[Photograph of Jean Watson]. (2010). 4 th Annual Envision Conference
Nursing: The Art and Science of Caring. Oakland University, Rochester, MI.
April Bilbe,
Ashley Denhartigh,
Barb Hulwick,
Dana Raymer &
Deborah Schaefer
Questions & Problems to Solve
Why are we doing this assignment?
Why did we choose Jean Watson’s Theory of Caring?
Evaluate: What is Jean Watson’s Theory of Caring?
What are the origins of Jean Watson’s Nursing Model?
What is Jean Watson’s historical background?
What are Jean Watson’s philosophic values re: nursing and knowledge?
What influenced Jean Watson’s Philosophy?
Information & concepts: How does this model define the four global
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?
Why are we doing this assignment?
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.
Why did we choose Jean Watson’s
Theory of Caring?
 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.
Evaluate: What is Jean Watson’s
Theory of Caring?
Andrews & Arnerich (2008) state:
The philosophy of caring and science examines the
relatedness of ALL and includes human science,
human caring processes, experiences and
Caring is a moral ideal: mind-body-soul,
engagement with another.
What are the Origins of
Jean Watson’s Nursing Model?
Watson’s Motivation for Developing Her Model:
 Education
 Life
Exploration of Self
What is Jean Watson’s
historical background?
Historical Background
O According to Jesse (2010), during an undergraduate course Watson studied Yakom’s 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).
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).
Watson’s fifth book Caring Science as Sacred Science (2005) describes her own life’s 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 selftranspersonal growth, and attention to both caring science and healing through forgiveness, gratitude ,
and surrender” (Jesse, 2010, p. 93).
O As a dedicated learner, Watson’s continual education has led her to think deeply about nursing and
the science of caring.
Her own life experiences have shaped what her theory is today.
What are Jean Watson’s
philosophic values re: nursing &
knowledge development?
 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).
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
 “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).
 “The
nurse’s 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).
 “Caring
in the nursing profession takes
place every time a nurse-to-patient
contact is made... That caring makes a
difference to the patient’s sense of well
being. Caring may occur without
curing but curing cannot occur without
caring” (Vance, 2003, para. 1).
What Influenced Jean Watson’s
 Theorists
 Florence
Nightingale, Henderson, Leininger,
Peplaw, Rogers, Newman, and Gadow (Jesse,
2010, p. 94)
 Jesse (2010) states “She describes a close
connection with ‘Nightingale’s sense of
‘calling,’ guided by a deep sense of
commitment and a covenantal ethic of human
service’ (Watson, 2007a)” (p. 94)
Philosophy Influence Continued
 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).
Information and concepts: How
does this model define the four
global concepts?
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
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 Watson’s 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
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
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
What is our interpretation &
inference and what are some
possible implications &
Clarification of Origins:
Watson’s 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.
Clarification of Origins (cont):
It is very clear that various theorists
and philosophers, along with Jean
Watson’s own reflective thinking has
influenced her work.
As shown in previous slides, Watson’s 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 person’s environment should be
conducive to healing and that the person and their environment are connected.
The person’s frame of reference is also something that should be considered,
and the nurse should strive to stay within the person’s 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.
Specificity and scope of view:
Watson’s 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
Watson’s 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 Watson’s theories while
developing her Quality Caring Model
When could this model be
used in practice?
Watson’s 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.
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.
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 patient’s
environment in order to facilitate the patient’s
cultural traditions.
What are the 10 Carative Factors?
10 Carative Factors (Alligood & Toomey, 2010, p. 94)
Formation of a Humanistic altruistic System of Values= satisfaction through giving and extension of the sense of self
(Watson, 1979).
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,
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).
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).
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,
Systematic Use of the Scientific Problem-Solving Method for Decision Making=using the nursing process problemsolving approach dispels the traditional image of the nurse as the doctor’s handmaiden (Watson, 1979).
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).
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).
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).
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).
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 Watson’s Philosophy and Theory of
Transpersonal Caring, I know that I must not prejudge 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.
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 Watson’s 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 Watson’s carative factors comes into
play. Which one?
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
Watson’s 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.
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.
Answer 1. As the nurse caring for her, Watson’s Theory directs me that patients must satisfy
lower order needs before attempting to attain higher order needs. Betty’s pain and anxiety
must be controlled before she can process and accept what is happening physically.
Answer 2. One of Watson’s 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. Watson’s 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 Watson’s
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.
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Caring. Nursing Administration Quarterly, 32 (1), 15-20.
Vance, T. (2003). Caring and the Professional Practice of Nursing Part II. RN Journal. Retrieved
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Watson Caring Science Institute (WCSI). (2009). Caring Science Ten Caritas Processes.
Retrieved from http://www.watsoncaringscience.org/j_watson/theory.html
Weblink: http://journals.lww.com/naqjournal/toc/2008/04000

Jean Watson Presentation NURS324