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HELPING ART OF CLINICAL NURSING
THEORY OF HUMAN CARING
In partial fulfillment of the requirements in Theoretical Foundations in Nursing
Submitted by: Rosella Marie M. Ocampo, R.N. Submitted to: Mary Grace D. Brackett, R.N., Ph. D. Theoretical Foundations in Nursing Professor March 19, 2011
ERNESTINE WIEDENBACH’S HELPING ART OF CLINICAL NURSING
"My thesis is that nursing art is not comprised of rational nor reactionary actions but rather of deliberative action." Wiedenbach, 1964 Nursing encompasses autonomous and collaborative care of
individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. As Wiedenbach quoted, nursing is a deliberative (responsible action). It is not the result of an instinct but a result of the nurse’s purpose to help and individual in need. Nursing is both patient and nurse centered which means that it is mutual. More and more people are in need of help and it has been an imperative for nurses to care the people who are in need of help. Helping behavior refers to voluntary actions intended to help the others, with reward regarded or disregarded. It is a type of prosocial behavior (voluntary action
intended to help or benefit another individual or group of individuals, such as sharing, comforting, rescuing and helping). Persons are different from each and it is a challenge for nurses to develop an individualized nursing care plan. Wiedenbach’s theory is a solution to the obstacle faced by nurses. It is within this theory that there is a mutual understanding between the nurse and the patient being cared for gearing toward the goal of meeting the needs of the patient.
OBJECTIVES: Upon successful completion of this discussion, the reader will be able to:
Wiedenbach’s model for health
Define Wiedenbach’s Prescriptive theory and Helping Art of Clinical Nursing
Present the relationship between Wiedenbach’s model and concepts in nursing’s metaparadigm
Provide an example of use of Wiedenbach’s model in clinical practice
HISTORICAL EVOLUTION OF THE THEORY/ BACKGROUND OF THE THEORIST Ernestine Wiedenbach was born on August 18, 1900, in Hamburg, Germany to an American mother and a German father who migrated to the United States when Ernestine was a child. The affluent family supported the idea of a college education for their daughter and she graduated with a Bachelor of
At the Maternity Center in New York City. This position brought new opportunities to experience many different facets of nursing and to meet national leaders in both nursing and health care. she began her studies in nurse-midwifery. when she played a critical role in the recruitment of nursing students and military nurses (Parker. In 1952. 2001). her advocacy for quality nursing education and her leadership role with her classmates resulted in dismissal from the school. Because of her interest in education. Her later interest in a nursing career was reluctantly accepted by her family. 2001). her personal mentors included such pioneers such ad Hazel Corbin and Hattie Hemschemeyer (Parker. Her independent characteristics overruled her parents’ reluctance and enrolled in a hospital school of nursing. 2001). Wiedenbach had many interests and held a variety of professional positions. she became a professional writer for the American Journal of Nursing (AJN) (Parker. 2001). teacher. She was also involved with the New York State Nurses’ Association and with various nuring committees. including that of Adelaide Nutting. she began taking graduate courses part time at Columbia University. she returned to clinical practice and to her love of maternal-child nursing. Her tenure in the AJN office included the years during World War II.) (Parker. Gesse. At age 45.Arts degree from Wellesley College in 1922. Early in her studies there. she was admitted to Johns Hopkins School of Nursing and graduated in 1925 (Nickel. author. Wiedenbach joined the faculty of Yale University School of Nursing where her roles as practitioner. who realized her potential. 1992. After the war. Through the intervention of friends and faculty. Pursuing nursing in this era was atypical for someone who came from a family of gentility (Parker. and theorist would . & MacLaren. 2001). After completing a master of arts in 1934.
Wiedenbach’s love for interaction with students persisted even after her mobility decreased. She retired from Yale in 1966 as an associate professor emeritus and subsequently held part-time positions at California State University and the University of Florida. Wiedenbach graciously accepted and invented Dombro to her house for tea to discuss it further (Parker. They enjoyed discussing the past. Her pattern of intellectual productivity continued with the publication of another book: Communication: Key to Effective NursingI (Wiedenbach & Falls. She was adamant about improvement of the quality . present. Following this contact and the childbirth education conference. This rekindling of ties to the nursing education community did not deter Wiedenbach from being an advocate for the residents of the retirement village. She telephoned and requested Wiedenbach’s participation in a childbirth education conference being held at Florida International University (FIU). She eventually moved to a Miami. Wiedenbach and Falls became involved in developing and teaching a university course on communication in nursing. Florida. heard that Wiedenbach is living nearby. and future of nursing and nurse-midwifery and she always reminded students and faculty of the need for clarity of purpose. 2001). who was active in Miami’s childbirth education movement. 1978) (Parker. based on reality (Parker. She was an activist in promoting change in policies and practices related to nutrition and creative activities for many talented residents now in their late stages of life. Caroline Falls (Parker. In 1972. Marcia Dombro. She and Caroline Falls continued to give informal seminars in their home for Professor Theresa Geese and the University of Miami nurse-midwifery students. 2001).be consolidated. retirement village with her college roommate and lifelong friend. 2001). 2001).
In April 1998. Nickel’s home for several months until the retirement village was restored (Parker. where she continued to apply her perspective theory of nursing in everyday living. searched for Wiedenbach was much in need of the caring that she herself had promoted so strongly in nursing. her friend Caroline Falls died of heart failure. Whatever the individual does represents his or her best judgment at the moment. Wiedenbach died at age 98 (Parker. . During this period. events began to occur that profoundly affected Wiedenbach’s remaining years. 2001). Self-awareness and self-acceptance are essential to the individual’s sense of integrity and self-worth. Until the end of her life. who had become a personal friend. In 1992. Wiedenbach continued to be productive and maintain a central purpose as long as she was able (Parker. 2001). which she prepared on her Braille typewriter. 2008). 2001). Wiedenbach continued to maintain the independent spirit that originality fueled her productivity and creativity. and Hurricane Andrew destroyed the retirement village. She even continued to use her gift for writing to transcribe books for the blind. Susan Nickel. Wiedenbach stayed at Ms. Wiedenbach believes these characteristics require respect from the nurse (George.of life and level of independence for those who lived in the village. APPROACH TO THE DEVELOPMENT OF THE MODEL WIEDENBACH’S THEORY AND NURSING’S METAPARADIGM Wiedenbach (1964) emphasizes that the human or individual possesses unique potential. and needs stimulation. including Lamaze childbirth manual. strives toward self-direction. causing a temporary relocation into unfamiliar surroundings.
a major component of her theory. It is of interest that in that book she recommended that babies be in hospital rooms with their mothers rather than in a central nursery. she incorporates the environment within the realities. atmosphere. According to Wiedenbach (1970). mental. CONCEPTUAL FRAMEWORK Ernestine Wiedenbach. Wiedenbach first published Family-centered maternity nursing in 1958. the framework is a complex of extraneous factors and circumstances that are present in every nursing situation. 2008). humans. and happenings” (George. . began her nursing career in the 1920s. This innovative concept was not widely implemented until 20 years later. In Wiedenbach’s work. and not merely the absence of disease and infirmity (George. 2008). setting. nursing. According to Wiedenbach (1969). Nursing is a helping process that will extend or restore the patient’s ability to cope with demands implicit in the situation (George. a progressive nursing leader.Wiedenbach (1977) does not define the concept of health. One element of the realities is the framework. which she described her ideas about nursing as a “concept and philosophy” derived from 40 years of nursing experience (George. The framework may include objects “such as policies. In 1964 she wrote Clinical nursing-A helping art in. 2008). 2008). However. she supports the World Health Orgaanization’s definition of health as a state of complete physical. is a practice discipline designed to produce explicit desired results. a clinical discipline. time of day. and social well-being. The art of nursing is a goal directed activity requiring the application of knowledge and skill toward meeting a need for help experienced by a patient.
1964). Wiedenbach (1964) states the characteristics of a professional person that are essential for the professional nurse include the following (George. Wiedenbach specified the following four elements: (1) philosophy. It is a key factor in assisting the nurse to identify the patient’s need for help (Wiedenbach. Clarity of purpose. and confidence in the area of health (Wiedenbach. . Ability to establish and sustain purposeful working relationships with others. Nursing wisdom is acquired through meaningful experience (Wiedenbach. the worth of the individual. 2. “People may differ in their concept of nursing. and understanding to those in need of care. (3) practice. but few would disagree that nursing is nurturing or caring for someone in motherly fashion. Sensitivity alerts the nurse to an awareness of inconsistencies in a situation that might signify a problem. 1970) (George. 2008). 2008): 1. and the aspirations of each human being determine the quality of the nursing care. Nursing is a helping service that is rendered with compassion. 1977) (George. Wiedenbach (1964) stated. 2008). 2008). 1994). (2) purpose. The nurse’s purpose in nursing represents a professional commitment (Wiedenbach. 3. Mastery of skills and knowledge essential for fulfilling the purpose. 1977) (George.Ernestine Wiedenbach concentrated on the art of nursing and focused on the needs of the patient. both professional and nonprofessional individuals. counsel. She postulated that clinical nursing is directed toward meeting the patient’s perceived need-for-help (Tomey. That care is given in the immediate present and can be given by any caring person. The nurse’s beliefs and values regarding reverence for the gift of life. and (4) art. skill.
