Jean Watson’s Theory of Human Caring - PowerPoint Presentation

Slide1

Jean Watson’s Theory of Human Caring

Watson’s middle-range explanatory nursing theory focuses on the human component of caring and the moment-to-moment encounters between the one who is caring and the one who is being cared for, especially the caring activities performed by nurses as they interact with others. (Kearney-Nunnery

R. 2008, p. 73)Slide2

Rationale for Use of Nursing Theory

Caruso’s Research Theory

“The rationale for implementing Jean Watson’s Theory of Human Caring was that it addressed the following needs for nursing in the health system. The theory was found to be: applicable to nurses and patients in all setting including both ambulatory and acute care, applicable to nurses and patients at all phases of development, a guide for all nursing roles and specialties (direct care, administration, education, quality, research, etc.), consistent with the institution’s model of caring, a guide to help articulate what nursing is and does, beyond task orientation, a framework that helps build awareness of how our values guide moment-to-moment practice, incorporating important aspects of patient safety, knowing the patient helps the nurse identify variations in patterns that can be important for patient safety such as develop of side effects, toxicities, or complications, knowing the patient and patient advocacy also enables the nurse to intervene in small problems before they become big or complex problems, and focusing on nurses as well as patients” (Caruso, Cisar, and Pipe, 2008, p. 126).Slide3

Rationale for Use of Nursing Theory

Smith’s Research Study

Smith (2004) reflects “the purpose of this column is to review the body of research related to Watson’s theory of transpersonal caring (Smith, p. 13). Smith “provides an overview of the studies, identifies measurement instruments developed, critiques the body of work, and offers suggestions for future research” (Smith, p. 13).Slide4

Rationale for Use of Nursing Theory

Journal of Health and Human Services Administration

Watson’s Human Caring Theory has been adopted in numerous hospitals through out the United States including many achieving Magnet status. Magnet hospitals must demonstrate criteria that recognize quality patient care, nursing excellence, and innovations in professional practice according to the Journal of Health and Human Services Administration (2009). Munson

Medical Center received Magnet Recognition Certification in 2006, and its annual report states Munson adopted Watson’s theory as a framework for addressing the values, knowledge, and practice of nursing, which is unique to human caring.

Researching areas utilizing Dr. Watson’s theory a direct correlation between the theory of human caring and Magnet hospitals became evident. This prompted a closer look into Munson’s Magnet Force inspiration.

According

to the annual report; Munson uses Watson as the nursing theorist that drives nursing care and also chooses to use Relationship Based Care as a professional Model of Care. They work together to support three key relationships;

1.) The relationship between the nurse, patient, and family.

2.) The nurses relationship with his/herself.

3.) The relationship with peers, colleagues, and communitySlide5

Rationale for Use of Nursing Theory

Perry’s Research Study

Jean Watson’s theory of Human Caring supports “Role modeling excellence in clinical nursing practice”. The nursing needs in our health care system apply as follows:Positive role modeling behaviorsContributions to education of clinical nursesConnections/acknowledgement of patients and colleagues Supportive interactions

Consistent caring practices day to day Slide6

Research Studies Selected

There is a plethora of research topics relative to Jean Watson and her nursing theory

. There are personal topics such as background, education, personal and professional accomplishments. There is information available on the Watson Caring Science Institute and the different programs offered within. Articles are available linking Dr. Watson and her theory application to different disciplines in the nursing profession as well as her theory involvement with Magnet as it is achieved by hospitals and institutions

.

There are in-depth studies available looking at the ten clinical caritas processes and how they can be implemented into a nurse’s personal practice as well as hospital wide.Slide7

Further Studies Related to Watson’s Theory

Andershed

& Tenestedt (1999) to identify and catagorize family members’ involvement in the care of a dying relative and to examine findings in light of Watson’s and Swanson’s theories.Clayton (1989) to investigate the phenomenon of transpersonal caring interactions between elderly individuals and nurses and to determine the caring needs of institutionalized elderly.

Updike, Cleveland, and Nyberg (2000) to develop and test a curriculum focused on complimentary healing modalities (CHMs) and to evaluate the effectiveness of the program toward expanding professional nurse’s knowledge and clinical skills in caring-healing concepts and practices and increasing nurse’s satisfaction with expanded clinical practice; integrating CHMs into the care of children hospitalized on the hematology – oncology unit; and improving organizational support for CHMs. (Caruso, table 1).Slide8
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Research

Findings

CarusoCaruso et al (2008) states “nursing leadership wanted to engage nurses in the process of adopting a unifying nursing model, highlighting the linkages among the theory, professional nursing practice, health nurse workforce enhancements, and patient safety” (Caruso et al, pp 126-127). To do so, “the question arises how to implement the theory in practice and how to educate the nursing staff on the principles of the theory” and the author further develops “the curriculum on the 3 tenets of the organization: Research, Education and Clinical Practice” (Caruso et al, p. 129). Caruso et al also states “as nurses continue to search the literature in a quest for best practice, it is imperative to preserve the human touch and the caring moments of the interpersonal relationships while using a framework to guide nursing practice” (Caruso et al, p. 126) and reasons her organization chose Watson are outlined above.Slide10

Research

Findings

Smith Smith (2004) reviewed the body of research available at the time related to Watson’s caring theory (40 studies) and compiled “a comprehensive summary and analysis of the research including strengths, weaknesses, and suggested directions for the future (Smith, p. 13). Smith discovered four categories of research common to Watson’s theory. These

are:

a) the nature of nursing caring

b

) nursing caring behaviors as perceived by clients and

nurses

c) human experiences and caring

needs

d

) evaluating outcomes of caring in nursing practice and education (Smith, p. 14

).

