Importance of Nursing Theory
Introduction
Nursing, in general, refers to the nurturing and caring for a sick person. But over the years, such duties are institutionalized and carried out in a professional and scientific manner. Today, nursing has become a specific profession. Nurses are formally educated in their field and trained in the science and art of nursing, which have been developed over the years of study and research. Although, one does not need to have a background in the nursing profession in order to perform such task, caring and nurturing becomes more effective for those who are knowledgeable and experienced in nursing. The beginning of nursing as a distinct discipline can be traced to Florence Nightingale, a British nurse who took the initiative to focus on the training and education of nurses (Masters, n.d., p. 47). Over the years, a plethora of theories about nursing emerged. These theories are then organized and put into meaningful practice, particularly in the training and education of modern nurses. Nursing theories provide a theoretical framework that is essential in the practice of the nursing profession. One of the most important nursing theories is the ‘Human Caring Theory.’ Developed by Dr. Jean Watson, a professor of nursing at the University of Colorado in the 1970s, the Human Caring Theory or Human Caring Model is described as a reconciliation of nursing and psychological practices. Being educated both in nursing and psychology, Watson combined acceptable nursing practices with her knowledge in human psychology in order to “bring meaning and focus to nursing as an emerging discipline and distinct health profession that had its own unique values, knowledge, and practices, and its own ethic and mission to society”. Watson’s ‘Human Caring Theory’ has become a universal nursing theory that is being adopted in most nursing curriculums today.
A theory is defined as “an organized, coherent, and systematic articulation of a set of statements related to significant questions in a discipline that are communicated in a meaningful whole” (Masters, n.d., p. 48). Until it is proven wrong, a theory remains the most significant conceptual tool or model that guides the practice and further research and development of a particular discipline or profession. It is, therefore, important to include nursing theories in the study of nursing, particularly in the master’s program nursing theories provide a theoretical framework, which forms the basis of the modern nursing profession. Theories are important in nursing, primarily because nursing, as a practice, can be conducted in a variety of ways. Without a theoretical framework, the practice of nursing can become easily disorganized and unfocused, with no clear purpose or objective. Being a “systematic accumulation of knowledge,” theories are essential to the advancement of any profession (Alligood, 2014, p.2).
The importance of theory in any profession could not be undermined. According to experts, theory must be coupled with the practice since “theory without practice is empty and practice without theory is blind” (Alligood, 2014, p.2). It is often easy to relate nursing theories with the theories of other healthcare professions, primarily because most medical practitioners share common core values, ethical principles and clinical practices. However, nursing theories can be identified because it focuses not only on the clinical aspect of healthcare, but also on the human aspect of care. Nursing theories reflects the mandate of the nursing profession, which, according to the American Association of Colleges of Nursing, is “to optimize the health and well-being of populations”. For the same reason, most nursing theories are often broad, encompassing different domains that include not only nursing, but also a client-nurse relationship, environment and practice (Kim & Kollak, 2006, p. 4).
The challenge in the use of nursing theories is not on its inadequacy, but rather on its plurality. Because of the many nursing theories that has been developed over the years, it is often difficult to make sense of all them all and how they can be put into effective practice. With the development of the many nursing theories, it has become challenging and sometimes confusing to determine what theory to utilize in a particular situation. It is, therefore, important to become acquainted with different nursing theories in order to increase the nursing practitioner’s arsenal in providing quality healthcare.
Jean Watson’s Human Caring Theory
The theory of human care is a nursing theory attributed to Dr. Jean Watson, a professor of nursing in the University of Colorado. It is believed that the theory was developed by Watson between 1975 and 1979, which, he later on introduced in a book entitled ‘Nursing: The Philosophy and Science of Caring,’ (Watson, J., 2014; Kim & Kollak, 2006, p. 172). This book was published in 1979 and was used as a textbook in an integrated nursing program at the University of Colorado (Alligood, 2014, p.96). The book laid the foundation of many other books authored by Watson that is based on human caring theory; the latest of which is the book, ‘Human Caring Science: A Theory of Nursing,’ which was published in 2011 (Alligood, 2014, p.96). Watson’s theory of human care suggests that, “the goal of nursing is to help persons attain a higher level of harmony within the mind-body-spirit” (Masters, n.d., p. 51). Accordingly, the attainment of such harmony also increases the potential of healing (Masters, n.d., p. 51).
