The Twenty-First Century has blessed the medical world with a myriad of technological advances: superior health care and training mechanisms, increased patient safety, effective care coordination between different physicians and medical facilities, more efficient equipment, expedited lab results, thorough documentation of care for patient’s access, and so on (Rauv, 2017).
On the flip-side, too many times in the medical field, nurses, and other medical professionals have dehumanized patient care. Due to the technology era that we live in, a nurse’s duties have dramatically heightened leading to less and less time spent between the patient and the physician. Shorter and colder interactions have dramatically increased to the point where healthcare professionals neglect to get to know and care for their patients, treating patients as a medical case or objects rather than an actual human being. Such interactions should never be the case, especially in the medical setting when a patient is in such a vulnerable state of mind and body.
As defined by the eminent Nursing Philosopher, Jane Watson, nursing is a “human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human care transactions” (1988b, p. 54). Through her Theory of Human Caring, Watson has established the importance of the nurse-to-patient interaction through three imperative concepts of nursing: The carative factors, the transpersonal caring relationship, and the caring occasion/caring moment that all emphasize care in the nursing practice.
Jean Watson has been an influential part of the development of nursing curriculum for the baccalaureate program in health, human caring, and healing. Watson specifically has emphasized that while nursing is a skill-based practice, it is more than just a job and truly about the rapport established between the nurse and patient. According to Watson, caring is the quintessential element of Nursing.
In her article, “Caring Science and Human Caring Theory: Transforming personal and professional practices of nursing and health care.” She states that Caring is a professional ethical covenant that nursing has with the public to sustain human caring in instances where it may be threatened; it necessarily involves something deeper and more substantial than a ‘customer model’ orientation (Watson, 2009, p. 470).
In Jean Watson’s Theory of Caring, she incorporates kindness, harmony between the mind body and soul, concern, and love not only for the patient but also for the nurse. She believes that nurses have the potential to make a difference and can help individuals achieve a state of optimal health by providing an environment that fosters awareness and consciousness of the patient and nurse as holistic beings. Nurses are the patient’s support system; through their authenticity and caring demeanor, nurses can establish a trusting and humane relationship with their patients (Chitty, Black, 2017, p. 271). Such a relationship creates a mutual understanding between a patient and nurse, making patients feel safe to express their emotions and own perspectives.
First and foremost, Jane Watson developed the carative factors as the original blueprint for professional nursing practice. The carative factors were developed in 1979 as ten diverse components that distinguish indispensable actions that nurses must take into account that a nurse’s end goal is not only to provide proper and sufficient customer service because it is a part of their job description but how to implement humanistic and individualized care to each patient they encounter. This is not to be confused with “curative factors” which Watson defines as a medical term such as curing a patients’ disease (Tomey, Alligood, 2006).
In short, the carative elements consist of the Humanistic-altruistic Values; Instilling/enabling Faith-Hope; Sensitivity to self and others; Helping-trusting, human care relationship; Expression of positive and negative feelings; Creative problem-solving caring process; Transpersonal teaching-learning; Supportive, protective, and/or corrective mental, physical, societal, and spiritual environment; Human needs assistance; and the Existential-phenomenological-spiritual dimensions (Watson, 2007).
In 1998, the caritive factors were later revised as the “caritas processes” which literally translates to “cherish, to appreciate, to give special if not loving, attention to” in Greek (Watson, 2008, p.39). The caritas processes build upon the foundation of nursing practice providing not only a more explicit guideline for nurses to follow, but pertains more to the essence of the nurse-to-patient relationship by creating a spiritual and worldly dimension to these newly revised processes including but not limited to the transpersonal caring relationship, caring occasion and a caring moment (Watson, 1997).
Taking both the carative factors and the caritas processes into account, the transpersonal caring relationship opens up another dimension on the spiritual connection between both nurse and patient. Watson specifically describes the transpersonal nurse as one who “has the ability to center consciousness and intentionality on caring, healing, and wholeness, rather than on disease, illness and pathology”(Watson Caring Science Institute and International Caritas Consortium, 2013). Such a deep and special kind of commitment portrays a nurse’s abilities to go beyond doing their job.
While it is their duty to perform an objective assessment of their patience medial dilemma, a transpersonal nurse will go above such a task by tapping into their patient’s inner-being, or spirit and soul. In other words, a nurse will put aside their own ego and personal life to heal and care for their patient. A nurse involved in such a practice shows legitimate concern for the well-being of their patient as well as their own well-being. Not only is the nurse genuine in their delivery of care, but they are fully focused on their patient and their needs to provide the most effective healing and comfort for their patients.
The Transpersonal caring relationship summons an ontological development, accentuating that how while the two—the nurse and their patient—are completely unique beings, they are both a part of a united alliance. The carative factors and the transpersonal relationship work in tandem to form the instant when the nurse and patient actually connect with one another. This component, otherwise known as the “caring occasion/caring moment”, is simply the exact point when the patient and nurse interact in such a manner that a moment for human caring is created not only physically, but also spiritually.
To quote Watson, “The self we learn about …is every self. IT is universal – the human self. We learn to recognize ourselves in others… their dilemmas in ourselves… (it) keeps alive our common humanity and avoids reducing self or other to the moral status of object” (Watson, 1988). The instances are not only meaningful to the patient, but also to the nurse and they have the potential to create an occasion of healing for the patient as well as creates meaning to the nursing profession. The caring occasion/caring moment is not just about a nurse doing their job. On the contrary, it is at this moment in time in which the totality of both human’s existence including their past, their viewpoints, ambitions in life, and feelings all mesh together in their human-to-human interaction during the nurse’s efforts to care for their patient.
Jean Watson’s holistic approach to caring for patient’s influences every aspect of the way care is delivered and taught in the sense that nurses make an effort to build relationships with their patients and ensure their dignity, trust, and comfort both mentally and physically. Watson’s theory has been integrated into the nursing school curriculum. Her theory is even exhibited simply through the way professors instruct their students. Besides teaching the necessary skills (science) to be a competent nurse, nursing professors and instructors incorporates how nursing is also an art form, encompassing nursing’s humanitarian and philosophical aspects. For instance, an instructor can portray an opportunity of caring between the nurse and patient through sharing their own experiences while working as a nurse.
Aside from the scholastic setting, a myriad of hospitals with magnet status have adopted Watson’s Theory of Caring as a framework for transforming nursing practice as well as incorporating holistic critical thinking in deciding if a patient is receiving the best line of care that is humanly possible. Her theory is being utilized in a variety of healthcare settings and throughout by various people and populations. Her theory is demonstrated in a number of clinical settings such as critical care units, neonatal intensive units, pediatric units, and gerontological units (Tomey & Alligood, 2006).