Studying nursing theory, came across Jean Watson

allnurses Guide · Jul 5, 2010

A profession's theory should define that profession as being distinct from others. While caring is central to nursing, it is also central to any "service" profession such as social work, medicine, teaching, even many lawyers go into that profession out of a pure desire to show caring for others.
Watson's theory is not inaccurate, but it is woefully incomplete. As a noetic scientist, Watson brings a unique view to defining the profession of nursing from which we can pull out some useful wisdom. At the same time, we need to be careful about using theories that fail to capture the overall mainstream purposes of nursing.
As a profession that seeks respect from society, I think we need to be careful about presenting pseudo-scientist as the face of nursing.

So, what is the theory of medicine, pharmacy, social workers, PT, OT, etc. I must have missed their defining theories.

jbluehorseh · Jul 5, 2010

i got my final grade in my nursing theory class. a+. my final paper was on jean watson's theory, and i scored a 98% on it.

bottom line -- mysticism is not something that should be part of nursing. if we want to be respected as professionals, we should choose something far away from shamanism and faith healing, and closer to science.

i do not agree with most shamanism and faith healing as primary treatment. it does not hurt and using it as a commentary alternative treatment does not hurt because it helps the patient get through difficult times. it is not any different then having a priest come in and pray for a patient. or hospitals that are faith based and they dictate their views on patients ( abortions)

algebra_demystified · Jul 5, 2010

As a profession that seeks respect from society, I think we need to be careful about presenting pseudo-scientist as the face of nursing.

I would say we should run screaming from pseudo-science. I certainly wouldn't want anyone who believes she's healing me with love to manage my ventilator settings or check my lithium levels.

:twocents:

algebra_demystified · Jul 5, 2010

So, what is the theory of medicine, pharmacy, social workers, PT, OT, etc. I must have missed their defining theories.

You mean pharmacists don't have a defining theory? I just lost all respect for pharmacists.

:clown: :jester: :clown:

nursemike, ASN, RN · Jul 6, 2010

You mean pharmacists don't have a defining theory? I just lost all respect for pharmacists.

Some alchemists' early attempts at pharmacy were about as pseudo as a science can get. I don't think it's strictly necessary to repeat their errors in developing a body of knowledge in nursing. The scientific method has come a long way since doctors routinely bled their patients to let out harmful humors. It's hard to dispute the value of EBP over voodoo.

That said, I don't think we can safely discard a holistic approach to nursing. There's a great deal more to mental health than maintaining therapeutic levels of lithium, and it's not an unreasonable assumption that many patients may benefit from contact with caring nurses. But it's hard to see how to put that on a scientific basis. We could measure whether patients had better outcomes under the care of one nurse or another, but I think we are almost necessarily going to venture into speculation as to why one nurse is more effective. There have been ample examples in just this thread that defining even so basic an idea as caring is not easy, and I'm personally comfortable with the idea that some elements are simply undefineable. Even so, it's probably worth giving some serious thought to these undefined and possibly undefineable problems.

I think it is possible to recognize that the boundaries between cutting edge science and mysticism are not always clear without leaping to the conclusion that all mysticism is cutting edge science. I think it's equally wrong to think that which is measurable and quantifiable is all that matters. A scientist is not a priest, but a scientist is also not an engineer. Our work as nurses is intimately involved in the human condition. A skillful technician can manage ventilator settings. We need to be equally adept at tasks like discussing with families whether it's worth maintaining ventilation. I don't have to believe a back rub realigns a patient's energy field to know that a back rub does more than stimulate circulation.

allnurses Guide · Jul 6, 2010

i do not agree with most shamanism and faith healing as primary treatment. it does not hurt and using it as a commentary alternative treatment does not hurt because it helps the patient get through difficult times. it is not any different then having a priest come in and pray for a patient. or hospitals that are faith based and they dictate their views on patients ( abortions)

true-- they don't hurt, and i would agree that there is often a subjective experience by the patient and the practitioner that the alternative therapies "really work because people tell me they feel better afterwards".

some nurses have chosen to go into practice offering massage therapy, reiki, reflexology, iridology. . . there are probably hundreds of variations on the theme of which "disturbed energy field" is one. i say, go for it!! where i have a problem is in the area of insurance billing and whether or not such things can be used in conventional hospital settings when 80%(at least) of the nurses caring for a patient either think it's bunk, or can't agree as to exactly which spikes, colors and wave patterns are emanating from the patient. you can't track progress when only 1 person can see something.

GilaRRT · Jul 6, 2010

Come on guys, we can address a persons psychological well being without resorting to making up theories about energy fields and so on. That's all this nursing theory spin is, why do we continue to insert strange words and concepts into the nursing definition of something that has already been defined and fits into the realm of reality?

Doc Lori, R.N. · Jul 6, 2010

Wow, what a diverse bunch of opinions! Here's my humble take on it, approaching the matter from the perspective of an experienced registered nurse and a transpersonal counselor, which is the basis of Watson's theory and approach. Here we go, in a large nut shell. Ask yourself what giving, caring and healing means to you, and why you became a nurse to begin with. Ask yourself if you are able to perform and satisfy your desire to give "compassionate caring" in the professional healthcare setting. Actually, ask yourself, more accurately, which percentage of your desire to give care stems from compassion, or from the need for praise and sense of self worth, from outside of yourself, because you don't have a good sense of self innately.

