Can Someone Be a Nurse Without Jean Watson?? - page 9

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   donmurray
    This man was speaking against the setting up of the UK nursing register in 1904! It happened anyway. I'm a RN, I was not seeking to reopen the "are we a profession" debate, but pointed to his comment about pseudo-scientists, relating it to Susy K's question on gaining respect from the scientific community, which I do not believe we yet have done. (excuse the awful grammar!)
  2. by   Q.
    Originally posted by semstr
    Susy, question: do you learn something about the European theories too? like Juchli, Krohwinkel and Kppeli?
    Are you into the nursing-phenomenens and stuff like that?
    Take care, Renee
    No, I don't think so. Do you have any info?
  3. by   rncountry
    Perhaps instead of it being nursing theory it should be nursing philosophy. The two ends of nursing should be split, scientific and philosophy. I agree with suzy, to attempt to base a philosophical theory off as science only downgrades nursing, and I personally find it embarrassing some of the things floated out there. I always have been interested in holistic nursing, which is not to say the "alternative" treatments ends of it. I mean the treating of mind, body and spirit. Some of that would require theory, though it should be presented as a philosophical theroy not science, unless it can meet the requirments of scientific theory. I don't know if I made much sense on that, but I hope so.
    To me at least Kant makes sense though not an easy read. And stargazer you cracked me up. Personally I'll take throwing the aura in the dryer, I don't have time to provide any other form of fluffing!
  4. by   WashYaHands
    From what I know about Jean Watson's research, she did not intend for it to be viewed as a hard science/natural science research method. Her work is described as a philosophy and a theory. Nursing considers it a theory because nursing theories are used to explain why we do what we do in practice. In her research she sought to explore the difference between "taking care of" and "caring about" patients. She wanted to describe the similarities and differences between what nurses consider care and what patients consider care, and to generate a testable hypothesis around the concept of nursing care. Watson believes that "caring" is a nursing term, which she believes represents the factors that nurses use to deliver health care to patients. The way that I understand it is that she sees caring (as opposed to curing) one of the things that makes nursing unique and deliniates nursing from medicine. That's not to say that nurses arent educated in medicine or that we dont practice medicine (we do), but we also have other qualities, which is why nursing is described as both a science and an art. I think she wanted to delve into the "art" aspect of nursing.

    Linda
  5. by   NurseMark25
    Whoa! Dr. llg,

    I understand that you have a Ph.D. That's great. I pray that it is not in nursing, otherwise you have wasted your education. I am a clinical nurse. I do not theorize. I do not perform research. I do not want to be a manager. I want to be an outstanding professional nurse. Nursing is something that has been taken to a level that is almost ludicrous, especially when we are discussing a doctorate in nursing. A nurse's practice is limited to the institution or environment she or he works in. Nurses only have so much clinical skill. You can only start an IV so many times before it gets boring. You can only listen to someone's lungs so many times before you've heard them all. Nursing is a very technical, task-oriented job. It is a very limited profession. Unless you are an NP, you cannot prescribe. You cannot diagnose. You cannot cannot treat ailments. You cannot interpret lab tests and you cannot interpret diagnostic tests. Yet, we seem to have so many of these theorists that attempt to make the profession more than it is. I don't believe the nurses in this thread are confusing philosophical theory with scientific theory. I believe the nurses are trying to say that because nursing is technical and task-oriented, a scientific theory fits better than a philosophical one. Furthermore, philosophical theorists seem to be more than just a little off. Scientific theory seems more practical, whereas philosophical theory has too much fluff.

    It seems to me that theorists emerged in the profession as a result of women who went into nursing, found out they really didn't like it or realized it was not what they had imagined, and because they were already stuck, advanced their education so that they could become these "great thinkers" and escape the horrors of bedside nursing. Now you and I both know the textbooks say this is not true... they created their philosophical hogwash to help people understand nursing and become great nurses themselves. Funny thing is though, I have yet to have a conversation with my emergency room colleagues discussing nursing theorists and how they helped us to become great nurses. We discuss interesting cases, discuss the lab reports, the clinical findings with the nursing assessments, the medications given... all the scientific medical jargon, not the fluffy caring jargon. Caring is not included in any of our conversations. And my colleagues are some of the best nurses around.

    Now I may have offended some of the nurses on this thread. For that I apologize. But I believe that I am looking at nursing from a very practical point- of- view. The best thing that this profession has done so far is creating the nurse practitioner and certified registered nurse anesthetist positions. This is where nursing is getting dynamic. Breaking away from that whole "nurse is maid and doctors' servant mentality" to "look what we can do, AND we can do it just as well as a doctor if not better". These professions make a statement. They say, "Nurses are valuable. Their services are just as important as a doctor. We will no longer be dictated to. We no longer have to take low paying jobs and like it. We are our own profession." It's a beautiful thing.

