Application of Jean Watson theory of Human Caring to clinical Practice
Introduction
The Jean Watson’s theory of human caring explains the role of nursing and related caring actions taken by those in the profession as well as how they interact with others. The theory is based on values and assumptions to explain human caring from a metaphysical, existence and spiritual perspective. These values include the sense of respecting the life of beings and recognizing the ability of humans to change, giving regard to the spiritual component of an individual and the integrated power of a person to develop and transform and having the drive to assisting a person to become more knowledgeable, have self-control and effectively self –heal irrespective of the state of health the person is in. The theory is based on assumptions touching on human life, the science of nursing and the nursing process. According to Watson, human life is centered on the power of the soul which is not subject to space or time determinants. This means that no matter the surrounding circumstances affecting the outer body internally or externally, the soul shapes its own parameters of time and space. She also describes nursing as a human science and the interactions with health-illness experiences that are dealt with from a professional, ethical, scientific, personal and esthetic dimension. She also argues that the nursing process is not about diagnosis and treatment but a consolidated effort to provide human care (Watson & Watson Caring Science Institute, 2009).
The author, Jean Watson, is a distinguished professor of nursing at the University of Colorado Health Sciences Centre. She is also a fellow of the American Academy of Nursing. She has previously served as dean of Nursing at the University Health Sciences Center and President of the National League for Nursing. She holds an undergraduate and graduate degree in nursing and psychiatric-mental health nursing and PhD in educational psychology and counseling. Her research has been in “human caring and loss” (Fawcett, Watson, Neuman, Walker & Fitzpatrick, 2001).
The purpose, underlying assumptions, primary concepts, and the theory model structure
The major concept of Watson’s theory of human caring revolves around transpersonal human caring. This concept of human caring may be analyzed on three perspectives and these are life, illness and health. In this context, human life entails the mental, spiritual and physical being. The illness does not necessarily mean disease but is any form of disharmony within a person or his/her soul and may be affecting the individual consciously or sub consciously. Health, under this concept is described as the well being or harmony of the three spheres of human being, which is the body, mind and soul (Chantal, 2006).
Based on this theory, the core aim of human caring entails a giving-receiving model in which the nurse and the patient interact and experience each other through the mental, physical or spiritual contacts or a combination of all three spheres (Chantal, 2006).. This means the ultimate purpose or goal of the nursing profession is to give the patient relative level of coordination or harmony within themselves so as to achieve self-healing and the ability to provide care to them based on the acquired knowledge (Chantal, 2006).
The theory is based on several assumptions that describe nursing on a totally different platform from the conventional concept of providing treatment to the unhealthy. These assumptions state that the care offered by the nurses to the patient can only be successfully useful if the basis is interpersonal interaction. This means the nurse and the patient can freely interact and understand each other on a personal level. This creates a platform for nurse to offer all the help the patient requires to ensure he/she achieves internal harmony which is the recipe for enhanced self-healing (Chantal, 2006). Another assumption is that the definition of an effective caring environment is one that gives room for the person to choose the most appropriate of actions that make them comfortable and allow them to achieve optimum personal satisfaction. The environment should also be supportive of the individual’s potential development. The theory also assumes that the process of caring should encompass accepting the patient without basing the care only on the condition he/she is in currently but also what this individual may become later (Chantal, 2006).
The theory goes on to argue that caring is only effective if it promotes the health of the individual, the family and societal growth. According to Watson, caring is about the entire health well being as opposed to the curative perspective. This means that the nursing profession does not only concern itself with getting the patient cured from a disease but focuses on the patient becoming healthy and regaining the harmony of the mind, soul and spirit. In this perspective therefore, she states that the science of caring goes hand in hand with the science of curing. The nursing profession’s agenda, based on Watson’s assumptions should be categorically, offering care. This care entails considering all the carative factors that make the individual achieve satisfaction in the needs they pursue in life (Fawcett, Watson, Neuman, Walker & Fitzpatrick, 2001).
How the Watson’s theory model addresses the concepts of person, environment, health, and nursing
The Watson’s model has put emphasis on the person, the environment, health and the nursing practice in general. The human being has been comprehensively described as a central component of the nursing profession. It looks at the person as an integral part that requires all the necessary attention. The person in question deserves to be cared for, to be understood and respected. It gives a paradigm shift to the whole concept of offering health care to patients from simple diagnostic and treatment procedures to a more compressive affair that involves a closer understanding of the patient as a human being with psychological, physical and many other needs (Watson, 2006).