When the desire for giving, caring for and healing others comes from a compassionate place in your being, it's wonderful-- "( I helped someone ) feel better", the emphasis being on that person feeling better, not that you are the one who did it. This is being unattached to the results of your healing and caring. You don't do it to feel good about yourself, you do it truly out of caring for another.

Working in a traditional healthcare setting requires you to be attached to the results of your work. Is that compassionate caring, or does one's ego become attached to the results? Of course it does. You are forced to be accountable, therefore you are attached to the results. This sets up battle between your compassionate Self (Spirit ) and your Ego Self (Mind). Usually, the ego wins initially, until crisis occurs. This is the beginning of getting caught up in toxicity of the healthcare work place. You realize that it provides you with an opportunity to live in this toxicity. This creates an internal environment where you are happy to be miserable, placing blame at others, or falsely judging others, taking no responsibility in determining why you respond to things the way you do. One's dysfunctions are being completely enabled. Ignorance is bliss, right? If there is nothing wrong with me, because I am walking perfection, it must be everyone else's problem. Where you are forced to come to terms with your life ( during active burn out and compassion fatigue ) your choices and the manner in which you respond to others and certain circumstances are addressed at their core level. You are forced to become accountable to yourself, and to possibly come to terms with some uncomfortable things about your past.

One is basically drawn to/energetically invites crisis in order to heal from the inside-out.

The ultimate blessing and shift that comes along with crisis is self love, healthy boundaries, and how to differentiate between the messages that you are receiving: from your Spirit Self or your Ego, and teach them both to play nicely with each other in your sand box.

The nurses for whom I provide counseling typically become healers because of being wounded, as did I. This is an energetic attraction, as when we become healers, not only do we heal others, we heal ourselves. Whether we have poor self esteems, poor senses of self worth, have been forced to take on adult roles when we should be carefree and child like, or are victims of physical abuse or neglect, we allow the ego to be stroked for the sake of obtaining our sense of self worth and esteem from the actions which we provide for others, simply and sadly because those very core and imperative qualities were possibly not instilled in us as children, because we were given the message that we exist to provide for others, and that this is how we were expected to obtain praise.

In my experience, nurses get burned out at the exact point which I just pointed out above. When they are beginning to get louder and more extreme messages from their Spirit Selves, that something just is not right. It is through hard work that a realization of massive importance is revealed:

"I became a healer to be healed".

Also in my experience, it is the nurse who is just about to enter into a burnout zone who resists these concepts. It doesn't feel safe. It may upset their internal apple cart, and they will have to do all that soul searching. This is a normal process, and with respect to all health care professionals, everyone is entitled to be where they are, emotionally, mentally, and so on.

Watson's work takes all this into consideration, and more. She recognizes that we are all individual parts of a whole system. You can have a unit of nurses who really understand what caring means, then have one person who wears the ego shield wherever they go, creating a toxic environment.

Big nutshell, I told you!

allnurses Guide · Jul 6, 2010

Thank you for your excellent post Doc Lori. Going to a counselor who's focus is on nurses, and understands issues unique to nurses, is a pretty rare commodity!

From what I understand, Watson's inclusion of the nurse's psychological status into the patient's experience is a groundbreaking idea, for sure.

I've had a real love-hate relationship with nursing, too-- but used other means of self-discovery to come to a place of internal peace about the whole thing that works well for me. For example, I recognize that it isn't my responsibility to heal the patient, and I've come to terms with the fact that I may never see the results of what I do, and that in fact despite my best efforts, bad outcomes occur. People die, and abused children are given back to their parents to be abused again, people who can't walk across the room without their O2 continue to smoke.

I agree the issues that confront us as individuals in nursing are very much associated with our past and everything we were or are at that point in our lives, and we ignore those triggers at our peril.

Though Watson and transpersonal counseling are one way of addressing the issues, there are others as well. When I started there were no grief counselors for us, and I still carry with me events and people from my early experiences in nursing, that are still raw and maybe I'll share them at some later date, recognizing the emotional energy they still generate all these years later.

Thanks again for sharing your perspective!!:redpinkhe

Doc Lori, R.N. · Jul 7, 2010

Thank you, nursel56. Yes, counseling specific to nurses is rare for sure, and it really seems to resonate! I hope you continue to be open and whole :) Best wishes!

MA Nurse · Jul 15, 2010

I haven't read much of her work, but what I've seen so far looks like the ravings of a schizophrenic. It looks like she rejects the medical model completely and believes in telepathy and mind reading over distances, and unmeasurable electromagnetic fields that are created when nurses care about their patients.
What is a "mindbodyspirit" and what am I supposed to do with it? Does she even believe in germ theory?
I'm having a hard time believing that this is taken seriously in graduate level classes.

i am having a hard time with this, too. I posted a post about her too. No wonder she is talking in the Mary Baker Eddy library! Weird!

MA Nurse · Jul 15, 2010

That's not what her theory says, though. Her theory is that to care is to cure. She says that the spiritual component of caring IS the cure, and it is more important than anything else. She says that people exist outside of the medical model and that trying to fix the human body puts all of us in danger, and that it's possible that all of humanity will be exterminated unless nurses stop practicing according to the industrial-clinical-medical model and use the moment of caring to cure the patient.
She says that an electromagnetic field is generated between the nurse and the patient that is bigger than either one, and that it transcends time. It leaps beyond any need for proof.
See her 2005 guest column for further weirdness.
I am appalled that this is discussed seriously in a graduate level course.
I think that maybe the first iteration of her theory was reasonable but as her work developed over time... it just went way off the deep end.

I wonder if she is a Christian Scientist??