NCM 100

Theoretical Foundation in Nursing

Jean Watson:
Theory of Human Caring

❖ Jean Watson’s Background - third book, Postmodern Nursing and

- Dr. Jean Watson was born on June 10, Beyond(1999)
1940, West Virginia
- Bachelor of Science in Nursing at ❖ Theory of Human Caring
University of Colorado, 1966 - Caring is the essence of nursing and the
- Masters Degree in Psychiatric –Mental most central and unifying focus of nursing
Health Nursing practice
- PhD. In Educational Psychology and - Nursing is concerned with promoting
Counseling ,University of Colorado, health, preventing illness, caring for the
1973 sick, and restoring health
- Professor at the University of Colorado
Health Sciences Center ● Major Concepts of Theory of Human Caring
- Founder of Center for Human Caring in 1. The Carative Factors
Colorado 2. The transpersonal caring relationship
- Fellow of the American Academy of 3. The caring occasion or caring moment
Nursing
- Dean of Nursing at the University ➢ Watson’s Seven Assumptions
Health Sciences Center 1. Caring can be effectively
- Past President of the National League demonstrated and practiced only
for Nursing interpersonally.
- Author 2. Caring consists of carative factors that
result in the satisfaction of certain
❖ Jean Watson’s Awards human needs.
- She received a Kellogg Fellowship in 3. Effective caring promotes health and
Australia individual or family growth.
- Fulbright Research Award in Sweden 4. Caring responses accept person to
- Six Honorary Doctoral Degrees, choose the best action for himself or
including three International Honorary herself at a given point in time.
Doctorates 5. A caring environment is one that offers
○ Sweden the development of potential while
○ United Kingdom allowing the person to choose the best
○ Quebec, Canada action for himself or herself at a given
point in time.
❖ Jean Watson’s Books Published 6. Caring is more “healthogenic” than is
- First book, The Philosophy and Science curing. A science of caring is
of Caring (1979) complementary to the science of
- Second book, Human Science and curing.
Human Care — Published in 1985 and 7. The practice of caring is central to
reprinted in 1988 and 1999 nursing. (Watson, 1985)
➔ Watson’s 10 Carative Factors 5. Promotion and acceptance of the
- The original carative factors served expression of positive and negative
as a guide to what was referred to feelings
as the "core of nursing", in contrast - Feelings alter thoughts and behavior,
to nursing’s "trim". Core pointed to and they need to be considered and
those aspects of nursing that allowed for in a caring relationship
potentiate therapeutic healing - Increases one’s level of awareness
processes and relationships; they - Awareness of the feelings helps to
affect the one caring and the understand the behavior it cause
one-being-cared-for.
6. Systematic use of a creative
1. Formation of a humanistic-altruistic problem-solving caring process
(selfless) system of values - Allows for control and prediction, and
- Begins at an early age with values permits self-correction
shared with the parents
- Own life experiences, learning one 7. Promotion of transpersonal
gain and exposure to humankind teaching-learning
- Necessary to the nurse’s own - The caring nurse must focus on the
maturation promotes altruistic learning process as much as the
behavior towards others teaching process
- Understanding the person’s perception
2. Instillation of faith-hope of the situation assists the nurse to
- When modern science has nothing prepare a cognitive plan
further to offer the person, the
nurse can continue to use faith- 8. Provision for a supportive, protective, and
hope to provide a sense of or corrective mental, physical, societal,
well-being through beliefs which and spiritual environment
are meaningful to the individual. - The nurse manipulates the external
and internal variables to provide
3. Cultivation of sensitivity to oneself and support and protection for the
to others person’s mental and physical
- Development of one’s own feeling well-being
is needed to interact genuinely - External and Internal environment are
and sensitively with others. interdependent

4. Development of helping-trust, human 9. Assistant with gratification of human needs

caring relationship - Watson created an hierarchy of need
- Strongest tool is the mode of similar to that of Maslow’s
communication, which establishes - Each need is equally important for
rapport and caring quality nursing care
- Characteristics are Congruence, - All needs deserve to be attended to
Empathy and Warmth and valued
- Communication includes verbal,
non-verbal and listening which
connotes empathetic
understanding
10. Allowance for existential - ➔ Transpersonal Caring Relationship
phenomenological spiritual forces - An intersubjective (shared by one
- The nurse assists the person to find conscious mind), human to human
strength or courage to confront life relationship that encompasses two
or death individuals, both the nurse and the patient
in a given moment.
➢ Watson’s Ordering of Needs - It protects, enhances and preserve human
dignity, humanity, wholeness and inner
1. Lower Order Needs (Biophysical harmony
Needs)
- The need for food and fluid ➔ Caring Occasion / Caring Moment
- The need for elimination - The moment when the nurse and another
- The need for ventilation person come together in such a way that
an occasion for human caring is created.
2. Lower Order Needs - Both persons come together in a
(Psychophysical Needs) human-human transaction.
- The need for activity and
inactivity
- The need for sexuality “Maybe this one moment, with this one
person, is the very reason we’re here on earth
3. Higher Order Needs (Psychosocial at this time.”
Needs) - JEAN WATSON
- The need for achievement
- The need for affiliation

