Studying nursing theory, came across Jean Watson

[algebra_demystified]

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.

[elkpark]

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

It's my understanding that the "disturbed energy field" dx (which is one of the ones that make my teeth hurt) comes to us courtesy of Dolores Krieger and the Therapeutic Touch gang ...

[metal_m0nk, BSN, RN]

Again, I thank you for the great discussion.

Ditto. :)

[metal_m0nk, BSN, RN]

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.

Interesting analysis. And while it may not have been intended, I can definitely see how it could have that effect.

[Moogie]

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.

Thank you for providing the article information; just skimmed it briefly and I would agree with you that it certainly is passionate! I definitely understand why someone who is not "into" Watson---for whatever reason---would object to some of the things she writes in the piece, particularly when she talks about the violence in health care. That whole concept was very foreign to me the first time I had heard it in a graduate course---I had a professor who was very much into Nancy Diekelmann and the first time I read Diekelmann's ideas about violence and oppression in health care, I thought she was from another planet. But a few years ago, after I took some time away from school (as a student and an instructor) and worked in long-term care, I finally "got" Dieklemann's perspective.

You might just be having a Whiskey-Tango-Foxtrot moment because this isn't familiar to you. It might make more sense as you get done with this class and move on. Or it might never make sense to you. Anyway, thanks again for the article and for a good discussion!

[llg, PhD, RN]

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.

I think the gender issue is definitely part of the picture. A lot of scholarship in nursing (particularly in the 1980's and 1990's) was based on feminist perspectives -- as was a lot of work in the Social Sciences in general.

But once again ... Isn't the "best" position of these matters one of balance rather than of one extreme view or the opposite. Shouldn't we be trying to find the "middle position" rather than either thinking that such theories are the greatest thing that ever came along or totally hating it?

[nursemike, ASN, RN]

A rock dropped from 5 feet above the Earth's surface will fall to the ground with a speed proportional to its mass now, just the same as it did 350, 500, or 1500 years ago.

OK, so in another life, I was a physics major, so I have to quibble, but not only for the sake of quibbling. In the seventeenth century, before there was a theory of gravity, Galileo demonstrated that objects do not fall to the ground with a speed proportional to their mass. A bowling ball and a baseball fall at the same rate. So does a feather, in the absence of air resistance. That's picky, I know, but it does tend to reinforce the argument that people often dismiss theories without full understanding them. (I don't fully understand Watson, either, but I am impressed at how much her theory of caring, stripped of jargon, is good, common sense.)

So, I've had an interest in science as long as I can remember, and I did, briefly, major in physics, until it proved incompatible with my minors in girls and beer. At around that time, I was forced to take some psych courses, and in those days behaviorism was all the rage. I HATED behaviorism, which I felt was adequate for training mice to run mazes, but had prescious little to do with people. I've never disputed that operant conditioning can work, but the mere title of Skinner's Beyond Freedom and Dignity damns the whole movement. To me--and I'm right about this--there is nothing beyond freedom and dignity. Without them, my cats' lives wouldn't be worth living, and they understand that, even if Skinner couldn't.

Still, behaviorism was the rage, and I know why. Psychologists had an inferiority complex. Physical sciences dealt in objective, quantifiable data and repeatable experiments. Psych dealt in feelings and wanting to have sex with your mother and other unscientific stuff. So, behaviorism to the rescue: a theory of psychology that is repeatable and quantifiable, and if perhaps not entirely objective, at least dispassionate. Hurray!!!

Except, of course, that psych was still 50 years behind the times, because the physics of the 20th century has taught us that that which is quantifiable, repeatable, and objective is merely an approximation of reality, workable for such everyday tasks as putting a man on the moon, but inadequate to fully explain how he got there. Not long after mathematicians proved that a logical statement can be both true and false, physicists found particles that behaved in just that manner. To over-simplify quantum electrodynamics, all of reality is invisible electromagnetic fields. And while theories have supplanted QED, they haven't made reality more concrete. The distinctions between actual concrete and a vaccuum just get more and more vague.

So, here we are in nursing, some arguing evidence-based practice and you have to treat what you can measure, when the most fundamental of sciences tells us what can be seen and measured is just the tip of the iceberg, and others saying, no, no, no, you have to treat the soul as well as the body (and often trying to show measurable, objective data to support their position.)

