Jean Watson
http://www.watsoncaringscience.org
Jean Watson,
PhD, RN, AHBBC, FAAN
Evolution of Transpersonal
Caring Theory
 Margaret
Jean Harman Watson was born and
raised in a small West Virginia town in the
Appalachian Mountains named Welch.
 Being
the youngest of eight siblings, she was
surrounded by a large extended family.
 She
moved to Colorado after marrying Douglas,
had two daughters and five grandchildren.
 Watson
established the Center for Human Caring at
the University of Colorado in the 1980’s.
 It was described as the “first interdisciplinary center
committed to using human caring knowledge that
forms the moral and scientific bases for clinical
practice, scholarship, and administration and
leadership”. (Watson, 1986)
 Watson’s
first book, Nursing: The philosophy and
science of caring (1979), developed from her notes
for an undergraduate course taught at the University
of Colorado (Alligood, 2010).
 Yaloms’ eleven curative factors stimulated Watsons’
thinking about her ten carative factors (Alligood,
2010).
 Caratives were described as the organizing
framework for her book.
 Her
early work embraced the ten carative factors
but has evolved to include “caritas” that make
connections between caring and love (Alligood,
2010).
 She
added “spiritual aspects and believes that the
core of nursing is seen in those nurse-patient
relationships that result in a therapeutic outcome
(Alligood, 2010, p. 102).
Metaparadigms
 Nursing
theories embrace the concept
that they all have elements that address
four major paradigms:




Environment
Person
Health
Nursing
Environment
 In
her original caratives, she refers to the
nurses role in the environment as
“attending to supportive, protective, and
or corrective mental, physical, societal,
and spiritual environments” (Watson, 1979,
p. 10).
 In
her later work, she describes that “healing space
can be used to help others transcend illness, pain,
and suffering” (Watson, 2003, p. 200).
 She also emphasizes that environment and person
are connected: “when the nurse enters the patients’
room, a magnetic field of expectation is created”
(Watson, 2003, p. 200).
 Her
broad view of environment is:
The caring science is not only for sustaining
humanity, but also for sustaining the planet…Belonging is to an infinite universal
spirit world of nature and all living things;
it is the primordial link of humanity and life
itself, across time and space, boundaries
and nationalities. (Alligood, 2010, p. 99)
Person
 Watson
uses the words human being, person, life,
and self interchangeably. She views the person as
“unity of mind/body/spirit/nature” (Alligood, 2010,
p. 99).
 She feels that “personhood is tied to notions that
one’s soul possess a body that is not confined by
objective time and space..” (Alligood, 2010, p. 99).
Health
 Her
definition of health is “unity and harmony within
the mind, body, and soul”, “the degree of
congruence between the self as perceived and the
self as experienced” (Alligood, 2010, p. 99).
 She further states “illness in not necessarily disease;
instead it is a subjective turmoil or disharmony within
a person’s inner self or soul”
Nursing
 Nursing
consists of “knowledge, thought,
values, philosophy, commitment, and
action, with some degree of passion”
(Watson, 1988, p. 53).
 Nurses go beyond procedures, tasks, and
techniques used in practice settings.
(Watson, 1988, p. 53).
http://www.watsoncaringscience.org/
media/caring_moment.mp3

New to nursing in 1979 with “deep roots in philosophy
and ethics and become more closely aligned with
Rogerian science of unitary human beings” (Foster,
2006).

Basic assumptions of Caring Science.

