Jean Watson’s Theory of Human Caring represents a dramatic paradigm shift, and as a result, it has been a source of great controversy since its introduction.
The purpose of this paper is to discuss the comprehension of the theory, the implications of caring, and the application of the theory to practice in an attempt to show that the Theory of Human Caring is valuable to the nursing profession. Sources include published literature, including the work of Jean Watson. Jean Watson’s Theory of Human Caring: Is It Valuable to the Profession of Nursing?
Jean Watson’s Theory of Human Caring represents a dramatic paradigm shift, and as a result, it has been a source of great controversy since its introduction. It is still a relatively new theory, with the first publication in 1979 in Watson’s book Nursing: The Philosophy and Science of Caring. Possibly due to its newness, there is still much debate over the ease of comprehension of her work, the implications of caring within her theory, and whether her theory is applicable to nursing practice in today’s world of advanced technology and budget cuts.
This paper will explore each of these issues regarding the theory, and attempt to demonstrate that Watson’s Theory of Human Caring definitely has a place in nursing practice today. A Summary of Jean Watson’s Theory of Human Caring Jean Watson views nursing as an art and a science, which has the goal of preserving the worth of humankind through the process of caring.
Caring is seen as the essence of nursing and a moral ideal: Caring…has to become a will, an intention, a commitment, and a conscious judgment that manifests itself in concrete acts.
Human care, as a moral ideal, also transcends the act and goes beyond the specific act of an individual nurse and produces collective acts of the nursing profession that have important consequences for human civilization (Watson, 1988, p. 32). Also, Watson stresses the subjectivity of the human experience, and uses the term phenomenal field to describe a person’s individual frame of reference, which is influenced by past experiences and can never be truly known by another person. Anotheraspect of Watson’s theory is transpersonal caring, in which nurse and patient
coparticipate in the goal of achieving health (Watson, 1988, p. 70). Watson (1988) defines health as harmony between mind, body and soul, and illness as a subjective disharmony between mind, body, and soul. As well, integral to Watson’s theory are the 10 carative factors that serve as a “framework for providing a structure and order for nursing phenomena” (Watson, 1997, p. 50). The 10 carative factors are as follows: 1) Humanistic-altruistic system of values 2) Faith-hope 3) Sensitivity to self and others 4) Helping-trusting, human care relationship
5) Expressing positive and negative feelings 6) Creative problem-solving caring process 7) Transpersonal teaching-learning 8) Supportive, protective, and/or corrective mental, physical, societal, and spiritual environment 9) Human needs assistance 10) Existential-phenomenological-spiritual forces. All of this is presupposed by a knowledge base and clinical competence (Watson, 1988, p. 75). Watson (1988) believes that nursing must separate itself from the reductionistic views of the traditional science medical paradigm and focus on movement towards a human science nursing paradigm.
Watson also readily acknowledges that her theory is a work in progress, and she “invites participants to co-create the model’s furtheremergence” (Watson, 1997, p. 52). This is in accordance with her theory in that she believes that everything is in an unending process of becoming (Watson, 1988). Discussion of The Theory of Human Caring Comprehension Watson’s Theory of Caring has been influenced by a variety of disciplines outside of nursing. For example, Watson (1997) acknowledged that aspects of psychology, existential-phenomenological philosophy, and metaphysics helped to mold her theory.
As a result, authors such as Cohen (1991) and Barnhart et al. (as cited in McCance, McKenna, & Boore, 1999) believe that one must have background knowledge of these disciplines in order to fully understand Watson’s theory. Furthermore, it has been suggested that nurses may not possess this knowledge (McCance et al. , 1999), which may make the theory less appealing. To expand, McKenna (as cited in McCance et al. , 1999) stated that “theory should be easily understood if it is to gain the attention and commitment of hard pressed clinicians” (p. 1393).
However, it must be stated that nurses should not be viewed as incapable of acquiring knowledge in disciplines such as psychology and philosophy. As well, the application of Watson’s theory in a variety of different areas of nursing (which will be discussed later in this paper) suggests that nurses have been able to utilize the theory successfully, regardless of educational background. Watson has also been criticized for using language and concepts in her model that are difficult to understand (Barker & Reynolds, as cited in Sourial, 1996), which has the
potential to limit the theory’s success. Sourial (1996) found that Watson frequently substituted different terms for the same idea without explanation, leading to confusion (i. e. , caring transaction, caring moment and caring occasion are equivalent terms). Sourial(1996) suggested that using “consistent terminology…[and] additional diagrams would help to clarify and make her [Watson’s] theory more concise” (p. 403). Conversely, Walker (1996) argued that Watson “explain[s] abstract phenomena by using ordinary language in extraordinary ways” (p.
992), and that she “ weaves concepts and ideas together with the elegant simplicity of a work of literature” (p. 993). Furthermore, students of the College of Nursing in London who were taught to use the Theory of Human Caring, “found the language in Watson’s model difficult, describing it as ‘American’ at first, but they were quickly able to find examples from their experience and use Watson’s concepts skillfully and fluently” (Allan, 1996, p. 43). It is easy to see from the above sources that the perceived difficulty of Watson’s language is a subjective experience.