MARGARET JEAN WATSON

“Humans cannot be treated as objects and that humans cannot be separated from self, other,
nature, and the larger workforce.“

EDUCATION
▪ Dr. Watson was born and raised in a small town in the Appalachian Mountains of
West Virginia in the 1940’s
o 1958-61
• R.N. Diploma in Nursing Accomplishments
• Lewis-Gale School of Nursing  International Kellogg
o 1962-64 Fellowship in Australia
• B.S. in Nursing  Fulbright Research Award
• University of Colorado in Sweden
o 1964-66  Six Honorary Doctoral
• M.S. in Psychiatric Mental-Health Nursing; Minor Psychology Degrees
• University of Colorado  Including 3 International
o 1969-70S Honorary Doctorates
• Graduate Work: Social and Clinical Psychology (Sweden, UK, Canada)
• University of Colorado  1993 National League for
o 1969-73 Nursing Martha E. Rogers
• Ph.D. in Educational Psychology and Counseling Award
• University of Colorado

FACTS
▪ Listed here are many of her accomplishments of distinction, most of which were given for
recognition of her work in making significant contributions to nursing knowledge and the
science of care.
▪ Some notable mentions include her six honorary doctoral degrees, three of which are
internationally recognized from Sweden, the UK and Canada.
o Her recent undertaking involves the Centre for Human Caring in Colorado, in which
she is the founder. Here, programs have been established to promote human caring
activities of nursing as a way to branch off from reductionist models of the
biomedical approach.
o Dr. Watson founded and directs the non- profit Watson Caring Science Institute,
dedicated to furthering the work of caring, science, and heart-centered Carita‘s
Nursing, restoring caring and love for nurses’ and health-care clinicians’ healing
practices for self and others.
o Distinguished Nurse Scholar, recognized by New York University
o Norman Cousins Award in 1999
o Recognition for her commitment to developing; maintaining and
exemplifyingrelationship-centered care practices
o Founder of the Centre for Human Caring in Colorado
o Is a Fellow at the American Academy of Nursing
o Influences
 o Her theories are influenced by the Eastern Philosophy viewpoint, seeing the body as a
whole unit, not a sum of parts. This idea links to previous theories to her time,
including those of Nightingale, Leininger and Paterson & Zderad. Because of her
background in psychology, theorists like Carl Rogers and Richard Lazarus also show some
influence.

Theory of Human Caring Watson’s Motivation for Developing

Her Model:
 It is the Blueprint for nurses to
 Education
restore the art of nursing
 Life Experiences
practice and better care fortheir
 Exploration of Self
patients and themselves
 Nursing has changed
dramatically as science and
medicine have adapted to meet
Major Elements of the
Caring Theory
the growing demands of our  Carative factors, evolving into
population. It’s increasingly a Clinical Caritas Processes
skilled –based profession with  Transpersonal Caring
paper works to accomplish. Relationships
However, it is important to  Caring occasion/Caring
remember the roots of nursing moment
which are based on caring and
healing principles.

Carative Factors
o Guides the core of nursing
o 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, 1997, p.
50).
o Contrasts the curative factors of medicine (curative means to cure a disease)
o Carative factors evolve into Caritas factors
o Watson now makes connections between human caring, healing, and even peace
in our world, with nurses as caritas peacemakers when they are practicing human
caring for self and others. Caritas comes from the Latin word meaning “to cherish
and appreciate, giving special attention to, or loving
Ten Carative Factors