A need is anything the individual may require “to maintain or sustain himself comfortably or capably in his situation”.: Barnum (1994) quoted that Wiedenbach states that it is the nurse’s way of giving a treatment. for example. Dedication to furthering the good of mankind rather than to selfaggrandizement. that the same act done with caring and without caring could have a different outcome (Tomey. that enables a patient to benefit for it. Wiedenbach’s philosophy of practice is influenced by her conception of nursing is an art. To be meaningful. he or she may not take action to relieve or resolve it (Tomey. 5. Wiedenbach believed that every individual experiences needs as a normal part of living. Barnum (1994) quoted that Wiedenbach believed that the intention of the nurse was an important part of her effectiveness. not just the fact that a treatment is given him. which is “any measure or actions that enable the individual to overcome whatever interferes with his ability to function capably in relation to his situation. An attempt to meet the need is made by the intervention of help. 1994). The nurse’s way of using the means available to her to achieve the results she . 1994). If the individual does not perceive a need as need-for-help. and it is her way of expressing her concern – not just the fact that she is present or speaks – that enables him to reveal his fears. Wiedenbach combines these two definitions into a more critical concept for her theory of a Need-for-Help. . It is crucial to the nursing profession that a Need-for-Help is based on the individual’s perception of his own situation. help must be used by an individual and must succeed in enhancing or extending his capability.4. Interest in advancing knowledge in the area of interest and in creating new knowledge. .
determined to a large degree. by her central purpose in nursing and the prescription she regards as appropriate to its fulfillment. Barnum (1994) cited that Wiedenbach claimed that the thoughts and feelings. thoughts and feelings have a discipline role to play. . a written communication. as stated by Barnum (1994). yet. identifies his need for help. including reactions. they are intimately involved not only in what she does but also in how she does it. are integral parts not only of what we do or say but also of how we do it… The thoughts and feelings that precede and accompany each act are the less apparent parts of nursing. They underlie every actions she takes. According to Barnum (1994). as quoted by Barnum (1994). ensuring her successful practice. for the nurse whose action is directed toward achievement of a specific purpose.. the nurse is a functioning human being. a gesture. If she recognizes her thoughts and feelings. the secret of the helping art of nursing lies in the importance the nurse attaches to her thoughts and feelings and the deliberate use she makes of them as she observes her patient. because they set direction for each act. As such she not only acts. According to Wiedenbach. The thoughts she thinks and the feelings she feels as she goes about her nursing is important. but she thinks and feels as well. Wiedenbach analyzed the “invisible” act of caring and found that it was a tool that could be used to the nurse’s advantage.desires in her practice is an individual matter. be in the form of spoken word. they are the real determiners of the results the nurse achieves. ministers to his need and validates that the help she gave was helpful. respects their importance. and disciplines herself to harness them to her purpose and her philosophy. According to Wiedenbach. or a deed of any kind.
” she presents these principles of helping: (1) the principle of inconsistency/consistency. (2) ministration of the help needed. It is important for the nurse to observe the patient astutely and then critically analyze her observations. what Wiedenbach called concern is what we label caring. The principle of inconsistency/ consistency refers to the assessment of the patient to determine some action. 1994). and (3) validation that the help provided was indeed helpful to the patient (Wiedenbach. According to Barnum (1994). Within Wiedenbach’s (1964) “identification of the patient’s need for help. According to Wiedenbach. but she will in all probability experience enduring satisfaction from the helping service she has rendered. (2) the principle of purposeful perseverance. and (4) prevention of the recurrence of his problem or development of a new one which may cause anxiety. this is not the way we usually think about the caring part of nursing. word. And although she explored these feelings methodically. and need. the art of clinical nursing is directed toward achievement of four main goals: (1) understanding of the patient and his condition. situation. THEORETICAL ASSERTIONS The practice of nursing comprises a wide variety of services. disability or distress. or appearance that is different from the expected-that is. something out of the ordinary for this patient. each directed toward the attainment of one of its three components: (1) identification of the patient’s need for help. 1977). and (3) the principle of self-extension. (3) improvement of his condition or situation within the framework of the medical plans for his care. (Tomey. (2) enhancement of the patient’s capability.not only will she enrich her nursing practice. The principle of purposeful perseverance is based .
and seeks patient concurrence and acceptance of suggestions for implementation (Tomey. It is important that the nurse recognizes when these limitation are reached and that she seek help from others. the nurse explores the meaning of the patient’s behavior with the patient. 2008). the nurse implements it and ministration of needed help occurs. 1994). If the patient does not concur with the plan or accept suggestions for implementation. Finally. If the patient concurs with the plan and accepts suggestions for implementing it. The nurse perceives whether the patient’s behavior is consistent with nurse’s concept of comfort and seeks clarification from the patient to determine whether he or she believes the need-for-help was met. Wiedenbach posits the validation that the need-for-help was met is important. 1994). the nurse determines whether the patient can resolve his or her problem or if the patient has a need-for-help (Tomey. The nurse needs to strive to continue her efforts to identify and meet the patient’s need for help in spite of difficulties she encounters while seeking to use her resources and capabilities effectively and with sensitivity. presents the plan. Wiedenbach stated that ministration of needed help involves the nurse making a plan to meet patient needs and presenting it to the patient. The principle of self-extension recognizes that each nurse has limitations that are both personal and situational. the nurse uses powers of observation to look and listen for actual consistencies and inconsistencies in the patient’s behavior compared with the nurse’s expectations for patient behavior. First. Then the . the nurse once again forms a plan to meet the need. Wiedenbach affirmed that identification of the patient’s need-for-help involves four steps. the nurse needs to explore the patient’s nonacceptance. If the patient has a need-for-help. including through prayer (George. the nurse determines the cause of the patient’s discomfort or incapability. Third. Second.on the nurse’s sincere desire to help the patient.
1994). Prescriptive theory (a situation-producing theory) may be described as one that conceptualizes both a desired situation and the prescription by which it is to be brought about. 2. The prescription for the fulfillment of the central purpose. Wiedenbach (1964) states (George. Wiedenbach’s (196) prescriptive theory is made up of three factors. This central purpose (or commitment) is based on the individual nurse’s philosophy.nurse needs to take appropriate action on the basis of the feedback (Tomey. The central purpose which the practitioner recognizes as essential to the particular discipline. Thus. The Central Purpose The nurse’s central purpose defines the quality of health she desires to effect or sustain in her patient and specifies what she recognizes to be her special responsibility in caring for the patient (Wiedenbach. 1970). or concepts (George. 3. 2008): . 2008): 1. The realities in the immediate situation that influence the fulfillment of the central purpose. a prescriptive theory directs action toward an explicit goal. WIEDENBACH’S PRESCRIPTIVE THEORY Theory may be described as a system of conceptualizations invented to some purpose.
unique to each nurse. and individuality of each human being. Human beings need stimulation in order to make the best use of their capabilities and realize their self-worth. (2) a respect for the dignity. goal and guide of clinical nursing… Purpose-that which the nurse wants to accomplish through what she does-is the overall goal toward which she is striving. 3. and desire not only to make the best use of their capabilities and potentialities but also to fulfill their responsibilities. Any of these concepts might be further developed. 1970) emphasizes the second in her work. worth. and is an integral part of her. guides her thinking about what she is to do and influences her decisions. and expressed in her way of nursing. 2008): 1. Philosophy underlies purpose. It is her reasons for being and doing… Philosophy. 2. Human beings are endowed with unique potential to develop within themselves the resources that enable them to maintain and sustain themselves. autonomy. Human beings basically strive toward self-direction and relative independence. an attitude toward life and reality that evolves from each nurse’s beliefs and code of conduct.Purpose and philosophy are. and purpose reflects philosophy. formulating the following beliefs about the individual (George. respectively. It stems from both her culture and subculture. and (3) a resolution to act dynamically in relation to one’ beliefs. Wiedenbach (1964. and so is constant. Wiedenbach (1970) identifies three essential components for a nursing philosophy: (1) a reverence for the gift of life. motivates the nurse to act. However. It is personal in character. .
A prescription is a directive activity (Wiedenbach. 2008). It “specifies both the nature of the action that will most likely lead to fulfillment of the nurse’s central purpose and the thinking process that determines it” (Wiedenbach. Thus.4. the central purpose is a concept the nurse has thought through-one she has put into words. 1969). 5. 2008). The Prescription Once the nurse has identified her own philosophy and recognizes that the patient has autonomy and individuality. and (3) practitioner-directed action . (2) recipient-directed action (“the recipient of the action essentially directs the way it is to be carried out.”. whereas involuntary action is an unintended response (George. 1970). Self-awareness and self-acceptance are essential to the individual’s sense of integrity and self-worth.”). 2008). A prescription may indicate the broad general action appropriate to implementation of the basic concepts as well as suggest the kind of behavior needed to carry out these actions in accordance with the central purpose. she can work with the individual to develop a prescription or plan for his or her care (George. evidence that the recipient understands the implications of the intended action and is psychologically. . physically and/or physiologically receptive to it. Voluntary action is an intended response. . These actions may be voluntary or involuntary. A prescription is a directive to at least three kinds of voluntary action: (1) Mututally understood and agreed upon action (“the practitioner has . Whatever individuals do represent their best judgment at the moment of doing it. and accepts as a standard against which to measure the value of her action to the patient (George. believes in.
and most importantly. To specify the objectives of her practice in terms of behavioral outcomes that are realistically attainable. capabilities. who is the practicing nurse or her delegate. she must then consider the realities of the situation in which she is to provide nursing care.(“the practitioner carries out the action . the nurse is the propelling force that moves her practice toward its goal. (3) the goal. 2008). and (5) the framework (George. To practice nursing in accordance with her objectives. 1969). physiological.”)(Widenbach. The agent or nurse has the following four basic responsibilities(George. and spiritual—that are at play in situation in which nursing actions occur at any given moment. she not only has established the prescription for her nursing but also is ready to implement it (Wiedenbach. capacities. emotional. commitment and competence in nursing. The Realities When the nurse has determined her central purpose and has developed the prescription. To reconcile her assumptions about the realities. she may engage in innumerable acts called forth by her encounter with actual or discrepant factors and situations within the realities of which she herself is a part (Widenbach. . 1967). Realities consist of all factors—physical. The agent. . 2. is characterized by personal attributes. psychological. (4) the means. . Once the nurse has formulated a central purpose and has accepted it as a personal commitment. 2008). In the course of this goal-directed movement. 1970) (George. 2008): 1. . . 3. with her central purpose. As the agent. (2) the recipient. Wiedenbach (1970) defines the five realities as: (1) the agent. .
dignity. The goal is the end result to be attained by nursing action. professional. It is a conglomerate of “objects.4. The means comprises the activities and devices through which the practitioner is enabled to attain her goal. The patient is vulnerable. . 1970) (George. problems. techniques. 1970) (George. 2008). and autonomy (Wiedenbach. and most important. and risks losing individually. 2008). 1967). or anticipated” (Wiedenbach. dependent on others for help. procedures. atmosphere. worth. that may be current. existing or missing. 2008). the patient. and devices that may be used to facilitate nursing practice. setting. capacities. 1970). The framework is composed of all the extraneous factors and facilities in the situation that affect the nurse’s ability to obtain the desired results. 1970) (George. the ability to cope with the concerns or problems being experienced (Wiedenbach. The goal is the desired outcome the nurse wishes to achieve. and happenings. of using the means available is individual and is determined by her central purpose and the prescription (Wiedenbach. The recipient. environmental. The patient is the recipient of the nurse’s actions or the one on whose behalf the action is taken. The nurse’s way of giving treatments. The stipulation of an activity’s goal gives focus to the nurse’s action and implies her reason for taking it (Wiedenbach. such as policies. 1967). The means includes skills. 1970) (George. The framework consists of the human. time of day. is characterized by personal attributes. humans. and organizational facilities that not only make up the context within which nursing is practiced but also constitue its currently existing limits (Wiedenbach. 2008). aspirations. of expressing concern. To engage in related activities which contribute to her selfrealization and to the improvement of nursing practice (Wiedenbach. pas.
