LEARNING THEORY GROUP PRESENTATION: JEAN WATSON By: April Bilbe, Ashley Denhartigh, Barb Hulwick,...
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LEARNING THEORY GROUP PRESENTATION: JEAN WATSON By: April Bilbe, Ashley Denhartigh, Barb Hulwick, Dana Raymer & Deborah Schaefer [Photograph of Jean Watson]. (2010). 4 th Annual Envision Conference Nursing: The Art and Science of Caring. Oakland University, Rochester, MI.
LEARNING THEORY GROUP PRESENTATION: JEAN WATSON By: April Bilbe, Ashley Denhartigh, Barb Hulwick, Dana Raymer & Deborah Schaefer [Photograph of Jean Watson]
LEARNING THEORY GROUP PRESENTATION: JEAN WATSON By: April
Bilbe, Ashley Denhartigh, Barb Hulwick, Dana Raymer & Deborah
Schaefer [Photograph of Jean Watson]. (2010). 4 th Annual Envision
Conference Nursing: The Art and Science of Caring. Oakland
University, Rochester, MI.
Slide 3
Questions & Problems to Solve Why are we doing this
assignment? Why did we choose Jean Watsons Theory of Caring?
Evaluate: What is Jean Watsons Theory of Caring? What are the
origins of Jean Watsons Nursing Model? What is Jean Watsons
historical background? What are Jean Watsons philosophic values re:
nursing and knowledge? What influenced Jean Watsons Philosophy?
Information & concepts: How does this model define the four
global concepts? What is our interpretation & inference and
what are some possible implications & consequences? When could
this model be used in practice? What are the 10 Carative Factors?
What is an example of a case study?
Slide 4
Why are we doing this assignment?
Slide 5
The Purpose of This Project is to: Compare and contrast nursing
models, chosen at random, by peers. Practice working effectively in
on-line groups. Demonstrate the use of the critical thinking
process using the elements of reasoning.
Slide 6
Why did we choose Jean Watsons Theory of Caring?
Slide 7
Some of us have seen Jean speak in person. Witnessing her
passion and talents as a speaker really made her stand out. No
matter the specialty realm, all nurses can relate to relationships
and caring.
Slide 8
Evaluate: What is Jean Watsons Theory of Caring?
Slide 9
Andrews & Arnerich (2008) state: The philosophy of caring
and science examines the relatedness of ALL and includes human
science, human caring processes, experiences and phenomena. Caring
is a moral ideal: mind-body-soul, engagement with another.
Slide 10
What are the Origins of Jean Watsons Nursing Model?
Slide 11
Watsons Motivation for Developing Her Model: Education Life
Experiences Exploration of Self
Slide 12
What is Jean Watsons historical background?
Slide 13
Historical Background O According to Jesse (2010), during an
undergraduate course Watson studied Yakoms 11 Carative Factors,
which led her to develop her own 10 Curative factors. O Her first
book Nursing: The Philosophy and Science of Caring (1979) was
developed off of the notes from these studies (p. 93). O Life
experiences were the motivation for her third book, Post Modern
Nursing and Beyond (1999). O Jesse (2010) explains that both the
tragic experience of losing her husband and the loss of her left
eye allowed her to experience her own theory at work, as the people
around her cared for her during these troubling times (p.93). O
Watsons fifth book Caring Science as Sacred Science (2005)
describes her own lifes passage. O This book leads the reader
through thought-provoking experiences and the sacredness of nursing
by emphasizing deep inner reflection and personal growth,
communication skills, use of self- transpersonal growth, and
attention to both caring science and healing through forgiveness,
gratitude, and surrender (Jesse, 2010, p. 93). O As a dedicated
learner, Watsons continual education has led her to think deeply
about nursing and the science of caring. O Her own life experiences
have shaped what her theory is today.
Slide 14
What are Jean Watsons philosophic values re: nursing &
knowledge development?
