Jean Watson’s Theory of Caring

1. Jean Watson’s Theory of Caring Kortni Pedlow Tiffany Hammond

2. Jean Watson • An American nursing scholar born in West Virginia, currently living in Colorado • Earned her undergraduate and graduate degrees in nursing psychiatric-mental health nursing and holds her Ph.D. in educational psychology and counseling from the university of Colorado • At the University of Colorado, Dr. Watson currently holds the title of Distinguished Professor of Nursing and the Murchinson-Scoville Chair in Caring Science, the nation’s first endowed chair in Caring Science, based at the University of Colorado Denver College of Nursing since 1999. • Founder of the Center for Human Caring in Colorado. http://www.millionnurseproject.org/index.html • Featured in numerous national videos on nursing theory and the art of nursing. • Recipient of several national and international honors and awards, including The Fetzer Institute Norman Cousins Award, in recognition of her commitment to developing; maintaining and exemplifying relationship-centered care practices. • Served as author /co-author of over 14 books ranging from empirical measurements of caring to new postmodern philosophies of caring and healing.

3. Watson’s Theory of Caring • Developed in 1979 • Major Elements: - Carative Factors - Transpersonal caring relationship - Caring occasion/Caring moment

4. Carative Factors • Serve as a guide for the core of nursing • Comprised of 10 elements: 1. Humanistic-altruistic system of value 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 assistant 10. Existential-phenomenological-spiritual forces (Watson, 1988b, p. 75) • As her theory evolved clinical caritas (from the Greek meanings to cherish and to give special attention) replaced the carative factors

5. Transpersonal Caring Relationship • A special kind of human care that depends on: - The nurse’s moral commitment in protecting and enhancing human dignity as well as the deeper self - The nurse’s caring consciousness communicated to preserve and honor the embodied spirit, therefore not reducing the person to a moral status of an object - The nurse’s connection and having the potential to heal since experience, perception, and intentional connection are taking place • Describes how the nurse goes beyond the objective assessment to show concern toward the person’s subjective/deeper meaning of their healthcare situation. • Involves mutuality between the two individuals involved

6. Caring Occasion/Caring Moment • “The moment (focal point in space and time) when the nurse and another person come together in such a way that an occasion for human caring is created” (Watson, 1988b, 1999). • Both the nurse and one being cared for can be influenced by the caring moment

7. Theory of Caring in Research • Jean Watson has researched and published the utilization of her theory multiple times • Jean Watson’s Theory of Caring, among others has been used in research towards an empirical development of a middle range theory of caring • Research has been conducted and Watson’s theory has been adopted in multiple institutions throughout the world (Ex: Union Hospital of Cecil County is adopting Jean Watson’s Theory of Caring for their magnet journey) • Examples of the global use of caring: http://www.nursing.ucdenver.edu/faculty/jw_connections.htm • Examples of Watson’s Theory used in research: http://www.nursing.ucdenver.edu/faculty/references.htm • Nurses are able to evaluate their use of the caring theory by this patient survey: http://www.nursing.ucdenver.edu/faculty/articles/CaringFactorScale.pdf

8. Theory of Caring in Nursing • Nursing is based on the concept of care. Many nurses have adopted Jean Watson’s Caring Theory in their practice. • Nurses should establish a caring relationship with patients. • Mutuality should be obtained between the nurse and patient concerning the patient’s healthcare situation and needs. • Nurses should treat patients as holistic beings (body, mind and spirit) with a positive regard. • Nurses should promote health through knowledge and intervention, and display acceptance towards patients that is unconditional. • Caring occasions/moments should transform both the patient and nurse, as they are linked together.

9. Theory of Caring Applied • Carative factors used with postpartum women experiencing multiple emotions 1. never pass judgments, provide all patients with the same respect and level of care. 2. instill hope in the mothers that they will be able to care for their babies and return to their “normal” state of health. 3. discuss the patient’s perceptions and feelings towards their birthing/parenting experiences. 4. provide a trusting relationship where the patient feels that you are committed to helping them. Advocate for the patient. 5. enable the patient to discuss positive and negative feelings concerning her current healthcare/home situation. 6 & 7. use creativity during teaching opportunities and holistic treatments involving pain management. 8. ensure that their environment is comfortable and enables them to get rest. Ensure that the patient’s home environment is safe for mother and baby upon return. 9 & 10. help patients reach harmony (mind, body, spirit) through holistic and caring modalities. Promote mother-infant bonding. Assess patient’s support system.

10. Theory of Caring Applied • Carative factors used with patients suffering MI, Stroke, CHF, COPD on a telemetry floor 1. never pass judgments, provide all patients with the same respect and level of care. 2. instill hope in the patients with MI or Stroke that they will get through this tough time, and patients with CHF or COPD that they will get through this exacerbation and return to their baseline health. 3. discuss the patient’s feelings and perceptions about their quality of life and symptom management. 4. provide a trusting relationship where the patient feels that you are committed to helping them. Advocate for the patients as needed. 5. enable the patient to discuss positive and negative feelings concerning his/her current healthcare situation and come to a mutual agreement. Multidisciplinary rounding. 6 & 7. use creativity during teaching opportunities and holistic treatments involving symptom management. Involve family in teaching as much as possible. 8. ensure that their environment is comfortable and enables them to get rest. 9 & 10. help patients reach harmony (mind, body, spirit) through holistic and caring modalities. Initiate or continue palliative care and assess patient’s support system.