WIEDENBACH’S CONCEPTUALIZATION OF NURSING PRACTICE AND PROCESS According to Wiedenbach (1967). nursing practice is an art in which the nursing action is based on the principles of helping. The success of professional nursing practice is dependent on them. Since nursing requires thought. 2008). The nurse develops a prescription for care that is based on her central purpose. The nature of the nursing act is based on thought. Unless the realities are recognized and dealt with. 1970). and realities are interdependent in Wiedenbach’s theory of nursing. Nursing action may be thought of as consisting of the following four distinct kinds of actions (George. 2008). The nurse thinks through the kind of results she wants. it can be considered a deliberate responsible action (George. 2008). then accepts responsibility for the acts and the outcome of those acts (Wiedenbach. The concepts of central purpose. .The realities offer uniqueness to every situation. which is implemented in the realities of the situation(George. gears her actions to obtain those results. prescription. they may prevent the achievement of the goal(George. 2008): • • • • Reflex Conditioned Impulsive (Spontaneous) (Automatic) (Impulsive) Deliberate (Responsible) Nursing as a practice discipline is goal-directed.
looking for an inconsistency between the expected behavior of the patient and the apparent behavior. assumption. 2008). or carry out a therapeutic procedure. Evidence must come from the patient that the purpose of the nursing actions has been fulfilled (Wiedenbach. This consciousness arousal leads to a . In Wiedenbach’s (1977) nursing process. Third. wisdom. The second component is the ministration of the help needed. Second. 2008). the nurse observes the patient. make an adjustment in the plan of action (George. it is influenced by the nurse’s culture. 1964) (George. she validates with the patient that her help is needed (George. knowledge. and concern (George. First. sensitivity. she attempts to clarify what the inconsistency means. Wiedenbach (1977) views the nursing process essentially as an internal personalized mechanism. This situation exists among the realities and serves as a stimulus to arouse the nurse’s consciousness. After help has been ministered. design. Wiedenbach’s nursing process begins with an activating situation. and (3) validation that the action taken was helpful to the patient (Wiedenbach. she determines the cause of the inconsistency. (2) ministration of the help needed. the nurse will need to identify the cause and. if necessary. the nurse may give advice or information. 1977). make a referral. Finally. As such. and decision.Nursing practice has three components: (1) identification of the patient’s need for help. 2008). Should the patient become uncomfortable with what is being done. she identifies seven levels of awareness: sensation. Within the identification component. apply a comfort measure. In ministering to her patient. 2008). purpose in nursing. The third component is validation. realization. the nurse validates that the actions were indeed helpful. there are four distinct steps. perception. insight.
1977) (George. The involuntary response is to adjust the thermostat (George. 2008). 2008). The next four levels of awareness occur in the voluntary phase: realization (in which the nurse begins to validate the assumption previously made about the patient’s behavior). “No. The design is the plan to readjust the thermostat and get a blanket as confirmed by the patient. it’s hot in here!” She immediately goes to the thermostat and sets it to a lower temperature. The nurse responds. The decision is the . To continue with the previous example: the nurse ask. The patient agrees.subjective interpretation of the first three levels. I’m not. Progressing from intuition to cognition. I have felt cold since I washed my hair”. perception (the interpretation of a sensory impression). The sensation is the room temperature. The realization is the validation of the patient’s perception of temperature comfort. The insight is the additional information that the patient had washed his or her hair. “I will readjust the thermostat and get you a blanket”. and assumption (meaning the nurse attaches to the perception). insight (which includes joint planning and additional knowledge about the cause of the problem). which are defined as: sensation (experienced sensory impression). “My. These three levels of awareness are obtained through the focus of the nurse’s attention on the stimulus: they are intuitive rather than cognitive and may initiate an involuntary response. a nurse enters a patient’s room and states. the nurse’s actions become voluntary rather than involuntary. design (the plan of action decided on by the nurse and confirmed by the patient). The perception is “It feels hot”. the patient must be hot”. “Are you too warm?” and the patient replies. The assumption is “If I am hot. For example. and decision (the nurse’s performance of a responsible action) (Wiedenbach. 2008). “That would be wonderful!” The nurse readjusts the thermostat and gets a blanket for the patient (George.
She identifies the patient’s need for help (makes a nursing diagnosis). philosophy. the comparison of Wiedenbach’s prescriptive theory. Pennsylvania (Wiedenbach. 1964). assesses the education. Validation is then obtained that the help provided was indeed helpful to the patient (evaluation) (George. deliberately carried out and patient centered”. III. 2008). identifying outcomes and setting goals affected by the realities. purpose).THEORY SYTHESIS WIEDENBACH’S THEORY AND CLINICAL PRACTICE Wiedenbach consistently emphasized “purpose and “patient” in her many writings and presentations about her perspective of nursing practice. In a presentation entitled “A Concept of Dynamic Nursing” at a conference in Pittsburgh. 2008).nurse readjust the thermostat and gets a blanket for the patient (George. Their plan is implemented or the nurse provides the help needed. individual’ and life experiences status and (her central for health potential development. a nurse with her unique personality. She formulates a plan with the patient. 1962). (Wiedenbach. the practice of nursing. 2001): . she described the model as follows (Parker. She stated: “The practice of clinical nursing is goal directed. or the strengths and limitations of the situation (the environment). Figure 6-1 represents a spherical odel she created in 1962 that depicts the “experiencing individual” as the central focus. In summary. and the nursing process as outlined in Chapter 2 of this book is as follows: in the practice of nursing.
In its broadest sense, Practice of Dynamic Nursing concentric may be envisioned as a set of circles, with the experiencing individual in the circle at its core. Direct service, with its three components, identification of the individual’s experienced need for help, ministration of help needed and validation that the help provided fulfilled its purpose, fills the circle adjacent to the core. The next circle holds the essential concomitants of direct service’ coordination, i.e., charting, recording, reporting, and conferring; consultation, i.e., conferencing, and seeking help or advice; and collaboration, i.e., giving assistance or cooperation with members of other professional or non-professional groups concerned with the individual’s welfare. The content of the circle represents activities which are essential to the ultimate wellbeing of the experiencing individual, but only indirectly related to him; nursing education, nursing administration and nursing organizations. The outermost circle comprises research in nursing, publication and advanced study, the key ways to progress in every area of practice. She explained the elements of the second sphere to her presentation audience in the following way (Parker, 2001): Implicit in identification is the individualization of the individual and what he is experiencing. This calls for awareness of how the individual differs in appearance, manner, and behavior, from any other individual, and from the nurse’s expectation of him. It calls
for recognition too, that the individual’s perception of his condition or situation grows out of his background of experiences and understandings, which many be called his frame-ofreference; while the nurse’s perception of it is in relation to her background of experiences and understandings, that is, her frame-of-reference. Activity in this unit of Practice (identification)is directed toward ascertaining 1) whether the individual is experiencing discomfort or incapability; 2) the cause of the discomfort or incapability he may be experiencing; 3) the need required to restore comfort or capability; and 4) whether the need represents a need-for-help, one, in other words which the individual is unable to meet himself, unaided. The unit Ministration involves providing the help which is needed. Underlying it, is the assumption that the individual must be accepting of any applied resource, be it a bit of advice, a recommendation, or a comfort or therapeutic measure, if he is to derive maximum benefit from it. Application of resource, thus, is dependent first of all, on selection of one which is appropriate to the need which has been identified, and second, on its acceptability to the individual. In this unit o Practice, i.e., Ministration-of-Help-Needed, the full range of resources to which the nurse has access may come into play, and the greater her stock of resources, the greater her potential for effective services. Included in such range would be her own beliefs, values, knowledge, skills and know-how; those of others whom she knows or whom she has heard, i.e., members of other professions or the laity; and those represented by facilities of the community and beyond. Validation has as its goal, evidence that, as a result of the help that was provided, the individual is experiencing
improvement in his feeling of comfort and capability in relation to his immediate situation. Such improvement may be measured by the individual’s verbal and non-verbal behavior, on the assumption that he will respond behaviorally, to how he is currently experiencing his situation. Implicit in this unit are 1) clarification of the meaning to the individual, of his behavior; and 2) classification of his meaning according to the nurse’s concept of comfort and capability in the context of the individual’s situation. Essentially, this means that to validate the effectiveness of Practice, how the individual is experiencing his immediate situation must be consistent with the nurse’s expectation of the outcome of her ministration. Wiedenbach’s clinical application of her prescriptive theory was always evident in her logical clinical examples. They often related to general basic nursing procedures, but more so with maternity nursing practice. In discussing the practice and process of nursing, she stated (Parker, 2001): The focus of Practice is the experiencing individual, i.e., the individual for whom the nurse is caring, and the way he and only he perceived his condition or situation. For example, a mother had a red vaginal discharge on her first postpartum day. The doctor had recognized it as lochi, a normal concomitant of the phenomenon of involution, and had left an order for her to be up and move about. Instead of trying to get up, the mother remained, immobile in her bed. The nurse who wanted to help her out of bed expressed surprise at the mother’s unwilling to do so, when she seemed to be progressing so well. The mother explained that she had a red discharge, and this to her was evident of onset of hemorrhage. This terrified her and made her afraid to move. Her sister, she added, had hemorrhaged and almost lost her lfie the day after she had her baby two years ago.