Carative Factors to Caritas Processes.
Caring Science
• Caring
• Humanity
• Carative Factors/Caritas Processes
• Effective Caring
• Acceptance
• Relationship
• Curing Science
(Watson, 2008)
•
Factor
Process
Humanistic-Altruistic
System of Values
Cultivating the Practice of
Loving-Kindness and
Equanimity Toward Self
and Other as Foundational
to Caritas Consciousness
(“Jean Watson’s Philosophy”, 2010)
(Watson, 2008)
Factor
Installation of Faith and
Hope
(“Jean Watson’s Philosophy”, 2010)
Process
Being Authentically
Present: Enabling,
sustaining, and Honoring
the Faith, hope, and Deep
Belief System and the
Inner-Subjective Life World
of Self/Other
(Watson, 2008)
Factor
Cultivation of Sensitivity to
Oneself and Others
(“Jean Watson’s Philosophy”, 2010)
Process
Cultivation of One’s Own
Spiritual Practices and
Transpersonal Self, Going
Beyond Ego-Self
(Watson, 2008)
Factor
Process
Developing a HelpingTrusting Relationship
Developing and Sustaining
a Helping-Trusting Caring
Relationship
(“Jean Watson’s Philosophy”, 2010)
(Watson, 2008)
Factor
Process
Promotion and Acceptance
of the Expression of
Positive and Negative
Feelings
Being Present to, and
Supportive of, the
Expression of Positive and
Negative Feelings
(“Jean Watson’s Philosophy”, 2010)
(Watson, 2008)
Factor
Process
Creative Use of Self and All
Systematic Use of the
Scientific Problem-Solving Ways of Knowing as Part of
the Caring Process; Engage
Method for Decision
in the Artistry of Caritas
Making
Nursing
(“Jean Watson’s Philosophy”, 2010)
(Watson, 2008)
Factor
Process
Promotion of Interpersonal
Teaching and Learning
Engage in Genuine
Teaching-Learning
Experience That Attends to
Unity of Being and
Subjective meaningAttempting to Stay Within
the Other’s Frame of
Reference
(“Jean Watson’s Philosophy”, 2010).
(Watson, 2008)
Factor
Process
Attending to a supportive,
Protective, and/or
Corrective Mental, Physical,
Societal, and Spiritual
Environment
Creating a Healing
Environment at All levels
(“Jean Watson’s Philosophy”, 2010).
(Watson, 2008)
Factor
Assistance with
Gratification of Human
Needs
(“Jean Watson’s Philosophy”, 2010).
Process
Administering Sacred
Nursing Acts of CaringHealing by Tending to
Basic Human Needs
(Watson, 2008)
Intrapersonalinterpersonal need
(self-actualization)
──────
Psychosocial Needs
(achievement, affiliation)
───────
Psychophysical Needs (activityrest, sexuality)
───────
Biophysical Needs (food, water,
elimination, ventilation
Watson’s additional needs:
Knowledge, beauty-aesthetics, evolving
self-actualization that is spiritually
meaningful, and “need to connect with
that which is greater than self--to
surrender to a higher source with a sense
of awe toward the mystery and wonder
of life, whether humanity itself, nature,
God, Spirit, or a Divine universe”
(Watson, 2008, p. 147).
Factor
Process
Allowance for ExistentialPhenomenological Forces
Opening and Attending to
Spiritual/Mysterious and
Existential Unknowns of
Life-Death
(“Jean Watson’s Philosophy”, 2010).
(Watson, 2008)

Please click on the following link:
http://www.youtube.com/watch?v=hcrTnKxJEa
8
Watson’s theory in
clinical practice.
The nurse considers the patient as
a whole.
“The nurse makes a moral
commitment and direct
intentionality and consciousness
to the protection, enhancement,
and potentiation of human dignity,
wholeness, and healing, such that
a person creates or co-creates his
or her own meaning for existence,
healing, wholeness, and caring”
(Kearney, 2008, p. 74).
The nurse is able to “connect with
the inner condition (spirit) of
another” (Kearney, 2008, p. 74)
and create caring moments.
The nurse uses the healing
modalities to help bring harmony
to a patient.
 The healing modalities include:
 The use of auditory, visual and tactile therapies.
 Gustatory
 Mental/cognitive
 Kinesthetic
 Caring consciousness
 Understanding own life history
The nurse should “potentiate
comfort measures, pain control, a
sense of well-being or spiritual
transcendence of suffering”
(Kearney, 2008, p. 74).
Framework for patient
assessment.
Watson’s theory challenges nurses
to go beyond the tasks and
procedures of nursing and really
dig for the core of nursing (Tomey,
2010, p. 98)
Ways to incorporate Watson’s
theory into nursing assessment





