Concept of

Caring in
Nursing

Irma Nurbaeti
 Definition
 Caring --- action or activity towards providing care
 Care --- assist others with real or anticipated needs to promote
health and wellness
 Care and caring are predominantly used to describe the
inherent work and value of nursing.
 Nursing is a nurturing profession and caring is the essential
component of its holistic practice
 Concept of Caring
 Caring and nursing have always been thought of
synonymously.
 Most individuals choose nursing as a profession
because of their desire to care for other individuals.
 Caring as a central concept has led to the
development of several caring theories.
 Two well known theories were developed in the
1970’s, Leininger’s Theory of cultural care and Jean
Watson’s Theory of human caring (McCance,
McKenna, Boore 1999).
Nursing and Caring, Nurse and Care
 Two sides of the same coin
The 5 C's of Caring
 Commitment (komitmen)
 Conscience (hati nurani)
 Competence (kompetensi)
 Compassion (welas asih)
 Confidence (kepercayaan diri)
 JEAN WATSON’ S
THEORY OF
CARING: NURSING
CARE AND
NURSING ART
[Photograph of Jean Watson]. (2010). 4 th Annual Envision Conference
Nursing: The Art and Science of Caring. Oakland University, Rochester,
MI.
Watson’s Motivation for Developing
Her Model:

Education
LifeExperiences
Exploration of Self
 Historical Background
O According to Jesse (2010), during an undergraduate course Watson
studied Yakom’s 11 Carative Factors, which led her to develop her own
10 Curative factors.

O Her first book Nursing: The Philosophy and Science of Caring

(1979) was developed off of the notes from these studies.

O Life experiences were the motivation for her third book, Post
Modern Nursing and Beyond (1999).

O Jesse (2010) explains that both the tragic experience of losing her
husband and the loss of her left eye allowed her to experience her own
theory at work, as the people around her cared for her during these
troubling times.
Watson calls for joining of science
with humanities so that nurses will
have a strong liberal arts background
and will understand other cultures as a
requisite for using Care Science and a
mind-body-spirit framework” (Jesse,
2010).
 The nurse must connect with the patient on a spiritual level
through sincere presence.
 Watson believes this connection is made through:
 Words
 Behaviors
 Body Language
 Feelings
 Thoughts
 Senses
 Intuition
 Movements
 Gestures
 Facial Expressions
 Information
“A caring moment involves an action and choice by
both the nurse and the other. If the caring moment
is transpersonal, each feels a connection with the
other at the spirit level, thus it transcends time and
space, opening up new possibilities for healing
and human connection at a deeper level than
physical interaction” (WCSI, 2009, “Caring
Science Ten Caritas Processes,” ).
“The nurse’s own life history,
previous experiences, opportunities
for focused study, having lived
through or experienced various
human conditions, and having
imagined others’ feelings in various
circumstances are valuable teachers
for this work…”
“Caring in the nursing
profession takes place every
time a nurse-to-patient contact is
made... That caring makes a
difference to the patient’s sense
of well being. Caring may occur
without curing but curing cannot
occur without caring” .
Jeanwatson’s theory influenced by:
Florence Nightingale, Henderson,
Leininger, Peplaw, Rogers, Newman, and
Gadow
Jesse (2010) states “She describes a close
connection with ‘Nightingale’s sense of
‘calling,’ guided by a deep sense of
commitment and a covenantal ethic of
human service’ (Watson, 2007)”
Nursing Paradigm
Human Being
A nursing model that takes into account both the art and science of

nursing-considering mind, body and spirit of the patient and the nurse

A caring process-The privilege that nurses have to uphold the

commitment to present compassionate human caring to society and

humanity

Ten Caritas process- Be sensitive to self and others by nurturing

individual beliefs and practices

Environment
The Caring Theory is groundwork for healing practices-it can be

practiced in many settings; nurse, group, system, organization,

curriculum and population needs

Caring in nursing is culturally diverse. The caring model can be

practiced across all nursing practices as a vital method to study and

explain the nursing knowledge

Health

Caring Science-Uphold caring for those whose dignity and

humanity are threatened

 To create an environment that allows healing of the mind,

body and soul

The action and task of the nurse which strives to help the

patient obtain the right care and achieve wellbeing

Nursing
Caring in nursing- Continuous theme for caring model-building and

developing relationships.