Nurses should have the sincerity and concern when using our helping hands because our thoughts and feelings are expressed through our actions. she recognized gross differences. ~Laurence Leamer. When the mother tried to do this. If a nurse’s thought and feeling is to give help to her patient because she is concerned with her welfare. As nurses. We nurses should not only offer our hands to help. not just because it is in her job description. IV. and validated it by getting out of bed without further encouragement (Wiedenbach. THEORY DERIVIATION The difference between a helping hand and an outstretched palm is a twist of the wrist. patients turn to us because they are in need of something. no man is an island. and accepted the nurse’s explanation of the origin of the discharge. The mother then voiced her relief. but also we have to offer our helping hands with the intention of augmenting the . but then encouraged her to compare her current experience with that of her sister. Each person has the tendency to have a feeling of need and this need may pertain to a person.The nurse expressed her understanding of the mother’s fear. King of the Night As the saying goes. emotional or even spiritual. Our role as nurses is helping hands of God to those in need. be it physical. 1962). the patient would sense the nurse’s concern.
Nursing Theories: The Base for Professional Nursing Practice. A nurses’ objective must comprise of the sincerity of providing the needs of the patient and not just because their job is asking them to do. Philadelphia: J. . B. Lippincott Company. The patient may not always verbalize this need-of-help therefore implying that we nurses should be extra sensitive when it comes to assessment of patients. Philadelphia: F. V. Based from Wiedenbach’s theory. it is essential that they determine their objectives in working. (2001). Davis. Parker. J. Nursing Theory: Analysis. Nursing Theories and Nursing Practice. M. BIBLIOGRAPHY Barnum. (1994).B. If the purpose of the nurse is to promote health then that is what the patient would feel. George. New Jersey: Prentice Hall. the role of the nurses is not merely carrying out orders from physicians. We do not only base our observations with their subjective cues but also we assess their objective cues. Evaluation. 4th ed.health of the person. We should learn to assess if the patient is in need-of-help. 5th ed.A. (2008). Before nurses begin their day. The nurses’ helping hand should always be ready in their everyday encounter with patients because these people come to nurses because they are in need-of-help. Application. It is with their purpose that their actions would radiate their intentions. The purpose defined by the nurse would determine their interventions and plans in the care of the patient. We should put in our hearts and minds the vocation this profession entails. Nurses should define their purpose of entering nursing.
healing and caring profession. and being and becoming the Caritas Field. Louis. A.N. 5th ed. Dr. A nurse should prioritize caring as her primary role in dealing with her patients and not merely by what her profession denotes. Ph. The said quote connotes that nursing is geared towards providing care. St. Margaret Jean Herman Watson R. She called upon nurses to come of age and establish nursing as a full mature health. In that same occasion.. Missouri: Mosby year book.D. INTRODUCATION Above all. JEAN WATSON’S THEORY OF HUMAN CARING I.Tomey. nursing is caring. Nurses enter the experience with their whole being. According to Arnold and Boggs (1989). considering the current crisis within healthcare. caring is a commitment by the nurse to become involved since it is relational in character. Watson proposed that nurses engage in a regular practice of cultivating love and caring within themselves. (1994). Nursing theorist and their work. as a way of co-creating the profession's future. It involves patients in their struggle for . Nurses have to be conscious of their significance and approach in serving their clients to provide their utmost quality care.
it represents the archetype of an ideal nurse. Caring endorses our professional identity within a context where humanistic values are constantly questioned and challenged (Duquette & Cara.health rather than simply doing those actions they cannot perform for themselves. and health maintenance. Despite such hardships. to provide compassion to ease patients’ and families’ suffering. Nurses care for others during times of physical discomfort. Nurses must now deal with patients’ increased acuity and complexity in regard to their health care situation. Upholding Watson’s caring theory not only allows the nurse to practice the art of caring. “I care about your health. as in the statement. Upholding these caring values in our daily practice helps transcend the nurse from a state where nursing is perceived as “just a job. and to promote their healing and dignity but it can also contribute to expand the nurse’s own actualization. and interest. 2000). Promoting and applying these caring values in our practice is not only essential to our own health. Gaut claimed that nurses express caring as concern for others. “I like you and care for you.” The changes in the health care delivery systems around the world have intensified nurses’ responsibilities and workloads. as in the statement.” and as a fondness or attachment. emotional stress. as nurses. concern. . as exemplified in the statement.” to that of a gratifying profession. nurses must find ways to preserve their caring practice and Jean Watson’s caring theory can be seen as indispensable to this goal. “I will be caring for you today.” as a responsibility. As quoted by Arnold and Boggs (1989). but its significance is also fundamentally tributary to finding meaning in our work. Watson is one of the few nursing theorists who consider not only the caredfor but also the caregiver. compassion. Being informed by Watson’s caring theory allows us to return to our deep professional roots and values. In fact. It includes the act of giving freely and willingly of oneself to another through warmth.
and practices of human caring that are geared toward subjective inner healing processes and the life world of the experiencing person. this emerging . THEORY ANALYSIS HISTORICAL EVALUATION OF THE THEORY The theory of Human Caring was developed between 1975 and 1979. but stood in stark contrast to "curative factors." which complemented conventional medicine." At the same time. knowledge. the reader will be able to: • Describe the historical background of the development of Watson’s theory • Define Watson’s Human Caring Theory and the Carative factors and Clinical Caritas • Present the relationship between Watson’s theory and concepts in nursing’s metaparadigm • Provide an example of use of Watson’s theory in clinical practice II. She tried to make explicit nursing's values. while Watson was engaged in teaching at the University of Colorado. combined and informed by her doctoral studies in educational-clinical and social psychology. requiring unique caring-healing arts and a framework called "carative factors.OBJECTIVES: Upon successful completion of this discussion. it emerged from her own views of nursing.
and as such cannot be considered qualitatively continuous with traditional. and power rather than circumstance (Alligod and Tomey. Watson’s work embraces concepts of mind and other concepts. 1994). scientific methodology” (Tomey. reductionistic. She previously served as Dean of Nursing at the University Health Sciences Center and is a Past President of the National League for Nursing. phenomena that occur when an authentic caring relationship exists between the nurse and the patient. Jean Watson was born in a small. Her latest activities include Founder and Director of a new non-profit foundation: Watson Caring Science Institute (Parker. Watson’s philosophy and theory of human caring are concerned with spirit rather than matter. 2002). scientific.philosophy and theory of human caring sought to balance the cure orientation of medicine. Jean Watson graduated from the . inner knowledge. It is a moral ideal rather than a task-oriented behavior and includes such characteristics as the actual caring occasion and the transpersonal caring moment. flux rather than form. She views nursing and caring as “both as human science and an art. Watson referred to caring as the essence of nursing practice. Jean Watson is Distinguished Professor of Nursing and holds an endowed Chair in Caring Science at the University of Colorado Denver and Anschutz Medical Center Campus. and professional standing with itself and its public (Parker. giving nursing its unique disciplinary. close-knit town in the Appalachian Mountains of West Virginia in the 1940s. 2002). She is founder of the original Center for Human Caring in Colorado and is a Fellow of the American Academy of Nursing. BACKGROUND OF THE THEORIST Dr. 2002).
a Fulbright Research Award in Sweden. in 1964. She continued her nursing studies at the University of Colorado at Boulder. Canada). Spain. She has been Distinguished Lecturer and Endowed Lecturer at universities throughout the United States and been around the world several times. including The Fetzer Institute Norman Cousins Award.D. and a Ph. She holds eight (8) Honorary Doctoral Degrees. in diverse settings worldwide. seek to bridge paradigms as well as point toward transformative models for the 21st century.com) A new edition of Assessing and Measuring Caring was published in September. Dr. Currently she is working on a new revised work on . British Colombia and Quebec. Nursing The Philosophy and Science of Caring is now available . including an international Kellogg Fellowship in Australia.upcolorado. earning a B. She is a widely published author and recipient of several awards and honors. 2002).(www. She is the recipient of several national awards. including 5 International Honorary Doctorates (Sweden. As author /co-author of over 14 books on caring. Watson has been featured in numerous national videos on nursing theory and the art of nursing.S. maintaining and exemplifying relationship-centered care practices (Parker. Virginia. Clinical nurses and academic programs throughout the world use her published works on the philosophy and theory of human caring and the art and science of caring in nursing (Parker. Watson’s caring philosophy is used to guide transformative models of caring and healing practices for nurses and patients alike.S. United Kingdom. her latest books range from empirical measurements of caring. A new revised edition of her first book. to new postmodern philosophies of caring and healing.Lewis Gale School of Nursing in Roanoke. in recognition of her commitment to developing. Her books have been AJN books of the year awards. 2002). NY). an M. in 1961. in educational psychology and counseling in 1973. 2008 (Springer Publication. in psychiatric and mental health nursing in 1966.
