Can Someone Be a Nurse Without Jean Watson?? - page 5

Ok now, as I delve back INTO nursing philosophy and theories, I come across, again, the theories of Jean Watson that have been hailed as the greatest thing since polyurethane IV bags - The Caring... Read More

  1. by   Nurse Ratched
    Cactus wren, honey, I'll see your Tylenol and raise you an extra strength .
  2. by   Glad2behere
    Wow Jim,
    What a wonderful article. I have been needing some kind of validation of this since nursing school in 1977.

    I remember when I did a psyche paper in nursing school, I went through hours and hours of research and the emphasis of the paper was that chemicals in the brain (serotonin and dopamine) were in a state of imbalance. I made that wild hypothesis in the paper that mentally ill patients were impossible to cure until these imbalances were physiologically corrected through pharmacological remedies. We could pat the patient on the back and reorient them to time and space, but there was really little we could do other than to classify them and keep them from hurting anyone or themselves.

    I got a freaking D on the paper! Instructor told me it was all junk and their was no place for that kind of garbage in the nursing profession....I started to realize at that moment what was wrong in nursing.
  3. by   NurseMark25
    Hooray for all you nurses that believe one can be a nurse without caring for a patient as if they were your mommies and daddies! Finally, it is so refreshing to see nurses that do not have that sentimental non-sense feeling about their jobs! I work in an ER. I rarely care for a patient for more than 2 or 3 hours at a time. I don't know these people. I am not capable of caring for a patient who is a complete stranger. You see, it takes a while for people to build a relationship to have that kind of caring. I care about doing my job well and I care about my paycheck that comes about every two weeks. I care that my patients see a professional before them, someone they can trust their lives with. I care that I do not make mistakes in the care of a patient. So I care about my work, and in an acquaintance sort-of-way, I care about the person as a human.

    I have problems with nursing theorists. They try to make nursing or describe nursing in such a way that is downright ludicrous. There was one theorist that I read about that described nursing as the interaction of balls of energy that interact with each other,share energy, and affect each other.... blah, blah, blah. I laughed my -ss off after I read this. PLEASE! How does that have anything to do with nursing??? How does this help me triage a patient in active CHF coming in through the front ER doors? How does it help me understand whether or not a patient may be having a reaction to a drug I gave? how does it help me interpret abnormal lab tests so that I can let the physician know something is up with my patient??? Nursing needs to be more like medicine... scientific, yet still have more of a human touch to it. Do you know what would happen if I attached myself to patients like that quack nursing theorist suggests? I see death almost every day that I work... if I cared for my patients like I do my mom or my dad, I would never come back to work! Nursing burnout would be worse. A degree of detachment from a patient allows a nurse to be more objective, calculated, and cool-minded... assets that are very important in a field such as ours.

    I do not mean to offend anyone here. But if nursing were more like medicine, we would all be sticking together, working in unions, making great pay with great benefits, having great nurse-patient ratios, and running the hospitals. Instead, we have this stupid theory of caring that causes us to be selfless, take less pay, get disrespected, and get stepped on. No thank you!
  4. by   kids
    In 12 years of Nursing I think I have done a great job of caring for people I didn't/don't care about. My level of concern isn't based on emotional attachment...sometimes you carry a patient home in a little corner of your heart/brain...others cease to exist the minute you walk out the door, they all get the same treatment, both physically and emotionally.

    I don't remember taking any philosophical type nursing theory in my ADN program...all of our theory classes were pretty much lecture/study expansion on the skill or body system we were covering in clinical that term.
  5. by   Q.
    Originally posted by oramar
    Suzy, thank you for posting this question, I love this intellectual stuff. Also, I love to be introduced to some ideas I have not heard before.
    Oramar, and Marie:

    You're welcome!
    If you notice, I go in cycles. I only post these things when I'm in school. Summer I posted basically norhing! Heee Heee.

