easy applicability to everyday nursing care. (McEwen &Willisand Willis, 2014).However, nurses most both integrate both theory and empirical data toinflict change on nursing practice.
Overview of Nursing Theory
The purpose of Watson’s Theoryof Human Caring is to bring meaning to the nursing as an emergingdiscipline and profession with its own ethical contributions tosociety. This theory also brings recognition that spiritual andethical dimensions are essential elements of the human care process.(McEwen & and Willis, 2014).
This theory identifies theelements of nursing metaparadigm. The nursing metaparadigm is theworldview perspective of the discipline. (McEwen & and Willis,2014). The nursingmetaparadigm consist of the person, the environment, health, andnursing. In the Theory of Human Caring, Watson identifies three outof four the elements of the nursing metaparadigm.Watson identifiesadditional concepts to include actual caring occasion, transpersonal,phenomenal field, self, and time. (McEwen & Willis, 2014)
The components of the Theory ofHuman Caring are distinctly identified and defined. Person or humanbeing is defined in this theory as valued person to be cared for,respected, nurtured, understood, and assisted. Health is defined asunity and harmony within the mind body and soul. (McEwen & andWillis, 2014). Nursing is defined as a human science of persons andhuman health illness experiences that are mediated by professional,personal, scientific, esthetic, and ethical human care transactions.(McEwen & and Willis, 2014).The person or human being, health, and nursing are components of thenursing metaparadigm. The theory excludes the defining theenvironment component of the nursing metaparadigm. However, thetheory does define five additional concepts utilized. An actualcaring occasion is defined as an occasion that involves the nurse andindividualactions and choices. Transpersonal is defined as anintersubjective human-to-human relationship in which the nurseaffects and is affected by the person of the other. (McEwen &Willis, 2014)
Phenomenal field is defined asthe totality of human experience of one’s being in the world.(McEwen & Willis, 2014) Self is defined as the organizedconceptual gestalt composed of the perceptions of the characteristicsof the “I” or “ME” and the perceptions of the relationship ofthe “I” or “ME” to others and to various aspects of life.(McEwen & Willis, 2014).Time is defined by present and past. Present is viewed in thistheory as more subjectively real and the past is viewed as moreobjectively real. (McEwen & Willis, 2014)
There are also 10 carativefactors identified in this theory. The 10 carative factors werelater redefined as the caritas process. (Wagner, 2010) The 10carative factors included in the caritas process are:
Practicing loving-kindness and equanimity within context of caring consciousness.
Being authentically present and enabling, and sustaining the deep belief system and subjective life world of self and one-being cared for.
Cultivating one’s own spiritual practices and transpersonal self, going beyond ego self.
Developing and sustaining a helping-trusting, authentic caring relationship.
Being present to, and supportive of the expression of positive and negative feelings.
Creatively using self and all ways of knowing as part of the caring process engaging in artistry of caring-healing practices.
Engaging in genuine teaching-learning experience that attends to wholeness and meaning, attempting to stay within other’s frame of reference.
Creating healing environment at all levels, whereby wholeness, beauty, comfort, dignity, and peace are potentiated.
Assisting with basic needs, with an intentional caring consciousness, administering ‘human care essential,’ which potentiate alignment of mind-body-spirit, wholeness in all aspects of care.
Opening and attending to mysterious dimensions of one’s life-death soul care for self and the one-being-cared for “allowing and being open to miracles.” (Wagner, 2010)
The concept of transpersonal isidentified in this theory. The relationship in this theory istranspersonal caring relationship. The relationship is one that goesbeyond ego to higher spiritual caring facilitated by caring moments. Caring moments are heart centered encounters with another person. When two people, each with their own phenomenal field come togetherin a human to human transaction that is meaningful, authentic,intentional, honoring, the person, and sharing human experience thatexpands each person’s worldview and spirit leading to new discoveryof self and other and new life possibilities. (Wagner, 2010).
