Acceptance in the Nursing Community
Margaret Jean Watson’s model or theory of caring can be considered as a foundation of our profession. It suggests the consideration of nursing as both a science and an art, and caring as a key factor in the human phenomena of nursing.
Jean Watson’s Philosophy and Science of Caring could be applied to the practice (a) as an organization or (b) as an individual.
As an organization, Watson’s theory on caring could be utilized as a framework in the delivery of nursing service in a medical institution. When utilized as basis of nursing in a hospital, nurses are made to focus on the value of care and on the integration of the carative factors in patient encounters.
“The Journey to Integrate Watson’s Caring Theory with Clinical Practice,” an article by Linda Ryan, presents the process of integration of Watson’s theory to the pattern of health care delivery in a clinical setting.
On the other hand, it is also remarkable to take note that Watson’s Theory could also be used in the setting of community health nursing. This article from the Adeline Falk Rafael presents the suitability of Watson’s idea on caring to the practice of nursing in the community. It even provides a community assessment tool that can be used as a basis of health care delivery as public health nurses.
On the application of the Caring Philosophy at the level of an individual nurse, it is important to remember that Watson is an “eternal optimist.” This implies the confidence of Watson to the direction of nursing and the value of nurses to the caring phenomenon.
While doing our functions as nurses, we are challenged by Watson to “care,” and while doing so, we are encouraged to answer the following questions (adapted from Theoretical Foundations of Nursing: The Philippine Perspective by Octaviano and Balita, 2008, p164):
· Did I become a nurse to care?
· Is caring the activity I want to involve in?
· Why should I “care”?
· What are my inspirations in performing my carative responsibilities?
· To whom should I “care?”
· When am I needed to “care?”
· How will I “care” for my clients?
· What are the factors than can improve my level of care?
· What may happen if I will not “care?”
· What are the circumstances or conditions which hinder me from “caring?”
· How can I improve my knowledge, skills and attitudes regarding care?
· Who cares/will care for me?
In other words, Watson’s idea on caring helps us reflect on the value of caring to our lives and its implications to our vocation or calling. It challenges us to ask ourselves about our own perceptions and opinions on caring for us to be better guided in our delivery of nursing service.
Watson emphasized the importance of describing nursing in terms of nurse-patient relationships rather than on procedures and tasks. Her theory on caring implies the need for nursing students to be trained on: personal growth, communication skills, therapeutic use of self, holistic assessment and caring towards health and healing.
When Watson authored Nursing: The Philosophy and Science of Caring, she introduced the science of human caring and this quickly became one of the most widely used and respected sources of conceptual models for nursing.
Watson’s theory opens up a challenging door that leads researchers and scholars to questioning whether or not patients do benefit from the caring transactions. Research and practice could focus on the patient outcomes of caring transactions to validate the idea that caring is the truest essence of our profession.
The Philosophy of Caring has been used to guide nursing care among specific type of clients. There have been specific researches to identify the relevance of Watson’s Theory on Caring to the nursing care of clients with depression, adult polycystic disease and hypertension. There are also researches that try to test if the theory could be applied within the perioperative nursing setting.
Watson’s works also paved for the construction of specific care models such as The Attending Nurse Care Model and the Quality Caring Model.
Application to a Specific Nursing Scenario
Mr. S. Solis, 77 years old, live in their house with his son a tricycle driver. Mr. Solis’swife of 58 years died 4 months ago, so his daughters who are living few towns away from their father becomes concerned about their father’s condition. He was diagnosed three years ago of prostate cancer in addition to his leg injury sustained after he fell from a carabao during his teenage years.. He can hardly walk straight but never used the quad cane his daughter bought for him. Although his prostate cancer doesn’t bother him, he eats very little saying “walang lasa ang food dahil hindi luto ng inay nyo”, later he refused to take a bath regularly and his son noticed that he is locking his cabinets and always holding his wallet tightly.
Functional deficit in mobility, nutrition, socialization, risk for safety and independence.
Risk for injury related to his movement without using safety device available;
Altered nutrition because of decrease in appetite and failure to prepare food for himself;
Risk for social isolation related to suspicion;
Risk for possible depression related to death of his wife
Goals and outcomes:
Physical Safety and Psychological Well-Being
Educating and reiterating the use of quad cane to walk around and rearranging the house so that Mr. Solis can move around independently.
Teaching intervention may include education to the family about balanced diet and preparation of food that would enhance his appetite.
Show support and regular visitation of the daughters to relieve their father’s loneliness and build his security ;
Referral to a psychiatrist that night need antidepressant therapy. If antidepressant therapy is prescribed for Mr. Solis, another nursing intervention is to monitor for and to teach about the possible side effects of antidepressant medication.
Focus on the data to indicate improvements in the identified areas of functional deficit.
In Mr. Solis' case, the purpose of nursing care derived form Watson's theory to promote dignity and harmony of mind, body and spirit. His dependency are seen as a opportunity for the family to give and receive love and concern rather than a burden for them. I was able to witness the change of behavior of both Mr. Solis and family towards each other. Caring starts from the family, the nurse helps to preserve, apply and show it.
Articles for Download. (n.d.). Watson aring Science Institute. Retrieved July 3, 2011, from http://www.watsoncaringscience.org/index.cfm/category/64/articles-for-download.cfm
Rafael, A. F. (2000). Watson's Philosophy, Science, and Theory of Human Caring as a Conceptual Framework for Guiding Community Health Nursing Practice. Advances In Nursing Science , 23(2)(December), 34-49. Retrieved July 3, 2011, from http://www.watsoncaringscience.org/files/pdf/Ovid_%20Falk%20Rafael_%20ANS_Adv.pdf
George, J. B. (2002). Nursing theories: the base for professional nursing practice (5th ed.). Upper Saddle River, N.J.: Prentice Hall.
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Mayo Clinic Libraries-Nursing Theorists. (n.d.). Mayo Clinic. Retrieved July 3, 2011, from http://www.mayo.edu/library/theorists-watson.html
Octaviano, E., & Balita, C. (2008). Theoretical Foundations of Nursing: The Philippine Perspective. Manila, Philippines: Ultimate Learning Series.
Quality Caring. (2007, September 12). Watson Caring Science Institute. Retrieved July 2, 2011, from www.watsoncaringscience.org/files/pdf/The_Catholic_University.pdf
Ryan, L. (n.d.). The Journey to Integrate Watsonâ€™s Caring Theory with Clinical Practice. Watson Caring Science Institute Website. Retrieved June 27, 2011, from www.watsoncaringscience.org/pdf/JourneytoIntegrate.pdf
Health Systems. (n.d.). Overview of Jean Watsonâ€™s Theory. Innovative Care Models. Retrieved June 27, 2011, from www.innovativecaremodels.com/uploads/File/caring%20model/Overview%20JW%20Theory.pdf
Watson, J., & Foster, R. (2003). The Attending Nurse Caring Model _: integrating theory, evidence and advanced caringâ€“healing therapeutics for transforming professional practice. Journal of Clinical Nursing, 12, 260-365. Retrieved July 2, 2011, from http://www.watsoncaringscience.org/files/pdf/FosterWatson.pdf