As

Smith’s research indicates, it is a review of all research available specifically

focusing

on Jean Watson’s and is the sole subject of Smith’s research.Slide11

Research

Findings

Journal of Health and Human Services Administration Healthcare inter/national clinical and educational systems incorporating Caring Theory into professional nursing practice models (many hospitals are Magnet hospitals or preparing to become Magnet hospitals) are examples of the changing momentum today, and are guided by a shift toward evolved consciousness. They rely on moral, ethical, philosophical, and theoretical foundations to restore human caring and healing and health in a system that has gone astray – educationally, economically, clinically, and socially.

This

shift is in a hopeful direction, and is based on a grass roots transformation of nursing, one that is from the inside out

.

The dedicated leaders who are ushering in these changes serve as an inspiration for sustaining nursing and human caring for practitioners and patients alike (Journal of Health and Human Services

Administration, 2009).Slide12

Research Findings

Perry

Perry states nurses that are “working in clinical settings are observed. Patients, family members, students, and other nurses watch their actions and interactions. Often these nurses are role models potentially influencing the behaviors and attitudes of others in either positive or negative ways. Knowingly or unknowingly their words and actions become living lessons” (Perry, p. 36)Perry points out that the study revealed the “major theme was that the exemplary clinical nurses were also excellent role models”. The themes included “attending to the little things, making connections, modeling, and affirming others. The themes are within the framework of Watsons’s “transpersonal caring”, (Watson, 1989). “A link is made between role modeling and the sharing of craft knowledge” (Perry, 2008, p. 37). Slide13
Slide14

Critique of the

Research

CarusoCaruso et al (2008) stated that “nurses found it difficult to verbally capture and communicate the essence of what nurse do and what nurses know” (Caruso et al, p. 130) in response to reflect on one of four questions created by a group of nurses tasked with representing clinical practice applications in the theory of human caring. Caruso et al also points out “the many nurses were unfamiliar with the Theory of Human Caring and that an education model was developed to describe the model and its use within the 3-tenet (Clinical Practice, Education and Research) environment” (Caruso et al, p. 131).Slide15

Critique of the

Research

SmithSmith (2004) identifies several weaknesses in the body of research. “The research is lagging behind Watson’s most recent theoretical work. Watson’s theory has evolved significantly, and inquiry related to her early work on the carative factors was in process as the theoretical thing moved toward a more unitary-transformative worldview. Another weakness is that many of the published studies have weak theoretical-empirical linkages, that is, the relations of the finding to the theory are not explicit” (Smith, p. 15).Slide16

Critique of the

research

Journal of Health and Human Services Administration The Journal of Health and Human Services Administration writes this particular article with an obvious slant toward the positives of Jean Watson’s theory. Negatives mentioned in personal nursing practices as well as hospitals all can be eliminated by infusing Watson’s theory according to the article.Personal nursing practice example

:

It has been reported in some comprehensive summary research that nurses who are not able to practice caring can become hardened, brittle, worn down, and robot-like. (Swanson, 1999).

Hospital example

: The journal reflects that hospital nurses are required to be a part of a “human spirit inspired” approach in order to lessen the lethargy and open their hearts. Lethargy and open-heartedness cannot be dictated.

Providing an environment conducive to practicing Watson’s theory is the hospital’s responsibility and choosing to practice human caring is the nurse’s responsibility. (Journal of Health and Human Services Administration, 2009).Slide17

Critique of the Research

Perry

Perry states the research is limited “investigating how role modeling by exemplary practitioners can be used to teach nursing in clinical practice arenas. The study described here provides a beginning point for an exploration of this phenomenon” (Perry, 2008).Slide18

Implications for

Practice

CarusoCaruso et al (2008) articulates implications for personal practice as related to some of Jean Watson’s caritas processes in that “authenticity involves a sense of self to be intentionally present with the patient or others. It means turning attention to what the persona is experiencing to support the individual in his or her belief system and discovering the things that will sustain and inspire hope or faith for that person (Caruso et al, p. 128). Caruso et al also states “the art of caring involves a spirit of exploring and discovering other approaches to care that build on the unique aspects of this client and the situations that might lend themselves to creative or artistic approaches to healing” (Caruso et al, p. 128).Slide19

Expressions of Caring

Introduce yourself

Focus on the patientBe engagedGive clear information to decrease uncertaintyEncourage patient expressionGive good physical careHelp patient establish realistic goalsSlide20

