Jean Watson
Caring Science as Sacred Science
In today’s world, nursing seems to be responding to the various demands of the machinery with less consideration of the needs of the person attached to the machine. In Watson’s view, the disease might be cured, but illness would remain because without caring, health is not attained. Caring is the essence of nursing and connotes responsiveness between the nurse and the person; the nurse co-participates with the person. Watson contends that caring can assist the person to gain control, become knowledgeable, and promote health changes.
| Major Concepts
Society provides the values that determine how one should behave and what goals one should strive toward. Watson (1979) states: “Caring (and nursing) has existed in every society. Every society has had some people who have cared for others. A caring attitude is not transmitted from generation to generation by genes. It is transmitted by the culture of the profession as a unique way of coping with its environment.” Human being is a valued person to be cared for, respected, nurtured, understood, and assisted. Health is the unity and harmony within the mind, body, and soul; health is associated with the degree of congruence between the self as perceived and the self as experienced. Nursing is a human science of persons and human health – illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human care transactions. Actual caring occasion involves actions and choices by the nurse and the individual. The moment of coming together in a caring occasion presents the two persons with the opportunity to decide how to be in the relationship – what to do with the moment. The transpersonal concept is an intersubjective human-to-human relationship in which the nurse affects and is affected by the person of the other. Both are fully present in the moment and feel a union with the other; they share a phenomenal field that becomes part of the life story of both. (Watson, 1999) |
Subconcepts
Phenomenal field The totality of human experience of one’s being in the world. This refers to the individual’s frame of reference that can only be known to that person. Self The organized conceptual gestalt composed of perceptions of the characteristics of the “I” or “ME” and the perceptions of the relationship of the “I” and “ME” to others and to various aspects of life. Time The present is more subjectively real and the past is more objectively real. The past is prior to, or in a different mode of being than the present, but it is not clearly distinguishable. Past, present, and future incidents merge and fuse. (Watson, 1999) Nursing interventions related to human care originally referred to as carative factors have now been translated into clinical caritas processes (Watson, 2006): 1. The formation of a humanistic-altruistic system of values, becomes: “practice of loving-kindness and equanimity within context of caring consciousness.” 2. The instillation of faith-hope becomes: “being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and one-being-cared-for.” 3. The cultivation of sensitivity to one’s self and to others becomes: “cultivation of one’s own spiritual practices and transpersonal self, going beyond ego self.” 4. The development of a helping-trusting relationship becomes: “developing and sustaining a helping-trusting authentic caring relationship.” 5. The promotion and acceptance of the expression of positive and negative feelings becomes: “being present to, and supportive of the expression of positive and negative feelings as a connection with deeper spirit of self and the one-being-cared-for.” 6. The systematic use of the scientific problem-solving method for decision making becomes: “creative use of self and all ways of knowing as part of the caring process; to engage in artistry of caring-healing practices.” 7. The promotion of interpersonal 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.” 8. The provision for a supportive, protective, and(or) corrective mental, physical, sociocultural, and spiritual environment becomes: “creating healing environment at all levels (physical as well as non-physical), subtle environment of energy and consciousness, whereby wholeness, beauty, comfort, dignity, and peace are potentiated.” 9. Assistance with the gratification of human needs becomes: assisting with basic needs, with an intentional caring consciousness, administering ‘human care essentials,’ which potentiate alignment of mindbodyspirit, wholeness, and unity of being in all aspects of care,” tending to both embodied spirit and evolving spiritual emergence. Watson’s (1979) ordering of needs: a. Lower Order Needs (Biophysical Needs) Survival Needs The need for food and fluid The need for elimination The need for ventilation b. Lower Order Needs (Psychophysical Needs) Functional Needs The need for activity-inactivity The need for sexuality c. Higher Order Needs (Psychosocial Needs) Integrative Needs The need for achievement The need for affiliation d. Higher Order Need (Intrapersonal-Interpersonal Need) Growth-seeking Need The need for self-actualization. 10. The allowance for existential-phenomenological forces becomes: “opening and attending to spiritual-mysterious and existential dimensions of one’s own life-death; soul care for self and the one-being-cared-for.” |
Assumptions
Caring can be effectively demonstrated and practiced only interpersonally. Caring consists of carative factors that result in the satisfaction of certain human needs. Effective caring promotes health and individual or family growth. Caring responses accept a person not only as he or she is now but as what he or she may become. A caring environment is one that offers the development of potential while allowing the person to choose the best action for himself or herself at a given point in time. Caring is more “healthogenic” than is curing. The practice of caring integrates biophysical knowledge with knowledge of human behavior to generate or promote health and to provide ministrations to those who are ill. A science of caring is therefore complementary to the science of curing. The practice of caring is central to nursing. (Watson, 1979). Relationships Transpersonal caring field resides within a unitary field of consciousness and energy that transcend time, space and physicality. A transpersonal caring relationship connotes a spirit-to-spirit unitary connection within a caring moment, honoring the embodied spirit of both practitioner and patient, within a unitary field of consciousness. A transpersonal caring relationship transcends the ego level of both practitioner and patient, creating a caring field with new possibilities for how to be in the moment. The practitioner’s authentic intentionality and consciousness of caring has a higher frequency of energy than noncaring consciousness, opening up connections to the universal field of consciousness and greater access to one’s inner healer. Transpersonal caring is communicated via the practitioner’s energetic patterns of consciousness, intentionality, and authentic presence in a caring relationship. Caring-healing modalities are often noninvasive, nonintrusive, natural-human, energetic environmental field modalities. Transpersonal caring promotes self-knowledge, self-control, and self-healing patterns and possibilities. Advanced transpersonal caring modalities draw upon multiple ways of knowing and being; they encompass ethical and relational caring, along with those intentional consciousness modalities that are energetic in nature that honors wholeness, healing, comfort, balance, harmony, and well-being. (Watson, 2005)
Strengths/Weaknesses
Strengths: Watson’s work can be used to guide and improve practice. It can provide the nurse with the most satisfying aspects of practice and can provide the client with holistic care. The theory is relatively simple. Watson’s work is logical in that the carative factors are based on broad assumptions that provide a supportive framework. The carative factors are logically derived from the assumptions and related to the hierarchy of needs. The carative factors delineate nursing from medicine. Weakness: Watson’s theory becomes more complex when entering the area of existential-phenomenology, for many nurses may not have the liberal arts background to provide the proper foundation for this area.
Analysis
It is undeniable that technology has already been part of nursing’s whole paradigm with the evolving era of development. Watson’s suggestion of purely “caring” without giving much attention to technological machineries cannot be solely applied but then her statement is praiseworthy because she dealt with the importance of the nurse patient interaction rather than a practice confined with technology. Watson stated the term “soul-satisying” when giving out care for the clients. Her concepts guide the nurse to an ideal quality nursing care provided for the patient. This would further increase the involvement of both the patient and the nurse when the experience is satisfying. In providing the enumerated clinical caritas processes, the nurse becomes an active co-participant with the patient. Thus, quality of care offered by the nurse is enhanced.
