You are on page 1of 27

The Philosophy and Science of Caring

Jean Watson, PhD, RN, AHN-BC, FAAN

SARAH BARNETT
MEGHAN BROWN
MISTY DONLEY
LESLIE RUSH

The Philosophy and Science of Caring


Jean Watson, PhD, RN, AHN-BC, FAAN

USING
"CARING
AS A
T HE M E " ,
JEAN
WATSON
D E VE L O PE D
T HE
"CARATIVE
F A C T O R S " T O HE L P DE VE L OP T HE E V E R
E V O L V IN G N UR S I N G P H I LO S O P H IE S A N D
THEORIES. (CHITTY, 308-9)

Born in West Virginia


Diploma nursing from LewisGale School of Nursing in 1961
BSN from University of Colorado
in 1964
MS from University of Colorado
in 1966
PhD from University of Colorado
in 1973
The Philosophy and Science of
Caring first published book in
1979
Founder, Center for Human
Caring, University of Colorado
Health Sciences Center in 1986
(Watson Caring Science
Institute, n.d.)

(Chitty, 308)

Jean Watson: Background and Education

Jean Watson: Background and Education


States my early work emerged from my own values, beliefs, and

perceptions about personhood, life, health, and healing(Tomey &


Alligood, 2006, p. 94)
Influenced by the nursing theorist/philosophers that came before her
like Nightingale, Henderson, and her own personal beliefs.
Knowledge development is important value as seen by her numerous
writings and teaching positions.
Values about nursing are "developing; maintaining and exemplifying
relationship-centered care practices" (Watson Caring Science Institute,
n.d.)

Jean Watson: Concept

JEAN WATSON'S PHILOSOPHY AND SCIENCE OF


CARING ADDRESSES HOW NURSES EXPRESS CARE
TO THEIR PATIENTS. CARING IS CENTRAL TO
NURSING PRACTICE, AND PROMOTES HEALTH
BETTER THAN A SIMPLE MEDICAL CURE. SHE
BELIEVES THAT A HOLISTIC APPROACH TO
HEALTH CARE IS CENTRAL TO THE PRACTICE OF
CARING IN NURSING (NURSING THEORY, 2011).

Global Concepts
Human Being (Patient and Nurse)

Is subjective and unique


Has distinct human needs, which are
biophysical, psychophysical, psychosocial
and interpersonal
Needs to be valued, respected, nurtured,
understood and assisted
Is directly influenced by the external
environment

Health

Nursing

Environment

Is critical to the holistic healing (mental,


physical, social, emotional, spiritual,
developmental, protective, supportive
environments), which is conducive to a
patients health and wellbeing

Viewed holistically, as the unity between


body, mind, and soul, with all parts working
together in harmony and functioning to their
full capacity
Absence of illness, or the presence of efforts
that leads its absence

Providing caring, professional and thoughtful


interactions to restore and promote holistic
health and to prevent illness
Based on human values
Dedicated to the wellbeing of others
Concerned with the health promotion, health
restoration, and illness prevention (Chitty &
Black, 2011, p. 309)

GLOBAL
CONCEPTS

Jean Watson: Theory and


Nursing Process

WATSONS NURSING PROCESS PARALLELS


THE SCIENTIFIC RESEARCH PROCESS. BOTH
PROVIDE A FRAMEWORK FOR DECISION
MAKING.
BOTH
INVOLVE
SOLVING
A
PROBLEM.

Jean Watsons Theory and Nursing Process


1) Assessment
Involves observation and identification of a problem
Includes the formulation of hypothesis
2) Care Plan
It helps to determine how variables will be examined and measured
It helps to determine what data will be collected and how it will be collected
3) Intervention
It is the implementation of the care plan
It includes the collection of the data
4) Evaluation
Analysis of the data
Effects of the interventions based on the data
Includes the interpretation of the results
It may also generate additional hypothesis

Interpretation & Inference

Caring can be effectively demonstrated and practiced only interpersonally.


Caring consists of carative factors that result in the satisfaction of certain human
needs.
Effective caring promotes health and individual or family growth.
Caring responses accept person not only as he or she is now but as what he or she
may become.
A caring environment is one that offers the development of potential while allowing
the person to choose the best action for himself or herself at a given point in time.
Caring is more healthogenic than is curing. A science of caring is complementary
to the science of curing.
The practice of caring is central to nursing.

