Watson Theory of Human Caring Research Paper

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Watson Theory of Human Caring


Values and Assumptions

The theory of human caring by Jean Watson involves caring actions by nurses in their interaction with others (Fawcett, 2002). Its values and assumptions have a metaphysical, phenomenological-existential and spiritual slant, based on Eastern philosophy. Its values include a deep respect for the wonder and mysteries of life and the power of the human being to change; high regard and respect for the spiritual or subjective nature of each person to grow and to change; and a non-paternalistic scheme to help the person or patient acquire greater self-knowledge, self-control and self-healing, whatever his or her illness. Its assumptions relate with human life, nursing science and nursing processes. Jean Watson's concept of human life draws from the belief that the soul possesses a body that is not limited by physical or concrete space and time. Experiencing a person is not subjected or limited to either external or internal perceptions of time or space. Rather, it determines its own time and space, which have no constraints. Watson also perceives nursing as a human science dealing with persons and health-illness experiences of human beings. These experiences are mediated by professional, personal, scientific, aesthetic, and ethical human care transactions. Human care is the process of nursing (Fawcett).

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Its main concept is transpersonal human caring, best understood within the ancillary concepts of life, illness and health (Fawcett, 2002). It defines human life as "spiritual-mental-physical being-in-the-world," traversing continuously in time and space. Illness is not always a disease, but can also be a state of turbulence or disharmony in a person's inner self, whether in the conscious or unconscious level. And health is the unity and harmony of the mind, body and the soul. Transpersonal human caring and caring transactions refer to scientific, professional, ethical, aesthetic, creative and personalized giving and receiving behaviors and responses between nurse and patient. These interactions allow them to experience each other via physical, mental and spiritual paths or a combination of these paths. From these, it can be gleaned that the precise goal of nursing is to help the patient gain a higher degree of harmony in mind, body and soul. That harmony produces self-knowledge, self-respect, self-healing, and self-care processes (Fawcett).

Carative Factors or Clinical Caritas

These are humanistic-altruistic system of values; faith-hope; sensitivity to oneself and others; helping-trusting and human care relationship; expressing positive and negative feelings; a creative problem-solving caring process; transpersonal teaching-learning; a supportive, protective, and/or corrective mental, physical, social, and spiritual environment; assistance to human needs; and existential-phenomenological-spiritual forces (Fawcett, 2002). These later evolved into 10 clinical caritas: loving-kindness and equanimity, authentic presence, spiritual practice and transpersonal self, a helping-trusting relationship, presence and supportiveness to the expression of positive and negative feelings, creative use of oneself in caring-healing practice, genuine teaching-learning experience to evident unity of being, healing environment in all levels, assistance with basic needs, and openness to spiritual mysteries and existential dimensions in one's own life (Hagedorn, 2004).

Actual Nurse/Patient Interaction

Jeanette is a 14-year-old Hispanic woman at the Adolescent Clinic who sought an annual exam with her aunt (Hagedorn, 2004). She did not have primary care before this time. Jeanette is a failing ninth-grader, who uses substances and engages in unprotected sex. Her aunt sought the help of a professional nurse practitioner or PNP to draw Jeanette away from risky behavior. The PNP took Jeanette into confidence, listened to side non-judgmentally. She took the place of Jeanette's aunt in the situation and relationship in order to secure Jeanette's health. This openness allowed Jeanette to reach a positive decision to use contraception and drug treatment because of the respect the nurse practitioner showed her (Hagedorn).

Analyzing Assumptions

Human life -- the PNP expressed effective recognition of the separate humanity of both Jeanette and her aunt and the importance of their concerns and situations. The PNP became the trusted adult to the aunt and friend to Jeanette. She treated Jeanette's confessions, decisions and behaviors are unique to herself as a human being. Thus, the PNP kept these confidential and valuable for an appropriate case assessment and intervention.

Nursing Science -- but these sentiments and dispositions depended on the PNP's nursing role and the resources of the community. The PNP must choose those, which are culturally acceptable in Jeanette's case and will lead to a change in the behavior of both Jeanette and her aunt through the PNP's caring way.

Nursing Process -- this is human caring itself, the connection established by the PNP with Jeanette as well as her aunt and the effects the PNP targets through her intervention. With a rich and deep understanding of Jeanette's history and her aunt's circumstances and preferences, the PNP is able to discuss the desirability of contraception and modifications of Jeanette's sexual activity with her. The PNP had to be very sensitive to Jeanette's side about this in seeking a response from her. Only an established and trusting relationship as the medium, an authentic engagement with the client and sincere listening to her true sentiments can secure positive health results.

Application of Carative Factors

Jean Watson's carative factors or clinical caritas are in operation in the relationship-intervention established by the PNP with Jeanette and her aunt. She showed loving-kindness and equanimity towards them separately and uniquely. She understood the trouble the aunt had with an errant niece who is a school failure and an unscrupulous teen-age who engages in indiscriminate sex. The aunt needed someone who can share her grief and responsibility in correcting the attitude and decisions of a rebellious niece. At the same time, the PNP opened up to the separate needs, feelings and needs of Jeanette in her own world. The PNP did not over-react or under-react to either of the clients but welcomed them equally and without judgment.

The PNP's presence is authentic in that she opened up and listened to the two clients beyond what her duty required. She did not just follow rules and fulfill her strict obligations. She did not deal with them automatically, coldly or distantly. She was a real person in the presence of other real persons, the clients.

Her dealing with Jeanette and her aunt went beyond official and legal boundaries expected of an ordinary nurse. The PNP, thus, performed spiritual practice and through a transpersonal self, a transcended self or ego. She had to be more than herself to encourage the same "leap of faith" from the aunt and Jeanette. Only a transcended self can afford to abandon its confinement in order to approach another trapped ego and help it move out of the trap. The PNP had to perform a spiritual act in order to bring about a healing in Jeanette and her aunt.

She is, thus, able to build a helping-trusting relationship with them. By giving them un-hurried time to listen to what they felt and had to say without criticizing or berating them, she gained their confidence and trust in her sincerity to help them in a real way. By providing them the resources that can fill their need, they realized that she can be trusted.

Reflections on Professional Experience

There are many important elements to advanced practice, but personalized care is always at the heart of it (Hagedorn, 2004). The PNP must attune herself to her patient in order to come up with appropriate actions. An "intuitive gap" is essential. This means a deep understanding of the whole situation or patient. How the patient sees how the disease process or health condition has affected his life should be established at the start of a caring relationship. This can be done through visual information and a written plan of recuperation. The PNP may also discuss cultural, environmental, social and emotional aspect of his health condition. As their relationship grows and deepens, they adjust their approach according to their developing needs, interests, and values. The use of caring and reflective approaches can motivate patients to express themselves and thus have a hand on their healthcare plan. Watson's 10 clinical caritas can be used in formulating the proper approach. It can be combined with creative caring adapted to the patient's unique personality or condition in achieving his recovery (Hagedorn).

In bridging the gap between research and practice, the unique contribution of nursing to healthcare must first be made thoroughly clear (Dorn, 2004). Caring is central to nursing and serves as its philosophical and conceptual frame of reference. Caring-based models that examine caring and its impact to health come in at this point. They consider the holistic nature of every patient and the complexity and uniqueness of the human condition. In using these models, nurses are better able to use and integrate the caring theory with research and evidence-based practice. They interpret evidence and its quality from a caring viewpoint in making decisions or changes in decision. When they do, they make explicit the clear contribution of nursing to healthcare (Dorn).

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