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Watson, J. Watson’s theory of human caring and subjective living experiences: carative factors/caritas processes as a disciplinary guide to the professional nursing practice1
Danish Clinical Nursing Journal. 2006; 20 (3): 21-7
The article offers an overview of Human Caring theory by Watson, the notion of human phenomena and Caritas. A special emphasis on the human caring theory's theoretical structure is given and is referred to as the 10 caritas processes or carative factors subjective experiences and processes of living. The main conceptual theory aspects and processes of human living are founded on the ethical and philosophical body of the caring theory. The two act as a guide and blueprint for professional practice and science of care respectively.
Goldin, M. and Kautz, D.D. (2010). Applying Watson’s caring theory and caritas processes to ease life transitions. International Journal for Human Caring, 14, 11-14.
This article is a personal account that describes the transformed life of a clinical expert who had faced a significant life challenge. The clinical expert applied the caring theory by Watson and the caritas processes to work through the life challenge. Though reflections and sustained effort, the clinician integrated the theory into her daily life successfully.
Caruso, E; Cisr, N; and Pipe, T (2008). Creating a Healing Environment an Innovative Educational Approach for Adopting Jean Watson’s Theory of Human Caring. Nurs Admin Q Vol. 32, No. 2, pp. 126–132
Current focus on nursing practice that is evidence based as well as empirical data highlights the need for re-examination of critical nursing theory in guiding practice. This article describes the approach, rationale, and outcomes of an educational approach that is innovative with regard to teaching the Watson human caring theory.
Savieto, R.M. and Leao, E.R. (2016). Nursing assistance and Jean Watson: a reflection on empathy. Esc Anna Nery 20(1):198-202.
This article sought to relate the theory of Human Care to empathy in the current nursing context. The article is a reflective and theoretic essay that proposes an empathy themed discussion and how it relates to human care theory.
Clark, C.S (2016). Watson’s Human Caring Theory: Pertinent
The paper provides a historical background on transpersonal psychology with regard to its link to the Human Care theory by Watson. The purpose is to support nurses and also nurse educators in embracing a more in-depth understanding of the healing process in Watson's theory as a time-space continuum.
Caritas nursing refers to the bringing of caring, heart centered love to human practices back to the working world as well as personal lives of individuals (Watson, 2009) The importance of this term is significant as the theory has over the last decade, guided the nursing practice, healing, and caring of relationships as part of the key nursing profession (Watson, 2009). This has led to a shift in nursing care in hospitals. Hospitals are tasked with showing that they uphold nursing excellence, quality patient care, and professional practice innovation while assuring quality care to their patients (Watson, 2009). Watson asserted that nursing administrators and leaders are committed to meeting high standards through nursing transformation and have sought after deeper caring levels and helping practices for their staff. They are achieving this through the implementation of the theory of Human Caring. The framework highlights prominent philosophical, ethical, and theoretical practices. The actions taken are guided by Caring Science and Caring Theory (Watson, 2009)
Thesis Statement: Self acceptance is the key to effective nursing care
The Caritas processes that will be discussed in this paper are the third and fourth processes.
#3Cultivating one’s own spiritual practices and transpersonal self, going beyond ego self. This calls for one to work from a consciousness that is fuller as well as an open heart centeredness while opening oneself to all chakras.
On a personal level, this process aligns with my personal values as I work toward practising it in daily and routine activities. The practice of self reflection such as meditation, prayer and journaling form part of my daily routines. In addition, I also practice discernment in evaluation of situations and circumstances as opposed to being judgemental. I have developed meaningful rituals for the practice of surrender, forgiveness, compassion, and gratitude. I accept others even as I accept myself on a spiritual basic level as worthy and unique, deserving care and respect. I also transform tasks into processes of healing and will forgive others even as I forgive myself. I strive to show genuine interest in other people, valuing their intrinsic goodness as well as my own. Finally, I practice with whole heartedness.
#4 Developing and sustaining a helping-trusting, authentic caring relationship. This involves developing, nurturing and maintaining caring relationships that are authentic, helpful, and treating. It involves entering into an experience with the aim of exploiting all possibilities in the relationship as well as in the moment.