(Nursing Theories: A Companion to Nursing Theories and Models, 2012).

Jean Watsons theory was founded on the humanistic aspects of nursing in


combination with scientific knowledge. Her concept shows a caring, nurturing
relationship between the nurse and patient.

Implications & Consequences

A more holilstic care approach.


Better nurse patient relationship.

Patient feeling more empowered in the decision making

process.

Evaluation of The Philosophy and


Science of Caring

JEAN WATSONS THE PHILOSOPHY OF SCIENCE AND CARING


PROVIDES A MODEL UNIQUE TO NURSING WITH CONCEPTS THAT
CAN BE APPLIED WITHIN MANY FACETS OF OUR WORLD.
INFLUENCED BY HER DESIRE TO RETURN THE HUMAN TO
HUMAN INTERACTION TO NURSING, WATSON RELATED HER
PHILOSOPHY
TO
THE
FOUR
GLOBAL
CONCEPTS.
THIS
PHILOSOPHY CAN BE APPLIED WITHIN ANY DISCIPLINE OF
NURSING BY PROMOTING HEALING NOT THROUGH FOCUS ON
THE CURATIVE FACTORS BUT INSTEAD THE MIND, BODY AND
SOUL OF THE PATIENT.

Evaluation of The Philosophy and Science of Caring: Origins


What Influenced The Philosophy and
Science of Caring?

Is The Philosophy and Science of


Caring unique to Nursing?

My focus has been on nursing in relation to


its covenant to offer compassionate human
service to sustain and preserve human
dignity and humanity; to sustain caring in
instances where it is threatened,
biologically or otherwise; a concern with
deep caring-healing relationships with
humans who are experiencing suffering,
loss, grief, death, change/ transition with
life threats and challenges, and seeking
meaning to be in right-relation, harmony
with self and other, and that which is
greater than human. Thus, my focus on
caring, and caring- healing relationships,
emerges from within the discipline of
nursing and the practice of professional
nursing; but paradoxically transcends
nursing. (Clarke, 2009).

Jean Watson, found herself frustrated by the


almost complete lack of conceptual, intellectual
or philosophical focus on the human aspect of
patient care. (Petrovski, 2012).
Watson's education in the early 1960s stressed
what she refers to as "curing techniques and
procedures related to a specific disease and its
treatment within medical science framework.
(Petrovski, 2012).
Called for a return to the earlier values of
nursing and emphasized the caring aspects of
nursing. (Chitty, 2010).
"No one was giving voice to the human
experience," says Dr. Watson. "I was longing for
intellectual theories or values or a conceptual
framework of what was happening with patient
care and the human-to-human relationships."
(Petrovski, 2012).

Evaluation of The Philosophy and Science of Caring: Global Concepts


The Philosophy and Science of Caring
addresses the Person

Both the patient and the Nurse (Chitty,


2010).
Dr. Watson has labored to transform
nursing into a holistic caring-healing
professional practice, grounded in the
philosophy, ethic and science of caring,
that addresses not just the body but the
unity of mind-body-spirit.(Petrovski,
2012).
Watson also focused on this reciprocity
of the relationship, which she indicated
addresses the importance of the nurses
own caretaking. (Lachman, 2012).

The Philosophy and Science of Caring


addresses the Environment

One that supports human caring


(Chitty, 2010).
The nurse guided by Watsons work has
responsibility for creating and
maintaining an environment
supporting human caring. (Chitty,
2010).

Evaluation of The Philosophy and Science of Caring: Global Concepts


The Philosophy and Science of Caring
addresses Health

In terms of health promotion and illness


prevention. (Chitty, 2010).
Illness and disease was equated with lack
of harmony within the mind, body and
soul experienced in internal and external
environments. (Chitty, 2010).
Nursing is concerned with health

promotion, health restoration, and


illness prevention. (Chitty, 2010).
Watson defines the persons health as a
subjective experience.

The Philosophy and Science of Caring


addresses Nursing

What nurses contributed to the


encounter with the patient. (Chitty,
2010).
Watson views nursing as both a science
and an art. according to Watson, being
an artist is part of our role and certainly
part of caring for patients and their
families. (Cara, n.d.).
Caritas honors the dignity of self and
other and wholeness of being, which
empowers nurses-and thereby their
patients-through the quality of their
caring-healing relationships and
interactions. (Petrovski, 2012).
Emphasized how the nurse and the
patient change together through
transpersonal caring. (Chitty, 2010).