Slide 15
Watson calls for joining of science with humanities so that
nurses will have a strong liberal arts background and will
understand other cultures as a requisite for using Care Science and
a mind-body-spirit framework (Jesse, 2010, p. 96).
Slide 16
The nurse must connect with the patient on a spiritual level
through sincere presence. Jesse (2010) states (pp. 97-98) Watson
believes this connection is made through: Words Behaviors Body
Language Feelings Thoughts Senses Intuition Movements Gestures
Facial Expressions Information
Slide 17
A caring moment involves an action and choice by both the nurse
and the other. The moment of coming together presents them with the
opportunity to decide how to be in the moment and in the
relationship as where as what to do with and during the moment. If
the caring moment is transpersonal, each feels a connection with
the other at the spirit level, thus it transcends time and space,
opening up new possibilities for healing and human connection at a
deeper level than physical interaction (WCSI, 2009, Caring Science
Ten Caritas Processes, para. 7).
Slide 18
The nurses own life history, previous experiences,
opportunities for focused study, having lived through or
experienced various human conditions, and having imagined others
feelings in various circumstances are valuable teachers for this
work (Jesse, 2010, p. 98).
Slide 19
Caring in the nursing profession takes place every time a
nurse-to-patient contact is made... That caring makes a difference
to the patients sense of well being. Caring may occur without
curing but curing cannot occur without caring (Vance, 2003, para.
1).
Slide 20
What Influenced Jean Watsons Philosophy?
Slide 21
Theorists Florence Nightingale, Henderson, Leininger, Peplaw,
Rogers, Newman, and Gadow (Jesse, 2010, p. 94) Jesse (2010) states
She describes a close connection with Nightingales sense of
calling, guided by a deep sense of commitment and a covenantal
ethic of human service (Watson, 2007a) (p. 94)
Slide 22
Philosophy Influence Continued Philosophers Carl Rogers,
Maslow, Heidegger, Erickson, Kierkegaard, Emmanuel Levinas, Knud
Logstrup, Selye, Lazarus, Rumi, Whitehead, de Chardin, Sartre, and
Thich Naht Hanh (Jesse, 2010, p. 94) Although influenced by the
work of others, Watson based much of her work off of her own ideas,
values, and beliefs about life, health, and healing (Jesse, 2010,
p. 94).
Slide 23
Information and concepts: How does this model define the four
global concepts?
Slide 24
Human Being A nursing model that takes into account both the
art and science of nursing-considering mind, body and spirit of the
patient and the nurse A caring process-The privilege that nurses
have to uphold the commitment to present compassionate human caring
to society and humanity Ten Caritas process- Be sensitive to self
and others by nurturing individual beliefs and practices
Slide 25
Environment The Caring Theory is groundwork for healing
practices-it can be practiced in many settings; nurse, group,
system, organization, curriculum and population needs Many Magnet
hospitals, one of those being John C. Lincoln North Mountain
Hospital, have adapted Jean Watsons caring model as a framework to
guide their practice Caring in nursing is culturally diverse. The
caring model can be practiced across all nursing practices as a
vital method to study and explain the nursing knowledge
Slide 26
Health Caring Science-Uphold caring for those whose dignity and
humanity are threatened To create an environment that allows
healing of the mind, body and soul The action and task of the nurse
which strives to help the patient obtain the right care and achieve
wellbeing
Slide 27
Nursing Caring in nursing- Continuous theme for caring
model-building and developing relationships. While the caring
process may begin with nurses it crosses over to many other
disciplines, causing a dramatic impact on the patient A special way
of being, knowing and doing with the goal of keeping the patient
safe in addition to maintaining and promoting the dignity of the
patient Caring is the spirit of nursing. Caring is a distinctive
characteristic of the nursing profession
Slide 28
What is our interpretation & inference and what are some
possible implications & consequences?
Slide 29
Clarification of Origins: Watsons theory is specific to the
nursing profession. The humanistic aspects of nursing are
emphasized, and intimate, personal moments between nurse and
patient are focused on.
