Like other healthcare professionals, nursing is defined based on the theoretical knowledge and scientific studies that have promoted its development as a science of care provision. Nursing theories are crucial in advancing nursing practice through the introduction of concepts of care that might have been overlooked. The works of theorists such as Florence Nightingale, who is considered the mother of nursing and Jean Watson have been influential in guiding nursing practice and promoting positive patient outcomes. Watson’s theory on human caring is one of the grand theories applicable in family nursing practice whose major concepts are related to the four concepts of nursing metaparadigm.
Theory/Author Name and Background
Jean Harman Watson developed the theory of transpersonal caring in 1979. She is an American nurse theorist who also works as a nursing professor. She has authored numerous books including Nursing the Philosophy and Science of Caring. Watson was born on June 10, 1940, in Williamson, West Virginia. She studies and graduated in 1961 at the Lewis Gale School of Nursing located in Roanoke, Virginia. Watson then pursued a bachelor of science in nursing at the University of Colorado at Boulder and graduated in 1964. In 1966, she graduated with a master in psychiatry and mental health nursing and in 1973 graduated with a PhD in educational psychology and counseling in 1973 (Masters, 2014). After her graduation, she worked as a nursing professor and was later on selected as a dean of the school of nursing at the University of Colorado Denver. The school developed its first doctoral programs for nurses under her leadership. Watson has focused her career in restructuring nursing education through the creation of nursing curriculums focused on human caring, healing, and health (Masters, 2014). Her theory and work have influenced development in nursing.
Watson used her experience in nursing practice to guide the development of her theory. In her first book, she identified the ten carative factors through her experience as a nurse and the information she obtained in her undergraduate studies. She identified a set of ten factors as the essential aspects of caring in nursing practice. She believed that without the caractive factors nurses were not practicing professional nursing but were only functioning as technical caregivers who had obtained a certain level of skills in patient care. The observations she made while working as a nurse helped her formulate her theory on nursing and its relationship to human caring through her first book Nursing: The Philosophy and Science of Caring. Her continued experience in nursing and the relationship between nurses and their patients assisted her in refining the carative factors that were the foundation of her work in her second book, Nursing: Human Science and Human Care, A Theory of Nursing (Watson, 2007). Her books relied on the expansion of the philosophical and transpersonal aspects of caring that Watson experienced through her career.
The problem or phenomenon of concern addressed by Watson in her theory was based on human caring. She focused on examining the different roles that nurses played in caring for patients and their impacts on the patients’ outcome. She believed that human caring involved practising loving and kindness, having faith and hope, developing trust and nurturing relationships among healthcare practitioners, forgiveness, applying a deeper understanding of care, balance, collaboration, promoting dignity, and being open-minded (Wei & Watson, 2019). These factors formed the ten carative factors of care that nurses were expected to adhere to while managing patients and interacting with each other. Other researchers such as Ozan and his colleagues utilized her theory in examining the application of her theory in the holistic care of women who were infertility and had not had much success with IVF. The researchers noted that the application of the ten carative factors in the research prepared the women for a positive or negative outcome (Ozan, Okumus, & Lash, 2015). The patients who have been managed through consideration of Watson’s theory relied on their nurses for guidance even after being informed about the failed IVF results proving that Watson’ s theory was applicable and useful.
Watson’s theory applied a deductive reasoning approach. Deductive reasoning entails moving from general ideology to a specific situation. In nursing, deductive reasoning begins with the establishment of a theory, which is then tested and further developed through its application in real life. During the initial steps in developing her theory, Watson relied on the information she had obtained through her education, her philosophical and intellectual reasoning, and her perception of nursing practice to determine the important factors that determined the caregiving process. She was also involved in different research studies that focused on examining the applicability of her nursing theory and its effectiveness in transforming nursing to the science of care provision. For instance, she worked with another researcher in examining the perspective on healthcare interprofessional team members on the effectiveness of her theory (Wei & Watson, 2019). Her involvement in empirical research studies promoted the reliability of her theory.
The major concepts of her theory are the caritas processes, the transpersonal caring relationship, and the caring occasion or caring moment. She defined the caritas processes as the ten carative factors that formed the foundation of her theory. Theoretical these factors included practicing loving-kindness and equanimity while caring for patients, sustaining deep belief systems in care provision, cultivating one’s own spiritual and transpersonal self, sustaining a helping-trusting and authentic relationship with other, being present and creative, engaging in genuine teaching, creating a healing environment, being open, and assisting patients with their basic needs. She described the transpersonal caring relationship as an inter-subjective, human-based relationship, where nurses affect and are affected by the other person. As such, the nurse goes beyond objective assessment and focus on developing a subjective and deeper-meaning relationship with the patients. Watson defined the caring moment as the period where nurses and patients come together to create an occasion for human caring through the human-to-human transaction. She described the caring occasion as being transpersonal (Bayuo, 2018). Her concepts focused on the provision of holistic care to patients in a manner that considers all their physical, psychological, and spiritual needs.