    Well, I look forward to the posts listed in response to this one. Remember, this is only an opinion, so please don't counter-attack too hard.
  6. by   Glad2behere
    Dr. llg

    I respect your opinions, I really do, and I am thrilled that someone in the upper echleon will at least admit or agree that nursing schools need vast improvement in scientific basis.

    I submit however, that any of that philosophical jargon only contaminates nursing as a profession. NurseMark25's post is right on, and as I said earlier, it is just grabblebrook to sell books.
    Apparently no one upstairs is listening, because all this bunk is coming from up on high, and really has nothing to do with the real world of nursing.

    I would like to make a suggestion if anyone is out there, and that is every PhD in nursing apply the simple concept of the nursing process to the practical environment. Assessment, planning, implementation, and evaluation. This is the one thing I learned from nursing school that makes sense, and it is applicable to anything, not just nursing. It is also applicable to TEACHING.
    I only wonder why nursing educators throw this simple concept out the window or botch it so badly in the first step. Assessment.

    None of these voodoo theories or philosophy carry any weight whatsoever because the information gathered is irrelevant, and the succeeding steps are all geared to justifying their importance.

    Guess what.....they ain't.

    What if nursing educators were to reassess nursing and come to a conclusion that there is a MIGHTY BIG DISCREPENCY and DISILLUSION between what is necessary to teach and what is taught.

    Analogy here. Nursing philosophy is at least this far off. Asking a 12 yo ice skating student to play professional hockey.
  7. by   globalRN
    Hello NurseMark25:

    I can appreciate your view and just want to comment on your post IMHO:


    'Whoa! Dr. llg,

    I understand that you have a Ph.D. That's great. I pray that it is not in nursing, otherwise you have wasted your education. '

    IMHO: we need more doctorally prepared nurses in nursing so that we can build our own body of knowledge and implement research based nursing practice whether it is in nursing education, research or clinical practice. Having doctorally prepared nurses advances nursing as a profession. Are you aware that nurses doctorally prepared nurses include PhD and
    DNSc(Doctorate Nursing Science). I would be interested in getting a DNSc...just not at this time in my life.

    'I am a clinical nurse. I do not theorize. I do not perform research. I do not want to be a manager. I want to be an outstanding professional nurse.'

    Dear NurseMark25, in order for us to be outstanding professional nurses we do need to utilize research and to support research especially when providing patient care. I am a clinical nurse and providing current research based care is very important to me.
    I share what I know. I provide the research findings/data to influence change in patient care standards if I see non-research based practice whether it is nursing or medical practice. Everyone is pretty keen on research based practice especially when it has to do with improved patient outcome...I have not had any problems with managers. doctors or bedside nurses. I will concede that I have never sat around with the above to discuss nursing theory/philosophy.

    I was reading a thread about ineffective nursing txs in nursing history here on this board. How did we find out those treatments didn't work and stopped doing them?.....through clinical research and the application of research findings. I feel that in order for nursing to advance as a profession: nursing education, clinical excellence and nursing research has to come together and to be in touch with one another. Educators have to be current clinicians in order to better prepare our new nurses, expert clinicians need to be involved in the educational and research process as it is through experience that one identifies research issues. Research findings alos need to be communicated and applied to education and to how it impacts patient outcome(applied research). When nurses support each other in all aspects of nursing, we will achieve the kind of professional recognition we want.

    "Nursing is something that has been taken to a level that is almost ludicrous, especially when we are discussing a doctorate in nursing. A nurse's practice is limited to the institution or environment she or he works in. Nurses only have so much clinical skill. You can only start an IV so many times before it gets boring. You can only listen to someone's lungs so many times before you've heard them all. Nursing is a very technical, task-oriented job. '
    - This is where we disagree, nursing is more than just the tasks
    you perform. I like Jean Watson's theory because I feel nursing
    is an art and a science...which is why it is pretty hard to 'put in a labelled box'

    'It is a very limited profession. '
    - There are so many different specialties in nursing that you can find one you enjoy and never worry about being unemployable. When I was in general duty, I did not love my work...I felt there was something missing...then I found ambulatory care/hem/onc/BMT and absolutely loved working with this population. Sure there are a lot of technical skills to practice...as you mentioned...listen to lungs, hearts, start IVs , give chemo, blood products etc. But what my patients and their famillies appreciated most was my 'caring' and my help and support as they deal with illness and death and dying.
    So this is the 'kinda fluff' that Jean Watson is trying to articulate about the nature of nursing and the quality of the nurse/patient interaction. That is my opinion.

    "Unless you are an NP, you cannot prescribe"
    -Some states have legislation for CNSs and NPs to prescribe.
    Some states also require national certification for prescriptive authority and CEU in pharmacology.

