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Running Head: Application of Jean Watson’s Theory of Human Care 1

Application of the Theory in Practice: Jean Watson’s Theory of Human Care

Submitted by: Antoinette Ellis

Fall 2015 December 6, 2015

Chamberlain College of Nursing

NR 501 Theoretical Bases of Advanced Nursing


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Theory is best described as the basis, or framework, of the nursing profession and helps

to identify the unique qualities of the profession (Watson, 2011). There are three types of nursing

theories: grand theory, middle-range theory and practice theories. Practice theories are known for

identifying with specific clinical nursing situation but on the other hand grand theories are

usually nonspecific and used for larger scopes such as leadership. Nursing theory is applicable to

any healthcare setting by any of the following: Education, Leadership, Informatics or Health

policies. A grand theory such as Jean Watson’s Theory of Human Care can be applied in

leadership to solve problems in nursing practice. The purpose of this paper is to discuss the

problems of staffing situations in healthcare setting and how application of Dr. Jean Watson’s

Theory of Human Caring helps address nursing practice staffing issues.

In reading Watson's theory she discussed the importance of self-growth with nursing

care. The self-growth is a result of personal gain in self-knowledge, self-reverence, self-caring,

self-control, and healing (Hood, 2014). Jean Watson's Theory of Human Care is a grand theory

that has great influence on patient outcomes and staffing satisfaction when used correctly.

Watson believes that it is not the part of the nurse to cure the patient, but relatively honor the

human magnitudes of nursing work and the inner life world and subjective experiences of the

people serve (Sitzman, 2013). The sections of this paper will address the problem/issue at hand,

the theory, and the strategy used to apply the theory to practice.

Problem/ Issue

Administrators and nurse managers face ongoing challenges with nurse staffing. Nursing

literature review validates that addressing nurse staffing issues ultimately leads to better patient

outcomes and higher quality of care. Nurse staffing shortage is known to affect patients, their

loved ones, future and current nursing staff, and the hospitals where they work (Martin, 2015).
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Insufficient staffing limits the number of compassionate nurses available ultimately results in a

decrease in patient satisfaction and outcomes.

One uncontrollable effect of nursing shortage results in a negative impact on the patient

and nursing staff (Martin, 2015). Staffing shortage could lead to job dissatisfaction and an

increase in the nurse’s workload. The nursing job dissatisfaction rate is four times higher than the

average worker in the U.S. dissatisfied with their job (Martin, 2015). Burnout is another concern

that we must face with nurse staffing insufficiency. The burnout could result in poorer quality

nursing care delivery and could led to legal uncertainties. For example, if a nurses’ work doubles

due to staffing there’s a larger window for medical errors. Any medical error could potentially

lead to legal damage such as lawsuits or loss of reimbursable cost (Li, 2013). “Not only have

higher nurse -to -patient ratios been shown to increase nurse burn out, it can have serious effects

on the health and well-being of the nurse. An unrealistic work lo a d may result in chronic

fatigue (Sitzman, 2013).”

Applying concepts and principles

There is no easy way for nursing leadership to fix the issues that occur due to nursing

staffing shortage. Because some leaders are not familiar with using a theoretical framework to

ground practice, the use of application of theory can stand as a potential challenge. The goal for

the application of Watson’s Theory of Human Caring is to reduce and address problems that

causes stress to all parties. She believes the use of her theory can aid in the healing process

between leadership and nurses to eventually result in a more permanent resolution.

The three major elements of Jean Watson’s theory are the Carative factors, the

transpersonal caring relationship, and the caring moment (Watson, 2011). Watson’s theory is
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composed of 10 Carative factors that functions as a framework for providing a structure and

order for nursing (Sitzman, 2013). The 10 Carative factors are:

1. humanistic- altruistic value system,

2. faith- hope,

3. cultivating a sensitivity to self and others,

4. helping-trusting humane care relationship

5. expression positive or negative feelings

6. using problem-solving for resolution

7. transpersonal teaching and learning

8. promoting a supportive environment

9. assisting with fulfillment of human needs

10. allowing for existential- phenomenological forces (Sitzman, K., & Watson, J.

2013).

She feels the use of the Carative factors can enhanced the emotional, spiritual and physical needs

of the patient. Her work focuses mainly on the nurse to patient relationship. Because she focuses

on that relationship she feels that dynamics can impact a patient’s feelings and how they heal

(Sitzman, K., & Watson, J. 2013). Watson believed that holistic health care is central to the

practice of caring in nursing.