On a personal level, I strive to love others with regard and unconditionally and also seek to work based on my colleagues' subjective reference frame. I hold a sacred healing place for those who may need healing in their time of distress and respond to others' congruent to the experiences they have lived. I also strive to be non-judgmental and I practice presence that is authentic. I bring my entire self to a relationship while demonstrating openness, sensitivity, genuineness, and honesty toward others.
Engages in therapeutic and professional relationships
The relevance of this standard is in the fact that it offers the basis of RN practice which is on purposeful engagement of professional and therapeutic relationships that are effective (NMBA, 2016). This is inclusive of collegial generosity with regard to professional relationships' respect and mutual trust.
The registered nurse is expected to establish, maintain, and terminate the relationship in a boundary-differentiating manner between personal and professional relationships. The nurse is expected to communicate in an effective and respectful way that shows consideration of a person's rights, beliefs, values, and dignity (Royal College of Nursing, 2008). Recognition of the fact that people are experts in their individual life experiences and proceeding to support and direct people to health related resources to optimize their outcomes should be the goal of the RN. The nurse advocates in a respectful manner, on the people's behalf, with regard to their legal capacity and autonomy. The RN fosters a learning and safety culture which includes engagement of health professionals as well as others in sharing practice and knowledge that is supportive of care, that is person centered (NMBA, 2016).
Nurses are accountable and responsible for their own safety and ensure their own capability to practice (NMBA, 2016). The RN is responsible for their own continuous self management in addition to contributing to the development of others. The nurse ought to provide education and information that enables decision making and taking action with regard to health.
In this regard, the nurse is supposed to consider and respond to their personal as well as others' wellbeing health in a timely manner in relation to his/her personal practice capacity. He/she ought to provide education and information that will enhance others' control over their individual health. The RN accepts to be accountable for any behaviours, actions, decisions, and responsibilities that come with their role and for the actions of those under their leadership. Further, the nurse seeks practice feedback and review and responds to it while actively engaging in the profession (NMBA, 2016).
The second and third standards of practice deal with the manner in which the nurse relates to themselves and others with regard to communication, respect, and delivery of service. The standards outline that the nurse should first accept that other people have a better experience of their individual lives and therefore they should be accorded the rights, dignity, respect, and autonomy they are due while ensuring that they get the best health outcomes (Galloway, 2013). In order to accept others as they are, it first starts with the individual acceptance of oneself. The nurse should have a clear perception of their capabilities and emotions and accept him/herself. By so doing, the nurse will be able to see and accept others as they are and accord them the care and love they deserve. In this way, the third and fourth caritas are harmonized with the second and third nursing practice standards. Self acceptance will free a nurse emotionally and psychologically to accept his/her colleagues and patients(Ryff & Singer, 2008) as they are and foster the development of healthy relationships with them for optimal health outcomes.
The nurse should be aware of the whole entity that is the patient regardless of the patient's illness or disease, and then proceed to create an experience of care according to Watson's theory. In addition, a caring occasion should be created by the nurse where the two share common experiences to better the process of healing. A nurse who has no inner perception of themselves (#3 caritas) will not know how to identify and act towards an unspoken need of a patient and show acts of care. For example, a nurse who has faced and learned how to deal with grief will know and create an opportunity for a patient who is going through grief to share his/her experience. When the patient gets to share the experience with the nurse, their healing process is accelerated.
To be human means one has to have the ability to feel as others do and this starts by recognizing and feeling one's own feelings (Porges, 2011). The development of feeling is encouraged by life experiences both good and bad. It is cultivated by looking inward and exploring one's feelings which leads to self acceptance as well as psychological maturation. When a nurse is sensitive to others, he/she is able to see the world form another's point of view which heightens his/her concerns for other's wellness, recovery, and comfort. A nurse should recognize and utilize their sensitivity to promote their personal development and actualization which will enable them to encourage the same in others. Failure to do so will mean failure in nursing care and failure of the #3 caritas.