1. FORMATION OF A HUMANISTIC-ALTRUISTIC VALUE
SYSTEM.
The value of altruism (regard for
others as a personal action) is learned at an
early age. It is a value shared with parents.
One's own life experiences are learning
opportunities to gain insights about dealing
with others. Caring based on humanistic values
and altruistic behavior "can be developed
through examination of one's own views,
beliefs, interactions with various cultures and
personal growth experiences." This
development is perceived necessary for the
nurse's own maturation.
2. INSTALLATION OF FAITH-HOPE.
This factor is deemed essential to both
carative and curative processes. To nurses, this
provides a basis for looking into the healing power
of belief, or thespiritual dimension, when curing
is not possible. The use of Faith-Hope as a
nursing intervention allows nurses to explore
alternative methods of healing, like
meditation. It seems that the goal for this
activity is the provision of a sense of wellbeing
through belief systems that are meaningful to
the client.
3. CULTIVATION OF SENSITIVITY TO SELF AND
OTHERS.
Nurses promote "health and higher-
level functioning only when they
perform person-to-person relationships
as opposed to manipulative
relationships." There is a need for the
nurse to develop and examine one's own
feelings. Through this process, increased
sensitivity to others is developed. The nurse
becomes honest and promotes self-growth
and self-actualization. Watson's premise
furtherstates "that at the highest level of
nursing, the nurse's human care responses,
human care transactions, and presence in
the relationship transcend the physical
material world." The explanation makes it
clear that interactions between the nurse
and the client deal with the person's
emotional and subjective world as a means
to learn the inner self
4. DEVELOPMENT OF A HELPING-TRUST
RELATIONSHIP.
Communication, both verbal and
non- verbal, is a mode of accomplishing a
helping-trust relationship to establish
rapport and caring. Characteristics
common to this carative factor are
congruence, empathy, warmth and
honesty. Positive acceptance of another
is most often expressed by body language,
touch and tone of voice. I'm sure that
given your clinical experiences, you can
think of many situations to relate to this
fourth carative factor.
5. PROMOTION AND ACCEPTANCE OF THE
EXPRESSION OF POSITIVE AND NEGATIVE
FEELINGS.
According to Watson, it is
important to facilitate awareness of
both negative and positive feelings to
improve on one's level of awareness.
Feelings need to be considered in a caring
environment. Being aware of both
positive and negative feelings leads to
better understanding of behavior.
6. SYSTEMATIC USE OF THE SCIENTIFIC PROBLEM-
SOLVING METHOD FOR DECISION MAKING.
This factor gives notice to the
limitations nurses have in assessing the
issue of developing a scientific base
because most of our time is dedicated to
the performance of nursing tasks such as
procedures and treatments.
Thus, recognition is given to the use of
the systematicproblem-solving method
in building nursing knowledge. In the
same way, the argument extends to
other methods of knowing like utilizing
research-based findings in order to
improve nursing practice and provide
holistic care.
7. PROMOTION OF INTERPERSONAL
TEACHING-LEARNING.
Through this factor, persons
(clients) gain control over their own
health because it provides them with
both information and alternatives.
Learning offers opportunities to
individualize information dissemination.
The caring nurse focuses on the learning
and teaching process, as well as in
understanding the client's perception
of the situation. This provides for a
cognitive plan workable within the
client's frame of reference.
8. PROVISIONS FOR A SUPPORTIVE, PROTECTIVE
AND (OR) CORRECTIVE MENTAL, PHYSICAL,
SOCIOCULTURAL AND SPIRITUAL
ENVIRONMENT.
There are two divisions or
categorizations relative to this factor:
external variables which include
physical, safety and environmental
factors; and internal variables which
refer to mental, spiritual or cultural
activities which the nurse may
manipulate for the person's well-
being. An interdependence exists
betweeninternal and external factors
since the person perceives the situation
in the environment as either
threatening or non-threatening. There
are events in a person's life that can
arouse a sense of threat. The person
appraises the situation and copes to the
best of his ability. Thenurse's assessment
capabilities can be valuable in helping
the person appraise the situation and
cope with it.
9. ASSISTANCE WITH THE GRATIFICATION OF
HUMAN NEEDS.
The hierarchy of human needs is
the essence of this carative factor. It is
grounded in a hierarchy of need similar
to that of the Maslow’s. Watsons has
created a hierarchy which she believes is
relevant to the science of caring in
nursing.
 10. ALLOWANCE FOR EXISTENTIAL-
PHENOMENOLOGICAL-SPIRITUAL FORCES.
Phenomenology is a way of understanding
people from the way things appear to them,
from their frame of reference. Existential
psychology is the study of human existence using
phenomenological analysis. This factor helps the
nurse to reconcile and mediate the incongruity of
viewing the person holistically while at the same
time attending to the hierarchical ordering of
needs. Thusthe nurse assists the person to find the
strength or courage to confront life or death.