According to Watson’s 2011, there are seven assumptions in relation to nursing care. The

first assumption is caring can be effectively demonstrated and practiced only interpersonally.

The first assumption is completed during physical contact and interactions. The second

assumption consist of carative factors in order to ensure human gratification. The third

assumption stresses the importance of effective caring to promote health amongst the patient and
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or family. The fourth assumption suggests that the acceptance of the patient’s state of mind is

important at all times. The fifth assumption is that we as nurses should ensure there is a caring

environment. That caring environment should allow the patient to make more health care related

decisions. The sixth assumption by Watson suggests that caring should focus on health healing

vs. curing. The last and seventh assumption is that nursing revolves around centralized care.

Watson’s theory emphasizes that in order for a caregiver to deliver quality patient care they

must deal with his or her own physical and emotional needs first (Watson, 2011). Simple

appraisal is an appropriate caring measure that can be used by leaders. The nurses work

environments and care preventions can be heavily influenced by implementation of Watson’s

Theory of Human Care. In order to demonstrate the theory the nurse leader or administrator

should transformational leadership to incorporate caritas factors amongst staff nurses. Examples

of demonstrating transformational leadership is by promoting staff involving and a healthy

caring environment. Both examples helps promote staff retention. Unit based and hospital based

shared governance should also be encouraged by leaders. The last example involves leaders as a

coach to deliver information to staff about changes to keep them informed.

Cone Health in Greensboro, NC applied the Jean Watson’s Caritas processes to nursing unit

to promote a caring environment for staff and patients. The application lead to staffing

improvement and significant improvements in the nursing practice environment at minimal

implementation (Summerell, 2015). The implementation of Jean’s theory ultimately increased

their nursing retention and helped solve staffing issues. The unit utilized Jean Watson’s Caritas

Processes in practice to promote staffing and healthier work environment. With the help of the

Caritas process the first change on the unit started with highlighting empathy, compassion,
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communication, teamwork, and respect over clinical experience. The unit focused on building

positive relationships during the welcoming and on-boarding process for new employees.

Cone Health leaders used orientation for new employees to promote professional growth

goals and activities by encouraging staff engagement via shared governance council meetings.

National specialty certification celebrations were done to promote participation. “From 2009 to

2013, that unit improved its National Database for Nursing Quality Improvement Practice

Environment scores from the 10th to 95th percentile and its health system employee engagement

scores 38th to 85th percentile (Summerell, 2015).” There has been an increase in the national

specialty certification from 6% to 64% of staff. There was also an increase from 3% to 14% of

nurse’s systematic achievement in the clinical career ladder for registered nurses.

Jean Watson's Theory of Human Care is a grand theory that has great influence on improving

clinical outcomes when used correctly. Watson believes that it is not the part of the nurse to cure

the patient, but relatively honor the human magnitudes of nursing work and the inner life world

and subjective experiences of the people serve (Sitzman & Watson, 2013). Although using the

application of Watson’s theory probably won’t result in complete resolution of the staffing issues

it definitely plays a major role in developing processes to lead to success. Watson’s theory

application helps reduce the probability of legal and ethical problems that could arise with

staffing issues.

Conclusion

In conclusion, theory drives nursing care from all aspects of healthcare. Many

organizations similar to mine will continue to use Jean Watson’s Theory of Human Caring as a

guide to patient care delivery and helping with solving staff related issues. Leaders and
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administrators should all realize that Watson’s theory serves as guide and the key to ensuring

everyone including nurses are taken care of as a whole. The Care Model started by Jean Watson

is a very good resource when applying theory to address healthcare issues such as staffing.

Today’s world healthcare is consistently changing with many technological advance but nursing

theories will always serve as a foundation for nursing care.


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References
Hood, L. J. (2014). Leddy & Pepper’s Conceptual Bases of Professional Nursing (8th ed.).
Li, Y. &. ( 2013). A literature review of nursing turnover costs. Journal of nursing management,
21(3), 405-418.
Martin, C. J. (2015). The Effects of Nurse Staffing on Quality of Care. MEDSURG Nursing,
24(2), 4-6 3p.
Sitzman, K. &. (2013). Caring Science, Mindful Practice. Human Caring Theory.
Summerell, P. (2015). Jean Watson’s Caritas Processes: A Model for Transforming the Nursing
Practice Environment. Critical Care Nurse, 35(2), e66-7 1p.
Watson, J. (2011). Human Caring Science: A Theory of Nursing (2nd ed.). Jones & Bartlett
Publishers.