Studying nursing theory, came across Jean Watson

GadgetRN71, ASN, RN · Jun 21, 2010

I suppose I'll have to wade through all this theory stuff when I start my BSN this winter. Not looking forward to it. I've nothing against abstract thinking..but I think some people go way too far in the other direction..hey, in nursing school, one of the nursing diagnoses was "disturbed energy field" which both confused and amused me greatly..was Jean Watson responsible for that one? :confused: :lol2:

allnurses Guide · Jun 21, 2010

I suppose I'll have to wade through all this theory stuff when I start my BSN this winter. Not looking forward to it. I've nothing against abstract thinking..but I think some people go way too far in the other direction..hey, in nursing school, one of the nursing diagnoses was "disturbed energy field" which both confused and amused me greatly..was Jean Watson responsible for that one?

Or just pick your BSN program from one that does the bare minimum in nursing theory....

metal_m0nk, BSN, RN · Jun 21, 2010

Frankly, I think much of the trouble is with nursing education itself because we do not teach students to think in the abstract. To be sure, much of nursing is task-oriented and based on principles and theories from the hard sciences. But nursing is an art as well as a science, so it behooves us to try to explore what do we mean by "nursing" and examine various theories which may vary in their validity and applicability in real-world nursing situations.

Watson seems to me to be trying to turn "caring" into a task based on principles and theories from the hard (and some of the softer) sciences, as though it could be compartmentalized and quantified. Number 6 in Watson's "Ten Cartinas Processes":

Use creative scientific problem-solving methods for caring decision making.

What??

Assuming for a moment that "caring" could ever actually be compartmentalized and quantified, should it be? I have no doubt in my mind that nursing is an art as well as a science. But true artists don't follow a manual. True artists tap into the intangible and channel it without defining it. Art isn't application, it's expression. How many times have you been put off by someone who *intends* to treat you fairly or *intends* spare your feelings. Quantifying and defining it weakens its effect. Caring is organic.

I suppose there are some who need an examination of Picasso's work stroke for stroke to be able to appreciate and be moved by it. But I would guess that there are plenty who don't. And I highly doubt that a philosophical examination of how his work has moved or inspired generations of artists, thinkers, and observers is going to inspire someone to care who doesn't.

In other words....

Watson is preaching to the choir. Her work serves very little practical purpose than to reinforce already existing belief systems and in all honesty, she isn't breaking any new ground. Most of what she is advancing has already been examined by philosophy, theology, sociology, and psychology.

Watson's Human Caring Theory is, for all intents and purposes, a creed. A creed has value in its own right as a set of guidelines for behavior or professional standards, but it has no place in scientific theory, unless it is to inform a standard for transparency and objectivity in research. Why? Because the proper application of philosophy is subject to personal interpretation. Watson gives her work much more weight than it deserves and in doing so, invites criticism of her rationale.

As for the rest...

And seriously, anyone who is in graduate school or is contemplating graduate school had better get used to examining even the most abstract nursing theories. A grasp of theory is going to be be required, to a greater or lesser degree, in all subsequent nursing courses as well as in writing a thesis or even a grad school project. As the level of education increases, so does the degree of abstraction. Most graduate students are asked to examine various nursing theories, apply them to case studies and clinical scenarios, and articulate how well their own philosophies of nursing may be congruent or incongruent with certain theories. I think that anyone who *hates* nursing theory and finds it all to be a waste is going to have a tough time with many graduate programs because of the level of abstract thinking that is required. Even if a theory seems useless or impractical, a student still needs to understand that theory in order to articulate why it may be less than useful in his/her practice.
In all honesty, I think that students and nurses who have strong, visceral objections to a certain theorist need to be aware that many schools do base their curricular philosophies on the works of some of these theorists. Watson's theory of caring is used in many, many schools and it would be tenuous indeed to end up attending a school (or working in an institution) that followed her ideas if one thought they were irrelevant.

I can't speak for anyone else on this one, but I personally have no desire whatsoever to earn an MSN or a PhD. in Nursing. I am interested in nursing for the practical application only. My plans are to use the skill set for public service. I've already got my personal philosophy worked out: first, serve humanity. If I do go for my masters, etc., it will most likely be in Microbiology and then onto either empirical research or teaching (or both).

algebra_demystified · Jun 21, 2010

Triquee,

I certainly understand your misgivings about pursuing an MSN. I'm doing this to repair my GPA so I can go on for a psych NP. If it wasn't for that, there's no way I would blow my money and my time studying nursing theory.

I'm straining at the bit to go on for advanced pathophysiology and pharmacology. This crap about energy fields is complete garbage. I'm paying almost $1000 to slog through this class, which I regard as a waste of time.

"You should care about your patients."

"Make sure there's no standing water in the room."

"If your patient asks you for help, try to figure out what's wrong."