Human caring connotes special relationships characterized by a high regard for the other person. In a transpersonal relationship, the nurse enters another's experience and vice versa and both persons are inter-subjected to each other (Favero, Luciane, & Pagliuca, et al., 2013). The nurse artfully forms a union and connects to the spirit of the other to form a connection that honours human dignity's and preservation upmost concern. A spiritual connection goes beyond the physical and the patient is able to allow themselves to be cared for by a nurse that is willing to meet their innermost needs in addition to the physical needs of wellness. (Austin et al., 2016) By honouring and listening to the patient's story, the nurse honours the feelings of the patient which are of importance and meaning to them and their healing. Listening to the patient's story could be the single act that can accelerate their healing beyond the physical.
Human beings are persons that thrive on relationships, without connectedness with each other, negative life outcomes follow (Hawkley, & Cacioppo,2010). A person that is in touch with themselves will be in a better position to reach out to others. A nurse that has a clear perception of themselves; their strengths and shortcomings, and has accepted themselves as they are is able to project their self acceptance to others. Such a nurse is more open to accepting others as they are and teaching them to do the same. A self-aware nurse is able to show care to the patient, foster and maintain healthy relationships with patients and colleagues, and is able to connect with the spirit of the patient to accelerate their physical and psychological healing. This is the core of Watson's theory of human care in nursing practice.
Austin, P.D. et al., (2016)“The Ability of Hospital Staff to Recognise and Meet Patients’ Spiritual Needs: A Pilot Study.” Journal for the Study of Spirituality 6. 20-37. http://bit.ly/2naEBad
Caruso, E; Cisr, N; and Pipe, T (2008). Creating a Healing Environment an Innovative Educational Approach for Adopting Jean Watson’s Theory of Human Caring. Nurs Admin Q Vol. 32, No. 2, pp. 126–132
Clark, C.S (2016). Watson’s Human Caring Theory: Pertinent Transpersonal and Humanities Concepts for Educators. Humanities 5, 2. doi:10.3390/h5020021
Favero, Luciane, & Pagliuca, et al., (2013). Transpersonal caring in nursing: an analysis grounded in a conceptual model. Revista da Escola de Enfermagem da USP, 47(2), 500-505. https://dx.doi.org/10.1590/S0080-62342013000200032
Galloway, J (2013). Dignity, values, attitudes, and person centred care. Available at: file:///C:/Users/cash/Downloads/2013-dignity-values-attit--person-centred-care%20(1).pdf
Goldin, M. and Kautz, D.D. (2010). Applying Watson’s caring theory and caritas processes to ease life transitions. International Journal for Human Caring, 14, 11-14.
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms. Annals of Behavioral Medicine?: A Publication of the Society of Behavioral Medicine, 40(2), 10.1007/s12160–010–9210–8. http://doi.org/10.1007/s12160-010-9210-8
Nursing and Midwifery Board of Australia (2016). Registered Nurse Standards of Practice. file:///C:/Users/cash/Downloads/Nursing-and-Midwifery-Board---Standard---Registered-nurse-standards-for-practice---1-June-2016.PDF
Porges, S.W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. New York: W. W. Norton & Company.
Royal College of Nursing (2008). Defending Dignity: Challenges and Opportunities for Nursing, London, RCN
Ryff CD, Singer BH (2008) Know thyself and become what you are: a eudaimonic approach to psychological well-being. J Happiness Stud 9: 13–39.
Savieto, R.M. and Leao, E.R. (2016). Nursing assistance and Jean Watson: a reflection on empathy. Esc Anna Nery 20(1):198-202. Available at: http://www.scielo.br/pdf/ean/v20n1/en_1414-8145-ean-20-01-0198.pdf
Watson, J (2006) Watson’s theory of human caring and subjective living experiences: carative factors/caritas processes as a disciplinary guide to the professional nursing practice1 Danish Clinical Nursing Journal. 20 (3): 21-7. http://www.scielo.br/pdf/tce/v16n1/a16v16n1.pdf
Watson, J (2009). Caring science and human caring theory: transforming personal and professional practices of nursing and healthcare. Journal of Health and Human Services Administration, 31(4),466-482.
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