Jean Watson’s Caring theory or model seeks the balance between the physical, mental and spiritual healing process. The theory is based on three major concepts; the first of which is caritas or carative factors. Watson developed the ten carative factors, which she further revised and developed into the ten Clinical Caritas Processes. Originally, the ten carative factors are: 1) Formation of a humanistic–altruistic system of values; 2) Instillation of faith–hope; 3) Cultivation of sensitivity to one’s self and to others; 4) Development of a helping–trusting, human caring relationship; 5) Promotion and acceptance of the expression of positive and negative feelings; 6) Systematic use of a creative problem solving caring process; 7) Promotion of transpersonal teaching– learning; 8) Provision for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment; 9) Assistance with gratification of human needs; and 10) Allowance for existential–phenomenological–spiritual forces .
The second major concept of Watson’s human caring theory is the ‘transpersonal caring relationship,’ which suggests that care should go beyond the physical attachment and “seeks to connect with and embrace the spirit or soul of the other through the processes of caring and healing and being in authentic relation in the moment”. Watson believes that despite the patients’ illness or disability, the nurse should view them as a whole because the nurse looks into the patients’ inner self and not in the physical aspect alone. The concept of the transpersonal relationship suggests that the nurse should treat the person with respect, love and compassion, knowing that he or she is dealing with a spiritually whole and complete person regardless of their diseases.
Lastly, the third major concept is the caring moment or caring occasion. According to Watson, a caring moment occurs between a nurse and a patient while interacting with each other. The caring moment is an opportunity wherein the nurse and the patient can establish a transpersonal relationship with each other. If executed properly, the caring moment can become a positive experience both for the nurse and the patient that could significantly contribute to the patient’s healing process. Many scholars acknowledge that Watson’s caring theory is one of the most relevant theories in modern nursing. Chantal Cara, a University of Montreal professor, for instance, observed that Jean Watson’s caring theory can be seen as an ‘indispensable tool’ to address the changing health care environment. Some see Watson’s Human Caring Theory as a ‘paradigm shift’ in the nursing profession because it focused more on care rather than the traditional nursing that is more focused on the clinical aspect of the profession.
Watson’s theory of human care touches on the four metaparadigms of the nursing profession. These four central concepts are person, environment, health and nursing. Watson’s theory of human care impacts the person metaparadigm by advocating unity of the mind, body and spirit. The theory of human care also impacts the environment by promoting a non-physical environment wherein the “the nurse is not only in the environment, but the nurse is the environment” (Masters, n.d., p.52). In terms of health, the theory of human care promotes wholeness, harmony, and comfort (Masters, n.d., p.52). Moreover, its carative factors as well as its emphasis on transpersonal relationship in caring moments contribute significantly to the theory’s nursing metaparadigm. Watson’s theory of human care is an important topic in advance nursing studies, such as in a master’s program, because the theory goes beyond the clinical aspect of nursing as a profession. This theory provides a holistic approach to healthcare, which is important in master’s track that focuses on nursing practice. However, the theory also requires nurses to acquire new skill sets, particularly soft skills in dealing with patients.
Application of Specific Nursing Theory to Selected Professional Nursing Practice Area
The caring model was meant as a guide for nursing practitioners as it emphasizes not only the clinical or hard skills required to practice the nursing profession, but also the soft skills, which are equally important in providing quality healthcare. Nursing practitioners should always bear in mind that their clients are human beings and they should always be regarded as persons regardless of their health status. Watson’s theory suggests that an effective nurse practitioner focuses not only on the physical aspect, but also on the non-physical aspect of a person. Watson’s human caring model promotes inner healing, believing that the component that makes up the human being, such as the body, the soul and the spirit, is acknowledged in the nursing process.
Watson’s human caring theory may be attributed to many real life scenarios wherein the patient experiences a significant improvement in the quality of life. This improvement, even applies to patients suffering from terminal diseases such as cancers. Nurses that practice palliative care utilize Watson’s human caring model in improving their patient’s quality of life. As observed by scholars, “Watson’s theory of human caring was chosen as a framework for the delivery of palliative care because of its compatibility with the philosophy of palliative care nursing” (McKay, Rajacich, & Rosenbaum, 2002, p.34). At times, the healing of serious illnesses may seem unexplained and deviate from established medical norms. However, based on the Watson’s caring model, such healing may occur and is a possibility. Watson’s caring model opens the possibility of miracle or spiritual healing, which may deviate from the scientific traditions of nursing. Watson’s caring model is also observed to have a positive effect on patients with hypertension. In a study conducted by scholars, it was found that Watson's Caring model increased the quality of life of patients with hypertension (Erci, Sayan, Tortumluoglu, Kiliç, Sahin, & Güngörmüş, 2003). It is subsequently recommended by the same scholars who conducted that study that the Watson caring model should be used to guide nursing practitioners in dealing with hypertensive patients (Erci, Sayan, Tortumluoglu, Kiliç, Sahin, & Güngörmüş, 2003).
Conclusion
Nursing theories are important in the practice of the nursing profession because they provide the framework that serves as guide for nursing practitioners. Furthermore, nursing theories support the nursing metaparadigms of people, environment, health and nursing. Over the years, many nursing theories have been developed and are still being developed. Just like other professions and disciplines, the nursing profession is still a work in progress wherein every discovered theory opens new doors towards a better and more quality focused healthcare. One of these major nursing theories is Jean Watson’s Human Caring theory or model. Under this theoretical framework, Watson suggested that patients should not be perceived as just mere objects in nursing, but as persons who require holistic nurturing and care. Watson’s theory is based on three major concepts that aim to guide nursing practitioners in their delivery of care. These major concepts are the carative factors, the transpersonal caring relationship, and the caring moment or caring occasion. Watson’s human caring model does not only focus on the physical needs of a patient, but also on their psychological and spiritual needs; hoping to initiate an environment that promotes wholeness, harmony and comfort. This environment, according to Watson, is essential in the healing process as well as in the improvement of the patient’s quality of life. Watson’s caring model can be effectively utilized in almost all nursing practice, particularly in hypertensive patients. It is also recommended in patients who are under palliative care.
References
Alligood, M. (2014). Nursing Theory: UTILIZATION & APPLICATION, 5th Ed. Retrieved August 2016, from http://www.rhc.ac.ir/: http://www.rhc.ac.ir/Files/Download/pdf/nursingbooks/Nursing%20Theory%20Utilization%20&%20Application-2014%20-%20CD.pdf
American Association of Colleges of Nursing. (2016). Nursing Research. Retrieved August 2016, from http://www.aacn.nche.edu/: http://www.aacn.nche.edu/publications/position/nursing-research
Cara, C. (n.d.). A Pragmatic View of Jean Watson’s Caring Theory . Retrieved August 2016, from http://watsoncaringscience.org/: http://watsoncaringscience.org/files/PDF/Pragmatic_View.pdf
Current Nursing. (2012). Jean Watson's Philosophy of Nursing. Retrieved August 2016, from http://currentnursing.com/: http://currentnursing.com/nursing_theory/Watson.html
Erci, B., Sayan, A., Tortumluoglu, G., Kiliç, D., Sahin, O., & Güngörmüş, Z. (2003). The effectiveness of Watson's Caring Model on the quality of life and blood pressure of patients with hypertension. Retrieved from http://www.ncbi.nlm.nih.gov/: http://www.ncbi.nlm.nih.gov/pubmed/12519271
Gessner, G. (n.d.). Nursing Model: Jean Watson’s Caring Theory. Retrieved August 2016, from blogs.commons.georgetown.edu: https://blogs.commons.georgetown.edu/gtg6/files/Nursing-Model.pdf
Kim, H.S., & Kollak, I. . (2006). Nursing Theories CONCEPTUAL and PHILOSOPHICAL FOUNDATIONS, 2nd Ed. Retrieved August 2016, from http://vct.qums.ac.ir/: http://vct.qums.ac.ir/portal/file/?180438/nursing-theoris-and-details.pdf
Masters, K. (n.d.). Framework for Professional Nursing Practice. Retrieved August 2016, from http://samples.jbpub.com/9781449691509/81982_CH02_Pass1.pdf
McKay, P., Rajacich, D., & Rosenbaum, J. (2002). Enhancing palliative care through Watson’s carative factors. Retrieved from http://www.canadianoncologynursingjournal.com/: http://www.canadianoncologynursingjournal.com/index.php/conj/article/view/416/417
Watson, J. (2014). Jean Watson’s Theory of Human Caring. Retrieved August 2016, from http://watsonibb.erciyes.edu.tr/: http://watsonibb.erciyes.edu.tr/wp-content/uploads/2015/01/3312_Ch18_321-340.pdf
Watson, J. (n.d.). THEORY OF HUMAN CARING. Retrieved August 2016, from http://watsoncaringscience.org/: http://watsoncaringscience.org/images/features/library/THEORY%20OF%20HUMAN%20CARING_Website.pdf