4. Higher Order Needs (Intrapersonal

- Interpersonal Need)
- The need for self-actualization

➢ Caritas Processes
- "Caritas" comes from the Greek
word meaning to cherish, to
appreciate, to give special
attention, if not loving, attention to;
it connotes something that is very
fine, that indeed is precious.
- “At this time, I now make new
connections between carative,
caritas and without hesitation
invoke the "L" word, which caritas
conveys, that is love, allowing love
and caring coming together for a
new form of deep transpersonal
caring.” (Watson, 1998)
Jean Watson “Tokyo Interview” Youtube Videos
Summaries and Key Points

❖ Introduction to the Theory of Human ● Introduction to Caritas Processes

Caring - Ten Caritas Processes, defining them as
- this theory is really essential to guide universal elements of human caring
our practice very crucial in clinical essential for nursing practice.
practice world - Emphasizes that understanding and
- a opportunity for nursing to be using this shared language allows
informed by its moral and ethical nurses to articulate their practice more
foundation, its philosophy, and values confidently amidst a hectic
toward humanity and sustaining postmodern world.
human caring
- sometimes referred to as a theory of ● The Caritas Processes
transpersonal caring
- it takes place in the moments with you ➔ Foundational Caritas Processes
and another human being or a family - The First Caritas Process focuses on
or even a colleague offering loving kindness and
- a model of caring science that helps equanimity to oneself, stressing the
us advance our practice and really necessity of self-care to sustain
fulfill our mission compassionate service to others.
- practice nursing in the fullest way of - The Second Caritas Process underlines
what you love and what has called the significance of authentic presence
you to this profession with patients, which fosters faith and
- underneath the theory is you, you hope in their healing journey.
become the theory, you become the
starting point by engaging in self ➔ Building Self-Awareness and Relationships
caring and self knowledge or advance - The Third Caritas Process relates to
about human caring self-sensitivity and acknowledging
one’s own emotions, vital for being
❖ The Ten Carative / Caritas Processes compassionate towards others.
- The Fourth Caritas Process outlines the
● Summary establishing authentic and trusting
- This elaborates on the "Ten Caritas relationships, which builds on the
Processes," which encapsulate the foundation of self-compassion and
essence of the theory of human caring genuine presence.
in nursing. It emphasizes the
importance of self-care and ➔ Expressing Emotions and Healing
compassion for oneself as Environment
foundational to providing care for - The Fifth Caritas Process highlights the
others, and explicates each process as importance of allowing the expression
a guide for nurses to enhance their of both positive and negative feelings,
professional practice and relationships aiding in the healing process of
with patients. patients.
 - The Sixth Caritas Process promotes self-awareness and intentionality in
a shift from traditional providing care. This theory connects
problem-focus nursing, advocating historical nursing values to ethical
for creative processes that engage practices, highlighting the significance
patients in their own healing of emotional connection with patients.
journeys. It outlines the Ten Caritas Processes
and discusses caring healing
➔ Educational and Environmental modalities, encouraging healthcare
Aspects professionals to approach their
- The Seventh Caritas Process practice with a deeper understanding
revolves around the educational of humanity and holistic care.
role of nurses, emphasizing
personalized teaching that ● Introduction to Human Caring Theory
resonates with patients' unique - Jean Watson introduces the Essence of
experiences. Human Caring Theory, emphasizing the
- The Eighth Caritas Process connection between the self and
recognizes that the nurse's compassionate care in healthcare
presence shapes the healing professions.
environment, with a focus on - She encourages viewers to pause and
compassion and authenticity reflect, preparing to engage with the
being crucial in clinical settings. theory intellectually and emotionally.

➔ Addressing Needs and Embracing ● “Key Points”

Uncertainty
- The Ninth Caritas Process stresses the ➔ Foundations of Nursing and Compassion
nurse's role in addressing patients' - The essence of the theory is rooted in
basic needs with dignity, treating these the legacy of Florence Nightingale,
acts as sacred. underscoring nursing as a profound
- The Tenth Caritas Process professional calling focused on
acknowledges the importance of compassionate human service.
humility and the acceptance of the - The theory promotes human integrity
unknown, encouraging openness to and the sustainment of humanity
miracles and unique patient through a commitment to
experiences. compassionate care beyond mere
tasks and skills.
❖ The Essence of Human Caring Theory
➔ Personal Connection and Ethical
● Summary Foundations
- This presents the Essence of the Human - Personal experiences and caring
Caring Theory, emphasizing the moments serve as the foundation for
foundational role of compassion and understanding the theory, allowing
relational presence in nursing and nurses to give voice to their
healthcare.​The speaker uses a singing compassionate practices.
bowl as a metaphor for resonating - The theory aims to inform nursing
with the vibrations of the human heart, practices with a focus on relational
stressing the importance of connection, advocating for seeing
 patients as whole individuals rather ❖ Integrating Human Caring into Basic Nursing
than merely diagnosing conditions. Education

