Paper #3
Course coordinator: Theresa Keane Ph.D.,NPP
Tatyana Lekomtseva
NUR 3130/Section 2717
05/10/13
Most of us choose nursing as a profession because of our desire to care for other people. According to Watson’s theory of caring, caring is the moral ideal, and entails mind-body-soul engagement with one another (Polit & Beck, 2010). Watson’s theory addresses how nurses express care to their patients, and how this caring can help patients get healthy. The major elements of Watson’s theory are the carative factors, the transpersonal caring relationship, and the caring moment. The theory contains 10 basic ideas or the 10 primary carative factors. Watson’s carative factors attempt to “ honor the human dimensions of nursing’s work and the inner life world and subjective experiences of the people we serve” (Watson, 2011). According to Watson (2011), the term “transpersonal” means to go beyond one’s own ego as it allows one to reach deeper spiritual connections in promoting the patient’s comfort and healing.
The first research demonstrated the effectiveness of a nurse’s caring relationship according to Watson’s Caring Model on the blood pressure and the quality of life of patients with hypertension ( Erci, Sayan, Tortumluoglu, Kilic, Sahin and Gungormus, 2003). The Watson’s Caring Model theoretically and philosophically guided this research study. The Watson’s model can guide public health nurses to design specific and effective care interventions, which can lower blood pressure of the patients and improve quality of life. The researchers used the one group pretest-post-test design. Before the study, the six nurse researchers were prepared in the Watson Caring Model by twice weekly sessions for a total 15h of didactic content in the model and the 10 carative factors (Erci et al, 2003). The nurse researchers developed how the model could be used in the care of hypertensive patients. The nursing care based on the Watson’s Caring Model began after 1 month’s preparation. The researchers educated the participants about hypertension, about improving self-health, enabling and authenticating the deep belief system and subjective life world of the patients (Erci et al, 2003). Also, the researchers created a healing environment at all levels including physical as well as nonphysical. The participants were taught that the researchers were present and supportive of the expression of positive and negative feelings (Erci et al, 2003). Erci et al., (2003) found that the increase in the mean scores of total scale, medical interaction, physical symptom and activity and general well-being were statistically significant for differences between pre test and post-test scores. After the intervention, the differences between systolic and diastolic in the blood pressure before and after the intervention were found to be statistically significant. Erci et al., (2003) concluded that nursing care that was given according to Watson’s Caring Model was likely to associated with increased quality of life of the patients and decreased blood pressure. This result was possible because the Watson’s Caring Model considers persons holistically together with their physical, psychological and social environment, and increases problem solve capacity (Erci et al., 2003).
I think the Watson’s Caring Model has taught nurses to be less task-oriented and become more aware of caring practices. The nurses should focus on what’s important to the patient. As a nurse working in a very busy pre-op area, I still prefer to spend a sufficient time with my patients. While I help patients settle in their rooms, I arrange their environment so that they can feel somehow comfortable. During the time in the pre-op area, I always ask about patient’s feelings and their priorities for their care plans. Most patients like to share their life stories with me which allow me to know them as persons not just “cases” going for surgery in our clinic. I agree with J. Watson that we need to spend uninterrupted time with patients and to find our “caring moments”. Unfortunately, some coworkers think that caring part takes too much time. They told me that my job is to admit the patient, take vital signs, complete all necessary paperwork and administer any necessary medications as per surgeon order and that is it. But, I have found that establishing trusting relationship with patients and focusing on the patients’ priorities will often help them participate more actively in their healing process. I think it is very important to establish a transpersonal caring relationship that will as Watson described “protect, enhance, and preserve my patient’s dignity, humanity, wholeness, and inner harmony” (Watson, 2011).
In the second study, researchers applied Watson’s Caring Theory to assess patient perceptions of being care for in a multicultural environment (Suliman, Welmann, Omer and Thomas, 2009). Many factors including cultural differences can influence caring as an act of providing care to patients in any health facility. The researchers (Suliman et al, 2009) found many studies that have shown that patient perceptions of caring may be different compared with staff nurse perceptions, especially when the patient and nurse come from different ethnic and cultural background, which means culturally learned behaviors, techniques, actions and patterns. According to Watson’s Caring Theory, nurses can play important role helping the patient to achieve a higher degree of harmony within mind, body, and soul through caring relationships (Suliman et al, 2009). Many studies were done before to define the concept of caring and caring behaviors. The researchers identified a list of most important caring behaviors. Suliman et al., (2009) used a questionnaire survey to explore perceptions of important caring behaviors and how frequently those caring behaviors were attended to by nurses. The questionnaire was based on Watson’s carative factors. The researchers collected data by using seven subscales of the Caring Behaviors Assessment of Chronin and Harrison to assess nursing behaviors and a Wilcoxon signed-rank test to examine the discrepancy between patient perceptions of the most important caring behavior subscales (Suliman et al, 2009). 392 patients were selected from three hospitals in three different regions of Saudi Arabia. The study indicated that patients rated overall caring behaviors as more important (97.2%) than frequently experienced (73.7%) (Suliman et al, 2009). The researchers found that the supportive/ protective/corrective environment subscale was rated as most important and most frequently experienced. Teaching/learning and helping/trust subscales were important too but less frequently experienced. The researchers explained that these two subscales require effective communication between patient and nurse (Suliman, 2009). Suliman et al., (2009) found that the lack of fluency in language resulted in miscommunication that could negatively influence the nurse-patient relationship.
As a NYC nurse, I also work in the multicultural environment where almost all patients and nurses are from diverse national background. Language is a very important part of how culture functions. The frequency of caring attended to by nurses in teaching/learning and helping/trust behavior subscales in that study were low because of the result of culture differences and language barriers that existing between patients and nurses. Nurses should use all possible ways to help alleviate language communication barriers and enhance interpersonal communication skills to create trusting, helping and caring relationships.
References
1. Eric, B., Sayan, A., Tortumluoglu, G., Kilic, D., Sahin, O., & Gungormus, Z. (2003). The effectiveness of Watson’s Caring Model on the quality of life and blood pressure of patients with hypertension. Journal of advanced Nursing, 41(2), 130-139.
2. Polit, D.F. & Beck, C.T. (2010). Essentials of Nursing Research. Appraising Evidence for Nursing Practice. Woters Klumer Health/Lippincott Williams & Wilkins.
3. Suliman, W.A., Welmann, E., Omer, T., & Thomas, L. (2009). Applying Watson’s Nursing Theory to assess patient perceptions of being cared for in a multicultural environment. Journal of Nursing Research,17(4), 293-300.
4. Watson, J. (2011). Postmodern Nursing and Beyond. New edition. Boulder, CO: Watson Caring Science Institute. Retrieved from: www.watsoncaringscience.org