    For those of you unfamiliar with Watson, she is typically presented with other fundamental theorists, such as Henderson and Rogers. Usually those three. Of course, depending on the philosophy of your nursing school you attended, Watson may have been omitted. As with Karen's school, they came from Neuman's theoretical framework, which, I just read two critiquing articles about her. In fact one of them tested her theory/philosophy in setting up a curriculum. The author never did state the outcome; so I am going to look at your post a bit more carefully and probably use them in discussion, if you don't mind.
  6. by   Q.
    Originally posted by Stargazer
    That, for me, is the key. In order for any theory to have scientific validity, it needs to be measurable, testable, and reproduceable.

    In a field where so much of what we do IS measurable, as Raskin points out--infection control, wound healing--there's really no reason why we can't be proving sound science-based theories with concrete outcomes. And given that fact, pie-in-the-sky models with no practical applications are just self-indulgent academic wankathons.
    I agree, except there are things nurses do that aren't measurable; ethics for one, caring the other. Also, it seems that nursing borrows alot of it's theories from other disciplines; why is that?

    I really want to construct a philosophy of nursing that can actually define the profession; one that does so without the academic/philosophical jargon, one that allows a nurse to take that and adapt it to individualize her practice, and one that address the nurse as a whole: her scientific, empirical knowledge that IS measurable, and the pieces of nursing that are hard to define and measure - like the art of nursing.
  7. by   Q.
    Originally posted by OBNURSEHEATHER


    Since I have never even heard of her, I would have to say yes.

    Heather
    Only you, Heather.
  8. by   Q.
    Originally posted by NurseMark25

    I do not mean to offend anyone here. But if nursing were more like medicine, we would all be sticking together, working in unions, making great pay with great benefits, having great nurse-patient ratios, and running the hospitals. Instead, we have this stupid theory of caring that causes us to be selfless, take less pay, get disrespected, and get stepped on. No thank you!
    There is alot that nursing can learn from medicine. Medical education struggled during it's early colonial times, but toughened up, standardized, and walla - we have what we have today. A defined profession with standardized education, measurable outcomes and respect.
  9. by   Glad2behere
    Suzy,

    I am all for you. Do something that makes sense....PUHLEEZ!

    I think it is interesting and congratulate you on your efforts.

    Will we get to read it and burn it if we don't like it? (laugh)

    Make some minor editing adjustments?

    Just teasing, I think it's wonderful...finally somebody on the right track!
  10. by   Stargazer
    Originally posted by Susy K
    I agree, except there are things nurses do that aren't measurable; ethics for one, caring the other.
    Okay, but these are present in medicine as well; and somehow medicine doesn't seem to be having the kind of identity crisis that nursing is.
    Also, it seems that nursing borrows alot of it's theories from other disciplines; why is that?
    I think it's because nursing is essentially being a jack-of-all-trades. We have to know medicine AND pharmacology AND psychology AND social services AND dietary AND...well, you get the idea.

    I'm not saying that caring or the art of nursing aren't important and a big part of what we do. I'm just saying that I think those things are virtually impossible to quantify or regulate or even teach. And to turn your question around, caring and ethics are part of medicine and other disciplines as well--so how come we're the only ones so bent on trying to define it and categorize it? And is that really where we should be concentrating our energies in developing a unified theory of nursing (if such a thing is possible)? Wouldn't it be better to construct a "base" of scientific theory first? When we're done with that, THEN we can kick back and have a glass of wine and get all metaphysical.

    I have no answers, folks--I'm just here to ask the big questions. :chuckle
    Last edit by Stargazer on Sep 12, '02
  11. by   rebelwaclause
    Originally posted by Susy K
    ...Wondering what your thoughts are on if someone can be a nurse and NOT subscribe to the caring theory. Can one be a competent nurse and NOT care about her patients any more deeply than simply getting the job done?
    My background prior to becoming a nurse is customer service. Within the customer service realm, I was formally trained in Franklin-Covey Time Management, Kaset Skills, and other Leadership/Customer Service based training courses. The names probably aren't familiar to many nurses, but a few may recognize Kaset as being the corporate trainers for Walt Disney and Federal Express. At one point, these two companies where leaders in customer service based on customer satisfaction.

    My training in customer service has been marketable in my healthcare career. The aspects of my formal customer service training that have been most effective in my nursing career is negotiation, and Kaset's famous Human-Business Model, which simply says address a person's human needs before doing business interactions. For nursing, this would mean allowing a patient to verbalize needs and concerns before our assessment, treatments, carrying out order's, etc., or whatever else we need from them.

    I have seen far too many nurses lacking the skills needed to even know how to remain a nursing professional, get the job done and not emesh with every patient that pulls at the heartstrings. This, in my opinion, takes more than over analyzed theories of caring and more than relying that instinct will pave a way to understanding needs. The average patient (reiterate "average") doesn't want a mother or father figure to nurture and cuddle them. They probably could care less if we care about them past the eight hours you'd spend with them. They do want to be treated professionally, with friendly, competent service. They want their problems resolved. When patients have a problem and need attention, they want to know that you will help them find a solution, even if you can't handle it yourself. They respond favorably to negotiating, rather than "no" or " I can't". Many times I've seen nurses give a patient a blank face to the simplest of problems or requests that require a certain amount of flexibility. I don't think its because they want to be aloof, I believe its because they have a whole lot of theory training, but ZERO problem solving skills beyond nursing outcomes, or the thought of following guideline to a tee.

    So, do I think can one be a competent nurse and NOT care about her patients any more deeply than simply getting the job done? Yes and no. The word "care" can be subjection, person to person. There has to be a certain amount of compassion for our trade present to even be a nurse. I mean, look at what we do on a daily basis. I can care about how my nursing skills is effecting my patients, but not want to bond with that person on a emotional level. That would imply my competency and value of getting the job done, without caring on a deep level.

    I hope I haven't played on words here. This topic is a little challenging to make a point effectively without addressing a gazillion other aspects of that point. With this being said, I hope you understand my point above.
  12. by   semstr
    here my 0.2 -cents.
    First time I read Watson's theory, it was a long, hard way.
    But, I like her theory, although it is very, very philosophical and at some times (for my taste) too no, na. (we say that here, when you mean, no kidding)

    One part of my teaching classes, is about the different theories, developed in the last century (now how does that sounds, he?).
    It is impossible to know all of them, there are so many and a lot of them are not very often used. Because, they are theories and nothing else.
    But for a good discussion, that is one of the ways I like to teach, they are good.

    We use, for the basic nursing skills, either Roper or Orem's ADL.
    For me and (from the feedback my collegues and I get from the students) the brandnew students, the "easiest" way to understand where to put in your nursing skills.

    Where I have big problems though, are the nursing diagnosis from the NANDA. They are pretty "strange" put (especially in their German translation!) and I have troubles with them, because they only diagnose the defencies (sp?) of a patient.
    Now, most patients, have ressources too, how small they may be.
    These diagnosis are too negativ for me.
    So what do you use in your hospital or healthcare centres?

    Thanks for a great thread, Susy!! Renee
  13. by   James Huffman
    Susy writes: "I really want to construct a philosophy of nursing that can actually define the profession; one that does so without the academic/philosophical jargon, one that allows a nurse to take that and adapt it to individualize her practice, and one that address the nurse as a whole: her scientific, empirical knowledge that IS measurable, and the pieces of nursing that are hard to define and measure - like the art of nursing."

    I found Dorothea Orem's self-care deficit theory to be good on this. I'm not sure it's really possible to build a philosophy of nursing without academic/philosophical jargon, but Orem's theory is a good place to start.

    Jim Huffman, RN

    www.NetworkforNurses.com

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