Professional Documents
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Caring and Nursing Have Always Been Thought of Synonymously
Caring and Nursing Have Always Been Thought of Synonymously
Most
individuals choose nursing as a profession because of their desire to care for
other individuals. Caring as a central concept has led to the development of
several caring theories. Two well known theories were developed in the 1970s,
Leiningers Theory of cultural care and Jean Watsons Theory of human caring
(McCance, McKenna, Boore 1999).
Jean Watson defines caring as a science. She states; Caring is a science that
encompasses a humanitarian, human science orientation, human caring
processes, phenomena, and experiences. Caring science includes arts and
humanities as well as science. A caring science perspective is grounded in a
relational ontology of being-in-relation, and a world view of unity and
connectedness of all. Transpersonal Caring acknowledges unity of life and
connections that move in concentric circles of caring-from individual, to others,
to community, to world, to Planet Earth, to the universe. Caring science
investigations embrace inquiry that are reflective, subjective and interpretative
as well as objective-empirical; Caring science inquiry includes ontological,
philosophical, ethical, historical inquiry and studies. In addition, caring science
includes multiple epistemological approaches to inquiry including clinical and
empirical, but is open to moving into new areas of inquiry that explore other
ways of knowing, for example, aesthetic, poetic, narrative, personal, intuitive,
kinesthetic, evolving consciousness, intentionality, metaphysical-spiritual, as well
as moral-ethical knowing. Caring science is an evolving new field that is
grounded in the discipline of nursing and evolving nursing science, but more
recently includes other fields and disciplines in the Academy, for example,
Women/Feminist studies, Education, Ecology, Peace Studies, Philosophy/Ethics,
Arts and Humanities, Mindbodyspirit Medicine. As such, caring science is rapidly
becoming an Interdisciplinary Transdisciplinary field of study. It has relevance to
all the health, education human service fields and professions (Watson 2003).
Caring behaviors are defined as; Behaviors evidenced by nurses in caring for
patients.
The top ten caring behaviors, derived from nursing literature are; attentive
listening, comforting, honesty, patience, responsibility, providing information so
the patient can make an informed decision, touch, sensitivity, respect, calling the
patient by name (Tabers 1993).
Some Caring behaviors are evident in other professions. Law enforcement is
noted for their honesty and respect. Psychologists are comforting and require
attentive listening skills to help their patients. Teachers must possess patience,
attentive listening, sensitivity, and great responsibility to mold our children into
productive adults. The lists of professions are endless.
Madeleine Leininger subscribed to the central tenet that care is the essence of
nursing and the central, dominant, and unifying focus of nursing (Leininger
1991). Watson describes nursing as a human science, with the major focus being
the process of human care for individuals, families, and groups. Her theory is
based on a form of humanism and has its origins in metaphysics (philosophy of
being and knowing) (McCance, Mckenna, Boore 1999).
The goal of nursing with Watsons theory is centered around helping the patient
gain a higher degree of harmony within the mind, body, and soul. It is achieved
through caring transactions. Watsons ten carative factors, referred to as
interventions of the theory, are presented in table one. (McCance, McKenna,
Boore 1999). It also involves the transpersonal caring relationship.
Transpersonal caring is demonstrated in an event or actual caring occasion.
Transpersonal conveys a concern for the inner life. The patient is viewed as
whole and complete, regardless of illness or disease (Watson 2003). The
transpersonal nurse seeks to connect with, embrace the spirit or soul of the
patient, through the processes of caring and healing (Watson 2003).
Caring in the nursing profession takes place every time a nurse-to-patient
contact is made. The nurse enters the world of the patient in order to come to
know the patient as a caring person, and that it is from this epistemology that
the caring of nursing unfolds (Schoenhofer 2002). That caring makes a
difference to the patients sense of well being. Caring may occur without curing
but curing cannot occur without caring (Watson 2003).
It is with that belief that nurses care for patients in the hope that we contribute
to the cure or wellbeing of that patient.
