“Caring” is an important concept in nursing. No matter where the nurse works: hospital; hospice; doctor’s office, an attitude of caring is required. What is caring though? How can we define? What characteristics can a nurse demonstrate that would tell a patient that the nurse cares? Jean Watson’s model of Caring Science and Theory encompasses philosophical, theoretical and moral foundation for nursing (Watson 2009). Caring Science Theory and Watson’s contributions in this area are shaping the way nurses approach their practice. Watson’s original work was the Ten Carative Factors. Over the years and through more research she developed the Ten Caritas Processes which expands and solidifies her original work. Both define attributes both interpersonal and intrapersonal for the nursing profession.
The first Caritas is “Embrace altruistic values and Practice loving kindness with self and others.” (2014). This Caritas embraces respect for a patient the nurse being open and available to them. Observable behaviors would include: listening to the patient; paying attention to others and treating others with kindness. The nurse honors their own gifts and talents. A nurse’s motivation in practice should always be unselfish and rooted in goodness.
The second Caritas is an “Instill faith, hope and honor in others” (2014). Listening to the patient, allowing time for reflection and incorporating the patient’s values into the care plan are some of the tenets. An attitude of approaching life and exploring it rather that solving problems as they come up. Simple behaviors include making eye contact and calling the patient by their preferred name.
“Be sensitive to self and others by nurturing individual beliefs and practices” (2014). Through journaling and reflection, a nurse becomes more aware of their beliefs and values as well as encouraging growth. Not being judgmental of others, transforming “tasks” into healing moments and valuing intrinsic goodness in others and self are the key concepts of this Caritas.
The fourth Caritas proposes that the nurse enters into an experience to explore possibilities of the moment. “Develop helping – trusting- caring relationships” (2014). To develop a relationship at this level, verbal and nonverbal communication are important, both expressively and receptively. This communication should be open and honest.
“Promote and accept positive and negative feelings as you authentically listen to another’s story”. The end result of communication is to understand others. To listen to a patient as they tell their story, the nurse should encourage this expression, both the good and the bad. The nurse should be tolerant and nonjudgmental in these situations. Not allowing negativity in the process to take hold of one’s thoughts is also important. Helping others to see the positive of their situation is also paramount.
The sixth Caritas, “Use creative scientific problem-solving methods for caring decision making” (2014). Not only should nurses be up to date on scientific theory and practices in medicine, they need to know how to apply it creatively. The search for alternatives for the patient is also encouraged. Use of one’s self to promote healing through touch, voice laughter and smiling are just some of the acts a nurse can do to apply this Caritas.
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The seventh Caritas also deals with communication and also with teaching and learning. Share teaching and learning that addresses the individual needs and comprehension styles. “Share teaching and learning that addresses the individual needs and comprehension styles” (2014). Speaking calmly, respectively and truly listening to others. Learning from others what their views and opinions are and incorporating this knowledge into their practice. Participating in higher education and collaboration with others in the health care field. Helping patients to understand their health and helping them formulate questions to clarify with other health care workers and doctors.
“Create a healing environment for the physical and spiritual self which respects human dignity” (2014). The creation of space that promotes healing is the main idea of this principle. The nurse is aware of factors in the environment such as: light, water, air, noise, cleanliness, privacy nutrition, safety and comfort. Also being aware of and recognizing the patient’s routines and rituals are very important.
Viewing others as an integrated whole and respecting their individual needs is significant. “Assist with basic physical, emotional, and spiritual human needs” (2014) is the ninth Caritas. Making the patient feel whole, comfortable and respecting their perceptions of the world. Being respectful and understanding of the patient’s family and significant others fits into this Caritas.
The last Caritas is the most important in the practice of caring in nursing: “Open to mystery and Allow miracles to enter” (2014). Being accepting of the unknown, surrendering control and accepting miracles and understanding for the unexpected and inexplicable that occur in life. This last Caritas asks the nurse to be open and accepting which can be a difficult idea for many. By being open and appreciating the surprises life brings, the good and the bad, help the nurse to be comfortable and at peace with life’s circumstances.
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The Ten Caritas Processes are an interesting set of principles to help guide nursing practice. The have evolved over the years as Watson has devoted time to more research on the subject. They provide a guiding framework for nursing that promotes understanding and respect.
References
Watson, Jean (2009). Caring science and human caring theory: transforming personal and
professional practices of nursing and health care. Journal of Health and Human Services
Administration. 31(4), 466-482.
Watson, Jean (2014). Caring theory and research. Watson Caring Science and Institute and
International Caritas Consortium, http://watsoncaringscience.org/