Other theories generated from The Philosophy and Science of Caring

Jean Watson has researched and published the utilization of her theory multiple
times
Following publication of her 1979 work, Watsons caring theory evolved from
basic thinking to one of greater awareness of divine and holistic
interpersonal relationships
In 1985, she proposed eleven assumptions to explain the relationship
between nursing, human values, and caring for others
In 1999, Postmodern Nursing and Beyond, Watson describes an ontological
shift in human consciousness by suggesting practice paths for practitioners
Jean Watsons Theory of Caring, among others has been used in research towards
an empirical development of a middle range theory of caring.
(Swanson, 1991).

Evaluation of The Philosophy and Science of Caring: Practice Situations

Kaiser Permanente Northern California is systematically integrating caring science and theory-based
practices in all of the 21 Northern California Kaiser facilities. Others, such as Baptist Health in
Jacksonville and Miami, Fla., Children's Hospital Colorado, the Michael F. DeBakey Veterans Hospital in
Houston, and Atlanta Veteran's Hospital, are engaged in new forms of evidence-based caring science
knowledge. In these systems, nurses are becoming scholar clinicians, implementing new professional
Caring Science models system wide, as well as exploring new empirical connections between human
caring and patient outcomes. (Petrovski, 2012).
The frequency and number of Magnet hospitals use of caring theory as one core Magnet criterion, is
evidence and testimony of caring theory and its impact on nursing over time. (Clarke, 2012).

Evaluation of The Philosophy and Science of Caring: Practice Situations


Questions to use in practice that can help assess the person
Tell me about your spiritual and cultural beliefs?
Tell me about your goals and expectations?
Questions to help the nurse reflect upon his/her caring practice
How do I express my caring consciousness and commitment to the persons and their
families? To working colleagues? To other health care professionals? To my superiors? To
the institution?
How do I define the person, environment, health/healing, and nursing?
Questions to use in practice that can help assess the patients perspective about health
Tell me how you perceive yourself in this situation?
What meaning are you giving to this situation?
Tell me about your health priorities?

(Cara, n.d.)

Conclusion

JEAN WATSON EMPHASIZED THE CARING ASPECTS


OF NURSING (CHITTY, 2011, P. 308).

WATSONS PHILOSOPHY FOCUSED ON THE HUMANTO-HUMAN RELATIONSHIP (CHITTY, 2011, P. 308).

1.

Ten Caritas
Processes
(Watson Caring Science Institute,
2013).

By using Watsons 10
Carative Factors, the
nurse is enabled to
share their genuine
selves with patients
(Chitty, 2011, p. 309).
Beyond the tasks of
nursing care, the
patient necessitates a
holistic model to reach
wellness or even a
peaceful passing.

2.
3.

4.
5.

6.
7.

8.

9.
10.

Embrace altruistic values and Practice loving


kindness with self and others.
Instill faith and hope and honor others.
Be sensitive to self and others by nurturing
individual beliefs and practices.
Develop helping trusting- caring
relationships.
Promote and accept positive and negative
feelings as you authentically listen to
anothers story.
Use creative scientific problem-solving
methods for caring decision making.
Share teaching and learning that addresses
the individual needs and comprehension
styles.
Create a healing environment for the
physical and spiritual self which respects
human dignity.
Assist with basic physical, emotional, and
spiritual human needs.
Open to mystery and Allow miracles to enter.

Conclusion: continued

The caring model encompasses nursings metaparadigm: environment,

person, health, & nursing.


Allowing the self to be open to giving and receiving care on a level
beyond just meeting physical needs opens the nurse: patient
relationship to greater healing, understanding and overall care.
RNs that follow this philosophy create and maintain a supportive
environment that embraces human caring while continuing to meet the
patients primary human requirements. (Chitty, 2011, p. 309)

Jeans
Million
Nurse
Project

Be a part of Jeans Million Nurse Project: Nurses


around the world bring this loving heart-centered
caring energy of Love and Caring to their individual
work every day. However, nurses may be silently
unaware of their actual energetic linkage and
connection they have with others in their
environment, and their natural capability of
unlimited expansive potential to affect the universal
consciousness field of humanity (Watson Caring
Science Institute, 2013).
For more info, visit
http://watsoncaringscience.org/educationprograms/million-nurse-project/.