Come on. Really? This is a Masters level education? It reminds me of my bachelors in PR. The woman who taught my final class, and for whom I wrote an 80 page paper with all kinds of statistical analysis, had a PhD. The substance of her PhD paper was, Do adolescent girls admit that they read romance novels for the sex scenes in front of their peers or in front of adults.

I'm going to write the paper and try to put a positive spin on Watson, but I'm just cringing inside at the idea that I have to pay lip service to this nonsense.

allnurses Guide · Jun 21, 2010

My theory is that Jean Watson's theory represents institutional sexism in that it flourished in an almost completely female era and disproportionate emphasis on traditional female values like "caring" and bonding with the patient, and all the rest of that left-brainy stuff. Women are far more comfortable with it than men, and there is a certain unfairness as men are required to spend energy trying to adapt to something inherently awkward in many cases.

It is good to care, but most men think it's a total crock. If the workforce had been 50% men back then, would Jean Watson be on the pinnacle today? I doubt it. I'm sure there would still have been theories, but it would have reflected a more balanced view in it's implementation.

metal_m0nk, BSN, RN · Jun 21, 2010

Come on. Really? This is a Masters level education? It reminds me of my bachelors in PR. The woman who taught my final class, and for whom I wrote an 80 page paper with all kinds of statistical analysis, had a PhD. The substance of her PhD paper was, Do adolescent girls admit that they read romance novels for the sex scenes in front of their peers or in front of adults.

This is exactly the reason why the vast majority of Masters theses and Doctorate dissertations go unread and unnoticed by all but the student's supervisory committee.

whichone'spink, BSN, RN · Jun 21, 2010

I did not like nursing theory when I took Foundations of Nursing almost a year ago. If I have to go through that all over again, then I would rather go to PA school than NP school.

llg, PhD, RN · Jun 21, 2010

Watson is preaching to the choir. Her work serves very little practical purpose than to reinforce already existing belief systems and in all honesty, she isn't breaking any new ground. Most of what she is advancing has already been examined by philosophy, theology, sociology, and psychology.
Watson's Human Caring Theory is, for all intents and purposes, a creed. A creed has value in its own right as a set of guidelines for behavior or professional standards, but it has no place in scientific theory, unless it is to inform a standard for transparency and objectivity in research. Why? Because the proper application of philosophy is subject to personal interpretation. Watson gives her work much more weight than it deserves and in doing so, invites criticism of her rationale.
).

I appreciate your ability to critique Watson's work -- and find fault with it -- without blocking our further discussion.

I also agree with you that Watson's theory is a philosophic theory and not really a scientific one. One of the big problems with it is that most nurses aren't comfortable with philosophy. They think everything that is not "scientific" is "bunk." But there is a place in the world for philosophy and very valuable place for philosophy in the practice of science. Philosphies undergird all of our actions as practitioners and all of our scientific research. Philosophy was the "first" academic discipline, is at the root of all academic disciplines, and that is why the highest academic degree in all disciplines is called a PhD, a Doctor of Philosophy.

But ... as I said ... nurses aren't well educated in the study or use of philosophy as a rule. So, people try to turn Watson's theory into a scientific one and it's not well-suited for that. People judge it using scientific criteria and it comes up short.

It's not one of my favorite theories, but I find myself defending it because I think people often misjudge and mis-use it -- and I think there is a place for it in nursing. We need philosophies of and in nursing as well as scientific theories and models at all levels -- Grand Theory, Philosophies, Middle-Range Theories, Conceptual Models, etc. -- all of them. They can be useful tools if used properly, but like all tools, have the potential to be used poorly.

Thanks for the good discussion.

metal_m0nk, BSN, RN · Jun 21, 2010

I appreciate your ability to critique Watson's work -- and find fault with it -- without blocking our further discussion.
I also agree with you that Watson's theory is a philosophic theory and not really a scientific one. One of the big problems with it is that most nurses aren't comfortable with philosophy. They think everything that is not "scientific" is "bunk." But there is a place in the world for philosophy and very valuable place for philosophy in the practice of science. Philosphies undergird all of our actions as practitioners and all of our scientific research. Philosophy was the "first" academic discipline, is at the root of all academic disciplines, and that is why the highest academic degree in all disciplines is called a PhD, a Doctor of Philosophy.
But ... as I said ... nurses aren't well educated in the study or use of philosophy as a rule. So, people try to turn Watson's theory into a scientific one and it's not well-suited for that. People judge it using scientific criteria and it comes up short.
It's not one of my favorite theories, but I find myself defending it because I think people often misjudge and mis-use it -- and I think there is a place for it in nursing. We need philosophies of and in nursing as well as scientific theories and models at all levels -- Grand Theory, Philosophies, Middle-Range Theories, Conceptual Models, etc. -- all of them. They can be useful tools if used properly, but like all tools, have the potential to be used poorly.
Thanks for the good discussion.