Furthermore. The concepts are dealt with as nondiscrete. Watson (1985/88) views (George. Watson created a non-profit foundation: Watson Caring Science Institute. the sum of his or her parts”. 2002). 2008).‘Creating a Caring Science Curriculum for Caring Science’ (Springer in progress) (Parker.or herself… in general a philosophical view of a person as a fully functional integrated self… greater than. through the use of the mind. and different from. to higher levels of consciousness… one’s soul possesses a body that is not confined by objective space and time. and discontinuous (George. her descriptions of the metaparadigm concepts have been modified. to further the work of Caring Science in the world (Parker. Person (Human Being) Considering the individual human. environment. health. In 2008 Dr. 2002). As Watson has been inspired by quantum physics and has integrated varied ways of knowing and being and doing. intertwined. 2008): the human as a valued person in and of him. The human can go forward. . APPROACH TO THE DEVELOPMENT OF THE MODEL WATSON’S THEORY AND NURSING’S METAPARADIGM Watson’s earlier works address the metaparadigm concepts of person (human being). essential to human existence “is that the human has transcended nature-yet remains part of it. and nursing as somewhat more discrete concepts than do her later works.
We are spiritual beings having a human experience. inner self. 2008). This expanded view of what it means to be human. body or soul-provided the physical body is not perceived or treated as separate from the mind and emotions and higher sense of self (soul)… 4. loving way… In more recent work (1996). 2008): We are not human beings having a spiritual experience. both immanent and transcendent” (George. The spirit.all living things)”. . 1. or soul (geist) of a person exists in and for itself… 5. emotions.In 1996. 2008). Watson’s focus shifts more to the connectedness of all existence. to be healed. Of the basic premises identified by Watson (1985/88) on which her caring model is based. into infinity and into the universal or cosmic level of existence”. and inner self indirectly through any sphere-mind. but the mind and soul are not confined to the physical universe… 3. A person’s mind and emotions are windows to the soul… 2. She uses a quote of de Chadrin (1967) (George. People need each other in a caring. A person’s body is confined in time and space. considers person to be “embodied spirit. and of a field of connectedness between and among persons and environments at all levels. She further develops the concept of the “unity of mindbodyspirit/ nature. and to be whole. Watson elaborated on this transcendent nature of being human. A nurse may have access to a person’s mind. five relate to person (George. There is an “Unbroken wholeness and connectedness of all (subject-object-person-environment-natureuniverse.
. 2008). disease may not be present (George. and moral realms. but the two concepts do not fall on a continuum and can exist apart from one another (George. body. Watson notes that illness can result from a troubled inner soul. on the other hand. 2008): Subjective turmoil or disharmony within a person’s inner self or soul at some level or disharmony within the spheres of the person. and soul. aesthetic. Encompassing the entire nature of the individual in the physical. social. health or illness results from the congruence or incongruence between the self as perceived and the self as experienced. and illness can lead to disease. for example. 2008)r. in the mind. Health is also associated with the degree of congruence between the self as perceived and the self as experienced. body. rather than limited to aspects of behavior and physiology. does imply a healthillness continuum. As described in her 1985/1988 work (George.Health and Illness Watson considers illness to be a perceived state rather than presence of disease. either consciously or unconsciously… Illness connotes a felt incongruence within the person such as an incongruence between the self as perceived and the self as experienced (Waston. and soul. 2008): Health refers to unity and harmony within the mind. Or. Illness is defined as (George. 1985/ 1988). Watson’s definition of health. Disease may result from or be a causal factor in prolonged periods of incongruence.
such as social. Carative factor 8 is: “Attending to supportive. in discussions of her more recent thought. such as social. Watson reiterated the usefulness of her ten carative factors. One of these factors speaks to environment. 2008): . and nursing to consist (George. protective. this field form an “Unbroken wholeness and connectedness of all (subject-object-personenvironment-nature-universe-all living things)” (Watson 1996). 2008): of knowledge. or as the greater context. commitment. originally presented in 1979. However. As noted above. and action with some degree of passion… related to human care transactions and intersubjective personal human contact with the lived world of the experiencing person. that environment can be perceived to be a specific context. physical. Watson (1985/ 1988) defined nurse to be both a noun and a verb. thought. values. nondiscrete elements within a phenomenal field (George. It seems. environment is considered in the context of a human-environment field.Environment In 1996. and/ or corrective mental. or as the greater context of interacting. societal. and spiritual environments”. The verb “to nurse” is carried out through human care and caring. which Watson views as the moral ideal of nursing and (George. Nursing as Profession and Praxis In her own words. physical. then. 2008). physical. philosophy.
and when. and self-healing wherein a sense of inner harmony is restored regardless of the external circumstances. and existence. healing. The practice of nursing based on Watson’s theoretical and philosophical concepts differs substantially from biomedical/ natural-science based practice. national. and health-illness condition in a given ‘caring moment’. perceptions and lived experiences related to caring. 2008). Human care nursing involves a reciprocal relationship between the nurse and others as coparticipants in a pattern of subjectivityintersubjectivity evidenced in “consciousness. nursing “exists in order to sustain caring. The physical body is cared for. 1996) (George. by local. but the care is never separated from the context of the unity of mindbodyspirit/nature (George. healing. or global influences” (George. 2008). based on caring-healing knowledge and practices drawn from the arts and humanities as well as from traditional and emerging sciences. environmentally. or politically. Watson (1996) determines nursing to be both scientific and artistic.consists of transpersonal human-to-human attempts to protect. control. to help another gain self-knowledge. and experience or meanings that transcend the moment and go beyond the actual experience” (Watson. intentionality. 2008). As a profession. institutionally. and health where. enhance. OVERVIEW OF WATSON’S PHILOSOPHY OF HUMAN CARING . and preserve humanity by helping a person find meaning in illness. they are threatened biologically. suffering. pain.
mental/emotional experience. mental. deep imagination. and emotional existence of a person at any given time. which possess a greater sense of self awareness. Consciousness has the capacity to create and construct (Alligod and Tomey. geist. . By acknowledging a spiritual dimension to life. a higher(ascent) degree of consciousness.Watson’s notions of personhood and life are based on the concept of human being as embodied spirit. mystery and wonder of life because of the continuous yet unknown journey the soul takes. experience includes sensory motor experience. which is continuous in time and space. 2002). reverence. present and future in the moment. the uncanny. and experience the rational scientific culture inhibit (Alligod and Tomey. the mystical. and feminine/masculine archetypes. through the infinite and eternal. or higher sense of self) transcends the physical.” The locus of human existence is experience. 2002). one can more fully access the intuitive. dream work. chaos. Watson affirmed that “Human life is defined as being in the world. the body is a living spirit that manifests one’s being in the world and one’s way of standing and reflects how one holds oneself with respect to one’s relation to self and one’s consciousness or unconscious. and can come to “be” utilizing modes of awareness. and spiritual experience. Broadly defined. Watson view soul as the essence of the person. an inner strength. The human soul (also called spirit. From this higher sense of consciousness (soul level). Experience is translated through multiple layers of awareness. and a power that can expand human capacities and allow a person to transcend his or her usual self. Within a transpersonal framework. She respects the dignity. Watson is able to speculate on the human capacity to coexist with past. feeling. The soul and spirit are those aspects of consciousness that are not confined by objective space and time and that are unconstrained by linearity.
2002). the consequences will be significant for our actions (Alligod and Tomey. as parts of the evolutionary ontological process. 2002).Watson said the person is a living. 2002): • • • • Carative Factors (evolving toward "Clinical Caritas Processes") Transpersonal Caring Relationship Caring Moment/Caring Occasion Caring-healing modalities Other dynamic aspects of the theory which are emerging as more explicit components include (Parker. desires. manipulate and have power over. memories. Watson stated Intentionality is the projection of awareness or consciousness with some purpose and efficacy toward some object or outcome. “if our conscious intentionality is to hold thoughts that are caring. 2002): . MAJOR CONCEPTUAL ELEMENTS The major conceptual elements of the original and emergent theory are (Parker. life history. open. The self is the subjective center that lives within the whole body. growing gestalt that possesses three spheres of being-body. and so forth (Alligod and Tomey. loving. in contrast to an intentionality to control. kind and receptive. One’s intention and attention shape experiences. thoughts. Watson has said. sensations. The mind and emotions are the starting point and the point of access to the subjective world. mind and soul-which are influenced by the concept of self.
Watson offers another concept today that is more in keeping with Watson’s own evolution and future directions for the "theory".• Expanded views of self and person (transpersonal mindbodyspirit unity of being. the term "factor" is too stagnant for my sensibilities today. Clinical Caritas and Caritas Processes . • Caring consciousness as energy within the human environment field of a caring moment. embodied spirit. (consciously guided by one’s nursing theoretical-philosophical orientation). • Advanced caring-healing modalities/nursing arts as a future model for advanced practice of nursing qua nursing. • Caring-Healing Consciousness and intentionality to care and promote healing. 2002). • Phenomenal field/unitary consciousness: unbroken wholeness and connectedness of all. Watson offers the concept of "clinical caritas" and "caritas processes" as consistent with a more fluid and contemporary movement with these ideas and her expanding directions (Parker. providing a structure for the initial work. Original and Evolving Ten Carative Factors The original 1979 work was organized around ten carative factors as a framework for providing a format and focus for nursing phenomena. While "carative factors" are still the current terminology for the "core" of nursing.
"Clinical Caritas" is an emerging model of transpersonal caring and moves from carative to caritas. our subject matter. science. As we more publicly and professionally assert these positions for our theories. it connotes something that is very fine that indeed is precious. emerging cosmology. As one . This relationship between love and caring connotes inner healing for self and others. At this time Watson makes new connections between carative. that is love. 2002). in that it transcends conventional industrial. our ethics and our practices. as they are also being redefined. 2002). allowing love and caring coming together for a new form of deep transpersonal caring. is more than just a job. and the larger universe. cherishing our phenomena. Such maturity and integration of past with present and future. static models of nursing. It is when we include caring and love in our work and our life that we discover and affirm that nursing. and those we serve. like teaching. The word "caritas" also is closely related to the original word "carative" from Watson’s 1979 book. unfolding and evolving within a cosmology that is both metaphysical and transcendent with the coevolving human in the universe (Watson. even our science."Caritas" comes from the Greek word meaning to cherish. if not loving. to appreciate. attention to. the future of nursing is ironically tied back to Nightingale’s sense of "calling". and the profession itself. now require transforming self. acknowledging a convergence between art. while simultaneously evoking both the past and the future. and spirituality. we also locate ourselves and our profession and discipline within a new. extending to nature. 1998) (Parker. This integrative expanded perspective is both postmodern. guided by a deep sense of commitment and a covenantal ethic of human service. caritas and without hesitation invoke the "L" word. to give special attention. For example. which caritas conveys. but a life-giving and life-receiving career for a lifetime of growth and learning. and those we serve. It incorporates both art and science. Such thinking calls for a sense of reverence and sacredness with regard to life and all living things (Parker. including our institutions.
