PowerPoint Presentation

Group 1Ferris State UniversityNames listed are in order of appearance of works:Amelia Taggart, Holley West, Deanna Warnock,Anita Riddle, Carolyn Zielinski, andMary BierleinTheory of Human CaringJean Watson

http://www.watsoncaringscience.org

Thank-you for taking your time to watch our presentation.1Jean Watson, PhD, RN, AHB-BC, FAANEvolution of Transpersonal Caring Theory

2Margaret Jean Harman Watson was born and raised in a small West Virginia town in the Appalachian Mountains named Welch.

Being the youngest of eight siblings, she was surrounded by a large extended family.

She moved to Colorado after marrying Douglas, had two daughters and five grandchildren.

3Watson established the Center for Human Caring at the University of Colorado in the 1980s. It was described as the first interdisciplinary center committed to using human caring knowledge that forms the moral and scientific bases for clinical practice, scholarship, and administration and leadership. (Watson, 1986)

4Watsons first book, Nursing: The philosophy and science of caring (1979), developed from her notes for an undergraduate course taught at the University of Colorado (Alligood, 2010).Yaloms eleven curative factors stimulated Watsons thinking about her ten carative factors (Alligood, 2010).Caratives were described as the organizing framework for her book.

5Her early work embraced the ten carative factors but has evolved to include caritas that make connections between caring and love (Alligood, 2010).

She added spiritual aspects and believes that the core of nursing is seen in those nurse-patient relationships that result in a therapeutic outcome (Alligood, 2010, p. 102).

6 MetaparadigmsNursing theories embrace the concept that they all have elements that address four major paradigms: EnvironmentPersonHealthNursing

7 EnvironmentIn her original caratives, she refers to the nurses role in the environment as attending to supportive, protective, and or corrective mental, physical, societal, and spiritual environments (Watson, 1979, p. 10).

8In her later work, she describes that healing space can be used to help others transcend illness, pain, and suffering (Watson, 2003, p. 200).She also emphasizes that environment and person are connected: when the nurse enters the patients room, a magnetic field of expectation is created (Watson, 2003, p. 200).

9Her broad view of environment is: The caring science is not only for sustaining humanity, but also for sustaining the plan- etBelonging is to an infinite universal spirit world of nature and all living things; it is the primordial link of humanity and life itself, across time and space, boundaries and nationalities. (Alligood, 2010, p. 99)

10 PersonWatson uses the words human being, person, life, and self interchangeably. She views the person as unity of mind/body/spirit/nature (Alligood, 2010, p. 99).She feels that personhood is tied to notions that ones soul possess a body that is not confined by objective time and space.. (Alligood, 2010, p. 99).

11 HealthHer definition of health is unity and harmony within the mind, body, and soul, the degree of congruence between the self as perceived and the self as experienced (Alligood, 2010, p. 99).She further states illness in not necessarily disease; instead it is a subjective turmoil or disharmony within a persons inner self or soul

12 NursingNursing consists of knowledge, thought, values, philosophy, commitment, and action, with some degree of passion (Watson, 1988, p. 53).Nurses go beyond procedures, tasks, and techniques used in practice settings. (Watson, 1988, p. 53).

13Care for the JourneyJean Watsonhttp://www.watsoncaringscience.org/media/caring_moment.mp3

At this time we will listen to a message from Jean Watson titled Care for the Journey.14Uniqueness of ConceptsNew to nursing in 1979 with deep roots in philosophy and ethics and become more closely aligned with Rogerian science of unitary human beings (Foster, 2006).

Basic assumptions of Caring Science.

Carative Factors to Caritas Processes.

This is one of the newer theories having roots in 1979 which has continued to evolve until present day. We will be looking at each part of this unique theory .15Basic AssumptionsCaring ScienceCaringHumanityCarative Factors/Caritas ProcessesEffective CaringAcceptanceRelationshipCuring Science(Watson, 2008)

In 2008 Watson gave these assumptions: 1.Caring Science is the essence and core of the nursing profession 2. Caring is most effective if demonstrated and practiced interpersonally 3. Humanity is substantiated and upheld with human-to-human contact and seeing ourselves in others 4. Carative Factors/Caritas Processes comprise caring 5. Effective caring advances health, healing, wholeness, evolved consciousness, and inner peace 6. Responses of caring accept the person not only for who they are but also who they will become 7. The caring relationship and environment opens the door for potential that leads the person to choose the best action for themselves 8. Caring is more healthogenic than curing and the science of caring corresponds to the science of curing