I tend to get fidgety when people start talking about the profession of nursing. I was a carpenter for most of my working life, and I never saw anything wrong with a good, honest trade. But carpentry was not just a trade, it was (and still can be) a craft, because wood isn't entirely dead. It isn't steel, it isn't plastic, it moves, it breathes, it retains an element of the chaos that the tree had when it was a living being. And I really like the idea that nursing is both an art and a science--a craft, if you will--because we do need evidence-based practice, but we aren't diesel mechanics. Our medium moves and breathes and poops and cries and has fears and dreams and freedom and dignity, and when we are able to synthesize all of these conflicting values, it's not merely a profession: it's magic. It's nursecraft.

[nursemike, ASN, RN]

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.

I, uh, don't entirely agree with this.

[psychonaut]

An oldie but goodie:

http://www.sonoma.edu/users/n/nolan/N400/raskin.htm

I personally look forward to acquiring Jedi powers upon completion of my FNP.

Luckily, I have found that knocking out papers on nursing theory means a couple of hours of work (ok, maybe 3-4 for the grad school 20-page monsters) leading to an "A" grade. It is a distasteful, but brief (although regularly reoccurring) part of graduate nursing studies.

I have nursing texts in my possession. You can find old posts of mine where I expressed my willingness to set aside my initial "BS alert" regarding nursing theory, to give it a good reading, and try and make a logical judgment about both the field at large, as well as individual theories. Well, I read those texts cover to cover. I sought out primary sources when my texts seemed to be selectively quoting the theorist in question.

I consider my opinion of nursing theory to be informed. My rejection of it cannot be dismissed as due to poor teaching or failure to study the subject at hand.

A metatheory of nursing theory, examining the needs of the foundational nursing theorists to define themselves fundamentally as "not-medicine", would be an interesting study. It would also never happen from within the nursing academia, because it hits too close to home.

Frankly, it is something that I am willing to put up with to get a grad degree, considering that I know and have sincere respect for the intellectual and clinical acumen of most of my faculty.

[algebra_demystified]

I think the gender issue is definitely part of the picture. A lot of scholarship in nursing (particularly in the 1980's and 1990's) was based on feminist perspectives -- as was a lot of work in the Social Sciences in general.

But once again ... Isn't the "best" position of these matters one of balance rather than of one extreme view or the opposite. Shouldn't we be trying to find the "middle position" rather than either thinking that such theories are the greatest thing that ever came along or totally hating it?

I would disagree with trying to find balance. If I say 2+2=4 and someone else says 2+2=6, they're just wrong, and I'm not interested in splitting the difference and saying it's five.

Some scholarship is just crap.

Anybody that takes Freud too seriously... come on. I have never wanted to have sex with my mother, and I have yet to talk to anybody else who has. So, it's just crap. My apologies to a certain psychologist at work who made a book recommendation to me that had a lot of Freud in it for the first hundred pages. He asked me how it was. Guess what I told him? He's got a PhD in psychology, but his book recommendation was crap.

Now he calls me and asks for my opinion on his papers.

Years ago I worked for this bizarre company in Los Angeles that was run by a Scientologist and had to take their personality test and the Communications Course as a condition of employment. Guess what? It's crap. It's just crap, and that experience taught me that some things are totally worthless and should be ignored.

That probably sounds negative but it's really not. It's an affirmation that all of us have a BS detector built in. If yours works, you can pick out the crap and save others the hassle.

Why not find some good research and teach that?

[nursel56]

I, uh, don't entirely agree with this.

I think the most we can do is see trends in sub-groups-- you're right, my statement was too much of a stretch. It's been very interesting to see how many times men react differently from women (generally) though, and how those differences are shared by most other men.

Interesting analysis. And while it may not have been intended, I can definitely see how it could have that effect.

It wasn't intentional. I just wonder about the closed loop dynamics of an academia whose similarities in frame of reference run the risk of tunnel vision.

I think the gender issue is definitely part of the picture. A lot of scholarship in nursing (particularly in the 1980's and 1990's) was based on feminist perspectives -- as was a lot of work in the Social Sciences in general.

But once again ... Isn't the "best" position of these matters one of balance rather than of one extreme view or the opposite. Shouldn't we be trying to find the "middle position" rather than either thinking that such theories are the greatest thing that ever came along or totally hating it?