➔ Importance of Being Present ● Summary

- Acknowledging the inherent need - It discusses the integration of a caring
for every individual to be seen, science curriculum into nursing education,
heard, and cared for is essential in emphasizing the importance of fostering
fostering meaningful relationships in caring relationships between faculty and
care settings. students. It outlines the transition from a
- She emphasizes the importance of content-driven approach to one that
presence and intention in emphasizes practice, authenticity, and the
delivering care, transcending emotional dimensions of nursing. Key
traditional approaches and methodologies include emancipatory
focusing on human connection. pedagogies, emphasizing practice in a
loving environment, and using dialogue to
➔ Caring Healing Modalities enhance understanding.
- It discusses various caring healing
modalities, referring to Nightingale’s ● “Key Points”
beliefs about the role of nature, light,
and sound in patient healing ➔ Definition and Importance of Caring
- .These modalities are not limited to Science Curriculum
procedural tasks but include a holistic - A caring science curriculum is framed
approach to patient care, as a dynamic relationship between
emphasizing the energetic relationship faculty and students, focusing on
between nurses and patients. caring relationships rather than a
sterile, fact-driven education.
● Conclusion and Reflection - It balances technical competencies
- Jean Watson encourages healthcare with the literacy of caring, ensuring
professionals to advance their practice students learn about the nuances of
through the theory, highlighting the human caring as much as technology.
transformative potential of intentional
caring practices. ➔ Transition from Content - Driven to Caring
- This concludes with a call to reflect CUrriculum
upon the discussed concepts and - The shift from a content-driven
think about how they can be curriculum to one that allows for
integrated into everyday nursing understanding through authentic
practices for improved care delivery. experiences is essential for developing
competent practitioners.
- Emphasizing understanding, personal
practice, and integrating knowledge
into a caring context is key for
meaningful education.
➔ Emancipatory Pedagogies ➔ Expanding Ways of Knowing
- Emancipatory pedagogies - Incorporating various epistemologies
encourage creative learning enriches the learning process, allowing
environments, such as circular students to approach problems from
classrooms, which foster multiple perspectives.
community and personal - This provides insights into the human
engagement. dimensions of nursing, addressing both
- Utilizing arts and humanities allows patient and student experiences
for a deeper exploration of nursing
practices beyond technical skills. ➔ Overall Transformative Impact
- The integration of caring science
➔ Four Major Ingredients for curriculum can transform not just
Implementing Caring Science individual practices but the culture of
○ Practice: Students practice caring nursing education.
relationships in the classroom to - By aligning education with caring
mirror clinical environments. theories, the profession can uphold its
○ Modeling: Educators should model timeless values and improve overall
authenticity, helping students patient care outcomes.
discover their best selves rather
than trying to imitate others. ❖ Clinical Practice of Human Caring
○ Authentic Dialogue: Creating a
safe space for students to ask ● Summary
questions and engage in genuine - This explores the application of the theory
discussions is critical. of human caring in clinical practice,
○ Affirmation: Instructors should affirm emphasizing the significance of
students' highest ethical ideals, recognizing and articulating caring
supporting them during their moments. It discusses methods to
struggles. incorporate caring processes into nursing
practice, suggesting practices like mindful
➔ Connection Between Education and breathing and rituals to create
Clinical Practice compassionate environments, thereby
- The education methods used transforming care delivery and improving
directly affect clinical practice; an well-being for both patients and
authoritarian model in teaching healthcare professionals.
leads to professional distancing
with patients. ● “Key Points”
- The concept of praxis emphasizes
integrating knowing, being, and ➔ Understanding Human Caring Theory
doing into one cohesive act during - She emphasizes the relevance of the
patient care. theory of human caring in clinical
practice and how it might seem
abstract initially.
- Describing personal experiences of
caring moments can reveal evidence
of caring processes typically present in
nursing practice.
➔ Transforming Clinical Practice - The re-framing of traditional nursing
- By focusing on caring moments, practices allows for creativity and
nurses can become more personalization in caregiving.
intentional and systematic, moving
away from ad hoc caring ➔ Making Caring Visible
experiences towards a structured - Hospitals implementing caring theory
practice model. display visual representations of caring
- This shift enhances the overall processes, making explicit what has
delivery of care, influencing the traditionally been invisible in
dynamics of the healthcare healthcare.
environment positively. - Healing spaces have been established
within hospitals, facilitating
➔ Micro Practices for Compassionate environments for nurses to recharge
Care and reflect.
- Specific practices, such as pausing
and meditating before entering a ➔ Creating a Caring Culture
patient’s room, help nurses to - The integration of caring processes in
cultivate authentic presence and practice encourages a cultural shift
compassion. within healthcare environments
- Hospitals have adopted tools like toward collective compassion and
magnets on doors to remind nurses support.
to engage in self-care and - Utilizing theory in nursing leads to the
approach patients with mindful creation of holistic healing spaces that
compassion. positively impact patients and staff
alike, fostering a more humane
➔ Self-Care and Energy Cleansing healthcare system.
- Hand washing can serve as an
opportunity for nurses to cleanse
any negative energy while
promoting infection control,
emphasizing the importance of
self-care in sustaining
compassionate care.
- Breathing practices allow nurses to
connect with the rhythm of the
universe, promoting a calm and
present state to better serve
patients.

➔ Holistic Healing Modalities

- Nurses can incorporate various
forms of expression like art, dance,
and journaling as healing
modalities that honor patient
experiences.
NCM 100
Theoretical Foundation in Nursing
Ernestine Weidenbach:
The Helping Art of Clinical Nursing Theory

“Nursing is the art of nurturing or caring for

someone in a motherly fashion”
- ERNESTINE WEIDENBACH

❖ Objectives - Got a Certificate in Public Health Nursing in

- After 1.5 hours of interactive virtual 1934
lecture discussion the BSN level 2 - Work as a public health nurse at the
student nurses will be able to gain Association for Improving Conditions of the
beginning knowledge, skills and Poor (AICP)
attitude in The Helping Art Theory by - She left clinical nursing and work as a
Ernestine Wiedenback. professional writer at the Nursing
- Specifically, the students will be able Information Bureau (NIB) for the American
to: Journal of Nursing
1. Discuss the early life and - After bombing Pearl Harbor , she prepared
educational background of nurses to enter WWII through the NIB
Ernestine Weidenbach. - Graduated at School of Midwives at age
2. Identify her contributions in nursing 45 and practiced as a nurse-midwife at the
3. Explain her nursing theory Maternity Center Association
4. Discuss the four paradigms in - 1952- became a faculty of Yale University
nursing School of Nursing
- Became a Director of graduate programs
❖ Ernestine Weidenbach (1964) in maternal-newborn health nursing in 1956
- Theory: The Helping Art of Clinical - 1958- she wrote “ Family-Centered
Nursing Maternity Nursing”, a comprehensive test
- Born to a rich family in 1900 on obstetrical nursing
- Germany - She taught with Ida Jean Orlando ,
- Interest in nursing started watching the collaborated with Patricia James and
care of her sickly grandmother and a William Dickoff about nursing and
sister's friend who is a medical student philosophy at Yale
- Graduated with a degree in Liberal Arts
at Wellesley College in 1922 after which
she enrolled in nursing
- Graduated nursing in John Hopkins in
1925
- Supervisor at John Hopkins then
Bellevue in New York
- Graduated Master’s Degree at
Teacher’s College, Columbia University
-
● 4 Elements of Clinical Nursing ● Weidenbach Conceptualizes:
- Nursing as the practice of identification of
1. Philosophy a patient’s need for help
- Nurses' belief and attitude about ○ observation of presenting behaviors
life and how that effected reality and symptoms
for them ○ exploration of the meaning of those
- It motivates the nurse to act in a symptoms with the patient
certain way ○ determining the cause of discomfort
- 3 Essential components: ○ determining the patient’s ability to
a. Reverence for life resolve the discomfort
b. Respect for the dignity, worth ○ or if the patient has the need for help
and individuality of each from the nurse or other healthcare
human being professionals
c. Resolution to act on personally
and professionally held beliefs ● Concepts:

2. Purpose ➔ Person
- That which the nurses wants to - any individual who is receiving help
accomplish through what she (care, instruction or advice) from a
does. health professionals
- All of the activities directed
towards the overall good of the ➔ Environment
patient - not specifically addressed

3. Practice ➔ Health
- Are those observable nursing - Not defined
actions that are affected by beliefs
and feelings about meeting the ➔ Nursing
patient’s need for help - is a functioning human being who
acts, thinks and feel
4. Art - all actions, thoughts and feelings
- Understanding of patient’s needs underlie what the nurse does
and concerns • Developing goals
and actions – to improve patient’s ❖ Prescriptive Theory
condition • Focuses on prevention - Wiedenbach's prescriptive theory is based
of complications related to on three factors:
reoccurrence or development of - The central purpose which the practitioner
new concerns recognizes as essential to the particular
discipline.
- The prescription for the fulfillment of the
central purpose.
- The realities in the immediate situation that
influence the central purpose.