Nursing as a science experienced significant development in the past 50 years. The sheer expansion of medical care efforts across the world and the overall increase in the number of active nurses solicited the development of numerous nursing frameworks to help guide them in their practice. One particular framework that stands out is Jean Watson’s philosophy of nursing, which emphasizes creating a caring and loving environment in order to facilitate effective healing processes.
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Jean Watson is considered one of the most famous and well-known nursing theorists of the 20th century. She was born in West Virginia in 1940 (Watson, 2017). Her fascination with medicine and a penchant for caring developed during her time in school, when she chose to become a career nurse. Watson graduated in 1961 from Lewis-Gale School, after which she enrolled at the University of Colorado at Boulder, where she studied from 1964 to 1973, earning herself a doctorate in psychiatry and mental health nursing (Watson, 2017). Her work largely revolved around the fields of psychiatry, psychology, and patient education.
During her endeavors, she was able to observe how human relations and the environment affected the patients and their health. Although several prominent nursing theories were widely applied by that time, none of them addressed the intricate and delicate notions of psychiatric nursing, which encouraged Watson to create a nursing framework of her own (Watson, 2017). Watson’s theory of care was first published in 1988, in the Journal of Nursing, Human Science, and Human Care (Watson, 2017). Her paradigm had great success and saw application in many aspects of nursing and research. Jean Watson is now a distinguished professor of nursing, holding six honorary doctorate degrees, and being a chairwoman of Caring Sciences at the University of Colorado Health Sciences Center (Watson, 2017). The purpose of this paper is to analyze the theory’s core concepts, its application to nursing practice and research, as well as potential strengths and weaknesses of the paradigm.
Some of the core principles upon which Watson’s theory of care is built upon include the practice of love, kindness, and equanimity towards the patient. It is especially important in long-term care and psychiatric facilities, where the absence of love and feelings of isolation can be detrimental to the patient’s physical, emotional, and mental health (Alligood, 2017). According to Watson (2017), the purpose of a nurse is not just to facilitate a comfortable environment, but to become the environment for the patient, in order to cultivate a spiritual practice in order to ensure the wholeness of mind, body, and spirit. At the same time, Watson’s advocacy of this approach is largely utilitarian – she does not question miracles or other inexplicable life events, so long as they help the patient.
Watson’s theory covers all four aspects of nursing, which include the patient, health, environment, and nursing (Lee, Palmieri, & Watson, 2016). According to the presented theory of care, patients have a value within themselves and are to be cared for and assisted, viewed as something wholesome rather than the sum of their parts. Watson’s perceptions of health generally follow the guidelines of the World Health Organization (WHO) while adding additional dimensions to it, namely not only the absence of illness, but also the presence of high levels of physical, mental, and social functioning as well as an acceptable capability of daily functioning and self-care (Lee et al., 2016). The environment is perceived as one of the primary instruments of care, while a caring attitude is perceived as a cultural phenomenon, which transcends generations, therefore having its unique traits in every culture. In nursing, Watson believes in the holistic promotion of health and treatment of the disease.
Applicability of Watson’s Theory to Clinical Practice
As it is standard with any theory introduced into nursing, independent researchers analyzed Watson’s theory of human caring in order to determine how well it can be applied to clinical practice. Pajnkihar, McKenna, Stiglic, & Vrbnjack (2017) have recently conducted a thorough analysis of the framework in order to determine its actual usefulness in contemporary practice, education, and research. The study evaluated all of the major concepts of the theory, as well as its adequacy, acceptability, and testability instead of modern nursing philosophical views and paradigms.
The research found Watson’s theory of care to be a solid holistic framework that could be applied to many aspects of modern nursing. Pajnkihar et al. (2017) have emphasized the potential for further development of the theory in order to find practical application of it in all aspects of nursing science. Its educational value is enormous as it essentially teaches nursing students about what it means to be a caring nurse. It was concluded that the theory adheres to the existing standards of nursing due to putting a great emphasis on the environment and the patients, who are considered central to Watson’s essence of caring.
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Ozan, Okumus, and Lash (2015) have tested the applicability of Watson’s theory of caring in infertile women receiving in vitro fertilization treatment. In particular, the researchers were interested in examining the creative factor of health-healing-wellness, which was to be promoted by sustained interactions between the patient and the nurse. As was indicated by this study, Watson’s theory applies to nurse situations that have strong psychological aspects to themselves. It exemplified the value of theory-based nursing practice in assisting patients through stressful life events. In the scenario described by the researchers, Watson’s framework played a pivotal role in facilitating trust and healing during a moment where the patient realized her inability to conceive a child. The patient’s choice to turn to her nurse for healing instead of foregoing further treatment was paramount to success.
Relevance to Contemporary Practices and Research
The connection between the theorist and the theory at this point is obvious – Jean Watson formulated her theory based on her practice as a psychiatric nurse, and realizing that the existing models do not reflect on the nature of interpersonal relationships between the patient and the nurse nor do they realize the integral role a nurse plays in the environment surrounding the patient (Watson, 2017). Although her theory was initially to be applied to psychiatric environments, it proved to apply to any facet of nursing practice where the patient undergoes significant psychological and emotional stress.
Jean Watson’s theory of care, as evidenced by many corresponding studies, is highly relevant to modern healthcare. The paradigm shift from process-centered to patient-centered care that happened during the 1980s contributed to the relevancy of the theory, which put the patient’s physical, psychological, and emotional health first (Alligood, 2017). With medical efforts advancing and the focus on long-term care increasing, Watson’s theory finds significantly more outlets for utilization both within and outside of psychiatric care.
In terms of application to research, Watson’s theory offers an excellent framework for studies that aim to investigate the influence of interpersonal relationships and the environment on patient outcomes and the overall success of non-intrusive interventions. Examples of such research involve long-term care, post-operational care, psychiatric care, and any other aspects of nursing that involve long-term association between the nurse and the patient, where a nurse has an active role in constructing the physical and the emotional environment (Alligood, 2017).
Jean Watson’s theory of care is a powerful and all-encompassing framework that is centered on the patient and the environment while acknowledging the leading role of the nurse in ensuring a climate that facilitates the process of healing and personal growth. It adheres to four pillars of nursing and can be implemented in a multitude of environments to facilitate the process of long-term healing. Some of the strengths of Jean Watson’s theory involves the family aspect of nursing care and the importance of the patient’s cultural background as well as focus on appropriate nursing practices rather than technological advancements, which make it a solid framework to rely on in situations where resources available to the nurse are limited. The theory’s weakness lies in the overemphasis on psychological aspects of healing over biophysical needs of the body, as well as its apparent inapplicability in emergencies and triage, where a nurse’s time and resources are very limited, making it impossible to facilitate a healing environment and provide enough personal contact. Watson’s framework deserves additional research in order to determine the potential of its applicability in practice.
Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). New York, NY: Elsevier.
Lee, S. M., Palmieri, P., & Watson, J. (2016). Global advances in human caring literacy. New York, NY: Springer.
Ozan, Y. D., Okumus, H., & Lash, A. A. (2015). Implementation of Watson’s theory of human caring: A case study. International Journal of Caring Sciences, 8(1), 25-35.
Pajnkihar, M., McKenna, H. P., Stiglic, G., & Vrbnjak, D. (2017). Fit for practice: Analysis and evaluation of Watson’s theory of human caring. Nursing Science Quarterly, 30(3), 243-252.
Watson, J. (2017). Jean Watson – personal profile. Web.