16Carative/Caritas#1Factor

Humanistic-Altruistic System of Values

(Jean Watsons Philosophy, 2010)Process

Cultivating the Practice of Loving-Kindness and Equanimity Toward Self and Other as Foundational to Caritas Consciousness

(Watson, 2008)

The original Carative Factors of 1979 evolved into the Caritas Processes in 2002, which are to this day continuing to evolve. I will break down each of these original Carative Factors to current Caritas Processes. Each factor or process plays into the next and all are needed for caritas caring and to become a caritas nurse. The caritas processes are broadened versions of the original factors. In this slide the factor expresses the values gained in life through experience and demonstration of principles by parents during childhood, which creates ones selflessness towards others. The process explains that in order to practice caring you must first center and care for yourself in order to develop your consciousness. Once consciousness is developed the nurse does not just do the job, but becomes the caring force within their work. Knowing who you truly are in thoughts, actions, and beliefs and caring about yourself is the only way you can begin caring for others.17Carative/Caritas#2Factor

Installation of Faith and Hope

(Jean Watsons Philosophy, 2010)

Process

Being Authentically Present: Enabling, sustaining, and Honoring the Faith, hope, and Deep Belief System and the Inner-Subjective Life World of Self/Other

(Watson, 2008)

The carative factor states that for both carative and curative progression faith and hope are needed(Jean Watsons Philosophy, 2010)The process states you need to offer hope in order to feel hope and in offering faith and hope we can assist the patient in accessing their own belief system to promote healing (Watson, 2008). Watson (2008) states, presence of a caring professional may be a source of enabling, sustaining, and honoring the others belief system and source of hope (p. 64). Our bodies have an imbedded inherent ability to heal itself (Watson, 2008). We must continue to give our patients a sense of hope and believe in miracles so that they may tap into their inner strength needed to heal not only physically, but spiritually.18Carative/Caritas#3Factor

Cultivation of Sensitivity to Oneself and Others

(Jean Watsons Philosophy, 2010)

Process

Cultivation of Ones Own Spiritual Practices and Transpersonal Self, Going Beyond Ego-Self

(Watson, 2008)

The factor states that emotion needs to be felt as it occurs in order to interact authentically and sensitively with others, which will in turn help form person to person relationships promoting health and encouraging self growth (Jean Watsons Philosophy, 2010).According to Watson (2008) this lifelong journey is a process of evolving and honoring ones own inner needs, listening to the still, small voice inside, connecting with our deepest source for awakening into our being and becoming (p. 67). Without this journey we will loose our caring and compassionate selves and become cold and fragile. This process promotes spiritual development and helps us express our thoughts and feel our feelings (Watson, 2008, p. 68). We must stay in touch with our true humanity and put ourselves in the other side of the caring process in order to stay compassionate and giving of ourselves all the while caring for self first.19Carative/Caritas#4Factor

Developing a Helping-Trusting Relationship

(Jean Watsons Philosophy, 2010)

Process

Developing and Sustaining a Helping-Trusting Caring Relationship(Watson, 2008)

According to the factor communication is vital to developing a helping-trusting relationship and includes all verbal, nonverbal, and listening of an empathetic nature (Jean Watsons Philosophy, 2010). Characteristics needed are empathy, warmth, and congruence (Jean Watsons Philosophy, 2010). The process states increasing our humanity and validation of self shows the professionals integrity and opens up transpersonal dimensions of caring-healing (Watson, 2008, p. 72). Be mindful of what your patient is saying or expressing in all aspects of observance and empathize with warmth while giving of ones self. 20Carative/Caritas#5Factor

Promotion and Acceptance of the Expression of Positive and Negative Feelings

(Jean Watsons Philosophy, 2010)

Process

Being Present to, and Supportive of, the Expression of Positive and Negative Feelings

(Watson, 2008)

The original factor states that expression of ones true feelings are required to build a caring relationship and improve awareness of feelings in order to understand the behavior they generate (Jean Watsons Philosophy, 2010). Watson (2008) goes further in the caritas process by stating it is through being present to and allowing constructive expression of feelings that we create a foundation for trust and caring (p. 102). We must not only be aware of our own feelings but those of our patients. We need to be able to support expression of all feelings negative or positive without wanting to turn away or having a feeling of impending doom. Do not react negatively to ones feelings, listen compassionately and empathize without judgment.21Carative/Caritas#6Factor

Systematic Use of the Scientific Problem-Solving Method for Decision Making

(Jean Watsons Philosophy, 2010)

Process

Creative Use of Self and All Ways of Knowing as Part of the Caring Process; Engage in the Artistry of Caritas Nursing

(Watson, 2008)