Hope and commitment are ingredients of caring. Hope is described as more
than mere wishful thinking, but as an awareness of the moment alive with
possibilities (Schoenhofer 2002).
Hope may be the only crutch a patient has to keep their optimism. Nurses care
enough to honor that hope and support the patient. We view that patient as
whole and complete. The second carative factor of Jean Watsons ten carative
factors is faith-hope (see table one).
Hope is guided by our commitment as nurses to our patients. It is also clouded
with preconceived beliefs and morals that we are reared with.
I am a field nurse in a for-profit hospice organization. Caring is a central concept
to the delivery of hospice care. The patients we encounter are in a variety of
settings, such as, own home, nursing home, retirement center, family home, or
a friends home. They are often frightened with the knowledge of their imminent
death and in unfamiliar surroundings. They rely on the nurse and the delivery of
care to help them feel physically better.
As a hospice nurse we also view the patient as a spiritual being. That means
reaching out to the patient and forming a deeper connection to the spiritual
self. It means becoming one.
The one caring and the one being cared for are interconnected (Watson 1997).
Its experiencing human connection at a deeper level than a physical interaction
(Watson 2003)
The nurse must have an inner peace with her own mortality. The nurse must be
comfortable with death and dying and possess a deep understanding and
acceptance of all life cycles and be prepared for their own death (Watson 2002).
Caring is directed to a pain free death with dignity and a belief of a spiritual
transformation or journey after death.
Caring centers on the person, preserving dignity and humanity. It is a
commitment to alleviate anothers vulnerabilities by providing attention and
concern for each human life (Watson 2002). Hospice is holistic focused caring.
Our goal is to offer the dying patient the opportunity to die in the comfort of
their own home surrounded by those who care. The dying patient in the nursing
home is offered the opportunity to die with a caring nurse holding their hand.
Often the nursing home patient has no family or living relatives that can share in
the dying experience. The hospice nurse will be the one to care for the dying
patient and ease his journey. This relates to the carative factor number eight of
Jean Watsons ten carative factors, it states; supportive, protective, and/or
corrective mental, physical, societal and spiritual environment, and that is what
Leininger, M. M. (1991). Culture care Diversity and Universality: A Theory of Nursing. National League of
Nursing Press, New York. P 35.
McCance, T. V.; McKenna, H. P.; Boore, J. R. P. (1999). Caring: theoretical perspectives of relevance to
nursing. Journal of Advanced Nursing, Dec99, 30(6), 1388-1396.
Schoenhofer, S. O. (2002). Choosing personhood: intentionality and the theory of Nursing as caring.
Holistic Nursing Practice, July 2002. 16(4), 36-40.Taber, C. W., 1870-1968. Tabers Cyclopedic Medical
Dictionary, Ed. 17. p 322. Philadelphia: F. A. Davis Company.
Watson, J. (1988). New dimensions of human caring theory. Nursing Science Quarterly. 1(4), 175-181.
Watson, J. (1996). Watsons theory of transpersonal caring. In P. H. Walker & B. Nueman (Eds.), Blueprint
for use of nursing models: Education, research, practice, and administration. 141-184. NY: NLN Press.
Watson, J. (1997). The theory of human caring: Retrospective and prospective. Nursing Science
Quarterly. 10(1), 49-52.
Watson, J. (1999). Post modern nursing and beyond. Edinburg, Scotland, UK: Churchill-Livinstone:
Harcourt-Brace.
Watson, J. (2002). Intentionality and caring-healing Consciousness: A practice of transpersonal nursing.
Holistic Nursing Practice. July 2002. 16(4), 12-19.
Watson, J. (2003). Jean Watson and the theory of human caring. Theory overview. Retrieved on February
14, 2003, from http://ww2.uchsc.edu/son/caring/content/wct.asp.
Watson, J. (2003). Jean Watson and the theory of human caring. Definition description.
March 20, 2003
Teresa Vance, RN
Bacone College
Billie R. Tower BSN Nursing program