Watson's Theory of Caring Paper

Watson's Theory of Caring Paper

Watson's theory of caring began to develop 25 years ago "in a textbook planned to present integrated curriculum for undergraduate nursing programs to an original structure for the basic nursing process" (Alligood & Tomey, 2006, p. 103). Watson began by comparing the relationship between caring and nursing. Watson's idea was to develop nursing as a "human science" with unique values, knowledge, practices, ethics, and mission (Watson, Jackson, & Borbasi, 2005) distinct from but complementary to, medical knowledge (Watson, 1999, p. 14). Watson adopts several broad themes from nursing's heritage. She believes that each person has value in and of him or herself. She believes that individuals should "be cared for, respected, nurtured, and understood and assisted; in general a philosophical view of a person as a fully functional integrated self. The human is viewed as greater than, and different from, the sum of his or her parts" (Watson, 1999, p. 14). Watson emphasizes the human relationship between the nurse and her patient and how it affects his or her health. She stresses the importance of health, well-being, and the promotion of health. Watson's early writings "identified ten carative factors that served as the foundation and framework for the science and practice of nursing" (Watson, 1979, p. 17).

The combination of interventions can be referred to as carative factors and include:

1. Humanistic-altruistic system of values

2. Faith-hope

3. Sensitivity to self and others

4. Helping-trusting, human care relationship

5. Expressing positive and negative feelings

6. Creative problem-solving caring process

7. Transpersonal teaching-learning

8. Supportive, protective, and/or corrective mental, physical, societal and spiritual environment

9. Human needs assistance

10. Existential-phenomenological-spiritual forces.

All of this is presupposed by a knowledge base and clinical competence (Watson, 1979, p. 9-21).

She sees "the problem today seems to be that nursing has not developed the science of nursing in accordance with its theories" (Watson, 1999, p. 14). Her theory is based on a transpersonal caring relationship between the nurse and the patient; "the process affirms the subjectivity of persons and leads to positive change for the welfare of others, but also allows the nurse to benefit and grow" (Watson, 1999, p. 74-75).

I practice in Watson's theory with my patients in the emergency department. One particular event occurred when I was caring for a 34-year-old female who came into the emergency department. She was approximately nine weeks pregnant. She came into the emergency department because she had severe left sided abdominal pain and had started to bleed. She was very distraught and crying. As I handed her a tissue, she explained to me that her and her husband had been trying to start a family for the last two years. She is afraid that something she had done had made her start bleeding. As I begin speaking with my patient "Jane," I remember to use several of the "caritas": (1) humanistic-altruistic system of values (2) faith-hope (3) sensitivity to self and others (4) helping-trusting, human care relationship, (5) expressing positive and negative feelings, (6) creative problem-solving caring process and (7) transpersonal teaching-learning. Immediately upon meeting Jane I must determine who she is as a person. I also must decide how to care for her and determine whether or not I am open to participating in her personal story. I think about the health event that has brought her into my facility. I determine what information I need to nurse "Jane," and I try to imagine what this event must be like for "Jane." I allow "Jane" to express her fears openly. I also explain to "Jane" that at this point in her pregnancy there is nothing she had done to cause what is happening. I am open and honest with her when I explain to her the possibilities. I touch her hand to comfort her as I explain to "Jane" that although bleeding in pregnancy is not normal it does not mean that this pregnancy will not finish normally resulting in a healthy child. I tell her the doctor and I will be checking some labs, and do an ultrasound to make sure her baby is in the correct spot. I also explain that if the baby is where it should be that we will check to make sure the end of her cervix is closed. I explain that if it is closed that would be good. I am also honest with her that if her cervix is open she may go on to have a miscarriage. While telling her about the possibility of a miscarriage, I also relay the story of my own miscarriage. I also explain that I have three beautiful healthy children. I also explain the possibility of surgery if the baby is not in the correct spot, but go on to reassure her that if this is the case she will be able to continue trying to start a family as soon as the doctor says she is ready. I explain to her what to expect while she is in the emergency department. I also relay my experience with bleeding during my first trimester of all four of my pregnancies. "Jane's" husband works long hours and cannot be here with her. I offer to call someone to come sit with her as she waits. I also notice that she is wearing a medallion with a picture of the Virgin Mary on it, so I ask her if she wants to have a chaplain come pray with her. I call her mother to come sit with her and Sister Emily comes to pray with her. The emergency department is very busy, and I am unable to sit with her