This is one of the most profoundly changed factors in the caritas process. Watson states it is due to growth, maturity, and evolution over the years and in 1979 she was idealistic, nave and enamored with research and scientific methods as the basis for advancing nursing science and practice (2008, p. 107). The original carative factor use of the scientific problem-solving method is the only way to ensure control and prediction and that permits self correction (Jean Watsons Philosophy, 2010). It also stated one needs to be open to the other methods of knowing in order to have a holistic outlook (Jean Watsons Philosophy, 2010). The new caritas process is one that is creative, intuitive, aesthetic, ethical, personal, even spiritual process, as well as a professional empirical-technical process (Watson, 2008, p. 107). She goes on to say that the nursing process as learned as the mode of care does not work as simply as taught and the boundaries of that structure as a problem solving method are wrong (Watson, 2008). We have to look at the whole person as a spiritual being in order to treat and care for them in a holistic fashion. If we act like a scientific professional nurse we can not be caring, compassionate, consciously aware nurses who provide transpersonal care; we would be institutionalized robots. Watson states this (2008) Science and human values go together. A Caring Science makes explicit that a difference exists among data, information, and knowledge. Information is not knowledge; knowledge alone does not mean understanding; even understanding, in isolation, does not necessarily include insight, reflection, and wisdom (p. 109). 22Carative/Caritas#7Factor

Promotion of Interpersonal Teaching and Learning(Jean Watsons Philosophy, 2010). Process

Engage in Genuine Teaching-Learning Experience That Attends to Unity of Being and Subjective meaning- Attempting to Stay Within the Others Frame of Reference(Watson, 2008)

The carative factor maintains the learning process must be a focal point equal to the teaching process due to the cognitive plan necessitating inclusion of the persons perception of the circumstances (Jean Watsons Philosophy, 2010). The Caritas Process of teaching-learning is more relational, trusting, exploratory, engaging, and ultimately liberating for patient and others and involves power and control with, not over, the learner (Watson, 2008, p. 126). Results of this process are self-knowledge, self-care, self-control, and even self-healing possibilities (Watson, 2008, p. 126). The teaching-learning process is generally one of task and completion. We look at whether the patient understood and can demonstrate or recite information taught and not necessarily how the information impacted, affected, and generated the patients own problem-solving abilities. We need to look at this task as a chance to build our relationship with our patient and note not only their learning, but also their perception of the content taught intellectually, symbolically, and culturally as well as literally (Watson, 2008, p. 125).23Carative/Caritas#8Factor

Attending to a supportive, Protective, and/or Corrective Mental, Physical, Societal, and Spiritual Environment

(Jean Watsons Philosophy, 2010). Process

Creating a Healing Environment at All levels

(Watson, 2008)

According to the original factor we need to handle both the internal and external factors in order to protect and support our patients mental and physical well-being (Jean Watsons Philosophy, 2010). Internal and external environments are interdependent and thus we must provide comfort, safety, and privacy to our patients to fulfill our duties (Jean Watsons Philosophy, 2010). Watson states the Caritas Process provides comfort by, controlling pain and human suffering, which are subjective and affected by the patients experience, belief system, and the meaning of pain including spiritual and cultural meanings and associations with respect to pain and suffering (Watson, 2008, p. 130). We must take into consideration all forms of comfort. Every person has different things or feelings surrounding their sense of comfort and we need to be aware of all of these factors. For example some people enjoy light when they do not feel well, others prefer darkness; some wish to be touched, others may wish to be left alone. Talk to your patients on a human level and see what makes them comfortable and what is their definition or ideal of comfort.24Carative/Caritas#9FactorAssistance with Gratification of Human Needs(Jean Watsons Philosophy, 2010). Process

Administering Sacred Nursing Acts of Caring-Healing by Tending to Basic Human Needs(Watson, 2008)

Psychophysical Needs (activity-rest, sexuality) Biophysical Needs (food, water, elimination, ventilation Psychosocial Needs (achievement, affiliation) Intrapersonal-interpersonal need (self-actualization) Watsons additional needs: Knowledge, beauty-aesthetics, evolving self-actualization that is spiritually meaningful, and need to connect with that which is greater than self--to surrender to a higher source with a sense of awe toward the mystery and wonder of life, whether humanity itself, nature, God, Spirit, or a Divine universe (Watson, 2008, p. 147).

The carative factor is similar to that of Maslows Hierarchy of needs in that Watson orders the needs and finds each need is equally important for nursing care and health (Jean Watsons Philosophy, 2010). Watson states that each physiological component has a psychological correlate and each psychological function has a physiological correlate (Jean Watsons Philosophy, 2010). The Caritas Nurse creates space and places for dwelling, whereby the body inhabits the room in a good waythe body is able to embrace experiences as [dignifying] life sustaining, in the midst of pain and suffering; letting the human dwell (Watson, 2008, p. 145). When we touch our patients in any way be aware that you are not just touching the body, but also the mind, spirit, and heart of the person. We as nurses are to carry out tasks of basic human needs in a way that is caring and in a spirit of loving-kindness, with an intentional consciousness of dignity and honoring other (Watson, 2008, p. 146). Watson also states that soul care as well as physical care is required to respond to each and all needs (Watson, 2008, p. 146). 25Carative/Caritas#10Factor

Allowance for Existential-Phenomenological Forces

(Jean Watsons Philosophy, 2010). Process

Opening and Attending to Spiritual/Mysterious and Existential Unknowns of Life-Death

(Watson, 2008)

This final Carative Factor is best explained by each portion being defined. Jean Watson's Theory of Nursing (2010, December 21)as read in Current Nursing: Nursing Theories Phenomenology is a way of understanding people from the way things appear to them, from their frame of reference (Jean Watsons Philosophy, 2010). Existential psychology is the study of human existence using phenomenological analysis (Jean Watsons Philosophy, 2010). We need to analyze our patients holistically with the inclusion of what the eye does not see, spiritual and unexplained phenomena must be accepted while tending to the previously mentioned needs in order to assist the patient in their journey to confront life or death (Jean Watsons Philosophy, 2010). In 2008 Watson clarified her meaning of this Caritas Process by stating, all I am trying to say is that our rational minds and modern science do not have all the answers to life and death and all the human conditions we face; thus, we have to be open to the unknowns we cannot control, even allowing for what we may consider a miracle to enter our life and work (p. 191).

26Jean Watson Tik TokPlease click on the following link:

http://www.youtube.com/watch?v=hcrTnKxJEa8

This fun video on Youtube was created by a another group of nursing students in 2010. 27Watsons theory in clinical practice.

The next few slides will discuss ways to incorporate Jean Watsons theory into clinical practice. 28The nurse considers the patient as a whole.

It is important for a nurse to view their patient holistically and not for their illness or disease (Kearney, 2008, p. 74). The nurse should focus on caring, healing, and wholeness, rather than on disease, problems, illness, complications and techno-cures (Kearney, 2008, p. 74).29 The nurse makes a moral commitment and direct intentionality and consciousness to the protection, enhancement, and potentiation of human dignity, wholeness, and healing, such that a person creates or co-creates his or her own meaning for existence, healing, wholeness, and caring (Kearney, 2008, p. 74).

The nurse commits to helping a person to find themselves and allow them to create their own healing not just physically but emotionally as well. The nurse also helps the person find meaning for their own existence (Tomey, 2010, p.96). The patient is involved in promoting their own health as well as intervetions.30The nurse is able to connect with the inner condition (spirit) of another (Kearney, 2008, p. 74) and create caring moments.

A nurse is able to connect spiritually with a patient. They are able to accept the person on a deeper level than simply what appears on the surface. The nurse is in tune to a persons body language, emotions, behaviors and wellbeing. 31The nurse uses the healing modalities to help bring harmony to a patient.The healing modalities include:The use of auditory, visual and tactile therapies.GustatoryMental/cognitiveKinestheticCaring consciousnessUnderstanding own life history

The healing modalities help bring harmony to a patient by releasing some of the disharmony and blocked energy that interfere with the natural healing process (Kearney, 2008, p. 74). The use of music, chimes, sounds of nature, the use of light, color, texture, and aromatherapy are all examples of using auditory, visual and tactile therapies. Gustatory includes diet modification. 32The nurse should potentiate comfort measures, pain control, a sense of well-being or spiritual transcendence of suffering (Kearney, 2008, p. 74).

The nurse should have a caring relationship with the patient. By promoting comfort and measures the nurse builds a trusting relationship with the patient.33Framework for patient assessment.

Using Watsons theory on human caring we can open up a new way to assess our patients.34Watsons theory challenges nurses to go beyond the tasks and procedures of nursing and really dig for the core of nursing (Tomey, 2010, p. 98)

The core of nursing is the nurse to patient relationship. This relationship should foster healing and a therapeutic outcome (Tomey, 2010, p. 98).35Ways to incorporate Watsons theory into nursing assessmentDo an emotional and spiritual assessmentSit down while talking with patient and give them your undivided attentionActively listen to patientAsk open ended questions that will allow the patient to share their feelings on their views on things such as health and situationInstill hope and faith (Watson, 2007)

36 Transpersonal Caring InNursing Education

Watson has a unique approach to the application of her Theory of Caring in the nursing education process. Watson is well respected in her field as a nurse educator around the world.. 37Definition of Nursing Practice In the practice setting, nursing theory clearly defines the unique contribution of nurses to health care and helps distinguish nursing as a professional discipline with its own body of knowledge that is separate from the medical model of care (Marckx, 1995, p. 49).

Read quote. Watson promotes nurses as professionals. She uses her 10 carative factors as the framework for her teaching. 38Carative-a DefinitionCarative is the philosophy and theory of human caring. Dr. Jean Watson uses the term carative instead of curative to distinguish between nursing and medicine. Whereas curative factors aim at curing the patient of disease, carative factors aim at the caring process that helps the person attain (or maintain) health or die a peaceful death (Watson, 1979).

The original theory developed in 1979, was organized around 10 carative factors:

Source: Nursing: The Philosophy and Science of Caring by Jean Watson, RN, Ph.D. Boston: Little, Brown and Co., 1979.

Read Slide39Abbreviations of Watsons Carative Factors

They can be used as an expressive tool while directing the assessment, interventions, charting and full engagement of caring human dimensions of nursing practice (Rosenberg, 2006, p. 55)

This is the abbreviated framework that Watson uses to teach nurses how to incorporate her theory into their nursing practice. Watson has added a Caritas Process to coincide with each Carative Factor to provide the nurse with direction while applying the theory. The addition of the Caritas has made the use of Watsons theory easier to understand and implement. Read Quote40

Implication to Nursing Education

The carative factors, which represent the core of nursing and the primary ingredients of effective nursing practice, provide a language, structure, and order for studying and understanding nursing education and practice (Wade & Kasper, 2006, p. 163).

READ QUOTE The carative factors also help promote a holistic approach to nursing. They provide guidelines to lead the student towards a clearer understanding of the Transpersonal Caring Theory and its implications to nursing practice. 41Watsons ViewEntry Level of PracticeADN BSNMSNDoctorateAlthough the bachelors degree is considered still the [unresolved and impossible to implement] minimal entry level into the professional practice of nursing, the mature practice of nursing, as a career health professional, ideally should be at the professional doctorate level, or at least the graduate level. (Fawcett, 2002, p. 217).

READ Bullets and Quote. Watsons view on entry level practice has never waivered. Her rationale lies in the fact that all the other professional disciplines have doctoral entry levels. Some examples Watson uses are medicine, dentistry and law. She strongly feels that nursing is a profession separate but equal to the medical profession.42Transpersonal CaringInNursing Research

43

Current Research

Unitary-Transformative Paradigm> unity of mind, body, soul, nature and the universe > spirit to spirit connection (Watson & Smith, 2002, p. 458).

We are to realize that we have to pay attention to what is happening in the universe; we are not separate from the environment, nature and other humans (Fawcett, 2002, p. 216).

Watsons theory has viewed nursing as a meta-paradigm profession. Through her research she is moving her theory towards a Unitary paradigm. Unitary-transformative paradigm refers to a human being becoming whole or unified. It is a spirit to spirit connection that occurs during a caring moment. Watsons caring research is investigating the effects this paradigm has on caring science. She feels that nursing is moving into this new paradigm. Read Quote44The Watson Caring Science InstituteDr. Jean Watson, Founder, created her international nonprofit Watson Caring Science Institute in 2007 with the mission to restore the profound nature of caring-healing in todays healthcare systems and to retain its most precious resource, caring professional nurses and transdisciplinary care team members

Dr. Jean Watson, Founder, created her international nonprofit Watson Caring Science Institute in 2007 with the mission to restore the profound nature of caring-healing in todays healthcare systems and to retain its most precious resource, caring professional nurses and transdisciplinary care team members.

http://www.watsoncaringscience.org/

In 2007 Watson began her own Caring Science Institute. Through a multicultural approach Watson travels around the world speaking with nurses to develop her approach to education and advance the nursing practice through research. Her institute and website offer many educational opportunities and access to her many books, articles and webinars.45Million NurseGlobal Caring Field Project

Goal: Connect simultaneously with a million nurses (or more) around the globe: to create and radiate an energetic Caring Field of Heart-Centered Love for Self, Others, and the Planet Earth. This intentional focused experience honors and extends the human caring vibration of nurses into the universal energy field of humanity facilitating healing and health for all (Watson, 2010)http://www.watsoncaringscience.org/jeanmedpop.htm(Right click, select open hyperlink)

Watson implemented her first Million Nurse project January 1, 2010 at noon. She wanted to connect, through use of the internet, at least one million nurses at once. She is planning to host several more events to achieve Global Caring. Her goal, is to READ QUOTE Please take the time to open the link at the top of the slide and enjoy Jean Watsons Million Nurse Global meditation. This is an example of her work and thoughts as it relates to her theory of Transpersonal Caring.46HeartMathThousands of health professionals in clinics, hospitals, military facilities, coaching, couples therapy, and private practice are using the emWave technologies with clients. They have found that with consistent practice, clients can learn to reduce stress, manage the emotions associated with stress, expand their coping skills, and create a greater sense of well-being.

http://www.heartmath.com/

Jean Watson is an advocate of the HeartMath Institute research center. It is owned and operated by physicians. Their research revolves around the theory that hormones are secreted during periods of stress. These hormones are the cause of illness and disease. HeartMath believes that hormones secreted during solace help the healing process and promote a sense of well-being. This theory is the caring theory presented from the medical side of caring. HeartMath correlates well with Watsons caring theory from the nursing stand point.47Jean Watsons Philosophy and TheoryStrengths of this ModelJean Watsons theory is similar to the nursing process and follows a similar path as the scientific research process. 1. Assessment 2. Plan 3. Intervention 4. Evaluation, so it is familiar for nurses to follow.

Watsons work does follow logical steps.

Using the science of caring or the carative factors, shows how nursing differs from other professions.

It advocates for the healing of the patient as opposed to the technology needed.

Her philosophy is based on love/caring of the human being which is why many nurses chose their profession.

Jean Watsons theory is similar to the nursing process with 1. assessment, observing and identifying the problem; this also includes forming a hypothesis (Jean Watsons, 2010, para. 19). 2. Planning what information or data will be collected and how it will be used. 3.) Intervention. This is using the plan or putting the plan in to action. 4.) Evaluation. Data analysis, as well as determining if the interventions had any effects (Jean Watsons, 2010, para. 22) . This may also include looking at new theory based on the results of the data collected. Watsons theory is logical and for that reason also is familiar to nursing. Again, this is where Watsons theory delineates nursing from other caring professions. One example of the healing of the patient as a human being as opposed to the technology involved, is a program started at Baptist Medical Center, South in 2009, by artist Patty Magee, called Bedside Art, part of which is the placing of paintings or artwork by a local artist or staff at the bedside of patients or in the hospital unit. Patty writes, The Caritas Journey for all Nurse's is to explore every avenue in making patients comfortable. These avenues should not be limited to administering chemicals, but tapping into the emergence of creative opportunities. (Magee, 2009)48Jean Watsons Philosophy and TheoryLimitations of this ModelWatsons theory is first and foremost a psychosocial model. (Andrews, 2008.)With shorter hospitalization stays it is difficult to evaluate the effectiveness of the model in the hospital (Andrews, 2008).It is a relatively new theory (published in 1979) and hasnt been utilized a lot; it needs more nursing research to determine its effectiveness in nursing practice. Her theory language can be difficult to understand.

Limitations of this model. It is hard to find real limitations to this theory. a)This is not necessarily a limitation of this model, however Jean Watsons initial theory is based on the assumption of a persons faith in a higher being. She also believes that is necessary to have a strong liberal arts background to form a better value system to care for a human being; that this background will provide nurses with the foundation to develop a caring relationship. This seems to put a limitation on the education that a nurse must have to provide care to a human being. Unlike theorists Nightingale or Henderson, her theory is less concrete and is a psychosocial model. b) Since in- patient stays have become much shorter it is harder to evaluate the theory as it is applied to the human being. However, the model may be further researched in the extended caring milieu. Since it is a fairly new model, it will need time and research to develop the model and determine if it is an effective tool for nursing practice. One needs to research Watsons work to understand the language of the theory and how it is used in the model. 49Evaluation of Jean Watsons Theory of Human CaringIs about much more than giving care to a person.Is about caring for a persons body, mind, and spirit (soul) (Ryan, 2005).Is about the person giving care as well as the one being cared for (Sitzman, 2011).Is a moment to moment experience.Is holistic

Watsons theory is complex to understand because she does not talk about caring as we commonly think about it (Sitzman, 201150Caring RelationshipForgivenessCompassionLoveMindBodySoulHarmonySpiritualMystical

She talks about forgiveness, compassion, and love in a caring relationship. Both parties gain from it-the one being cared for and the one doing the caring (Sitzman, 2011). In Watsons theory, nursing is centered around helping the patient achieve a higher degree of harmony within mind, body, and soul, and this harmony is achieved through caring transactions involving a transpersonal caring relationship (Suliman, Welmann, Omer, and Thomas, 2009, pp. 293-294). A transpersonal relationship is spiritual, almost mystical (Suliman, Welmann, Omer, Thomas).51The Theory of Human CaringEvolved in the 1970s

Florence Nightingale

Caring leads to healing

love, compassion, and forgiveness.

