Introduction
Theory in nursing provides the framework of defining the field of nursing, determining when nursing is needed, and exploring the objectives of the nursing activities. Concepts and propositions “form the basic elements that build a particular nursing theory” (Watson, 2008, p. 112). Propositions are elements that manifest how concepts interrelate and affect each other in a given theory. In a theory, concepts are the fundamental structures that emerge from the utilization of theory in nursing. In the nursing profession, new and complex situations ought to develop often; however, nursing theories create a framework for critical analysis and decision-making.
This paper describes the middle range theory with specific reference to the Jean Watson’s theory of human caring. The caring theory reminds nurses to cherish their self-wellness and unique abilities always, as such aspects instill profound changes to the lives of patients. The middle range theory is less involving and it covers smaller scope as compared to the grand theories, but they hold significant promise in integrating theory-based research with nursing practice activities. During the past decade, the need to integrate nursing theories into medical practice within the health care system developed. Nursing leadership realized the need to strengthen clinical practice by incorporating established nursing theories such as the Watson’s theory of human caring. This paper describes how incorporating nursing theories would proclaim the practices, beliefs, and values that affect the nursing practice and link the gaps in professional nursing that had previously been overlooked. First, the paper will analyze the importance of nursing theories to the nursing practice. Secondly, it will give a summary of the concepts and propositions of the middle range theory and its impact on the nursing profession. Thirdly, it will describe how the middle range theory relates to and views nursing leadership or health policy. In conclusion, the paper will share views on what has been learnt on nursing theories coupled with giving the relevant directions on the topic.
Main Body
The role of nursing theories in the nursing profession is appreciated overwhelmingly for its contribution to tackling both tolerant and emerging issues in the nursing practice. Professional nurses have “integrated theories from nursing and behavioral sciences to record, organize, and generalize patient data in a bid to understand and tackle patients’ health needs” (Watson, 2008, p. 119). The concepts help in suggesting the relevant methods of nursing interventions that suit specific situations and the expected patient outcomes. The middle range theory provides nurses with a clear perspective to pursue difficult situations and predict a clear direction for intervention. Since the main objective of the nursing profession is to care for the wellbeing of humanity, this notion serves as the impetus to strengthen the healthcare system by unifying the vision and language of nursing. Nursing theories assist nurses in interpreting the key concepts in the nursing practice such as human health coupled with how they should reach and care for their patients. The Watson’s theory of human caring gives nurses the insight and the proper way to view fellow human beings. The theory of human caring challenges nurses to cherish humanitarianism and act as moral agents whilst maintaining professional efficacy. This aspect gives nurses a positive mentality to practice nursing as a science of caring (Watson, 2008).
The caring theory forms the basis to expound, direct, and back up nursing practice by communicating beliefs and creating harmonious perspectives in the nursing practice. This aspect is necessary for articulation, envisioning, and appreciating the nurses’ unique role in the human care system. The theory is built on core concepts that should guide the practices of the professional nurses and their relationship with patients. The concepts include caring for oneself as well as others based on a professional and moral concern for humanity. The Watson’s theory encourages nurses to practice health care across all divides by overlooking boundaries of race, religion, or class among other characteristics coupled with voluntarily limiting self-ego and pursuing nursing practice with passion (Watson, 2008). Nurses should be motivated by moral commitment to protect and care about others life. In addition, instilling faith and hope to patients and being present when they are needed to create and sustain the belief between self and the patient. The science of caring is critical in easing the nurses’ frustrations and confusions of perspectives on the patients’ health. The theory of caring brings order and meaning to the nurse-patient environment, which helps in building transpersonal compassion and care. Such cordial environment between the nurse and the patients promotes quick recovery and healing. According to Watson (2008), nursing care goes beyond the physical to meet the spiritual needs of the patient, thus promoting wholeness and healing.
The caring theory emphasizes that a nurse leader should always lead by example and be ready to empathize with the situations at hand. Regardless of the leadership qualities expected, nursing practice requires self-control on top of integrity, inspiration to fellow nurses to embrace the best care, and appreciation of teamwork since no one can achieve major outcomes alone. The nursing education should lay its basis on the moral principles of care for oneself and others during nursing practice. The core goals of a nurse should aim at achieving the best for the welfare of society. According to Watson (2008), nursing informatics should assist nurses to incorporate the science of caring to the nursing practice by ensuring communication and consultation in a bid to improve efficacy and quality of patient care environment. In addition, it weaves the caring notion into the fabric of the nursing philosophy and enables the leadership to create ways that best incorporate the caring mentality within their individual entities.
For instance, despite the knowledge about the caring theory, most nursing leaders remain egocentric. Most leaders will not willingly reveal things they do not understand to their fellow nurses. Failing to acknowledge teamwork or even delegate duties results in poor service delivery and the consequences affect the patient outcomes (Watson, 2008). On the contrary, if the nursing leadership takes into consideration the need for teamwork and a common goal of bettering the welfare of humanity, then nursing practice can achieve great milestones. For instance, in Rwanda, when the nursing leadership identified the need to introduce professional regulation to foster improvements in the quality of nursing education and the standards of practice, the involved parties engaged the entire nursing fraternity and all stakeholders (Benton, 2012). This vision was integrated into the government’s agenda to better health services. The Rwandan nursing community can now appreciate the high-quality skills and services that it offers to its patients as well as the unending morale to uphold the Watson’s caring theory.
The Watson’s theory of human caring views nursing leadership as a platform for acknowledging success. Leaders who take the time to evaluate and appreciate what other nurses are doing develop the nurses’ morale to hold high levels of integrity and standard service. For example, taking into reference to the case of Iran in 2002, the Iranian Nursing Organization developed a board to explore improvements in education, policy, and diversity to enhance the health benefits of the clients (Benton, 2012). The Iranian government and religious leaders across the divide appreciate the role of the nurses by being part of the Iranian National Nurse’s Day. This aspect fosters solidarity and brings forth opportunities through which nurses can share platforms and debate issues to raise the standards of nursing practice.
Conclusion
The undying need to understand and apply theory in nursing in different service delivery to patients has presented nurses with new frontiers of learning and practice. While pursuing this agenda, benefits have been realized and the barriers overcome. Even though the endeavor to integrate nursing theories with nursing practice might not have realized its full potential, the course is underway since nursing leadership continues to champion the incorporation of nursing theories to the existing nursing philosophy. The nursing informatics, policy, and education have played a crucial role, but the future holds an opportunity to offer unparalleled services through extensive research, reformed policy, and informed nursing leadership. The moral principles, caring aspects, and the social ideals advanced by Watson foster liberation and concern of humankind due to the sustainable patient-nurse relations. Nurses learn not only to care for others, but also themselves. A caring atmosphere creates a healing environment and this goal is achieved when caregivers are physically revitalized.
References
Benton, D. (2012). Advocating Globally to Shape Policy and Strengthen Nursing’s Influence. The Online Journal of Issues in Nursing, 17(1), 1-15.
Watson, J. (2008). Nursing: The Philosophy and Science of Caring. Boulder, CO: University Press of Colorado.