Watson’s theory is consistent with the use of concepts and other terms. She has provided definitions for the major concepts and other terms used in her theory to promote its effective application in other nursing sectors. Aside from the definition of the major concepts, Watson also defines the ten carative factors included in her theory. She defined embrace of loving-kindness as performing acts of kindness to patients and each other, faith-hope, as the need to maintain faith and hope in teamwork, trust as valuing inter-subjective interactions, nurture as cultivation of heart-centered caring relationships, forgive as acknowledgement and processing of positive and negative feedback, and creative self as the application of all ways of knowing. In the research studies that she has been involved in, Watson also defined balance as encouraging reciprocal teaching and learning patterns, co-creation as the development of caring-healing environments, minister as respecting human dignity and respect for colleagues, and openness as giving chance to miracles as being open-minded to healing processes (Wei & Watson, 2019). These definitions promote the applicability of her theory in nursing.
Explicit Values and Relationship between Concepts
The human caring theory defines nursing as a science of caring and is based on the view of nursing as a distinct science-based profession of care provision. Watson’s perceptions of nursing focused on differentiating nursing from skilled caregiving roles in healthcare. She viewed nursing as being based on scientific evidence and systematic provision of care to patients. She relied on her philosophical understanding and her observation of the interaction between nurses and other healthcare providers in interprofessional teams to form the core of her theory. This creates an explicit context as the theory relies on a wider understanding of philosophical underpinning of nursing and ethics. She argued that the establishment of an inter-subjective flow between two people ensured that the recipient was able to release some stress and disharmony of the mind, body, and soul, which in turn would free them of pent up energy and would promote healing (Bayuo, 2018). Her description of the nursing role in human caring clearly describes her theory.
Watson based her theory mainly on her ideas, values, and beliefs about healing and health. Her major concepts were interrelated as they focused on the process of caring for patients, relationships between caregivers, and the caring event or occasion. The caring event, occasion, or moment provides a ground for the application of the other two concepts. The caritas process, which involves the actions performed during the management of patients rely on the availability of an opportunity to offer the patient the care needed. Similarly, the care moment would not exist without the utilization of the caregiving processes that define care. The concept of transpersonal caring relationships also relied on the availability of the care moment. For instance, nurses and patients cannot form interpersonal relationships unless presented with a situation, where the patient is sick and requires the services of the nurse to promote recovery (Bayuo, 2018). These illustrations show the correlation between the major concepts in Watson’s theory.
Explicit and Implicit Assumptions (Values/Beliefs)
Watson’s theoretic assumption expanded over time as she gained more experience in nursing practice and understood the correlation between the nursing profession and caregiving roles. Her initial assumptions were based on viewing nursing as an accommodating and diverse way of understanding, becoming or evolving, utilization of ethical intuition and personal empirical knowledge, aesthetics, and a spiritual and metaphysical way of knowing as being the basis of caring. She valued caring of others, being kind, believing in healing miracles, and application of scientific reasoning in teams when caring for patients. The believed that caring environments were made possible by the existence of a transpersonal relationship between nurse and patients. She expanded her original assumptions of nursing as a caring science to include the honoring of patients’ rituals or spiritual beliefs in the provision of holistic care to patients. Her theory is built on the assumption that nursing is a science-based profession that focused on meeting the holistic needs of patients (Turkel, Watson, & Giovannoni, 2017). Watson’s beliefs and values were significant in her theoretical development.
Concepts of Nursing Metaparadigm
Watson’s theory contains a description of four concepts of the nursing metaparadigm. These concepts are person, environment, health, and nursing. Watson focused on the roles of nursing in caring for patients by including aspects of care provision in her theory. She believed that nursing was based on the application of scientific knowledge and evidence in care provision. She viewed nursing as a science-based profession. She also believed that nurses were supposed to perform loving and kindness acts towards patients and other healthcare providers to ensure that their relationships with patients promoted healing. In terms of the perception of a person, Watson believed that nurses as individuals should be open-minded to the unknown and acknowledge the beliefs of others. She also supported being kind and loving to self as people’s perception of themselves often affected their interaction and perception of others (Wei & Watson, 2019). Her theory contains a clear description of the metaparadigm of nursing.
Watson’s theory also relates to the metaparadigm concepts of environment and health. In terms of the environment, Watson acknowledges the role of the environment in influencing healing. Aside from her beliefs and values, she also based her theory on concepts that had been developed by Florence Nightingale and other theorists who developed their theories before her. Through Florence Nightingale’s focus on the role of the environment in patient outcome, Watson also acknowledged the environment as an influential factor in patient care. Watson believed that nurses were responsible for developing a caring-healing environment by working collaboratively with other healthcare practitioners. She understood that the relationship between healthcare providers and their interaction in the health facility or clinical setting affected the patients’ healing process. Regarding health, Watson addressed factors such as the importance of offering patients holistic care by being open-minded to people’s beliefs and respecting human dignity. She also believed that nurses needed to apply both medical knowledge and a caring heart at a deeper level to promote positive patient outcomes (Wei & Watson, 2019). Her considerations of the four nursing concepts ensured that the theory addressed the factors that nurses are supposed to consider in care provision.