The theory of Human Caring evolved in the mid- to late- 1970s and was brought about by Watsons personal tragedy in life as well as her life experiences Sitzman, 2011). Other theorists have theories that involve caring, such as Florence Nightingale but they delve on taking care of people, physical caring for them, and do not get involved with the higher order of things that are spiritual. Caring leads to healing. And Watson believes that love, compassion, and forgiveness from patients and nurses are very important in the caring and healing process (Watson, 2008, p. 134).52Aspects of The Theory of Caring Carative Factors

Caritas Processes

Curative Factors

Watson developed 10 carative factors to guide nursing care of others. She called them carative factors to differentiate them from medicines curative factors in caring for patients (Ryan, 2005). Curative deals with the human body and the disease states therein. Carative deals with the holistic view of caring for patients and their families and communities (Ryan). Those carative factors gave way to caritas processes and they are the first element of Watsons theory (Cara, 2005). Caritas originates from the Greek word meaning to cherish and give special loving attention. :Caritas nursing encourages nurses to practice through the caring and healing process. Nurses not only focus on the material form, but also focus on things of spirit and practicing caritas nursing (Lukose, 2011, p. 29).53Transpersonal Caring RelationshipTranspersonal caring relationship

Caring moment

Caring healing modalities.

The second element or aspect of Watsons Theory of Human Caring involves the transpersonal caring relationship (Cara, 2005) This goes to the spiritual relationship of patient and nurse. The nurse and patient reach out to each other. The connection is with the soul of each involved and is in the moment, right now, not generalized (Cara). This leads us to the third element of Watsons theory, the caring moment. An actual caring moment involves action and choice by both the one caring and the one being cared for (Watson, 1999, p. 116). The fourth element of Watsons theory is the caring healing modalities. The nurse is able to go into a deeper level of skilled and divine practices and the nurse and patient are connected to the high energy of the universe (Lukose, 2011, p. 29).54Caring for PatientsRecent Studies

What patients view as important in caring

Least important aspects of care

Recent studies have shown that the meaning of caring and caring behaviors was found to differ by patient category (Suliman, Welman, Omer, & Thomas, 2009, p. 294). Cancer patients thought that showing caring actions were more important to them than to intensive care patients. To intensive care patients technical competency (Suliman, Welman, Omer, & Thomas, p. 294) was the most important aspect of care. Patients on the Medical-Surgical floors placed a higher importance on physical comfort and the nurses ability to make them feel good, giving them a feeling of well-being (Suliman, Welman, Omer, & Thomas).When patients were asked in a survey in 2009 what the top 10 most important caring behaviors were most responses were that physical comforts were more important than the spiritual, soulful comforts. Numbers 1-8 were concerned with physical needs: getting pain medications when needed, making them physically more comfortable, delivering treatments and pain medication on time, etc. Number nine dealt with being kind and number 10 was that the nurse listens to them when they talk (Suliman, Welman, Omer, & Thomas, 2009).On the list of the 10 least important caring behaviors, ranking 10 was that the nurse talked to them about life experiences outside the hospital (Saliman, Welman, Omer, & Thomas, 2009). This gives the insight that physical comforts are more important, and patients depend on them more than the type of caring-healing processes that Watson theorizes about. But the studies clearly state that patients want to be cared for both physically and emotionally.55References

Alligood, M. R., Tomey, A. M.(2010). Nursing theorists and their work (7th ed.). St. Louis, MO: Mosby Elsevier.Andrews,M. (2008). Jean Watsons Philosophy and Science of Caring, Retrieved from www.slideshare.net/SacState35/jean-watson-presentation-presentation?from=shar_email-logout Caruso, E., Cisar, N., & Pipe, T. (2008). Creating a healing environment, an innovative educational approach for adopting Jean Watsons theory of human caring. Nursing Administration Quarterly. 32(2).Clark, P., Watson, J., & Brewer, B. (2009). From theory to practice: caring science according to Watson and Brewer. Nursing Science Quarterly, 22(4), 339-345. doi.10.1177/0894318409344769Jean Watsons philosophy of nursing (2010, June 27). Retrieved from http://currentnursing.com/nursing_theory/Watson.htmlFawcett, J. (2002). The nurse theorists: 21st century updates-Jean Watson. Nursing Science Quarterly, 15(3), 214-219. Foster, R. (2006). A perspective on Watsons theory of human caring. Nursing Science Quarterly, 19(4), 332-333. Retrieved from EBSCOhost.HeartMath. (2011). Retrieved from http://www.heartmath.com/jeanwatsonrox (2010, March 07). Jean Watson Tik Tok. Retrieved from http://www.youtube.com/watch?v=hcrTnKxJEa8