I understand where you're coming from. I read in the other thread that one of your ideals is to see nurses able to bring something of intrigue and value to the table with psychologists, biologists, mathematicians, etc. - something that is uniquely theirs that adds to the "conversation" of understanding the world and advancing toward a better existence for all. That is an honorable ideal, and one which I respect quite a bit.

It seems since the systematic overturn of the concept spontaneous generation (and other ideas like it), the intellectual world has moved (almost irreversibly) to a place within the confines of the scientific method. The consensus in academia seems to be that if today’s ideas are to be respected, adopted, and expounded upon, they ought to conform. That fact was glaringly evident as I skimmed textbooks on psychology and sociology this semester and last, because each one has its entire first chapter devoted to a discussion of the scientific method, sprinkled with ardent defenses of each -ology as a science. Each one is trying desperately to show that the world of ideas can be conformed to the standards by which the physical world is measured and thus garner the same respect and influence. Love it or hate it, conformity to the scientific method has become the yardstick by which even the merits of philosophy are being measured today.

Now, I know that the primary impact of a great number of ideas turns out to be a seed of abstract thinking planted in the mind of someone who is open, interested, and resourceful. But I also know that those types of seeds can be extracted just as easily from the work of Jimi Hendrix as they can from Jean Watson’s work and Jimi had no delusions about the impact or importance of his – he just went ahead and did it.

Watson on the other hand, seems to want badly to break into the realm of the scientific method – and for good reason. It is today’s gold standard. The problem is that there are rules in that realm – laws of nature – as well as a code of ethics. Not only are there standards for the acceptance of ideas into the realm of the scientific method, there is also an assumption that anyone entering the realm has given proper respect to those who are already there. For Watson’s ideas about energy fields existing between individuals, those people are Newton, Einstein, Hawking, etc. The scientific community is very strict about who plays on their field. Every newcomer is expected to build on the foundation that came before them. Until Watson is able to do that, she’s unlikely to break in and in my opinion, she shouldn’t. I also have great respect for the institution that has kept scientific inquiry living, growing, and breathing.

Unfortunately, so long as theorists like Jean Watson develop and advance theory that ignores the rest of the “conversation”, the image of nursing will likely suffer.

algebra_demystified · Jun 22, 2010

I would like to read that article at some point. In which journal did it appear? It doesn't sound like her earlier work so I am very curious to read it.
Thanks!

Watson, J. (2005, September). Guest editorial: What, may I ask is happening to nursing knowledge and professional practices? What is nursing thinking at this turn in human history? Journal of Clinical Nursing, 14(8), 913.

llg, PhD, RN · Jun 22, 2010

I understand where you're coming from. .

Great post. I think this is the first time we have "met" here on allnurses. I look forward to reading more of what you have to say in the future.

As you point out, it's very hard to do good science -- and also very hard to do good philosophy. And new ideas often take quite a while before they get tested and refined and incorporated into mainstream thinking. In the process, some parts of the theory get discarded, some gets revised, and some survives the scrutiny of the academic world.

Jean Watson is highly respected by many scholars all over the world (though I personally suspect that some of her ideas will not survive in the long run). When I was at the Univ. of Colorado as a grad student where she taught, scholars came from all over the world to meet with her. Also, she was a Fullbright Scholar, which is an honor that can't be ignored.

Watson has already contributed some valuable ideas to nursing, particularly the reawakening of the spiritual aspect of nursing that was being lost at the time she developed her theory. That's why she developed it -- as a response to those that were reducing nurses, patients, and whole health care experience to objectivity and sterile measurements. As someone educated in that time, she had a point. The health care industry WAS often ignoring the person behind the numbers. We didn't even call them patients at that time, the popular word was "client" and there was NO acknowledgement of the special care provider/patient relationship or that the relationship was any different from any other business deal. The was little acknowledgment of the human element in the situation at all.

The pendulum had swung too far to one side and someone needed to send it back swinging in the other direction. Jean Watson stepped up to the plate and started writing about that human element ... and she had the political and marketing skill to get her voice heard and become a major influence in changing the momentum of the nursing profession -- for both the better and the worse. Our profession has benefitted by that shift that she started, but we also have to live with some of the negative consequences of her work's weaknesses, too.

We have to take the "bitter with the sweet" as the saying goes. It will be up to the next generation to try to find a balance between the 2 extremes of that pendulum swing. I guess that is what I try to find.

Again, I thank you for the great discussion.

LETRN · Jun 22, 2010

I've always wondered if she was the inspiration behind the bogus nursing diagnosis 'disturbed energy field.'

I spent three years in nursing school desperately trying to make that diagnosis fit, just because it would've been a hilarious way to point out its ridiculous-ness :lol2: