Running head: REFLECTIONS ON JEAN WATSON'S THEORY OF HUMAN CARING 1 Reflections on Jean Watson's Theory of Human Caring

The Theory of Human Caring over thirty years ago to the nursing profession. In the theory it is stated that caring is the essence of nursing and that professional nurses have an obligation to provide the best environment for healing to take place. The theory’s carative factors outlines principles and ideas that should be used by the professional nurse to create the best environment for healing of the patient and of the nurse. This paper will describe and critique Jean Watson’s Theory of Human Caring and discuss how this model has influenced nursing practice.  Even so, nursing has struggled to find an identity apart from medicine. For years nursing theorists have examined how nursing is unique from medicine. While it was obvious that nursing was a different art than medicine, there was not any scholarly work to illustrate the difference. During the 1950’s nursing began building a body of knowledge, which interpreted and conceptualized the intricacies of nursing. Over the next several decades, nurse theorists rapidly grew the discipline’s foundation. One of the concepts that emerged was nursing as caring. Several theorists have identified caring as being central to nursing; however, Watson’s Theory of Human Caring offers a unique perspective. The theory blends the beliefs and ideas from Eastern and Western cultures to create a spiritual philosophy that can be used throughout nursing practice. This paper will describe and critique Jean Watson’s Theory of Human Caring and discuss how this model has influenced nursing practice.  She was also greatly influenced by her background in philosophy, psychology and nursing science. Watson’s first book Nursing: The Philosophy and Science of Caring (1979) was developed to bring a “new meaning and dignity” to nursing care (Watson, 2008). The first book introduced carative factors, which are the foundation of Watson’s Theory of Human Caring. The carative factors offered a holistic perspective to caring for a patient, juxtaposed to the reductionist, biophysical model that was prevalent at the time. Watson believed that without incorporating the carative factors, a nurse REFLECTIONS ON JEAN WATSON'S THEORY OF HUMAN CARING 4 was only performing tasks when treating a patient and not offering professional nursing care (Watson, 2008). In Watson’s second book, Nursing: Human Science and Human Care, A Theory of Nursing (1985), she discusses the philosophical and spiritual components of the Theory of Human Caring, as well as expands upon the definition and implications of the transpersonal moment. The second book redefines caring as a combination of scientific actions, consciousness and intentionality, as well as defines the transcendental phenomenology of a transpersonal caring occasion and expands upon the idea of human-to-human connection. Watson’s third book, Postmodern Nursing and Beyond (1999), focuses on the evolution of the consciousness of the clinician. The third book reinforces the ideas of the first two books and further evolves several concepts to include the spiritual realm, the energetic realm, the interconnectedness to all things and the higher power. The philosophy behind each book and the Theory of Human Caring is that all human beings are connected to each other and to a divine spirit or higher power. Furthermore, each interaction between human beings, but specifically between nurses and patients, should be entered into with the intention of connecting with the patient’s spirit or higher source. Each moment or each act can and should not only facilitate healing in the patient and the nurse, but also transcend both space and time. The components of Watson’s theories include the 10 carative factors, the caritas process, the transpersonal caring relationship, caring moments and caring/healing modalities. Carative factors are the essential characteristics needed by the professional nurse to establish a therapeutic relationship and promote healing. Carative factors are the core of Watson’s philosophy and they are (i) formation of a humanistic-altruistic systems of values, (ii) instillation of faith-hope, (iii) cultivation of sensitivity to one’s self and to others, (iv) development of a helping-trusting REFLECTIONS ON JEAN WATSON'S THEORY OF HUMAN CARING 5 human caring relationship, (v) promotion and acceptance of the expression of positive and negative feelings, (vi) systematic use of a creative problem solving and caring process, (vii) promotion of transpersonal teaching-learning, (viii) provision for supportive, protective, and/or corrective mental, physical, societal and spiritual environment, (ix) assistance with gratification of human needs and (x) allowance for existential-phenomenological-spiritual forces. Carative factors are intended to provide a foundation for the discipline of nursing that is developed from understanding and compassion. Watson’s caritas processes are the expansion of the original carative factors and are reflective of Watson’s own personal evolution. The caritas processes provide the tenets for a professional approach to caring, a means by which to practice caring in a spiritual and loving fashion. The transpersonal caring relationship is a relationship that goes beyond one’s self and creates a change in the energetic environment of the nurse and the patient. A transpersonal caring relationship allows for a relationship between the souls of the individuals and because of this authentic relationship, optimal caring and healing can take place (Watson, 1985). In the transpersonal relationship the caregiver is aware of his/her intention and performs care that is emanating from the heart. When intentionality is focused and delivered from the heart, unseen energetic fields can change and promote an environment for healing. When a nurse is more conscious of his or her self and surroundings, he or she acts from a place of love with each caring moment. Caring moments are any moments in which a nurse has an interaction with a patient or family and is using the carative factors or the caritas process. In order for a caring moment to occur the participation of the nurse and the patient is required. Practice based on the carative factors presents an opportunity for both the nurse and patient to engage in a transpersonal caring REFLECTIONS ON JEAN WATSON'S THEORY OF HUMAN CARING 6 moment that benefits the mind, body and soul of each person. The caring/healing modalities are practices that enhance the ability of the care provider to engage in transpersonal relationship and caring moments. Caring/healing exercises can be as simple as centering, being attentive to touch or the communication of specific knowledge. The goal of using Watson’s principles in practice is to enhance the life and experience of the nurse and of the patient.  The Theory of Human Caring was developed based on Watson’s desire to reestablish holistic practice in nursing care and move away from the cold and disconnected scientific model while infusing feeling and caring back into nursing practice (Watson, 2008). The purpose of the theory was to provide a philosophical-ethical foundation from which the nurse could provide care. The proposed benefit of this theory for both the nurse and the patient is that when each person reveals his or her authentic self and engages in interactions with another being, the energetic field around both of them will change and enhance the healing environment. The theory’s purpose is quite broad, promoting healing and oneness with the universe through caring. The positive impact of these practices is phenomenal and the beauty of the theory is that the caritas processes can be used to enhance any practice. When applied to nursing practice, the theory reestablishes Florence Nightingale’s vision that nursing is a spiritual calling. The deeper message within the theory is that being/relating to others from a place of love can transcend the planes and energetic fields of the universe and promote healing to one’s self and to