Theory-Based Exemplar paper TEP

Theory-Based Exemplar paper TEP

Theory-BasedExemplar paper TEP

Watson’sCaring Theory

Amongthe many used theories used by nurses today, Watson caring theory isone of them. Dr. Jean Watson, an American nursing scholar came upwith the theory. She was born in 1962 at West Virginia, but latermigrated to Boulder, Colorado. She has a degree, a master degree, andPHD in Nursing and Psychology, Psychiatric-Mental Health Nursing, andEducational Psychology and counselling respectively. So far, she haspublished several works on philosophy, as well as on human caringtheory that most nurses use for reference.

Nursingprofession come hand in hand with caring. In fact, nursing is allabout caring. Watson urges that caring is a core factor to nursinghence, nursing opt to protect human caring within their workingplaces. Health ministries, on the other hand, should not allow caringto wither in the health care centres. The purpose of this paper to isgive a synopsis of Watson’s caring theory, theory application toclinical practice, give an encounter that relates to Watson’stheory, and finally describe a person’s health and nursing based onWatson’s theory.

Watson’sCaring Theory

Watsoncaring theory states caring as the primary goal of nursing. That is,the process of helping a patient to attain high level of harmonythrough caring transactions in their body, mind, and soul. Below arethe three major elements of Watson’s caring theory:

  1. Carative factors

Thisis making connection between care and love based on ethical, moral,and philosophical foundation of love. Watson developed this factor in1979, and later revised it in 1985 and 1988. Watson associatedcarative factors with ten elements, namely

  • Human care relationship

  • Faith-hope

  • Human need assistance

  • Transpersonal teaching-learning

  • Sensitivity to self and others

  • Expressing positive and negative feelings

  • Creative problem-solving caring process

  • Existential-phenomenological-spiritual forces

  • Protective, supportive, and corrective physical, spiritual, mental, and societal environment

  • Humanistic-altruistic system of value

However,later in 1988, Watson replaced carative factors with clinical caritasprocess (Watson, 2006). The word “caritas” is a Greek word thatmeans giving special love attention. Correspondingly, the tenelements of carative factors were as well translated into clinicalcaritas processes. These processes are:

  • Sustaining and enabling self deep belief system and authentically being present

  • Offering basic needs with conscious caring intentions

  • Genuinely engage in a teaching-learning experience

  • Practice love and kindness in context of caring consciousness

  • Nurturing individual beliefs, practices, and personal growth

  • Develop a helping-trusting-caring relationship

  • Come up with creative problem-solving approaches for decision making

  • Creating a healing environment which respect human dignity

  • Promoting and accepting positive and negative feelings

  • Opening and allowing spiritual-mysterious happening

  1. Transpersonal Caring Relationship

Accordingto Watson (2006), transpersonal caring relationship is that specialhuman kind care that depends on nursing’s moral commitment toenhance and promote human dignity. In addition, it depends on nursingcaring consciousness to honour and preserve embodied spirit. It goesbeyond self-ego to reach deeper connection to the spirit created bycaring moments. Therefore, transpersonal caring embraces and connectssoul or spirit through the process of healing and caring. The nurseintentionality and caring consciousness influences transpersonalrelation as he or she enters patient’s life space to deal withtheir condition of being. In this context, the word “transpersonal”means going beyond one’s ego hence, transpersonal caringrelationship helps nurses to get into deeper spiritual connectionwith their patients (Thompson, 2005). As a result, they promotepatient comfort and healing. Additionally, transpersonal caringrelationship helps nurses to achieve their goals of enhancing,preserving, and protecting human dignity, and raise the level ofwholeness and inner harmony.

  1. Caring Occasion/Caring Moment

Watson(2006) describes caring occasion as the situation whereby a nursecome together with another person (the patient) and they both createhuman caring. Bultemeier(2012)also defines caring occasion as heart-centred encounters of a nurseand another person. Both parties have unique characters and havecapability to create human-to-human transaction that is genuine,meaningful, intentional, and honourable. The encounter expands aperson’s worldview and raises the spirit to discover one self andlife possibilities. Spear(2002) insists that nurses should be aware of their own consciousnessin a caring occasion/moment with a patient. During the caring moment,both the nurse and the patient can make any choice or take any actionthat pleases them. However, both parties, nurse and patient, cancreate their own life history depending on the actions and choicesthey take during caring moment. This moment gives them an opportunityto decide what to do during the moment/occasion. If the caringoccasion is transpersonal, they both feel connected at the spiritlevel hence transcending space and time, opening deeper level ofhuman connection, and opening new possibilities of healing.