Does Jean Watson


and her philosophy
influence your
nursing practice?

For a greater understanding of Jean Watson


and her philosophy, visit Watson Caring
Science Institute & International Caritas
Consortium
at http://watsoncaringscience.org/.

Case Study
Dean Smith is a 48 year old male with ALS (Amyotrophic lateral sclerosis) which
has left him unable to care for himself. Dean was a teacher prior to leaving for medical
disability. He is a widower with two adult children who do not live in the area and are not
close with their Dad. His support network is a former student, John, who assists him with
household chores and a neighbor, Beth, who manages his medications and takes him to
appointments. He presented to the Emergency Department with increased respiratory effort,
fever, and new onset inability to maintain oral secretions. Beth states that he is also having a
hard time responding to her and she and her husband are concerned to leave him alone.
Admission is arranged for probable pneumonia and likely placement in a skilled
nursing facility. Report is given from the ED to the Medical Surgical team and Dean is
admitted. During admission, Sally, the RN doing his intake notices that Dean is trying to
answer her questions but cannot. He is tearful, making fists and groaning. Sally asks the
CNA assisting them to please give them a minute and closes the computer. She pulls a chair
next to his bed, sits and holds his hand. She asks if he would like her to tell him a little about
herself. He squeezes her hand and attempts to nod. Sally proceeds to tell Dean about her
family, her dog, her career path and their church. Dean eventually relaxes and falls asleep.

Case Study: continued

Do Sallys actions follow the Watsons Carative Factors?


2. Looking at Factor 5: the promotion and acceptance of
the expression of positive and negative feelings, does
Sally sharing with Dean allow him to do this?
3. What are two ways that Sally followed Watsons
philosophy?
4. Would you have done this differently? How so?
1.

References
Cara, C. (n.d.). A Pragmatic View of Jean Watsons Caring Theory. Universit de Montral Faculty of
Nursing. Retrieved from http://www.humancaring.org/conted/Pragmatic%20View.pdf

Clarke, P.N., Watson, J., Brewer, B.B. (2009). From theory to practice : caring science according to
Watson and Brewer. Nursing Science Quarterly. 22(4). 339-345.
doi: 10.1177/0894318409344769
Chitty, K. K., & Black, B. P. (2011). Professional nursing: Concepts and challenges (6th ed.) Maryland
Heights, MO: Saunders Elsevier

Jean Watsons Theory of Caring. (n.d.). Metaparadigm. Retrieved from


http://upoun207grouph.blogspot.ca/p/metaparadigm-of-concepts.html
Lachman, V.D. 2012Applying the Ethics of Care to Your Nursing Practice. MedSurg Nursing. 21(2).
112-116 Retrieved from http://nursingworld.org/MainMenuCategories/EthicsStandards/
Resources/Applying-the-Ethics-of-Care-to-Your-Nursing-Practice.pdf
Nursing Theories: A Companion to Nursing Theories and Models. (2012). Jean Watsons philosophy of
nursing. Retrieved from http://www.currentnursing.com/nursing_theory/Watson.html
Nursing Theory. (2011). Jean Watson's contribution to nursing theory: Philosophy and science of caring.
Retrieved from http://nursing-theory.org/nursing-theorists/Jean-Watson.php

References
Petrovski, L. (2012). All you need is love (and human caring): transforming health care on nurse,
hospital at a time. Colorado Nurse. May/June/July, 15. Retrieved from CINHL
database.
Swanson, K.M. (1991). Empirical development of a middle range theory of caring. Nursing
Research, 40(3), 161-166. Retrieved from CINHL database.
Tomey, A. M., & Alligood, M. R. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO:
Mosby Elsevier.
Watson Caring Science Institute. (n.d.). Retrieved from http://watsoncaringscience.org/
Watson Caring Science Institute. (2013). Million Nurse Project. Retrieved from
http://watsoncaringscience.org/education-programs/million-nurse-project/.
Watson Caring Science Institute. (2013). Ten Caritas Processes. Retrieved from
http://watsoncaringscience.org/about-us/caring-science-definitions-processes-theory/.