Jean Watson observes the environment from a unique perspective. The society/environment greatly determines the relationship between the patient and the nurse. According to her, care is an integral part of any human society and having the caring attitude as a professional is not a hereditary concept transferred across generations; rather it is promoted by the professional culture in a profession as a method of fitting in an environment. The working environment should therefore be more enhancing in promoting a caring attitude by the professionals. The legendary nurse, Nightingale, revolutionized an attitude in her environment by changing the concept of treating patients as clients with her close focus on their wellbeing (Watson & Smith, 2002).
Watson’s concept of health markedly differs from that of the World Health Organization as she describes health as a high level of functioning in all spheres of human life. These are the physical, mental and social components. To her being healthy means the ability to have a level of functioning normally in day to day living and activities as well as the absolute absence of any form of illness whether mental or physical. She argues that if an individual is struggling to avoid such illnesses either by a change in the normal life style or way of thinking, then such a person is unhealthy (Fawcett, Watson, Neuman, Walker & Fitzpatrick, 2001).
Her concept of the nursing profession is that it should concern itself with providing care to the sick in an effort to bringing back their health. Nursing also entails promoting healthy lifestyles and coming up with ways of preventing illness of mental, social or physical body components. In her theory of human caring, Watson defines nursing as “a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions” (Basavanthappa, 2007, p105).
As a professional nurse, I would endeavor to observe a similar philosophy as Jean Watson’s theory proposes .Am strongly convinced that the nursing process does not entail only treating diseases in patients which practically means taking them as clients looking for a service, but should aim at restoring the patient to a harmonious state of the three components of the normal human being-the mind, body and soul. The treatment of the patient as the most integral part of the medical process would completely transform this medical field into a human-based process. This is the proposal I feel carries maximum weight in the entire Watson’s theory as outlined in the carative process.
How the theory addresses health promotion and primary health care principles.
According to Watson’s theory, provision of primary health care and health promotion is given in a new dimension. It is a clear shift from the conventional model of curing illnesses in patients by the nurses to comprehensive provision of health care that aims to harmonize the mind, body and soul. She describes the shift as “Curative to Carative” which is achievable in ten ways. These are the formation of a human approach in dealing with the patient. In this context the care provider, consciously puts himself/herself on the same platform as the patient. In this way, the care giver is able to respect the human dignity of the patient as though it were his/hers. By practicing kindness, the care giver demonstrates a respect for other people. This makes the patients feel appreciated and as a part and parcel of the medical care system. This will also help the nurse understand the challenges or vulnerabilities the patients go through in their struggle with illnesses which acts to inculcate a sense of being concerned and listening to others with a genuine reason and purpose to offer the necessary help (Drenkard, 2008).
The theory stresses on instillation of faith and hope. This entails offering a platform for one to believe that everything is alright. This is possible through constant encouragement to the patient. By availing oneself to assist the sick greatly improves their level of confidence and in turn boosts their recovery process. Listening to the patient promotes connection and interaction so they do not feel neglected or as a bother to others. It is a sign of honor when patients interact freely with the nurse as it helps to incorporate their desires and values as well as their beliefs in the treatment process. The interaction between a nurse and a patient brings out the role of arts and sciences in an effort to find the best solution in the healing process (Watson & Smith, 2002).
Another element of carative approach is the helping in achievement of the patient needs. The care giver should be ready and willing to meet the needs of the patient. This is by developing a sense of respect to the patient and providing them with essential needs to facilitate their healing process. This creates comfort since it acts as an assurance that their needs will be met. The Watson’s theory proposes the promotion of caring environments to facilitate healing of the spiritual component. Many patients always suffer and may harbor negative thoughts and feelings about themselves or others. The presence of the nurse’s support has a great impact on the expression of these attitudes. By creating a close relationship, the nurse is able to encourage the patient which contributes to the healing process. Through exchange of experiences, one is able to learn from others or be a source of new ideas on how to handle certain situations (Watson & Watson Caring Science Institute, 2009).