56References continuedJean Watson's Theory of Nursing (2010, December 21). In Current Nursing: Nursing Theories. Retrieved February 1, 2011, from http://currentnursing.com/nursing_theory/Watson.htmlKerney-Nunnery, R. (2008). Advance your career: Concepts of professional nursing. Philadelphia, PA: F. A. Davis CompanyLukose, A. (2011). Developing a practice model for Watsons theory of caring; Nursing Science Quarterly; 27-30. doi:10.1177/0894318410389073Magee, P. (2009, September 9). Journaling My Caritas Journey. In http://pattymageeart. blogspot.com/. Retrieved February 5, 2011Marckx, B. (1995). Watsons theory of caring; a model for implementation in practice. Journal of Nursing Care Quality, 9(4), 43-54.McCance, T. V., McKenna, H. P. and Boore, J. R. (1999), Caring: theoretical perspectives of relevance to nursing. Journal of Advanced Nursing, 30:13881395. doi:10.1046/j.1365-2648.1999.01214.xRaile, M, & Marriner-Tomey, A. (2010). Nursing theorists and their work. Maryland Heights, MO: Mosby.Rosenberg, S. (2006). Utilizing the language of Jean Watsons caring theory within a computerized clinical documentation system. CIN: Computers, Informatics, Nursing, 24(1), 53-56.57References

Ryan, L. (2005). The journey to integrate Watsons caring theory with clinical practice International Journal for Human Caring, 9(3), 26-33. Retrieved from EBSCOhost. Sitzman, K. Teaching-learning professional caring based on Jean Watsons Theory of Human Caring. International Journal for Human Caring, 11(4), 8-16.Suliman, W., Welmann, E., Omer, T., & Thomas, L. (2009). Applying Watsons nursing theory to assess patient perceptions of being cared for in a multicultural environment. Journal of Nursing Research (Taiwan Nurses Association). 17(4), 293-300, doi:10.1097/JNR.0b013e3181c122a3.Tomey, A. M., & Alligood, M. R. (2006). Nursing theorists and their work (6th ed.). St Louis: Mosby Elsevier.VanguardHealth Systems. (December, 2010) Overview of Jean Watsons Theory. Retrieved from http://www.innovativecaremodels.com/uploads/File/caring%20model/Overview%20JW%20Theory.pdfWade, G., & Kasper, N. (2006). Nursing students perceptions of instructor caring: an instrument based on Watsons theory of transpersonal caring. Journal of Nursing Education, 45(5), 162-168.Watson, J. (1979). Nursing: the philosophy and science of caring. Boston, MA: Little, Brown and Co. Retrieved from http://www.carative.com/carative.htmlWatson, J. (1979). Nursing: The philosophy and science of caring. Boston, MA: Little, Brown.

58References

Watson, J. (1986, Dec.). The dean speaks out: Center for human caring established. The University of Colorado School of Nursing News.Watson, J.(1988). Nursing: Human science and human care-A theory of nursing. New York, NY: National League for Nursing.Watson, J. (1999). Postmodern nursing and beyond. Edinburgh: Churchill Livingstone.Watson, J. (2001). Jean Watson: Theory of human caring. Nursing theories and nursing practice. pp. 343-354. Philadelphia,PA: Davis.Watson, J. (2003). Love and caring: Ethics of face and hand. Nursing Administration Quarterly, 27(3), 197-202.Watson, J. (2008). The philosophy and science of caring. Boulder, CO: University Press of Colorado.Watson, J. (2009). Watsons caring science institute international caritas consortium. Retrieved from: http://www.watsoncaringscience.org/Watson, J. (2009). Care for the journey (audio recording). http://www.watsoncaringscience.org/media/caring_moment.mp3Watson, J. (2010). The million nurse global caring field project. The Caring Science Institute. Retrieved from http://www.watsoncaringscience.org/jeanmedpop.htmWatson Caring Science Institute (2010). Jean Watson (Photogragh). Retrieved from http://www.watsoncaringscience.orgWatson, J. (2011). The caring science institute. Retrieved from http://www.watsoncaringscience.org/

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