The Carative Factors Evolve into Caritas Factors

Carative
▪ Faith and hope
▪ Helping-trusting, human care relationship
▪ Creative problem-solving caring process
▪ Expressing positive and negative feelings
▪ Transpersonal teaching- learning
Caritas
▪ Being authentically present and enabling the beliefs of the one being caredfor and the
one giving care
▪ Developing and maintaining a trusting, authentic, caring relationship
▪ Creative use of self
▪ Being present to and supporting the positive and negative feelings with aconnection of
a deeper spirit
▪ Engaging in genuine teaching-learning experience
Transpersonal Caring Relationship
o Transpersonal means to go beyond one’s own ego and reach a deeper spiritual
connection while comforting a patient.
o The transpersonal relationship depends on:
▪ A commitment from the nurse to enhance and protect human dignity
▪ An awareness from the nurse that they have the ability to heal
▪ The nurse must go beyond the objective role
▪ To preserve and protect a person’s humanity, and dignity
▪ Preserve a patient’s spirit to ensure the patient does not become an object
o The nurse’s caring and connection have potential to heal since experience,
intention, and perception are taking place.
o Nursing goes beyond an objective assessment and shows concern for the patient’s
own healthcare
o Goal of transpersonal caring relationship protects, enhances, and preserves human
dignity, humanity, wholeness, and inner harmony
Caring Occasion/Caring Moment
o Caring occasion is the moment when the nurse and another person come together in such
a way that an occasion for human caring is created. Both persons cometogether in a
human-human transaction. The one caring for and the one being cared for are
influenced by the choices and actions decided within the relationship
o Watson (1998, 1999) stated that when human caring is created the nurse and patientcome
together to create a moment, this is known as the caring occasion/caringmoment
o Watson (1999) feels as though the nurse and the patient must be aware of the caring
moment so as to make appropriate choices and actions, thereby the nurse without
knowing becomes a part of the patients “life history”

NURSING METAPARADIGM
Human Being
 The person is to be valued, cared for, respected and
viewed in a holistic way,as body, mind and spirit How does the theory apply to
Environment
 The person’s environment should be conducive to
our nursing practice?
healing and that the person and their environment
are connected. We agree with Watson and feel
 The person’s frame of reference is also something that that the contact and the bond
should be considered,and the nurse should strive to stay
within the person’s frame of reference between two individuals is the
 According to Watson, caring (and nursing) has existed foundation of nursing. We
in every society. Acaring attitude is not transmitted
from generation to generation. It is transmitted by the
provide this caring and z
culture of the profession as a unique way of coping with its approach to promote holistic
environment. health and prevent illness.
Health A “good” nurse cannot be
 Health is viewed as overall functioning and distress and defined solely by her ability and
disharmony can be caused by more than just disease
processes skills but also by how well she
 Watson believes that there are other factors that are interacts with the client and
needed to be includedin the WHO definition of health. She family while providing that
adds the following three elements:
o A high level of overall physical, mental and social care.
functioning
o A general adaptive-maintenance level of daily
functioning
o The absence of illness (or the presence of efforts that leads its absence)
Nursing
 Watson argues that caring is central to the profession of nursing and thatnursing care should
also focus on promoting health and preventing illness.
 The nurse should focus their care on healing and wholeness as opposed totasks, illness and disease

CARING AS THE ESSENCE OF NURSING (JEAN WATSON, 1979)

→ Watson viewed caring as the essence of nursing. Caring connotes responsiveness between the
nurse and the person. The nurse co-participates with the person. The purpose of caring is to assist
the person in gaining control and becoming knowledgeable, and in the process promote health
changes. If we have thought of the concept of empowerment while reading this, yes, we can say
that it is similar to that. By allowing the client to be knowledgeable, the nurse provides an
environment for better decision-making, better self-control and, better self-respect. The
concept is common to Filipino culture: “kakayahan" or "patibayin ang kakayahan," meaning
assisting the person in gaining control.
→ While it is true that caring as an attribute in nursing has been described and clarified by many
others, there is uniqueness in Watson's science of caring. Basic assumptions for the science of
caring are supported by ten carative factors that provide structure to the concept of caring.
According to Watson, the first three carative factors provide the philosophical foundation for
the science of caring. The remaining seven carative factors spring from the foundation laid by
these first three.

Theory of Caring Applied

→ Carative factors used with postpartum women experiencing multiple emotions
 Never pass judgments, provide all patients with the same respect and level of care.
 Instill hope in the mothers that they will be able to care for their babies and return to
their “normal” state of health.
 Discuss the patient’s perceptions and feelings towards their birthing/parenting
experiences.
 Provide a trusting relationship where the patient feels that you are committed to helping
them. Advocate for the patient.
 Enable the patient to discuss positive and negative feelings concerning her current
healthcare/home situation.
 Use creativity during teaching opportunities and holistic treatments involving pain
management.
 Ensure that their environment is comfortable and enables them to get rest. Ensure that
the patient’s home environment is safe for mother and baby upon return.
 Help patients reach harmony (mind, body, spirit) through holistic and caring modalities.
Promote mother-infant bonding. Assess patient’s support system.
→ “Caring in the nursing profession takes place every time a nurse-to-patient contact is made...
That caring makes a difference to the patient’s sense of well-being. Caring may occur without
curing but curing cannot occur without caring”
Strengths & Weakness
• S - Can be applied in any area of nursing
• S - Addresses all aspects of the health and illness continuum, and the concepts are
abstract and open to interpretation
• W- Lack of concrete guidelines do not have specific steps