Original Carative Factors The original carative factors served as a guide to what was referred to as the "core of nursing". and gifts into human service of caring and healing.enters into the transpersonal caring theory and philosophy. yet complements. treatment and technology. While the "trim" is important and not expendable.its raison d’etre for the public. for self and others. . 2002). 2002). Further. in contrast to nursing’s "trim". setting. they affect the one caring and the one-being-cared-for. to translate their unique talents. Nor can nursing’s trim define and clarify its larger professional ethic and mission to society . one simultaneously is challenged to relocate themselves in these emerging ideas and question for themselves how the theory speaks to them. if not enticed to examine and explore the critical intersection between the personal and the professional. interests. the basic core was grounded in what I referred to as the philosophy. and even the planet Earth itself (Parker. science. functional tasks. specialized focus around disease. inviting them into a new relationship with themselves and their ideas about life. the point is that nursing cannot be defined around its trim and what it "does" in a given setting at a given point in time. nursing. In this framework each one is also asked. that both differs from. and art of caring. and theory. Core pointed to those aspects of nursing that potentiate therapeutic healing processes and relationships. procedures. That is where nursing theory comes into play and transpersonal caring theory offers another way. that which has come to be known as "modern" nursing and conventional medical-nursing frameworks (Parker. Carative is that deeper and larger dimension of nursing that goes beyond the "trim" of changing times.
The first and most basic carative factor. 2000). focuses attention on the “full use of self and all . Watson stated the sixth carative factor. maintained the Caring Relationship. a Helping-Trusting. Watson pointed out that the nurse must instill in the other person a sense of faith and hope about the treatment and the nurse’s competence (Fawcett. Promoting and Accepting the Expression of Positive and Negative Feelings and Emotions. Forming a Humanistic-Altruistic System of Values. Watson viewed the Carative Factors as both hierarchical in nature. grounded on universal humanistic and altruistic values. 2000). the ability to utilize the self with others. she claimed that the best professional care is promoted when the nurse subscribes to such a value system. which is the focus of the third carative factor. empathy. The fourth carative factor. points to the range of feelings and emotions experienced by both nurse and other(s) and the need to facilitate the expression of such feelings and emotions. and nonpossessive warmth are essential elements helping-trusting further maintained that a helping-trusting relationship is a basic element of highquality nursing care (Fawcett. With regard to the second carative factor. congruence. Enabling and Sustaining Faith-Hope. Engaging in Creative. Furthermore.” Moreover. points out that human caring is. or genuineness. and Developing being. The fifth carative factor.Watson regards the carative factors as the foundation for “advanced practices and caring modalities for healing and health processes and outcomes. Individualized ProblemSolving Caring Processes. Being Sensitive to Self and Others. and the ability to give holistic care. according to Watson. processes She is of accomplished when the nurse views the other person as a separate thinking feeling Watson of the attitudinal relationship. plays a part in the nurse’s development of self. Watson noted the development of sensitivity to self and others. whereby each preceding factor contributes to the next one and interacting to promote holistic nursing care.
intuitive.” (Fawcett.” Watson’s addition of the phrase “that cannot be fully explained scientifically through modern Western medicine” to this carative factor implies that she recognizes the possibility of phenomena that are more in keeping with nonempirical ways of knowing. Watson linked the eight carative factor. The seventh carative factor. with the quality of holistic health care (Fawcett. Assisting with Gratification of Basic Human Needs while Preserving Human Dignity and Wholeness. or Corrective mental. as well as helping others to find meaning in life. affective. according to Watson. (Fawcett. 2000). The tenth carative factor. and indeed are used as the basis for some theory-guided practice models and . “a matter of existential-phenomenological [and spiritual] concern for the nurse who practices the science of [human] caring. The ninth carative factor. Promoting Transpersonal TeachingLearning. 2000). and Being Open To. 2000). aesthetic. While some of the basic tenets of the original carative factors still hold. including empirical. emphasizes the importance of appreciating and understanding the inner world of each person and the meaning each one finds in life. Physical. Existential-Phenomenological-Spiritual Dimensions of Caring and Healing That Cannot Be Fully Explained Scientifically Through Modern Western Medicine. and ethical knowledge. Watson identified and hierarchically ordered the needs she regarded as most relevant to nursing as human caring. emphasizes Watson’s view that nurses and patients are coparticipants in the process of learning. Protective.domains of knowledge. Allowing For. Attending to Supportive. Societal. and Spiritual Environments. “Dealing with another person as he or she is and in relation to what he or she would like to be or could be is”.
3. as part of my evolution and evolution of these ideas and the theory itself. becomes: "Being present to. 2. For example (Parker. as my ideas and values evolve. Cultivation of sensitivity to one’s self and to others becomes: "Cultivation of one’s own spiritual practices and transpersonal self. 2002). Development of a helping-trusting. consider the following within the context of clinical caritas. becomes: "Being authentically present. I now offer the following translation of the original carative factors into clinical caritas processes. human caring relationship becomes: "Developing and sustaining a helping-trusting.research. 5. For example. is to transpose the "carative factors" into "clinical caritas processes". transpersonal caring theory (Parker. From Carative Factors To Clinical Caritas Processes As carative factors evolve within an expanding perspective. and emerging. and enabling and sustaining the deep belief system and subjective life world of self and one-being-cared. Instillation of faith-hope. going beyond ego self". 2002). Promotion and acceptance of the expression of positive and negative feelings. what I am proposing here. . authentic caring relationship". Formation of humanistic-altruistic system of values becomes: "Practice of loving-kindness and equanimity within context of caring consciousness". 1. 4.for". suggesting more open ways in which they can be considered. and supportive of the expression of positive and negative feelings as a connection with deeper spirit of self and the one-being-cared-for".
whereby wholeness. 7. This direction ironically while embedded in theory. Promotion of transpersonal teaching-learning becomes: "Engaging in genuine teaching-learning experience that attends to unity of being and meaning attempting to stay within other’s frame of reference". . subtle environment of energy and consciousness. which potentiate alignment of mindbodyspirit. 10. soul care for self and the one-being-care-for. consistent with the Nightingale model of nursing. protective." What differs in the Clinical Caritas framework is that a decidedly spiritual dimension and an overt evocation of love and caring merge into a new paradigm for the next millennium. and spiritual environment. yet to be actualized. to engage in artistry of caring-healing practices".6. societal. Allowance for existential-phenomenological-spiritual forces becomes: "opening and attending to spiritual-mysterious. 8. physical. goes beyond theory and becomes a converging paradigm for nursing’s future (Parker. tending to both embodied spirit and evolving spiritual emergence. Such a perspective ironically places nursing within its most mature framework. and peace are potentiated". (physical as well as non-physical. and unity of being in all aspects of care". with an intentional caring consciousness. and existential dimensions of one’s own life-death. Provision for a supportive. becomes: "Creating healing environment at all levels. Systematic use of a creative problem-solving caring process becomes: "creative use of self and all ways of knowing as part of the caring process. 9. 2002). beauty. comfort. dignity. and/or corrective mental. administering ‘human care essentials’. Assistance with gratification of human needs becomes: "assisting with basic needs. but awaiting its evolution within a caring-healing theory. wholeness.
and with each other. dentistry. clinical practice models. 2002): The central task of health professions education . p. healing relationships with patients. medicine. faculty. and values necessary for effective relationships… Developing practitioners mature as reflective learners and professionals who understand the patient as a person. ethical. others interact with the original work at levels of concreteness or abstractness.must be to help students.in nursing. Blueprint. flexible.Thus. social work. the caring theory has been. recognize and deal with multiple contributions to health and illness. reflective practices that must be continuously questioned and critiqued in order to remain dynamic. This work posits a value’s explicit moral foundation and takes a specific position with respect to the centrality of human caring. and the basis for further advancement for caring-healing practices. psychology. and is being used. 2002). rather than a specific theory per sé. and their communities. this work is congruent with recent reports on health care and health professional educational reform. methods for research and inquiry. 2002). and endlessly self-revising and emergent" (Watson. as well as administrative directions for nursing and health care delivery (Parker. and the allied health professions . public health. Nevertheless. broad societal mission. intellectual blueprint for nursing’s evolving disciplinary/professional matrix. as a guide for educational curricula. and practitioners learn how to form caring. 1996. Ironically. Nevertheless. which call for "centrality of caringhealing relationships" as the foundation for all health professional education and practice reform. and with themselves…the knowledge. as well as a critical starting point for nursing's existence. Watson considers her work more a philosophical. and understand the . 143) (Parker. it’s use and evolution are dependent upon "critical. "caritas" and love as now an ethic and ontology. I quote (Parker. skills.
each fully embodied in the moment. reaching to the deeper connections to spirit and with the broader universe. healing. and is able to detect the other person’s condition of being (at the soul. Watson stated within the model of transpersonal caring. transpersonal conveys a concern for the inner life world and subjective meaning of another who is fully embodied. an ability to be present to self and other in a reflective frame. 39) Transpersonal Caring Relationship Watson termed transpersonal and a transpersonal caring relationship as the foundation of the work. p. and wholeness. but transpersonal also goes beyond the ego self and beyond the given moment. spirit level). illness and pathology. It implies a focus on the uniqueness of self and other and the uniqueness of the moment. while paradoxically capable of transcending the moment. 2002). Transpersonal caring calls for an authenticity of being and becoming. 2002). clinical . in the moment (Parker. wherein the coming together is mutual and reciprocal. the transpersonal nurse has the ability to center consciousness and intentionality on caring. (Pew-Fetzer Task Force Report. 1994. such a transpersonal relation is influenced by the caring consciousness and intentionality of the nurse as she or he enters into the life space or phenomenal field of another person. open to new possibilities (Parker. According to Watson. Transpersonal caring seeks to connect with and embrace the spirit or soul of others through the processes of caring and healing and being in authentic relation.essential nature of healing relationships. rather than on disease.