Implications for Practice

Journal of Health and Human Services Administration

Nurses are torn between the human caring values and the “calling” that attracted them to the profession, and the technologically, high paced, task-oriented biomedical practices and institutional demands, heavy patient load, and outdated industrial practice patterns (Watson & Foster, 2003). Considering the electronic systems currently used in hospitals, nurses are very challenged to include human caring as well as technological requirements.Slide21

Implications for Practice

Perry

Perry used an example that summarizes Watson’s theory. “I watched an exemplary nurse named Mary maintain the dignity of a man through the way she changed his dressing. Again in this situation it was the way she did the procedure that made her work outstanding, specifically the subtle ways she showed respect for the patient. It was the little things, the gentleness of her hands, the confidence of her voice, the extra drape placed discreetly over exposed parts of his body during the dressing change that made her care outstanding” (Perry, p. 39). This example is exactly a perception that exemplifies Watson’s caring theory. Slide22

Critical

Reflection

CarusoCaruso et al (2008) states “current focus on empirical date and evidence-driven nursing practice highlights the need to reexamine the importance of nursing theory to guide practice (Caruso et al, p. 126). Furthermore “a theoretical context for nursing is desirable so that thoughts and behaviors can be seen in a broader, systematic perspective of caring for the person as a comprehensive whole (Caruso et al, p. 127). Slide23

Critical

Reflection

SmithSmith (2004) describes “four categories of research related to Watson’s theory. They are a) the nature of nurse caring; b) nurse caring behaviors as perceived by clients and

nurses;

c) human experiences and caring

needs, and d

) evaluating outcomes of caring to nursing practice and education” (Smith, p.

14

).

While all categories of research utilized Watson’s theory, Smith relates the evaluation outcomes of caring to nursing practice and research may have the greatest significance in that studies mentioned “attempt to link healing outcomes with caring” (Smith, p. 15). Slide24

Critical Reflection

Journal of Health and Human Services Administration

Watson’s theory continues to provide a useful and important metaphysical orientation for the delivery of nursing care. The theory does not lend itself easily to research through traditional scientific methods. Watson’s theoretical concepts, such as the use of self, patient-identified needs, the caring process, and the spiritual sense of being human, may help nurses and their patients to find meaning and harmony in a period of increasing complexity (Alligood &

Tomey

, 2010, p. 102).Slide25

Critical Reflection

Perry

Perry reflects “role modeling may be useful to those who teach clinical nurses, both formally and informally, in practice settings. Exemplary practice nurses should be placed in situations in which they can share their craft knowledge with less knowledgeable peers and students. These practitioners have a unique opportunity to positively influence patient care outcomes, continuity of care, and the professional development of staff through role modeling as a way of sharing their craft knowledge” (Perry, p. 43).As stated in Kearney and Nunnery, “theory guides practice, but current knowledge and practice must be based on evidence of efficacy rather than intuition, tradition, or past practice” (Kearney and Nunnery, p. 104).Slide26

References

Kearney-Nunnery, R. (2008).

Advancing your career: Concepts of professional nursing (4th ed.). Philadelphia, PA: F. A. Davis Company

.

Caruso, E.A.,

Cisar

, N. & Pipe T. (2008). Creating a healing environment: An innovative education approach for adopting Jean Watson’s theory of human caring.

Nursing Administration Quarterly,

32. 126-132.

Smith, M. (2004). Review of research related to Watson’s theory of caring.

Nursing Science

Quarterly, 17

. 13-25.

doi

: 10.1177/08934318403260545.

Jean Watson

. (2009).

Journal of Health and Human Services Administration

.

Vol. 31, 

Issue 4,

p. 

466-82. Retrieved from

http://

proquest.umi.com/pqdweb?did=1667629091&Fmt=6&clientId=52840&RQT=309&VName=PQD

Munson Medical Center. (2009). Nursing Annual: Munson Adopts “Theory of Human Caring.”

Retrieved from

http://mmc-websrv.mhc.net/Home/MMC/Nursing/Magnet+Recognition+Program/Annual+Report.htmSlide27

References

Swanson, K. (1999) What is known about caring in nursing research: a literary meta-analysis. In A.S. Hinshaw, S. Feetham, and J. Shaver (Eds.) Handbook of Clinical Nursing Research (pp.31-60). Thousand Oaks, CA.: Sage Publications.

Perry

, Beth (May, 2008). Nurse Education in Practice.

Role modeling excellence in

clinical nursing

practice

. Center for Nursing and Health Studies,

Athabasca

University pp. 36 - 44

.

Swanson, K. (1999) What is known about caring in nursing research: a literary meta-analysis. In A.S.

Hinshaw

, S.

Feetham

, and J. Shaver (

Eds

). Handbook of Clinical Nursing Research

(pp. 31-60). Thousand Oaks, CA.: Sage Publications.

Watson, J. & Foster, (2003) The Attending Nurse Caring Model: integrating theory, evidence and advanced caring-healing therapeutics for transforming professional practice.

Journal of Clinical Nursing

, 12, 360-365.

Alligood

, M.R. &

Marriner-Tomey

, A.M. (2006). Nursing theorists and their work

(

6

th

ed.). St. Louis, MO: Mosby Elsevier.