Jean Watson’s caring philosophy and science in nursing originated as a textbook for nursing courses at the University of Colorado. Watson’s theory of caring was built upon her early work at the university. Her philosophy defines nursing activity in terms of humanistic aspects of life and centers around the caring process. Caring, according to Watson, represents all of the factors that nurses use in delivering healthcare, including knowledge of human behavior and responses to health problems, patient and family needs, and the strengths and limitations of both the nurse and patient. The nurse must also offer comfort and empathy to patients and their families. Watson’s theory encompasses a wide range of knowledge, skills, and expertise, spanning holism, empathy, communication, clinical competence, technical proficiency, and interpersonal skills.According to Current Nursing (2010), Watson's theo
...ry of caring encompasses four major concepts: the concept of human being, concept of health, concept of nursing, and the concept of environment. Watson defines a human being as a valued individual deserving of care, respect, nurture, understanding and assistance. A person is viewed as a fully functional integrated self consisting of three spheres of being - body, mind, and soul, influenced by the concept of self. The person is neither simply an organism nor simply spiritual. Rather, a person is embodied in experience in nature and the physical world and can also transcend the physical world. Health is defined as unity and harmony within the body, mind, and soul, as well as openness to increased possibility. It is a subjective experience that involves the process of adapting, coping, and growing throughout one’s life.According to Alligood (2010), Watson believes that health includes physical, social
esthetic, and moral aspects and is viewed as consciousness and a human-environmental energy field. It reflects a person's drive to actualize and develop their spiritual essence. Illness, which can lead to disease, is subjective disharmony within the mind, body, and soul. All three - health, illness, and disease - can exist congruently within a person. Nursing, as described by Watson, is a transpersonal interaction that involves a human-to-human connection with a spiritual dimension that facilitates healing. The goal of nursing is to achieve a higher degree of harmony within the mind, body, and spirit by empowering self-knowledge, self-reverence, self-healing, and self-care processes for diverse possibilities. According to Watson, the greater the nurse's genuineness and sincerity in caring, the more effective it is (Alligood, 2010).In order to achieve Watson's nursing objective, the nurse integrates caritas and human care processes with intention, transpersonal caring, and relationship-building, responding to individuals' subjective experiences to help them find meaning in life by exploring disharmony, suffering, and turmoil (Alligood, 2010, p.120). According to Alligood (2010), Watson's concept of environment encompasses not only physical surroundings but also nonphysical energetic environments. The nurse becomes the sacred space where healing occurs (Alligood, 2010, p.123). Watson asserts that the nurse does not just work in the environment, but actually is the environment capable of making significant changes (Alligood, 2010, p.123-124). The environment facilitates healing in combination with conscious and intentional caring practices (Alligood, 2010, p.124).According to Alligood (2010), a focus on healing spaces in healthcare facilities promotes the promotion of mind-body-spirit wholeness, recognition of hospital stress factors, and the critical role that emotions and senses play in healing, shifting patient care from illness and diagnosis
to human caring and spiritual health. This is driven by love or caritas, which does not negate objective medical and nursing science but includes subjective experiences, values, quality, and soul-human phenomena. Watson adds that caring in nursing involves conscious intent to preserve the patient's wholeness, promote healing, and preserve dignity in a single caring moment that becomes the focal point in space and time (UCD, 2008).According to UCD (2008), the caring moment involves a decision and action by both the nurse and patient, allowing them to determine how they will approach the moment and what actions they will take. When this moment is transpersonal, there is a spiritual connection between both parties that goes beyond physical interaction, enabling healing at a deeper level. One example of such a moment occurred when a 45-year-old female patient was admitted after calling 911 due to anxiety. Despite expressing dissatisfaction with her placement decision, an intentional caring presence was brought into the conversation during the report to ensure a positive outcome.In the moment, I was able to understand and relate to my patient's frustration with her current situation. By utilizing Watson's carative factors, I enhanced my attentiveness, listening skills, comfort, and patience during our interaction. To prepare for the interaction, I applied Watson's first carative factor to develop a humanistic-altruistic system of values and approach the situation with kindness and equanimity. I was mindful of my emotions and avoided letting prior information from the triage nurse cloud my judgment of the patient. Creating an ideal environment for caring involved being aware of my intentions, body language, thoughts, words, and behaviors along with those of my patient's. I realized that
my personal energy field was essential for fostering a transpersonal caring connection. Being open to each patient's unique needs and viewing them as individuals enabled me to offer them the best possible care. As I entered my patient's room, her body language indicated anxiety and despair, prompting me to provide comfort even though I felt somewhat uneasy about the situation.Utilizing Watson's third carative factor, which involves fostering sensitivity towards oneself and others, I demonstrated the cultivation of my own spiritual practices and transpersonal self. By being aware of my own emotional state and that of my patient's, I was able to move beyond my ego self. Upon introducing myself to my patient, she chose to avoid eye contact and remained turned away. Sensing my discomfort, I made a conscious effort to remain centered and open, stepping closer to her and resting my hand on the rail of her bed. Despite her tears and continued avoidance of eye contact, I maintained silence while showing empathy towards her emotions. As she cried, I could detect her anxiety and fear. When she finally reached out for my hand and squeezed it with force, I allowed her to do so without interruption. Ultimately, she met my gaze and I offered a gentle smile, demonstrating that it was okay to feel vulnerable in this moment. This helped to establish a helping-trusting relationship, which is Watson's fourth carative factor. It allowed my patient to open up about why she was in the emergency room that day - she had been experiencing anxiety for several weeks and had thoughts of not wanting to continue living.As I listened to my patient without interruption,
she confided in me about how her husband's disability income led to the state cutting off her cash aid and medical benefits. Without medical benefits, she was unable to obtain her anxiety medication or attend therapy. Recognizing the negative energy and disharmony hindering her natural healing process, I engaged in caring transpersonal nursing. After she spoke, I used Watson's fifth carative factor, promoting the expression of emotions, to discuss how it's normal to feel overwhelmed and out of control at times. We agreed that coming to the emergency department was necessary for her to receive referrals and resources for free healthcare services. As we continued speaking, my patient stopped crying and became visibly calmer, expressing a willingness to speak with our social worker about treatment for her anxiety. I reflect on each patient interaction utilizing retrospective reflection-on-action in response to their personal life situations.According to Alligood (2010, p.125), deeper personal meaning is developed by nurses as they reflect on their own lived experiences. This reflective process, known as retrospective contemplation, involves integrating physical, mental, and spiritual nursing experiences into one's personal history. The process begins with the nurse's unique experiences, which may initially induce feelings of discomfort or confusion due to inadequate understanding.
For instance, during an interaction with a patient, a nurse may feel uncomfortable even before entering the room. However, after some reflection, the nurse may realize that such feelings stem from their own anxieties and worries over the past few months. Despite this discomfort, the nurse's ability to understand and relate to the patient's needs can contribute towards developing a caring moment that helps to build a trusting relationship.
As Alligood (2010) suggests,
caring is not a one-time occurrence but instead must be consistently retrieved and recaptured in every caring occasion. By allowing patients to express themselves, they are given the opportunities to find their own voices through telling their stories and sharing their experiences.According to Alligood (2010), by examining and comprehending the apprehensions and individual spheres of the nurse and patient, a profound, intricate and comprehensive way of life may be identified and comprehended. (p.125).
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