Slide 30
Clarification of Origins (cont): It is very clear that various
theorists and philosophers, along with Jean Watsons own reflective
thinking has influenced her work.
Slide 31
Content: As shown in previous slides, Watsons Theory of
Transpersonal Caring adequately describes the four global concepts.
Human Being - Watson believes that the person is to be valued,
cared for, respected and viewed in a holistic way, as body, mind
and spirit. Environment - Watson believes that the persons
environment should be conducive to healing and that the person and
their environment are connected. The persons frame of reference is
also something that should be considered, and the nurse should
strive to stay within the persons frame of reference. Health -
Health is viewed as overall functioning and distress and disharmony
can be caused by more than just disease processes. Nursing Watson
argues that caring is central to the profession of nursing and that
nursing care should also focus on promoting health and preventing
illness. The nurse should focus their care on healing and wholeness
as opposed to tasks, illness and disease.
Slide 32
Specificity and scope of view: Watsons theory can be applied in
any area of nursing. The theory of caring addressing all aspects of
the health and illness continuum, and the concepts are abstract and
open to interpretation. In fact, lack of concrete guidelines has
been one of the criticisms of the theory, since nurses do not have
specific steps they can follow to apply the principles of the
theory in their practice.
Slide 33
Watsons influence: In Nursing Theorists and Their Work (2010),
Kristen Swanson credits Watson with influencing her exploration of
the concept of caring while completing her doctoral dissertation.
Dr. Joanne Duffy also states she was influenced by Watsons theories
while developing her Quality Caring Model
Slide 34
When could this model be used in practice?
Slide 35
Watsons theory can be applied during any interaction between
patient and nurse. It involves the nurse being involved in the
moment, being there with his or her own whole body and mind, and
focusing on the point in time that is occurring, not thinking about
what is going to happen next or tomorrow or when he or she gets out
of work.
Slide 36
Examples (cont): While helping a patient with their pre-op
Hibiclens bath, the patient expresses fear of the upcoming
procedure. The nurse repeats what the patient is saying regarding
her concerns so she can clarify what the patient is saying and
spends time discussing with the patient her fears and reviewing
what to expect before and after the surgery. The nurse allows the
patient to express herself without rushing through the shower so
she can pass meds to the next patient.
Slide 37
Examples (cont): The nurse is caring for an Asian immigrant who
speaks very little English. The patient has just had a baby via
C-section and will have to stay in the hospital for a couple of
days. The nurse decides to research cultural considerations for her
patient so that she can understand postpartum traditions that the
patient may choose to practice. The nurse communicates her findings
to the oncoming nurse and makes adjustments to her care and the
patients environment in order to facilitate the patients cultural
traditions.
Slide 38
What are the 10 Carative Factors?
Slide 39
10 Carative Factors (Alligood & Toomey, 2010, p. 94)
1)Formation of a Humanistic altruistic System of Values=
satisfaction through giving and extension of the sense of self
(Watson, 1979). 2)Instillation of Faith-Hope= the nurses role in
promoting wellness and positive health through developing effective
nurse-patient interrelationships and helping the patient learn how
to develop health-seeking behaviors (Watson, 1979). 3)Cultivation
of Sensitivity to Self and to Others=as realizes and accepts their
own sensitivity and feelings they become more genuine, authentic
and sensitive to others (Watson, 1979). 4)Development of a
Helping-Trust Relationship=the nurse can promote effective
communication by developing a helping-trust relationship, develop
empathy, use a moderate speaking volume, open relaxed posture and
congruent expression during conversations (Watson, 1979).
5)Promotion and Acceptance of the Expression of Positive and
Negative Feelings=sharing feeling is a risky experience for both
nurse and patient. The nurse must be open and prepared for both
positive and negative feelings (Watson, 1979). 6)Systematic Use of
the Scientific Problem-Solving Method for Decision Making=using the
nursing process problem- solving approach dispels the traditional
image of the nurse as the doctors handmaiden (Watson, 1979).
7)Promotion of Interpersonal Teaching-Learning=shifts the
responsibility of wellness and health to the patient as the nurse
facilitates, teaches and enables the patient (Watson, 1979).
8)Provision for Supportive, Protective, and Corrective Mental,
Physical sociocultural and Spiritual Environment=the nurse must be
aware of the internal and external environment of the patient
(Watson, 1979). 9)Assistance with Gratification of Human Needs=the
nurse recognizes the biophysical, psychophysical, psychosocial and
intrapersonal needs of self and patient all the while remembering
patients must satisfy lower-order needs before attempting to attain
higher-order needs (Watson, 1979). 10)Allowance of
Existential-Phenomenological Forces=the nurse has the
responsibility to go above and beyond the 10 carative factors and
help patients promote their own preventive health actions by
teaching patients personal changes to promote health, providing
support, teaching problem-solving methods and recognizing coping
skills and adaptation to loss (Watson, 1979).
Slide 40
CASE STUDY
Slide 41
Betty, a 59 year old factory worker, arrives at the emergency
room in a small, but busy hospital, not far from her place of
employment. She is complaining of intense pain in her left shoulder
and anxiety. As an ER nurse with 20 years experience, I have seen a
lot of drug seekers come in with the same complaints. Utilizing
Watsons Philosophy and Theory of Transpersonal Caring, I know that
I must not pre- judge any patient and I must develop a
Helping-Trust Relationship with each patient. Using empathy,
congruence, non-possessive warmth, and effective communication is
important in building a relationship with a patient in a short
amount of time, especially in an E.R. setting.
Slide 42
Betty cannot raise her left arm above chest level and there is
no obvious injury to the site. Her vitals are as follows: B/P
168/85, PR 115, and T 97.9. What aspect of Watsons Theory is put
into action here? Betty is given 50 mg of Demerol and 2 mg of
Ativan. She then states that she has been SOB occasionally. Her
pulse ox is 92% on room air. At this point another one of Watsons
carative factors comes into play. Which one?
Slide 43
Betty is diagnosed with a mass on her adrenal gland and an
enlarged lymph node near her heart. She is oriented, but sleepy
from the Demerol and Ativan and still complains of pain in her left
shoulder. Her husband lost his job when his shop closed after
working there for thirty years. She is not covered by any insurance
at this time. She has two grown children and her daughter, a nurse,
is present with her in the E.R. How can we approach this family
using Jean Watsons Theory? Which two of the original carative
factors could be utilized? Realizing that Betty and her daughter
were just given some potentially life threatening news, I
encouraged them both to express how they were feeling about this
diagnosis.
Slide 44
Prior to discharge, Betty was encouraged to seek an appointment
with an oncologist and given a prescription for pain meds to help
keep her comfortable until she can get in to see the doctor. I
walked them out of the cubicle and said a silent prayer for the
battle they were about to begin.
Slide 45
Key Answer 1. As the nurse caring for her, Watsons Theory
directs me that patients must satisfy lower order needs before
attempting to attain higher order needs. Bettys pain and anxiety
must be controlled before she can process and accept what is
happening physically. Answer 2. One of Watsons Original 10 Carative
Factors is the Systematic Use of the Scientific Problem Solving
Method for Decision Making. I realize that this newly conveyed
information may be connected to her original complaints and collect
this data for the doctor to review. It is important to keep things
organized, knowing what and when to relay for further
investigation. Answer 3. Watsons Theory, based on the Original 10
Caratives, includes Cultivation of Sensitivity to Self and to
Others. This explains that as nurses acknowledge their sensitivity
and feelings, they become more genuine, authentic, and sensitive to
others. This leads to self-actualization through self-acceptance
for nurses and patients. Another one of Watsons Caratives is
Promotion and Acceptance of the Expression of Positive and Negative
Feelings. This is a huge risk taking move on the part of nurses and
patients. Be prepared for whatever feeling is shared, good or bad.
Everyone acts and reacts differently and uniquely to each situation
presented to them, including minor and major health dilemmas.