I agree! And our collective knowledge may converge at some point in the future, as it seems "science" emerged out of the formerly amorphous realm of the mind, later to be validated with empiric results. The questions asked in ancient times haven't really changed over the centuries, but the answers have become more refined. People have always pondered the mysteries of reproduction. It was theorised that a little miniature person was transferred from father to mother--- that had to suffice until hard science disproved it. Maybe future nurses will look back on our time the way we look at treatments that require drilling holes in people's skulls to let the demons out.:)

You mentioned that Jean Watson presents her theories in an intentionally provocative way, I think the value of the ensuing discussion has merit even for those who think she's an oddball.

[metal_m0nk, BSN, RN]

OK, so in another life, I was a physics major, so I have to quibble, but not only for the sake of quibbling. In the seventeenth century, before there was a theory of gravity, Galileo demonstrated that objects do not fall to the ground with a speed proportional to their mass. A bowling ball and a baseball fall at the same rate. So does a feather, in the absence of air resistance. That's picky, I know, but it does tend to reinforce the argument that people often dismiss theories without full understanding them.

Seriously? Air resistance is a very real thing in my world. Where do you live that it isn't?

Main Entry: grav-i-ta-tion

Pronunciation: \ˌgra-və-ˈtā-shən\

Function: noun

Date: circa 1645

1 : a force manifested by acceleration toward each other of two free material particles or bodies or of radiant-energy quanta : gravity 3a(2)

2 : the action or process of gravitating

— grav-i-ta-tion-al \-shnəl, -shə-nəl\ adjective

— grav-i-ta-tion-al-ly adverb

— grav-i-ta-tive \ˈgra-və-ˌtā-tiv\ adjective

Source: Gravitation - Definition and More from the Free Merriam-Webster Dictionary

Think practical application - discard the vacuum. We don't exist in a vacuum.

It's short hand for the cheap seats - a relatable analogy. Not everyone was a physics major in a former life and you didn't bother to mention anything about force either so it could be supposed that you've done a disservice here also. I've studied physics and I am quite familiar with the concept. A launch into the finer points of gravitational theory isn't relevant to this discussion.

[elkpark]

Anybody that takes Freud too seriously... come on. I have never wanted to have sex with my mother, and I have yet to talk to anybody else who has. So, it's just crap. My apologies to a certain psychologist at work who made a book recommendation to me that had a lot of Freud in it for the first hundred pages. He asked me how it was. Guess what I told him? He's got a PhD in psychology, but his book recommendation was crap.

Now he calls me and asks for my opinion on his papers.

Years ago I worked for this bizarre company in Los Angeles that was run by a Scientologist and had to take their personality test and the Communications Course as a condition of employment. Guess what? It's crap. It's just crap, and that experience taught me that some things are totally worthless and should be ignored.

That probably sounds negative but it's really not. It's an affirmation that all of us have a BS detector built in. If yours works, you can pick out the crap and save others the hassle.

Why not find some good research and teach that?

But does one specific proposal by a theorist (Uncle Siggy or anyone else) that doesn't sound valid to you on first hearing mean that the entire body of that person's work is "crap"? I have a problem with that kind of "all or nothing" reasoning. I also have concerns with turning something as complex and subtle as, in your example, Freud's writings about children's sexuality into "I have never wanted to have sex with my mother, and I have yet to talk to anybody else who has. So, it's just crap." There's a lot more to Freud's psychosexual theory than that, and his psychosexual theory was only one small part of his total body of work.

I think that a lot of the problem with people finding nursing theory so distasteful and useless is that they don't get much exposure to it. They get a few "sound bites" in an Intro to Nursing Theory course, think that they don't make much sense, and decide that means all nursing theory is useless gibberish.

BTW, a few years ago, I was privileged to be able to attend a presentation by an international neuropsychiatric authority (the man who did most of the research on trauma that originally established PTSD as a diagnosis) -- the focus of his presentation (one of several I was able to attend -- the major teaching hospital at which I worked brought him in for a week-long "residency") was how the PET brain scan results in his current research supported the validity of Freud's theories, that Uncle Siggy was way ahead of his time in many ways and we were just now getting to the point where we have the technology to be able to verify how right he was (of course, a lot of us knew that all along ... :)).

I agree with you completely that Scientology is "just crap." And I'm known for having a particularly acute "BS detector." But I would never make the mistake (IMHO) of thinking that means that everything that doesn't initially sound right or valid to me should be dismissed out of hand.