Exemplar:My Encounter with Mr. Jones

Thepurpose of this section is to create a better understanding of Watsoncaring theory though a clinical narrative. The encounter will putinto account several clinical caritas process. This section utilizesthe Newman’s theory through a family case of Mr. Jones living inCalifornia. Mr. Jones is a sixty-one years old Caucasian, married,and a father to four children. He is a retired teacher living withhis family. Ever since he was young, he has always been an activechurch member, and an active member of community groups.

Lastmonth, I was assigned to take care of Mr. Jones, a man who was toundergo his third amputation. This time, he was scheduled for a kneeamputation on his left leg, after the previous amputation failed toheal properly. Since I attended him during the previous amputationprocesses, at least I know him well. Based on Watson theory, I hadalready developed a helping-trusting caring relationship with him,his family, and his friends who occasionally visited him. Since ourfirst meeting, I become fond of him. This enabled me to be alwaysthere for him whenever he needed me. In addition, I also embraced theact of kindness toward him. Mr. Jones shared his life story hence,he would refer him as a “person” rather than a “case” in thedepartment.

Itwas on a Monday when Jones was admitted in the hospital. His family,wife, and two sons brought him to the hospital. As I welcomed him, Iglanced at him with a smile, but he responded with a faint smile.Right away, I detected he was not pleased with the procedure ahead ofhim. However, it was my responsibility as a nurse to show caringtowards him. Based on Watson caring theory, this was to be a caringoccasion/ caring moment. I asked him about his progress and theeffectiveness of his medication since our last meeting. At thispoint, I was privileged to exercise my problem solving strategies incaring for Mr. Jones. I explained to him some of the creative waysthat I has come up with that he would use to remember to take hismedicine. According to Capasso(1998),nurses should use their creative problem-solving methods to meet theneed of their patients. From his facial expression, I would tell hewas glad to hear this, and he openly asks me questions regarding thesame. We both engaged in a loving communication that intended topromote his health. Likewise, Mr. Jones considers me as a “person”not just a “nurse.” This as well enabled his to be more open andshare his feelings. He was aware that I would always be there forhim, and that I was ready to undergo the amputation process with him.Our relationship had already become part of our life history (McCrae,2012).

Unfortunately,Mr. Jones was somehow depressed, and someone would tell from hisface. Probably, it was because of the previous unsuccessfulamputation and the fact that his leg needed to be amputated more.Naturally, most patients undergoing amputation usually faceself-denial at first especially if there family and friends do notsupport them. It even becomes worse if they are discriminated.However, as a nurse, I took the initiative and discussed his feelingsand perceptions concerning his from first amputations. Gigliotti(2002) urges that nurses should promote, as well as accept theirpatient’s positive or negative feeling. Therefore, I had toencourage reflection of his experiences and feelings. In addition, Ihad to make him see that there are still positive aspects of thesituation despite the pain behind it. Further, I had to make himaccept, as well as deal with the negative aspect of the situation.After admission, I escorted him to his ward and created anenvironment that would please him. This environment would generatehis wholeness and healing. Watson advocates that nurses andcaregivers should create environment where human connections canoccur naturally (Thompson,2005). In addition, they should create caring intentions and healingenvironment by attending to light, water, cleanliness, nutrition,safety, beauty, comfort measures, among others. Therefore, I ensuredthe room had enough light and it offered Mr. Jones an environment toease his healing. After he settled down, I utilised the opportunityask him about himself, how he felt, and what were his priorities forhospitalization and care plan. I tried to create a caringrelationship to promote spiritual growth. I encouraged him to talkout his views, and acknowledged it as an inner journey of healing.Mr. Jones explained to me that he wanted the amputation surgery totake place before schools breaks since his grandchildren will bespending their holiday at his house. Accordingly, we had to plan thewhole process to fit on his priority. Bultemeier(2012) urges that focusing to patients’ needs and priorities helpthem to participate actively in the healing process. Although toomuch time is initially takes, less time is taken in caring forpatients. I also asked for Jones’s bedpan as I helped him lay onhis bed. I ensured he was as comfortable as possible and felt lessworried. However, Mr. Jones could not hesitate to tell out hisworries. He was not comfort that he would not move by himself. Hisquestion was whether the surgery would offer any help or it was justtime and money wastage. He explained that since he lost his legs,some people did not respect him anymore. This left me speechless.Further, he explained he was not the same person who used walk on histwo legs. I asked him what makes him think that he had changed afterlosing his legs. In his response, he urged that he was no longeruseful and he lacked social recognition. He was disturbed that he wasa burden to his children who had taken the responsibility to takecare of him. From his reaction, I realised the caring values based onpreserving and respecting human dignity. I would not understand whyother people viewed him differently yet he was also a human beingjust kind any person. This also made me realise that there wasinter-relation between Mr. Jones and his environment. According toMcCrae(2012),it is very inhuman to discriminate or disrespect a person due totheir physical appearance. Instead, people need to see a personbeyond his or her looks and body, but look further to the mind andsoul.

