LEARNING THEORY GROUP PRESENTATION: JEAN WATSON. By: April Bilbe , Ashley Denhartigh , Barb Hulwick , Dana Raymer & Deborah Schaefer.
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By: April Bilbe,
Dana Raymer &
[Photograph of Jean Watson]. (2010). 4th Annual Envision Conference Nursing: The Art and Science of Caring. Oakland University, Rochester, MI.
Some of us have seen Jean speak in person. Witnessing her passion and talents as a speaker really made her stand out.
O According to Jesse (2010), during an undergraduate course Watson studied Yakom’s 11 CarativeFactors, which led her to develop her own 10 Curative factors.
O Her first book Nursing: The Philosophy and Science of Caring (1979) was developed off of the notes from these studies (p. 93).
O Life experiences were the motivation for her third book, Post Modern Nursing and Beyond (1999).
O Jesse (2010) explains that both the tragic experience of losing her husband and the loss of her left eye allowed her to experience her own theory at work, as the people around her cared for her during these troubling times (p.93).
O Watson’s fifth book Caring Science as Sacred Science (2005) describes her own life’s passage.
O “This book leads the reader through thought-provoking experiences and the sacredness of nursing by emphasizing deep inner reflection and personal growth, communication skills, use of self-transpersonal growth, and attention to both caring science and healing through forgiveness, gratitude , and surrender” (Jesse, 2010, p. 93).
O As a dedicated learner, Watson’s continual education has led her to think deeply about nursing and the science of caring.
O Her own life experiences have shaped what her theory is today.
Watson calls for joining of science with humanities so that nurses will have a strong liberal arts background and will understand other cultures as a requisite for using Care Science and a mind-body-spirit framework” (Jesse, 2010, p. 96).
The nurse must connect with the patient on a spiritual level through sincere presence.
“A caring moment involves an action and choice by both the nurse and the other. The moment of coming together presents them with the opportunity to decide how to be in the moment and in the relationship as where as what to do with and during the moment. If the caring moment is transpersonal, each feels a connection with the other at the spirit level, thus it transcends time and space, opening up new possibilities for healing and human connection at a deeper level than physical interaction” (WCSI, 2009, “Caring Science Ten Caritas Processes,” para. 7).
“The nurse’s own life history, previous experiences, opportunities for focused study, having lived through or experienced various human conditions, and having imagined others’ feelings in various circumstances are valuable teachers for this work…” (Jesse, 2010, p. 98).
“Caring in the nursing profession takes place every time a nurse-to-patient contact is made... That caring makes a difference to the patient’s sense of well being. Caring may occur without curing but curing cannot occur without caring” (Vance, 2003, para. 1).
Although influenced by the work of others, Watson based much of her work off of her own ideas, values, and beliefs about life, health, and healing (Jesse, 2010, p. 94).
Watson’s theory is specific to the nursing profession. The humanistic aspects of nursing are emphasized, and intimate, personal moments between nurse and patient are focused on.
It is very clear that various theorists and philosophers, along with Jean Watson’s own reflective thinking has influenced her work.
As shown in previous slides, Watson’s Theory of Transpersonal Caring adequately describes the four global concepts.
Human Being - Watson believes that the person is to be valued, cared for, respected and viewed in a holistic way, as body, mind and spirit.
Environment - Watson believes that the person’s environment should be conducive to healing and that the person and their environment are connected. The person’s frame of reference is also something that should be considered, and the nurse should strive to stay within the person’s frame of reference.
Health - Health is viewed as overall functioning and distress and disharmony can be caused by more than just disease processes.
Nursing – Watson argues that caring is central to the profession of nursing and that nursing care should also focus on promoting health and preventing illness. The nurse should focus their care on healing and wholeness as opposed to tasks, illness and disease.
Watson’s theory can be applied in any area of nursing. The theory of caring addressing all aspects of the health and illness continuum, and the concepts are abstract and open to interpretation. In fact, lack of concrete guidelines has been one of the criticisms of the theory, since nurses do not have specific steps they can follow to apply the principles of the theory in their practice.
