Studying nursing theory, came across Jean Watson - page 5

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... Read More

  1. Visit  llg profile page
    0
    Quote from nursel56
    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?
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  3. Visit  nursemike profile page
    8
    Quote from triquee
    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.
    hecallsmeDuchess, fungez, morte, and 5 others like this.
  4. Visit  nursemike profile page
    1
    Quote from nursel56
    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.
    algebra_demystified likes this.
  5. Visit  psychonaut profile page
    2
    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.
  6. Visit  algebra_demystified profile page
    1
    Quote from llg
    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?
    SummitRN likes this.
  7. Visit  nursel56 profile page
    1
    Quote from nursemike
    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.

    Quote from triquee
    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.

    Quote from llg
    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.
    SummitRN likes this.
  8. Visit  metal_m0nk profile page
    0
    Quote from nursemike
    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.
    Last edit by metal_m0nk on Jun 22, '10
  9. Visit  elkpark profile page
    6
    Quote from algebra_demystified
    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.
    Last edit by elkpark on Jun 22, '10
    morte, Spidey's mom, SharonH, RN, and 3 others like this.
  10. Visit  GilaRRT profile page
    3
    Again, I point to theories that advocate spirit and life fields. Pseudoscience, no place in our profession. I can appreciate the caring approach; however, the concept is nothing new.
    SummitRN, carolinapooh, and wtbcrna like this.
  11. Visit  llg profile page
    4
    Quote from algebra_demystified

    Why not find some good research and teach that?
    Most good research is based on a theory of some type or other. If you don't like a particular theory ... fine. But that doesn't mean we should stop theorizing.
    NRSKarenRN, elkpark, Moogie, and 1 other like this.
  12. Visit  nursemike profile page
    1
    Quote from triquee
    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.
    I concede that pointing out your error was roughly on a par with pointing out a grammatical error or misspelling, and not strictly relevent to the discussion. For that I apologize. Nevertheless, you were wrong. A bowling ball and a baseball--unequal masses--fall at the same speed, even in Earth's atmosphere. On the other hand, a 10kg rock and 10 kg of feathers--equal masses--fall at very different speeds on earth, but at the same speed as a single feather on the moon. This law is pretty much true throughout the universe in which I live.

    The point is interesting to me because Newton's law of universal gravitation is pretty much a foundation of the deterministic view of the universe and probably one of the best understood laws of classical physics, but also not entirely true. Einstein's theory of general relativity actually explains observed phenomena more accurately. But while Newton's science is adequate to put a man on the moon and Einstein's to explain the minute time discrepency he would experience, today gravity is the least understood of the physical forces. I don't mean to invoke the weirdness of quantum physics in the defense of pseudoscience, but I do argue that attempts to understand the human condition in strictly mechanistic, deterministic terms are not a great deal more accurate than some of the airy-fairy crap. Quantum effects in a macroscopic system like a human being may well be negligible, but I believe chaos theory (which is based in classical, not quantum, physics) is relevent. I mentioned diesel mechanics, and an automobile or truck is vastly simpler than a human, but really, anyone who has done much work on cars has probably experienced a little bit of voodoo in the process. In principle, you should be able to repair any engine by a straightforward algorithm, but in real life experience and intuition can save days of work.

    On the whole, I do think evidenced-based nursing is the best foundation for real-life practice, but with the proviso that we keep in mind that evidenced-based nursing is inherently biased in favor of that which is measureable and repeatable. That's fine, as long as we understand that our patients are not measurable and repeatable. I work on a neurosciences floor, so the mind-brain connection is pretty central to my work, and it doesn't take a great leap of faith to extend that to a mind-body connection. And while I'm personally fairly agnostic, I believe the inherent intimacy of our work necessitates recognition of the patients' spiritual needs beyond simply being PC. It isn't just that they have a right to have their beliefs respected, but that they need their beliefs as part of their overall health. Apparently there's a lot more to Watson's theories than I've read, and from some of the posts here it sounds like it may get pretty goofy, but the early premise that caring is important to nursing practice makes sense to me and conforms to my experience. I've seen references to at least one study that found patients who were prayed for, even when they were unaware of it, had better outcomes than a control group. I'm not assuming that's a valid study, and I can imagine that nurses might unconsciously be more diligent in their care of patients they'd prayed for. Still, it's interesting, and might be an argument supporting my view that finding a connection with my patients helps me care for them more effectively.
    elkpark likes this.
  13. Visit  metal_m0nk profile page
    0
    Quote from nursemike
    I concede that pointing out your error was roughly on a par with pointing out a grammatical error or misspelling, and not strictly relevent to the discussion. For that I apologize. Nevertheless, you were wrong. A bowling ball and a baseball--unequal masses--fall at the same speed, even in Earth's atmosphere. On the other hand, a 10kg rock and 10 kg of feathers--equal masses--fall at very different speeds on earth, but at the same speed as a single feather on the moon. This law is pretty much true throughout the universe in which I live.
    Dude, weight and mass are not the same thing.

    Translation: I'm ******* with you at this point.
    Last edit by metal_m0nk on Jun 22, '10
  14. Visit  jjjoy profile page
    1
    Quote from psychonaut
    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.
    That's the way foundational nursing theories came across to me as a student. They were written to counter the idea that nurses were just providing hygiene & comfort care and/or just assisting physicians. But if nursing is more than just hygiene & comfort care and physician assistance, then what is it? That's what some of these theories were addressing.

    Those theories, though, are conceptual frameworks, not scientific theories. When it comes to empirical research, I don't see nursing as a separate, unique field. Instead nursing is an interdisciplinary field involving physiology, psychology, pharmacology, sociology, education, etc. If one wants to put forward a theory of caring, there's also no reason it should be limited to nursing care. Given this interdisciplinary nature of nursing, it would seem to me that there's little need for "nursing theory". Instead, nursing practice is both informed by and contributes to theory in a variety of different fields.
    Last edit by jjjoy on Jun 22, '10
    NRSKarenRN likes this.


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