The nurse attempts to enter into and stay within the other’s frame of reference for connecting with the inner life world of meaning and spirit of the other. . and which is the highest sense of self (Fawcett. the ideal self that the person would like to be. the nurse pursues this goal through transpersonal caring relationship and the human care process and responds to person’s subjective worlds in such a way that individuals can find meaning in their existence through exploring the meaning of their disharmony. together they join in a mutual search for meaning and wholeness of being and becoming to potentiate comfort measures. 2000). and self-care processes while allowing for diversity and possibility. Nursing’s goal is to help persons gain a higher degree of harmony within the mindbodyspirit. wholeness. and turmoil within the lived experience. Self Watson identified the self as a transpersonal mind body spirit oneness. self-control. which generates self-knowledge. self reverence. 2002). The concept TRANSPERSONAL CARING RELATIONSHIP encompasses three dimensions – self. phenomenal field and intersubjectivity. This exploration promotes self-knowledge. In ontology of relation. self-love. and self-determination (Tomey. The person is viewed as whole and complete. or even spiritual transcendence of suffering. self-healing. the ego self. which is synonymous with the geist or soul or essence of the person. suffering. a sense of well-being.caritas consciousness is engaged at a foundational ethical level for entry into this framework. pain control. an embodied spirit. regardless of illness or disease (Parker. The self encompasses the self as it is. choice based on subjective intent. and the spiritual self. 2002).
and Intersubjectivity-are regarded as integral. 2000). enhances and potentiates human dignity.Phenomenal Field The phenomenal field is the totality of human experience (one’s being in the world). Intersubjective Transpersonal refers to an intersubjective human-to-human relationship in which the person of the nurse affects and is affected by the person of the other. As such. feels this condition in such a way that the recipient has a release of subjective feelings and thoughts he or she had been longing to release. intentionality and caritas consciousness by the nurse protects. They share a phenomenal filed which becomes part of the life history of both and are coparticipants in becoming in the now and the future. Phenomenal Field. 2000). there is an intersubjective flow between the nurse and patient (Fawcett. Watson explained: Human care can begin when the nurse enters into the life space or phenomenal field of another person. Assumptions of Transpersonal Caring Relationship Moral commitment. soul). 2000). The three dimensions of the concept TRANPSERSONAL CARING RELATIONSHIP –Self. wholeness and healing . Watson said that the intersubjectivity human flow from one to the other (is such that it) has the potential to allow the care giver to become the care receiver (Fawcett. The individual frame of reference that can be known only to the person (Fawcett. is able to detect the other person’s condition of being (spirit.
The result is an honoring of an I-Thou Relationship rather than an I-It Relationship (Parker. in the fullest sense of Nightingale’s view of nursing (Parker. thought. opportunities for focused studies. 2002).spirit level is translated via movements. gestures. behaviors. thus the nurse helps another through this process to access the healer within. technical. body language. feelings. allowing for awakening to a transpersonal condition of world and more fully actualizing the "ontological competencies" necessary for this level of advanced practice of nursing. aesthetic. or of . senses. facial expressions. the blocked energy that interferes with the natural healing processes. information. 2002). touch. biological. cognition. procedures. verbal expressions and other scientific. and human means of communication. and connect with the inner condition of spirit of another through genuine presencing and being centered in the caring moment. The caring-healing modalities within the context of transpersonal caring/caritas consciousness potentiate harmony. intuition. and so on.whereby allowing a person to create or co-create his/her own meaning for existence. wholeness. The nurse’s ability to connect with another at this transpersonal spirit. all contribute to transpersonal caring connection. institutional or otherwise. and personal spiritual practice assist the nurse in entering into this deeper level of professional healing practice. actions. into nursing human art/acts or intentional caring-healing modalities (Parker. unity of being by releasing some of the disharmony. The conscious will of the nurse affirms the subjective and spiritual significance of the patient while seeking to sustain caring in the midst of threat and despair. 2002).to. The nurse’s own life history. words. On-going personal and professional development and spiritual growth. accurately detect. The nurse seeks to recognize. sound. previous experiences. the energy field. having lived through or experienced various human conditions.
59. yet arises from aspects of itself that become part of the life history of each person. 1996 p. drama. literature.157 reprinted (Parker. Continuous growth is on-going for developing and maturing within a transpersonal caring model. etc. deep beliefs. The notion of health professionals as wounded healers is acknowledged as part of the necessary growth and compassion called forth within this theory/philosophy (Parker. It becomes transcendent whereby experience and perception take place. 2002). as well as part of some larger. Caring Moment/ Caring Occasion A caring occasion occurs whenever the nurse and another come together with their unique life histories and phenomenal fields in a human-to-human transaction. If the caring moment is transpersonal. (Watson. bio-energetics work. are valuable teachers for this work. and one’s world. personal story. p. 1985/1988. The moment of coming together presents them with the opportunity to decide how to be in the moment and in the relationship as where as what to do with and during the moment. others.having imagined others’ feelings in various circumstances. each feels a connection with the other at the spirit level. and relationship with self. A caring moment involves an action and choice by both the nurse and the other. Other facilitators are personal growth experiences such as psychotherapy. but the actual caring occasion has a greater field of its own in a given moment. narratives of illness journeys. thus . to some degree the necessary knowledge and consciousness can be gained through work with other cultures. The coming together in a given moment becomes a focal point in space and time.) along with an exploration of one’s own values. 2002)). meditation. transpersonal psychology. study of the humanities (art. The process goes beyond itself. and other models for spiritual awakening. more complex pattern of life.
1992. What we all learn from it is self-knowledge. which in turn affects the field of the whole. (Watson. Caring (Healing) Consciousness The dynamic of transpersonal caring (healing) within a caring moment is manifest in a field of consciousness. • The caring-healing-loving consciousness of the nurse is communicated to the one being cared for. 2002): • The whole caring-healing-loving consciousness is contained within a single caring moment. The transpersonal dimensions of a caring moment are affected by the nurse’s consciousness in the caring moment. 148) and include the following points (Parker. The role of consciousness with respect to a holographic view of science have been discussed in earlier writings (Watson. p. opening up new possibilities for healing and human connection at a deeper level than physical interaction. 2002): ….it transcends time and space. 1985/1988. • The one caring and the one being cared for are interconnected. The self we learn about …is every self. . IT is universal – the human self. finding their dilemmas in ourselves.We learn from one another how to be human by identifying ourselves with others. 59-60). pp. the caring-healing process is connected with the other human(s) and the higher energy of the universe. We learn to recognize ourselves in others…(it) keeps alive our common humanity and avoids reducing self or other to the moral status of object. For example (Parker.
2002). and living it out in one’s personal/professional life (Parker. it transcends time. Within this context. The process is intersubjective with transcendent possibilities that go beyond the given caring moment (Parker. even teach and research the caring theory. The ideas as originally developed. study. model. to truly "get it. thus the model is both an invitation and an opportunity to interact with the ideas. provide others a chance to assess. critique and see where or how. learn about. A model of caring includes a call for both art and science. one may locate self within the framework or the emerging ideas in relation to their own "theories and philosophies of professional nursing and/or caring practice. 1999). and new dimensions of mindbodyspirit medicine and nursing evolving openly as central to human phenomena of nursing practice (Parker. it is acknowledged that the process is relational and connected. 2002). as well as in the current evolving phase (see Watson." one has to personally experience it. Implications of the Caring Model The caring model or theory can also be considered a philosophical and moral/ethical foundation for professional nursing and part of the central focus for nursing at the disciplinary level. space. however. it offers a framework that embraces and intersects with art." If one chooses to use the caring perspective as theory. Watson emphasized that it is possible to read. ethic or ethos for transforming self . science. and physicality. 2002). philosophy. or if. humanities.• Caring-healing-loving consciousness exists through and transcends time and space and can be dominant over physical dimensions. experiment with and grow within the philosophy. spirituality.
environment. or self and system. caring. group. organization. 2002): • Is there congruence between (a) the values and major concepts and beliefs in the model and the given nurse. clinical administrative setting. nature and wider universe? • Are those working within the model interested in shifting their focus from a modern medical science-technocure orientation to a true caring-healing-loving model? This work. other. For example: In words of Teilhard de Chardin: "Are we humans having a bspiritual experience. or other entity that is considering interacting with the caring model to transform and/or improve practice? • What is one’s view of human? And what it means to be human. 1996. becoming. population needs. the following questions may help (Watson. healing. p. in both its original and evolving forms. etc. 161) (Parker. curriculum. or are we spiritual being having a human experience?" Such thinking in regard to this philosophical question can guide one’s worldview and help to clarify where one may locate self within the caring framework. transforming. growing. seeks to develop caring as an ontological and theoretical-philosophical-ethical framework for the profession and discipline of nursing and clarify its mature relationship . system. • Are those interacting and engaging in the model interested in their own personal evolution? Are they committed to seeking authentic connections and caring-healing relationships with self and others? • Are those involved "conscious" of their caring-caritas or non-caring consciousness and intentionally in a given moment and at an individual and system level? Are they interested and committed to expanding their caring consciousness and actions to self.and practice.
their appropriate numbers are identified within parentheses. Gangrene has ravaged both feet and legs. Nurses’ reflective-critical practice models are increasingly adhering to caring ethic and ethos (Parker. the reader can also refer to Table 3 for an example of a caring process using Watson’s caring theory (adapted from Cara. 2002). I am assigned to take care of Mr. education and research have developed throughout the USA and other parts of the world. It is December 5th. Nursing caring theory based activities as guides to practice. or has been used in specific settings (Parker. the purpose of which is to provide an expeditious grasp related to these abstract concepts. Watson’s work is consistently one of the nursing caring theories used as a guide. He is scheduled for an above knee amputation of his right . a 55-year-old Caucasian man who will undergo his 5th amputation. The reader shall also notice that this story deviates from the traditional format as it includes reflection and analysis. whenever a single or several clinical caritas process(es) (CCP) are encountered.THEORY SYNTHESIS CLINICAL APPLICATION The intent of this section is to create a better understanding of Watson’s theory through a clinical story. 2000). Because the nature of the use of the caring theory is fluid. 1999. Earlier publications seek to provide examples of how the work is used. For this reason. dynamic. Cara & Gagnon. III.and distinct intersection with other health sciences. 2002). Smith. and undergoing constant change in various settings around the world and locally I am not able to offer updated summaries of activities. Additionally.