In Nursing Theorists and Their Work (2010), Kristen Swanson credits Watson with influencing her exploration of the concept of caring while completing her doctoral dissertation. Dr. Joanne Duffy also states she was influenced by Watson’s theories while developing her Quality Caring Model
Watson’s theory can be applied during any interaction between patient and nurse. It involves the nurse being involved in the moment, being there with his or her own whole body and mind, and focusing on the point in time that is occurring, not thinking about what is going to happen next or tomorrow or when he or she gets out of work.
While helping a patient with their pre-op Hibiclens bath, the patient expresses fear of the upcoming procedure. The nurse repeats what the patient is saying regarding her concerns so she can clarify what the patient is saying and spends time discussing with the patient her fears and reviewing what to expect before and after the surgery. The nurse allows the patient to express herself without rushing through the shower so she can pass meds to the next patient.
The nurse is caring for an Asian immigrant who speaks very little English. The patient has just had a baby via C-section and will have to stay in the hospital for a couple of days. The nurse decides to research cultural considerations for her patient so that she can understand postpartum traditions that the patient may choose to practice. The nurse communicates her findings to the oncoming nurse and makes adjustments to her care and the patient’s environment in order to facilitate the patient’s cultural traditions.
Betty, a 59 year old factory worker, arrives at the emergency room in a small, but busy hospital, not far from her place of employment. She is complaining of intense pain in her left shoulder and anxiety. As an ER nurse with 20 years experience, I have seen a lot of drug seekers come in with the same complaints. Utilizing Watson’s Philosophy and Theory of Transpersonal Caring, I know that I must not pre-judge any patient and I must develop a Helping-Trust Relationship with each patient. Using empathy, congruence, non-possessive warmth, and effective communication is important in building a relationship with a patient in a short amount of time, especially in an E.R. setting.
Betty cannot raise her left arm above chest level and there is no obvious injury to the site. Her vitals are as follows: B/P 168/85, PR 115, and T 97.9. What aspect of Watson’s Theory is put into action here?
Betty is given 50 mg of Demerol and 2 mg of Ativan. She then states that she has been SOB occasionally. Her pulse ox is 92% on room air. At this point another one of Watson’s carative factors comes into play. Which one?
Betty is diagnosed with a mass on her adrenal gland and an enlarged lymph node near her heart. She is oriented, but sleepy from the Demerol and Ativan and still complains of pain in her left shoulder. Her husband lost his job when his shop closed after working there for thirty years. She is not covered by any insurance at this time. She has two grown children and her daughter, a nurse, is present with her in the E.R. How can we approach this family using Jean Watson’s Theory? Which two of the original carative factors could be utilized?
Realizing that Betty and her daughter were just given some potentially life threatening news, I encouraged them both to express how they were feeling about this diagnosis.
Prior to discharge, Betty was encouraged to seek an appointment with an oncologist and given a prescription for pain meds to help keep her comfortable until she can get in to see the doctor. I walked them out of the cubicle and said a silent prayer for the battle they were about to begin.
Answer 1. As the nurse caring for her, Watson’s Theory directs me that patients must satisfy lower order needs before attempting to attain higher order needs. Betty’s pain and anxiety must be controlled before she can process and accept what is happening physically.
Answer 2. One of Watson’s Original 10 Carative Factors is the Systematic Use of the Scientific Problem Solving Method for Decision Making. I realize that this newly conveyed information may be connected to her original complaints and collect this data for the doctor to review. It is important to keep things organized, knowing what and when to relay for further investigation.
Answer 3. Watson’s Theory, based on the Original 10 Caratives, includes Cultivation of Sensitivity to Self and to Others. This explains that as nurses acknowledge their sensitivity and feelings, they become more genuine, authentic, and sensitive to others. This leads to self-actualization through self-acceptance for nurses and patients. Another one of Watson’s Caratives is Promotion and Acceptance of the Expression of Positive and Negative Feelings. This is a huge risk taking move on the part of nurses and patients. Be prepared for whatever feeling is shared, good or bad. Everyone acts and reacts differently and uniquely to each situation presented to them, including minor and major health dilemmas.