Primary healthcare is promoted through development or creation of trust in human relationships. A member of the healthcare department facilitates healing with ease in patents by forming a trust-based relationship with them. This helps the patient to comfortably confide in the health professional on matters deemed secretive or confidential. This could be of great importance to the nurse in providing the best advice concerning any problem the patient may be experiencing. The helpful and caring nature of these relationships helps in extending unconditional love to others and responding to their requests in times of need. This communication promotes effective and result oriented discussions that in turn result in improved health (Drenkard, 2008).
The carative approach allows for integration in the use of scientific techniques of problem solving and the social aspects. By applying these two knowledge areas, it becomes easy to handle even the most complex of cases. The combination of ethical and personal aspects in management of patients makes the entire process of treatment focus on the patient as a human who needs assistance to be whole again as opposed to the use of only a scientific approach that aims at offering cure to an illness without the actual consideration of the patient’s human value. The Watson’s idea of providing support, care and protection to the patient facilitates human connections. These play an important part in creating an environment for healing. Provision of an enhancing environment during the healing process increases the potential of the components of the body to achieve harmony which is an integral element in healing (Watson, 1999).
In the entire process of health care provision, a vital concept is the adoption of a culture of being sensitive to others. By being sensitive to a patient’s needs; the nurse is able to arouse healing mentality in the patient. It is a demonstration of caring and the aspect of being concerned about others’ welfare (Watson & Foster, 2003).
Application of the theory during assessment, diagnosis, planning, implementing and evaluating patient care
The Watson’s theory offers a clear guideline in the nursing process in areas of assessment, diagnosis, planning, implementing and evaluating patient care. This is because the nursing process has a similarity with research process in terms of procedure. In assessment and diagnostic step, I would use techniques such as hypocritical method of observation of the patient to help identify the actual problem. I would then use my literature knowledge in nursing to formulate a workable method of analyzing the observations made. Assessment of the patient would also entail formulating a hypothesis based on the probable cause of illness, stating clearly all the variables(in this case, causative factors) in the data that will be used in determining the most appropriate method of treating the particular ailment (Watson & Watson Caring Science Institute, 2009).
In effective planning of the patient care, I would choose the most appropriate techniques of data collection, for instance carrying out lab tests or interviewing the patient in addition to determining what test to carry out and from what patient. The plan would also include choosing the most workable methods of examining data collected and the most accurate techniques and apparatus to use. The entire plan would involve a clear design to be used in identifying the disease and treating it. The Watson’s theory clearly describes the collection of all necessary patient data for analysis as the implementation of the plan. This is because with the information concerning the illness, one is able to do comparative studies with medical literature, past patient tests, or use the raw data to interpret a condition and make an inference concerning the results obtained to recommend the most appropriate treatment procedure (Basavanthappa, 2007).
Evaluation of patient care is an important element in the nursing process. This involves analysis of data collected on the patient and examination of any effects that may arise from the treatment. Evaluation also entails interpretation of obtained results from the patient. I would use this evaluation data to develop more hypotheses on various ailments (Watson & Foster, 2003).
The Watson’s theory of human caring has some gaps particularly in the carative processes. In an effort to address the challenges of the nursing profession through what Watson describes as ‘carative theories” which aims to shift the profession’s approach from curative to carative has to a large extent delineated the psychosocial needs of the patient. The theory also accords little attention to the person’s biophysical needs. I would recommend that other experts such as psychologists and physiotherapists be involved in the healing process, since the clinical officer may not have the expertise to effectively handle psychological and biophysical challenges affecting the patient. Furthermore, its applicability in nursing practice needs more research so as to fit in the fast changing tech-oriented medical structures such as the use of electronic medical files through which doctors are offering services online.
Conclusion
The Watson’s theory is a revolution in the nursing profession. The theory emphasizes on the importance of putting the patient at the center of the nursing process as opposed to the conventional treatment of patients as clients looking for medical services. The theory is based on values and assumptions to explain human caring from a metaphysical, existence and spiritual perspective. The theory’s main strengths are that it places the patient (formerly client) in a broader context of the nursing process, the family, the community and the integrated culture of the whole society. Additionally, the theory emphasizes the patient to be the central focus of the nursing practice rather than technology. The theory, however; has some gaps. These are; the ten carative factors developed by Watson have largely delineated all psychosocial needs of the patient. The theory also accords little attention to the person’s biophysical needs. Furthermore, its applicability in nursing practice needs more research backup.
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