I’ve always liked this patient (CCP#1). he returns a faint smile. his feelings. the nurse’s creativity contributes to making nursing an art. He shared with me his life story [referred to as phenomenal field by Watson]. CCP#10). CCP#10). [Although caring takes “too much time” according to some people. I know him quite well. it seems that we connected right away after our first meeting (CCP#4).] I ask him how he is doing and tell him that since our last meeting I thought of some creative ways of how he could remember to take his medicine (CCP#6. that focusing on the patients’ priorities and meaning will often help them participate more actively in their healing process. As we glance to each other. Smith knows me as a person. I cannot make this assumption and will have to discuss his perceptions and feelings pertaining to his lived experience (CCP#3. [According to Watson. Mr.” He knows that I care for him and that I am committed to helping him through his ordeal (CCP#4). [This is an example of what Watson means by our relationship becoming part of both our life history. we will have to plan everything according to his priority. I use the time we have together to ask about himself. I welcome him as he is admitted onto the unit. He explains that he wants to be home for Christmas because his son and grandson are coming to visit. even though more time was . I arrange his environment so that he can feel at ease (CCP#8). Right away. because the last amputation did not heal properly.] He responds that he will be happy to discuss it and also asks how I have been doing.] From his faint smile I can sense that he is depressed. I have found. a caring occasion takes place. he does not consider me as just another nurse. While I help him settle in his room. which allowed me to know him as a person not just “a case” going for surgery on our unit.leg. CCP#7). I am “his nurse. Therefore. Consequently. Probably since part of his leg has to be amputated some more. and his priorities for his care plan and hospitalization (CCP#5. through experience. [At this moment. since I took care of him during his past hospitalizations (CCP#4). CCP#5. However.
mechanical. Smith and his environment are interrelated (CCP#8. CCP#10).taken initially. I am speechless! [My patient makes me realize the importance of Watson’s caring values based on respecting and preserving human dignity. I am no longer the same guy!” I ask how losing his legs made him different (CCP#5. CCP#10)]. we become robotic. Without my legs. “If only you knew me back then. I understand more than ever that Mr. I noticed that. eventually. I want to help him reach some harmony (mindbodyspirit) in his life again (CCP#9). one has to look beyond the body. [I find it difficult to consider how people can disrespect a human being for being different! Yet. Trusting that I will return. I can’t even manage by myself anymore! I feel like a piece of meat in this bed! Will this surgery work this time or is it a waste of time and money?” I am troubled by his comment and ask him to clarify (CCP#5). [Watson (2000) reminds us that being caring is being vulnerable. he says to me. develop from the process and are characterized and guided by the inner journey of the one being cared-for. I feel powerless towards my patient. “Look at me.] While I help him settle in his bed. CCP#9. As Watson (2000) emphasizes. he thanks me for my help (CCP#4). As I leave the room. more time is saved in caring for patients. not knowing what to say or what to do.] Sensing that he wants to be alone. Yet. the outcomes that may arise. He says that he no longer has social recognition and usefulness. not the one caring (or attempting to cure). and look at the mind and the soul. he asks for the bedpan (CCP#9). hearing how other people’s reaction affects him. Promoting hope to patients when their situation is somber can be . I tell him that I will return in a few minutes and I gently pull the curtains to provide privacy and comfort (CCP#8). 6). when I was walking and working. detached and de-personal in our lives and work and relationships” (p. “If we are not able to be vulnerable with ourselves and others. As I install the bedpan delicately underneath him. He says that people used to respect him but losing his legs also made him lose this respect. He continues to say.
humancaring. Medical science has confirmed the benefits of stress reduction techniques such as yoga. a nurse intuitively knows the needs of the patient. not only in the physical body but in the patient's emotional state as well. humanity. But since I believe that giving hope is essential to his harmony. rather. wholeness. her focus fits well within the scope of Betty Neumann's theory of nursing.quite overwhelming (CCP#2). Watson advocates a mental state of caring. Framework Jean Watson's theory of caring focuses on love as the primary healing tool in nursing. “protect. is what nursing is all about!] (C. and preserve my patient’s dignity.C. as Watson states. RN) (http://www.pdf) JEAN WATSON’S THEORY OF CARING IN NURSING EDUCATION The past decade has been rich in the advancement of complementary approaches to traditional medicine.org/conted/Pragmatic%20View.. whose seminal work in the mid 20th century outlined the idea of the role of the nurse as an integral tool in creating balance. This methodology is not new.” Caring. One mindfulness practitioner is Jean Watson. Watson believes that in an ego-less state. focused not on the self but. for me. enhance. and inner harmony. it is my motivation that contributes to the way I actualize myself professionally. I will have to be somewhat creative (CCP#6). on the patient. . meditation and qigong. Caring for him is important to me. who promotes a theory of caring as the central tenet in her teaching philosophy. Caring allows me to work with passion! It becomes clear that my most important goal is establishing a transpersonal caring relationship that will. Another technique that is increasingly incorporated into the conventional practice of medicine is that of mindfulness training.
skill practice. practical application of existing theory. which focuses on recent medical . thereby creating a healing energy for those who come in contact with it. Jean Watson is also a proponent of the work of the HeartMath Institute. they exude. According to Watson. Tolle's writing explores the idea that the human race is currently involved in a shift of consciousness. there is evidence that a loving approach creates a physical change in the environment. Nursing Theory in Practice Nursing theory in practice is a fourfold process which comprises overall education. Jean Watson addresses these aspects of nursing theory in her nurse training program at the University of Colorado's Denver Health Sciences Center. through the realization that the self is already whole in the present moment.Energy Awareness Because nurses are on the front lines of caring. a research center directed by physicians. Influences Jean Watson has been highly influenced by the author Eckhart Tolle. Watson's own Center for Human Caring promotes her caring philosophy in several forms including multi-continent training sessions. Watson believes that nurses should be acutely aware of the type of energy. whose work focuses on the benefits of love-centered living. and examination and integration of new theories including psychological and philosophical discoveries. spiritually-centering meditation and devotional media. webseminar educational materials. Additionally. and an annual professional retreat to discuss practical nursing as well as application of new psychological theories. whether caring or indifference.
disease. THEORY DERIVIATION . Million Nurse Project Jean Watson's Million Nurse Global Caring Field Meditation.waldenu.evidence that our emotions significantly affect our health and well being. ultimately. 2010. initiated a worldwide day of caring. where nurses across the world shared in love-centered consciousness towards one another and their patients. HeartMath's philosophy is based on the idea that hormones secreted when we are under stress cause inflammation and. held on January 1. (http://connected. The HeartMath Institute provides guided meditations as well as centering exercises designed to stop stressful emotions by replacing negative thoughts with helpful ones.edu/curriculum-resources/learningcenters/item/860-jean-watsons-theory-of-caring-nursing-education) IV. while hormones secreted when we are at peace are healing to the body.
It is when we see the person as a whole being that we give our patients the chance to have a holistic wellness. an honest compliment. but also they should go deeper with the interaction of a patient. a kind word. V. They should be viewed as a whole. just as incorporating nursing with love and care. a listening ear. she gives love and care to her children. Nursing is not just the mere fact of giving medications and positioning the patient. Watson stated in her theory that we should not view a person as separate being but rather a unified being. all of which have the potential to turn a life around. BIBLIOGRAPHY . or the smallest act of caring. Nursing is just like seeing and treating one patient as your own child. a smile.“Too often we underestimate the power of a touch. Every person is like a circle.” Leo F. As a mother. Nurses should not only look after the physical illness inflicted in a person. It is very important that we show our care and our love to our patients. efforts make everyday might not be a big deal for us but it might be a big deal for others. Buscaglia We always tend to forget that big things come Small in small we packages. this would result in the holistic healing of an ill person. When nurses apply their profession with a little love and care. We should consider a person’s mindbodyspirit when giving care to them. It is viewing the patient as a whole.
A. Davis. 5th ed.A. M.watsoncaringscience.watsoncaringscience. and Tomey. George. J.cfm http://www. Tomey. St.html .humancaring. Arnold. St. (2002).org/conted/Pragmatic%20View. (1994). E. Missouri: Mosby year book. 2nd ed.: Elsevier Science.waldenu. Nursing Theories and Nursing Practice. Philadelphia: F. Analysis and Evaluation of Contemporary Nursing Knowledge: Nursing Models and Theories.org/j_watson/theory.BOOKS Alligod. 4th ed. Nursing Theory: Utilization and Application. K. Parker. (2000). J.edu/curriculum-resources/learningcenters/item/860-jean-watsons-theory-of-caring-nursing-education http://www. A.cfm/feature/84/theor y-of-human-caring.pdf http://www. 5th ed.A.A.org/conted/Pragmatic%20View. and Underman-Boggs. (2002).pdf http://www. Philadelphia: F. New Jersey: Prentice Hall. Louis. Nursing Theories: The Base for Professional Nursing Practice.org/cfwebstorefb/index. Interpersonal Relationships: Professional Communication Skills for Nurses.S.humancaring. (2008). INTERNET SOURCES http://connected. Louis: Mosby. Fawcett. R. M. U. M. Nursing theorist and their work. Davis. (1989).