Watson’s Theory Clarity
Watson’s theory is clear, has lucidness and is consistent. Although she has changed some aspects of her theory over the years, the changes applied have been focused on promoting its clarity by providing a clear definition of concepts and their interaction. For instance, after the publication of her first book, Watson worked of clarifying the meaning of the ten caritas processes and describing them in simpler terms to ensure that nurses who applied her theory in their practice understand its meaning. In her subsequent works and research studies, she illustrated the examples where her theory could be applied in clinical practice (Wei & Watson, 2019; Bayuo, 2018). Her theory has lucidness as it uses simple terms to explain Watson’s ideologies and philosophies about the science of caring. The theory is consistent because, despite the numerous publications and research works that Watson has utilized the theory, its main concepts are still retained.
Guiding Nursing Actions
Watson’s theory can be used to guide nursing practice by helping nurses understand that the nursing is more than just caring for patients and working as technical staff in healthcare facilities as it entails using scientific reasoning to understand patients’ health status and formulate their care plans. Watson’s theory can be used to help nurses view nursing as a continuum of care that entails establishing interpersonal relationships with patients, working closely with them and incorporating them in decision-making regarding their health by inquiring about their beliefs and being open-minded when dealing with patients who have different beliefs from those held by the nurse (Wei & Watson, 2019). Watson’s ten carative processes can guide nursing practice by helping nurses work with other healthcare professionals collaboratively and build their trust in their teams.
Use of Watson’s Theory in Family Nurse Practice
As a family nurse practitioner, I would apply Watson’s theory in care provision, through my interaction with other nurses and patients. I would apply the aspect of loving and kindness to those around me by supporting my colleagues in their decision-making roles, and showing understanding to my patients. I would nurture heart-centered caring relationships with my colleagues, members of interprofessional teams, and patients to ensure that I promote positive interaction in the healthcare setting and effective management of my patients. Through the interprofessional collaborations, I would focus on making the role of the nurse in decision-making, care provision, and use of evidence-based practice known to ensure that other nurses working in the team utilize the proper approaches of care provision. As a nurse, who understand the importance of treating patients with dignity, I would ensure that I respect patient’s beliefs and values and applying critical reasoning approaches in assisting patients to understand the importance of the intervention selected for their care instead of bullying them into submission (Wei & Watson, 2019). These approaches would ensure that I have a good relationship with both my colleagues and patients.
Watson’s grand theory of human caring addresses the need to view nursing as a caring science and acknowledging the multifaceted nature of healthcare that entails incorporating both medical knowledge, kindness and loving practices, and belief of the unknown in patient care. Understanding Watson’s theory can be effective in developing heart-centered caring relationships in clinical settings. I would use Watson’s theory in creating a suitable working environment for myself and coworkers by being kind to others, respecting people’s beliefs, using scientific evidence in clinical decision-making, and having faith in my interprofessional team members and their ability to make decisions that support patients’ well-being.
Bayuo, J. (2018). Case Study in CaringApplication of Watson’s Theory of Human Caring to End of Life Care in the Burns Intensive CareUnit: A Case Report. International Journal for Human Caring, 21(3), 142-144. Retrieved from https://www.researchgate.net/publication/324114879_Application_of_Watson’s_Theory_of_Human_Caring_to_End_of_Life_Care_in_the_Burns_Intensive_Care_Unit_A_Case_Report.
Masters, K. (2014). Nursing Theories: A Framework for Professional Practice. Jones & Bartlett Publishers.
Ozan, Y. D., Okumus, H., & Lash, A. A. (2015). Implementation of Watson’s Theory of Human Caring: A Case Study. International Journal of Caring Sciences, 8(1), 25-35. Retrieved from https://www.internationaljournalofcaringsciences.org/docs/4-Lash%20-%20Original.pdf.
Turkel, M. C., Watson, J., & Giovannoni, J. (2017). Caring Science or Science of Caring. Nursing Science Quarterly, 31(1), 66-71. Retrieved from https://journals.sagepub.com/doi/full/10.1177/0894318417741116.
Watson, J. (2007). Warson’s theory of human caring and subjective living experiences: Carative factors/ caritas processes as a disciplinary guide to the professional nursing practice. Texto Contexto Enferm, Florianópolis, 16(1), 129-135. https://www.scielo.br/pdf/tce/v16n1/a16v16n1.pdf.
Wei, H., & Watson, J. (2019). Healthcare interprofessional team members’ perspectives on human caring: A directed content analysis study. International Journal of Nursing Sciences, 6, 17-23. https://www.watsoncaringscience.org/files/PDF/Articles/IJNSarticle-Jan2019.pdf.