I.

Watson’s Philosophy and Science of Caring in Nursing Practice

BACKGROUND

-Watson’s work began as a textbook for an integrated nursing curriculum at the University of
Colorado.
-Begins with the question of the relationship between human caring and nursing, this initial work
laid the foundation for what was to become The Theory of Human Caring: Retrospective and
Prospective (Watson, 1997);

Overview of Watson’s Philosophy of Human Caring

- Watson describes her work as a framework, theory, model, worldview, or a paradigm

that is transdisciplinary. This means useful for all health professionals and healing practitioners,
particularly those practicing mind-body medicine.

Human Beings (Personhood)

Person is viewed holistically wherein the body, mind, and soul are interrelated, each
part a reflection of the whole, yet the whole is greater than and different from the sum of parts
(Watson, 1979, 1989).

The mind and emotions are the starting point and the access to the subjective world. The self,
the seat of identity, is the subjective center that lives within the whole of body, thoughts,
sensations, desires, memories, and life history. She gives honor to deep meanings and feelings
about life, living, the natural inner processes, personal autonomy, and freedom to make choices
shaped by subjective intent (Watson, 1985, 1999).

-Focuses on higher sense of self, transcending physical, emotional, and mental aspects.

Nursing (Transpersonal Caring-Healing)

Watson (1999) describes nursing as transpersonal that “conveys a human-to-human

connection in which both persons are influenced through the relationship and being-
together in the moment. This human connection...has a spiritual dimension...that
can tap into healing”

The goal of nursing in the caring-healing process is to help persons gain a higher degree of
harmony within the mind-body-spirit, which generates self-knowledge, self-reverence, self-
healing, and self-care processes allowing for diverse possibility.

The greater the “degree of genuineness and sincerity” (Watson, 1985, p. 69) of the nurse within
the context of the caring act, the greater the efficacy of caring.
Watson emphasizes the nursing act of helping persons while preserving the dignity and worth of
the patient or client regardless of his or her situation (Watson, 1979, 1985, 1999, 2005, 2008,
2011).

Caring science allows nurses to approach the sacred in caring-healing work

(Watson, 2005, 2008). In caring sciences, compassionate human service and caring
are motivated by love. The general goal is biophysical-mental-spiritual evolution for
self and others as well as discovery of inner power and self-control through caring.
Shifting the focus from illness, diagnosis, and treatment to human caring, healing, and
promoting spiritual health potentiates health, healing, and transcendence
(Watson, 1999).

“Caritas” means to cherish, appreciate, and give special attention (Watson, 1999, 2005) and is
related to “carative,” a deeper and expanded dimension of nursing that joins caring with love.
Caritas is differentiated from “amore” that “tends to be a love in which self-interest is involved”
(Watson, 2008, p. 253).

Health

Health is redefined in this philosophy as unity and harmony within the body, mind, and soul and
harmony between self and others and between self and nature and openness to increased
possibility. Watson (1989, 1999, 2008, 2011) defined health as a subjective experience and a
process of adapting, coping, and growing throughout life that is associated with the degree of
congruence between self as perceived and self as experienced.

Illness is subjective turmoil or disharmony within a person’s inner self or soul at some level or
disharmony within the spheres of mind, body, and soul.
Illness connotes a felt incongruence within the person such as incongruence
between the self as perceived and the self as experienced (Watson, 1985, 1988a), yet it
is also an “invitation to understand, to gain new meaning for one’s life pattern, to see
health and illness as evolving consciousness and opportunist for healing” (Watson,
2008, p. 228).

Illness may lead to disease but not on a continuum. Rather, she suggests that health, illness,
and disease may exist simultaneously (Watson, 2008).
Environment (Healing Space)

In the 10 carative factors and in clinical caritas, Watson (1999, 2008) addresses
the nurse’s role in the environment based on Nightingale’s tradition of the significance of the
environment for healing: “attending to supportive, protective, and/or corrective mental, physical,
societal, and spiritual environments” (Watson, 1979, p. 10) and recently as “creating a healing
environment at all levels” (Watson, 2008, p. 129). Watson (1999, 2005, 2008) has broadened
her focus from the immediate physical environment to a nonphysical energetic environment,
vibrational field integral with the person (Quinn, 1992; Watson, 1999, 2005, 2008, 2011).

The nurse becomes the environment in which “sacred space” is created. She describes how
the “nurse is not only in the environment, able to make significant changes in the ways of
being/doing; knowing in the physical environment, but that the nurse IS the environment”
(Watson, 2008, p. 26).

Watson also recognizes how environmental challenges to concepts of caring—including a

diminishing workforce, admission of more acutely ill patients with complex needs, cultural
differences, economic factors, as well as organizational, social, and health care policies—
influence the amount and quality of time a nurse can spend with clients/patients (Watson, 1999,
2005, 2008, 2011).

Critical Thinking in Nursing Practice with Watson’s Philosophy and Theory

Engaging in Watson’s philosophy and caring theory involves subjectivity and reflection. She
suggests that you:

•Experience the transpersonal body in centering and meditation practices.

•Experience your own caring through the use of art or healing therapies on yourself.
•Experiment with the conscious use of caring consciousness in patient relations.
•Compare your experience with the theory

Reflection is essential for nurses and guides the nurse towards the caring process. Reflection
could either be: reflection in-action which means reflection learned within the experience of
caring or reflection-on-action which is based on previous experiences.
Watson’s 10 Carative Factors
Advanced caring-healing arts or modalities

These modalities are also extensions of the carative factors of Watson’s earlier
work (1985) and the art of transpersonal caring that included “movement, touch,
sounds, words, color, and forms” (pp. 66-68).

These advanced caring-healing modalities include:

-the intentional conscious use of imagery and auditory, visual, olfactory,
tactile, gustatory, mental-cognitive, kinesthetic, and caring consciousness, which
includes psychological and therapeutic presence modalities (Watson, 1999, 2008).

By exploring the integration of such therapies as music, visualization, breath work,

aromatherapy, therapeutic touch, massage, caring touch, reflexology, dream work,humor, play,
journaling, poetry, art making, meditation, transpersonal teaching, dance, yoga, movement,
authentic presencing, and centering into caring practice as options for patient healing, the nurse
acknowledges the emerging consciousness paradigm.

Reference:

Alligood, M. Nursing Theory: Utilization and Application, 5th Ed. 2014 Mosby, Elsevier Inc.