Assumptions of the theory ofhuman caring are distinctly stated. The assumptions of nurse seeksto recognize, accurately detect, and connect with the inner conditionof spirit of another through genuine presencingpresenting and beingcentered in the caring moments. (Watson) To practice at this level ofnursing practice an on goingongoing personal and professionaldevelopment and spiritual growth in necessary. (Watson)The caring moments experienced promote harmony, wholeness, and unitybetween the nurse and the patient.
Nurse Patient Encounter
Mr. J is a 44-year-old malepatient admitted to a cardiac surgical intermediate unit with adiagnosis of lung mass. Mr. J had a thoracotomy, mass removal, andresection of the left lower lobe of his lung during this admission. During the surgical procedure, the physician biopsied a portion oflung resected as well as the mass that was removed. The patientprimary needs when arriving to the unit was pain management.
A patient controlled analgesia(PCA) pump was initiated. Mr. J was able to obtain better controlafter initiate of the PCA pump. New issues arose after the patientpain was controlled. The patient begins to voice concerns about theresults of the biopsy. It was now two after the surgery and thesurgical physician had not reported resulted.
Mr. J is an active 44 year oldthat works as a mechanical engineer. He exercising daily andmaintains a health diet. He has never smoked and drinks alcoholsocially. Mr. J realizes that he has no risk factors that will yieldto cancer. However, he realizes cancer cannot be completelydismissed.
The tension increased as Mr. Jwaited for results from the surgical physician. Mr. J was veryagitated. The agitation was verbally communicated to each nursetaking care of him. He stated, “Why can’t they just get me myresults?” The nursing staff acknowledged his concerns continued tocommunicate updates from the physicians.
It was postoperative day 4 andthe results of the biopsy were resulted. The surgical physician hadthe results and discussed them with Mr. J.I entered the room toassess his pain and noticed he was tearful. He stated, “It i’scancer.” I asked him did want to talk about the results, a chaplainto come, or did he just want to be alone at this time. He stated, “Ijust want to be alone.” I stated I give will you a few minutes andwill back to check on you. I returned about 30 minutes later toassess Mr. J’s pain scale.
When I entered the room, Mr. Jstated “I think I want the chaplain now.” I stated, “I willpage the chaplain for you . . . . . . . how is your pain right now?”I went on to page the chaplain for him. Ireturned to his room toassess him before the shift was to end.
I asked him was he able to talkto the chaplain. He stated, “Yes, thanks for everything.” I putmy hand on his shoulder and stated that is what I am here for. I donot mine listening either I know this is new for you. He stated,“When will you be back?” I stated, “I will return tomorrow.” He stated, “I am glad, I might need to talk.”
In the encounter Mr. J the coreconcept of relational caring for self and others is recognized. Asthe encounter unfolds so does transpersonal relationship identifiedin the human caring theory. The transpersonal caring relationshipinvolves caring created by caring moments. (Watson) In thisencounter, I established the transpersonal caring relationship when Iaddressed there was change in mood. Further engagement of thetranspersonal caring relationship took place when I offered toaddress the needs with time alone, chaplain, or listen to him. Atrusting relationship was established although Mr. J did not want toengage in conversation or utilize the chaplain at that time.
The caritas process is exhibitthroughout the encounter with Mr. J. The first caritas process wasdeveloping and sustaining a helping-trusting relationship. (Watson) As noted in the encounter there were issues with pain throughout theencounter the caritas process assisting basic needs. I maintained afocus on pain control even after the issues were resolved with paincontrol.
I continued to support thepatient from the time alone to the end of the encounter. Supportingthe patient’s feeling whether negative or positive is part of thecaritas process.
Thistheory does not only easily apply to the encounter it also appliesto the nursing process. A care plan for the nursing diagnosis ofineffective coping can utilize this theory.
In this paper the theory of humancaring was defined, reviewed, and applied to nursing care. Throughthis theory the individuals within the relationship are able to knowvia the scientific and spiritual means. This theory is consistentlyone of the nursing caring theories used as a guide.An in depth review of the application of this nursing theory wasdiscussed in the nurse patient encounter. The theory of human caringprovides the framework for nurse to explore other ways of knowing.
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