Do an emotional and spiritual assessment
Sit down while talking with patient and give them your undivided
attention
Actively listen to patient
Ask open ended questions that will allow the patient to share their
feelings on their views on things such as health and situation
Instill hope and faith (Watson, 2007)
In
Nursing Education
“ In the practice setting, nursing
theory clearly defines the unique
contribution of nurses to health care and
helps distinguish nursing as a professional
discipline with its own body of knowledge
that is separate from the medical model of
care” (Marckx, 1995, p. 49).
“Carative is the philosophy and theory of human caring.
Dr. Jean Watson uses the term “carative” instead of
“curative” to distinguish between nursing and medicine”.
“Whereas curative factors aim at curing the patient of
disease, carative factors aim at the caring process that helps
the person attain (or maintain) health or die a peaceful
death” (Watson, 1979).
The original theory developed in 1979, was organized
around 10 carative factors:
Source: Nursing: The Philosophy and Science of Caring by Jean Watson, RN, Ph.D. Boston: Little, Brown and Co., 1979.
“They can be used as an expressive tool while
directing the assessment, interventions, charting
and full engagement of caring human dimensions
of nursing practice” (Rosenberg, 2006, p. 55)
“The carative factors, which represent the core of
nursing and the primary ingredients of effective
nursing practice, provide a language, structure, and
order for studying and understanding nursing
education and practice” (Wade & Kasper, 2006, p. 163).
ADN
 BSN
 MSN
 Doctorate
“Although the bachelor’s degree is considered
still the [unresolved and impossible to implement]
minimal entry level into the professional practice of
nursing, the mature practice of nursing, as a career
health professional, ideally should be at the
professional doctorate level, or at least the graduate
level.” (Fawcett, 2002, p. 217).

In
Nursing Research

Unitary-Transformative Paradigm
> unity of mind, body, soul, nature
and the universe
> spirit to spirit connection (Watson &
Smith, 2002, p. 458).
“We are to realize that we have to pay
attention to what is happening in the universe; we
are not separate from the environment, nature and
other humans” (Fawcett, 2002, p. 216).
The Watson Caring
Science
Institute
Dr. Jean Watson, Founder, created
her international nonprofit Watson
Caring Science Institute in 2007
with the mission to restore the
profound nature of caring-healing
in today’s healthcare systems and
to retain its most precious resource,
caring professional nurses and
transdisciplinary care team
members
http://www.watsoncaringscience.org/
Million Nurse
Global Caring Field
Project
http://www.watsoncaringscience.org/j
eanmedpop.htm
(Right click, select open hyperlink)
Goal:
“Connect simultaneously with a million
nurses (or more) around the globe: to create
and radiate an energetic Caring Field of
Heart-Centered Love for Self, Others, and the
Planet Earth. This intentional focused
experience honors and extends the human
caring vibration of nurses into the universal
energy field of humanity facilitating healing
and health for all” (Watson, 2010)
HeartMath
“Thousands of health
professionals in clinics,
hospitals, military facilities,
coaching, couples therapy,
and private practice are using
the emWave technologies
with clients. They have found
that with consistent practice,
clients can learn to reduce
stress, manage the emotions
associated with stress, expand
their coping skills, and create
a greater sense of well-being.”
http://www.heartmath.com/
Strengths of this Model
a)Jean Watson’s theory is similar to the nursing process and follows
a similar path as the scientific research process. 1. Assessment 2.
Plan 3. Intervention 4. Evaluation, so it is familiar for nurses to
follow.
b)Watson’s work does follow logical steps.
c) Using the science of caring or the carative factors, shows how
nursing differs from other professions.
d)It advocates for the healing of the patient as opposed to the
technology needed.
e)Her philosophy is based on love/caring of the human being which is
why many nurses chose their profession.
Jean Watson’s Philosophy and
Theory
Limitations of this Model
a)Watson’s theory is first and foremost a psychosocial
model. (Andrews, 2008.)
b)With shorter hospitalization stays it is difficult to
evaluate the effectiveness of the model in the hospital
(Andrews, 2008).
c) It is a relatively new theory (published in 1979) and hasn’t
been utilized a lot; it needs more nursing research to
determine it’s effectiveness in nursing practice.
d) Her theory “language “can be difficult to understand.
*Evaluation of Jean Watson’s
Theory of Human Caring
* Is about much more than giving care to a
person.
* Is about caring for a person’s body, mind, and
spirit (soul) (Ryan, 2005).
* Is about the person giving care as well as the
one being cared for (Sitzman, 2011).
* Is a moment to moment experience.
* Is holistic
* Forgiveness
* Compassion
* Love
* Mind
* Body
* Soul
* Harmony
* Spiritual
* Mystical
*Caring Relationship
* Evolved in the 1970’s
* Florence Nightingale
* Caring leads to healing
* “love, compassion, and forgiveness….”
*
* Carative Factors
* Caritas Processes
* Curative Factors
*Aspects of The Theory
of Caring
* Transpersonal caring relationship
* Caring moment
* Caring healing modalities.
*Transpersonal Caring
Relationship
* Recent Studies
* What patients view as important in caring
* Least important aspects of care
*Caring for Patients
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