Afterabout one hour or so, I decided to give Mr. Jones sometime to restalone so that he would meditate on his own. I pulled down the windowcurtains to provide comfort and privacy. Before I left the room,Jones expressed his gratitude and looked forward to see me again.Indeed, caring is vulnerable. I felt powerless after chatting withJones, and I did not know what to do or say. I desired to help himattain highest level of harmony in the body, mind, and soul in hislife once more. The more I thought about him, the more I wasmotivated to give him hope. Therefore, I had be more creative andcome up with strategies to help him. Here, I realised to accomplishmy professional goal, caring had to be part of me. I also had toestablish a transpersonal caring relationship with Mr. Jones thatwould enhance, protect, and preserve his dignity, wholeness,humanity, and inner harmony. After all, nursing profession is allabout caring.

ViewingMr. Jones through Watson’s Theory of Caring

Accordingto Watson (2006), “being-in-the-world” person has a body, mind,and soul. These three spheres are unique for every individual and areinfluenced by self who are free to make choices. However, I would becomplex to discuss Mr. Jones case by referring him as“being-in-the-world” person. This is because I would not tell hisstory without considering the environment around him, his family,friends, his community, resources, and society. Nevertheless, I wasmore concerned about him and how he related with the environment.McCrae(2012) urges that creating a healing environment accelerate healingprocess. This involves creating a physical, non-physical, and subtleenvironment that enhances the beauty, comfort, peace, and dignity ofa patient. For my case, I created a healing environment by creatingcaring intentions by ensuring Mr. Jones had light, water, privacy,good nutrition, as well as there was cleanliness in his room. Thiswould expand his awareness and consciousness hence, promote body,mind, and soul wholeness. Spear (2002) advocated that hospital wardsbe like a healing, smoothing, and a sacred place. Further, hebelieves an organised and clean environment speedup healing.

Additionally,Watson theory of caring acknowledges the importance of body, mind,and soul unity of a person. Consequently, while I was attending Mr.Jones, I did not only take care of his body, but I also took care ofhis mind and soul. Mr. Jones souls related to his spirit that is,his inner and the spiritual self. It is his souls that made him dealwith the past, brought him to the present, and as well gave him thespirits to face the future. Similarly, his mind responds to hisemotions, memories, and intelligence. Additionally, Watson theory ofcaring takes into account respect for the choices and decisions thata person makes.

ViewingMr. Jones Health and Nursing in Respect to Watson’s Theory ofCaring

Accordingto Watson (1999), health does not simply mean absence of diseases. Hereasons that a person health is a subjective experience thatcorresponds to a person harmony. He believes that a person is in goodhealth when there is balance within the body, mind, and soul. Itexists when there is a relation between the degree of congruence andself. For instance, Mr. Jones is not healthy since his condition wasdeteriorating and health care professional advocated for a thirdamputation. On the other hand, Thompson (1999) believes health andillness and both be referred as health. Watson (1999) defines nursingas a caring science that includes humanities and art. In addition, hedefines nursing as human health and science of a person.


Itis so unfortunate that most nurses have learnt about Watson caretheory, but some are not aware of the care ethics. Care is animportant aspect for human development especially at fulfilling body,mind, and soul needs. Biologically, care is crucial for infantsurvival, as well as for dependent patients towards the end of life.Care is a basic need for human existence. Therefore, people whochoose nursing professional need to make a moral commitment that theywill care for all patients. In fact, this is reflected in the code ofethics for nurses. McCrae(2012) states that all nurses should respect the worth, rights, andthe dignity of their patients in regardless of their health problemnature. Nursing is a nurse and patient partnership whereby the twogrow in the “sense of higher level of consciousness.” Newman alsoredefines nursing as a process of recognising a patient in relationto environment and consciousness understanding (Capasso,1998).Nurses help their patients to uses the inner power to attain highlevel of consciousness. The detect disease process and come up withprevention measures.

Today,nursing can learn essential elements of caring by exploring theWatson theory of caring. Corresponding, they can apply the sameknowledge in their day-to-day activities and as they take care fortheir patients. Likewise, analysing the case of Mr. Jones has enabledme to understand more about human caring heritage. The experienceshave offered me some ideas and suggestions to grasp and utilizeWatson theory of caring in my working environment. In future, nurseswill need to work within a given caring-healing framework andhuman-environmental fields. In addition, they will have to payattention to consciousness, and come up with body-mind-soulmedication. They will also have to embrace healing arts, caring andhealing mysteries, as well as offer caritas services to theirclients. In other words, nursing has a vital role to play in themodern society such as making connections between love, caring,healing, and peace in the world.


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