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Dr. Watson's nursing theory of Philosophy and Science of Caring is unique in that
it focuses not only on the health of the patient but also on the well-being of the
nurse. Her 1979 book defined the philosophy of human caring and the art and science
of the nursing process.
Dr. Watson believes that nursing care is a transforming process in which both the
patient and nurse are changed. She defines nursing as a caring profession that combines
both human and scientific values to patient care. Nurses are caring people who can
change the patient's world for the better.
Concepts
- Human beings are valued people who need to be respected, cared for and understood. They are greater than the sum of their parts.
- Individual health is defined as a high level of overall functioning in all areas, a general level of daily functioning and the absence of illness or the existence of attempts that leads to its absence.
- Caring and nursing have been present in all cultures. Caring attitudes are passed on as a way to cope with the environment.
- Nursing focuses on promoting health and treating disease. Central to the caring practice of nursing, this is a holistic view of the patient.
Actions
- Nurses establish caring relationships with patients. They communicate and are receptive to patients' actual and perceived needs. They listen attentively to patients' concerns.
- Nurses treat patients as whole beings. They ask questions and listen carefully to the answers as well as to nonverbal reactions. They respond to psychological and emotional needs as well as physical needs.
- Nurses accept patients unconditionally. They are sensitive to the insecurities of the patients that are caused by being in vulnerable positions. They provide acceptance that is not based on the physical appearances, psychological needs or levels of medical compliance.
- Nurses treat patients with a positive attitude. They respect patients by showing caring and encouragement regardless of patient attitudes.
- Nurses encourage health with knowledge and intervention. They talk honestly with patients about their medical conditions and encourage patients to learn about their health through education and research. They teach health procedures and direct patients to healthy practices.
- Nurses spend quality time with patients. They stay with patients until all questions are answered or until the health procedure is finished. They give patients their interrupted attention and make them feel important.
Assumptions
- Caring is an interpersonal process.
- The fulfillment of patients' needs is the result of caring.
- Growth and health of the individual or family are promoted by caring.
- Caring accepts patients for what they are and what they will become.
- Caring environments allow patients to choose the best actions for themselves and also offers room for the development of potentials.
- The science of caring complements the science of curing.
- Caring is the central function of nursing.
Carative Factors
- Humanistic-altruistic values are learned in childhood and are shaped by life's experiences and learning. Maturation promotes caring behavior toward others.
- Faith and hope are necessary in the carative and curative processes. When there is nothing else to offer patients, nurses can provide a sense of well-being by offering faith and hope that is compatible with patients' belief systems.
- Nurses need to develop sensitivity to their own feelings as well as to those of their patients. They need this sensitivity to interact authentically with patients, and this self-growth is necessary to promote health and the potential of higher function of their patients.
- The most important resources nurses have are their communication skills. These skills include creating rapport with patients and listening with empathetic understanding.
- Nurses need to encourage and accept both positive and negative feelings from patients. Awareness of these feelings allows both nurses and patients to understand the behaviors they cause.
- The scientific system of caring that permits self-correction should be used to solve problems and make decisions.
- Nurses focus on teaching and learning processes. Understanding patients' interpretation of situations helps nurses prepare care plans.
- Nurses provide supportive, protective and corrective environments for patients of which there are external and internal variables.
- All of the patients' needs merit value and attention.
- Nurses help patients find the courage and strength to confront life and death while taking care of the hierarchical order of needs.
Dr. Watson has divided
the hierarchical needs into three categories. The first is lower order physical needs
that include fluid, food, elimination and breathing. The next is lower order psychophysical
needs that include activity, rest and sex. Lastly are the higher order psychosocial needs
that include the need for achievement, connection and self-realization.
The strengths of Watson's theory are that it puts patients at the forefront of nursing
practice rather than protocol. It also recognizes the importance of the family, community
and culture as influences on the health of patients. Its weaknesses are that the physical
needs of the patients are given less importance than the psychological and emotional
needs, and the carative factors address mainly the psychosocial needs of patients.
However, her theory brings new insights to the importance of caring for both patients
and nurses. It explains the concepts in detail and ties together other theories that
have traditionally been used in nursing education. It is a valuable addition to the
art and science of nursing practice.
Publications related to the Philosophy and Science of Caring Nursing Theory
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