    'You cannot diagnose. You cannot cannot treat ailments. You cannot interpret lab tests and you cannot interpret diagnostic tests. Yet, we seem to have so many of these theorists that attempt to make the profession more than it is.'
    -In our hem/onc/bmt clinic, we saw the patients first and had a lot of autonomy to obtain the labwork if justified by our assessments. As nurses, we can indeed diagnose and treat within the nursing framework and you can bet we interpreted lab and diagnostic data! As you are an ER nurse, I am sure you interpret the significance of lab and diagnostic data everyday to your patients.

    'I don't believe the nurses in this thread are confusing philosophical theory with scientific theory. I believe the nurses are trying to say that because nursing is technical and task-oriented, a scientific theory fits better than a philosophical one. '
    I seem to be hearing that too.....and from what I have read about bedside nursing today, there is barely any time to do all the assigned tasks let alone have interactions with patients.
  8. by   James Huffman
    If you didn't like nursing theory, that's cool.

    But if there's no one around doing the heavy intellectual lifting (and believe me, academic research and theorizing can be very hard work), it's a virtual guarantee that nursing will never advance professionally at all.

    All nurses -- even those who think of themselves as pure technicians -- are following someone's theory of nursing practice. You may have never consciously studied that theory, but you got it from somewhere (perhaps a teacher or colleagues), and you are putting that theory into practice every day. And that's OK, too, but never, ever think that you are not doing theory. Everything you do as a nurse is putting theory into action.

    As nurses, we all need each other. No one's there to give hugs to the academic who's up late doing a report on research. But that academic is needed. Badly.

    Jim Huffman, RN
    Last edit by brian on Sep 17, '02
  9. by   nursekac
    What an interesting thread. Having gone to school in the dark ages, I'm afraid that I haven't kept up with nursing theory.

    NurseMark, I believe that you don't give yourself credit. Everything you do, even though in the environment that you're working in, is rapid pace and mostly technological, is probably still based on a wholistic approach. Why you might chose to do one thing for one patient and another for another (with the same presenting problems) would depend on how you evaluate those patients' needs, assests and deficits. You then decide what you need to do and how to carry it out. (yes James, sounds like Orem doesn't it?) I'm like Jenny P, in that the only theory I was exposed to was Peplau and Henderson, until I began assisting with nursing orientation in the facility I work in. Our theorist is Orem. The theory didn't make sense at first, but the more I've explained it & talked about it, the more sense it makes. I think the regular "worker bees" (please, no offense anyone) don't actively think about theory, but we're really using the theories we've been exposed to all the time.
  10. by   WriteStuff



    "Good morning Ms. Watson, I will be your Nurse for today. I don't give a rat's ass about you as a human being, but I'm a "crackerjack" when it comes to starting your IV. So sit back, relax, and enjoy the ride."

    Employer interviewing the newly hired Nurse:

    "Now we have two campuses here at "The New World Hospital."
    You will be assigned to one or the other after we administer the h/she cares or does not care psychological profile."

    Patient to the Nursing Supervisor: "I don't care if it IS Nancy Nurse's day off, she didn't care for me, or about me yesterday, and I want her back today !!!"

    "Tongue in cheek", yes. Lucidrous, at best.
    The point being: the question itself has NO redeeming value.

    From a seasoned Nurse, after 31 years in the profession, who some days cared, some days did not, but EVERY DAY came home feeling something.

    Bonnie Creighton, RN
  11. by   globalRN
    To James Huffman: I second that sentiment.
    To writestuff: You are a hoot!
  12. by   semstr
    Susy, yes sure, but give me some time to find translations.
    Take care, Renee
  13. by   llg
    Ok. Here goes. To NurseMark25: I feel sorry for you. You are apparently in a dead-end job in a work environment that does not stimulate you to think or act beyond the performance of some basic technical skills. In my hospital's ED, we have EMT's and Paramedics who do that job. The nurses spend some of their time doing those technical skills, too, but we encourage them to have a more "global management of the patient" role as much as possible.

    I also note that when you wrote about advanced practice and any sort of "higer functioning" of nurses, it was in terms only of physician externder functions. There are many more possibilities for advancement of a particular nurse or of the profession in general than just physician extender functions. While I support my colleagues who choose physician extender roles, they are not the only opportunities for advancement. I am sorry that you have not been sufficiently exposed to those other possibilities to appreciate them.

    My own career path has followed the "Clinical Nurse Specialist" pathway. After being a NICU staff nurse, I got my MSN and worked as a neonatal CNS for many years. After getting my PhD, I returned to hospital work as a neonatal CNS. My professional passion has always been to try to help the staff be the best bedside nurses they can be and to support them in getting the resources they need.

    I believe in nursing and have tried to make things better for nurses and better for the patients. I have never been one to stand on the sidelines and criticize the people who run the unit -- or the hospitals. I have been one who joined the committee, got involved, gave my time, and got myself the best education I could get in an effort to make things better. Can you say the same?

    llg

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