A special way of being, knowing and doing with the goal of keeping the

patient safe in addition to maintaining and promoting the dignity of the

patient

Caring is the spirit of nursing.

Caring is a distinctive characteristic of the nursing profession

Watson’s theory is specific to
the nursing profession. The
humanistic aspects of nursing
are emphasized, and intimate,
personal moments between
nurse and patient are focused on.
Human Being - Watson believes that the person is to be valued,
cared for, respected and viewed in a holistic way, as body, mind
and spirit.

Environment - Watson believes that the person’s environment should be

conducive to healing and that the person and their environment are
connected. The person’s frame of reference is also something that should
be considered, and the nurse should strive to stay within the person’s
frame of reference.

Health - Health is viewed as overall functioning and distress and

disharmony can be caused by more than just disease processes.

Nursing – caring is central to the profession of nursing and that nursing

care should also focus on promoting health and preventing illness. The
nurse should focus their care on healing and wholeness as opposed to
tasks, illness and disease.
What are the 10 Carative Factors?
10 Carative Factors (Alligood &
Toomey, 2010)
1)Formation of a Humanistic altruistic System of Values= satisfaction
through giving and extension of the sense of self (Watson, 1979).
2)Instillation of Faith-Hope= the nurses role in promoting wellness and
positive health through developing effective nurse-patient interrelationships
and helping the patient learn how to develop health-seeking behaviors
(Watson, 1979).
3)Cultivation of Sensitivity to Self and to Others=as realizes and accepts
their own sensitivity and feelings they become more genuine, authentic and
sensitive to others (Watson, 1979).
10 Carative Factors (Alligood & Toomey, 2010)
4) Development of a Helping-Trust Relationship=the nurse can promote
effective communication by developing a helping-trust relationship,
develop empathy, use a moderate speaking volume, open relaxed posture
and congruent expression during conversations (Watson, 1979).
5)Promotion and Acceptance of the Expression of Positive and Negative
Feelings=sharing feeling is a risky experience for both nurse and patient.
The nurse must be open and prepared for both positive and negative
feelings (Watson, 1979).
10 Carative Factors (Alligood & Toomey, 2010)
6) Systematic Use of the Scientific Problem-Solving Method for Decision
Making=using the nursing process problem-solving approach dispels the
traditional image of the nurse as the doctor’s handmaiden (Watson, 1979).
7) Promotion of Interpersonal Teaching-Learning=shifts the responsibility of
wellness and health to the patient as the nurse facilitates, teaches and enables
the patient (Watson, 1979).
8) Provision for Supportive, Protective, and Corrective Mental, Physical
sociocultural and Spiritual Environment=the nurse must be aware of the
internal and external environment of the patient (Watson, 1979).
10 Carative Factors (Alligood & Toomey, 2010)
9) Preventive health actions by teaching patients personal changes to
promote health, providing support, teaching problem-solving methods and
recognizing coping skills and adaptation to loss (Watson, 1979).
10)Allowance of Existential-Phenomenological Forces
 the nurse has the responsibility to go above and beyond the 10 carative
factors and help patients promote their own preventive health actions by
teaching patients personal changes to promote health, providing support,
teaching problem-solving methods and recognizing coping skills and
adaptation to loss (Watson, 1979).
Specificity and scope of view:

Watson’s theory can be applied in any area of

nursing. The theory of caring addressing all aspects
of the health and illness continuum, and the
concepts are abstract and open to interpretation. In
fact, lack of concrete guidelines has been one of the
criticisms of the theory, since nurses do not have
specific steps they can follow to apply the principles
of the theory in their practice.
Caring in practice
 book\Assessing & measuring caring.pdf