Can Someone Be a Nurse Without Jean Watson??

[Q.]

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 Theory of Nursing.

Personally, I have never been a fan of Watson, only because I feel that she OVERemphasized the caring aspect, and, in my opinion, dumbified nursing - hence, the ad campaign in the late 80's "If Caring Were Enough, Anyone Could Be a Nurse." Watson threw a fit when she saw this.

As nursing evolves to a more technically challenging field, requiring more acute assessment skills, and as the

"How Women Know" movement which has shaped nursing education for the last decade or so has become archaic, wondering what your thoughts are on if someone can be a nurse and NOT subscribe to the caring theory. Can one be a competent nurse and NOT care about her patients any more deeply than simply getting the job done?

Watson's theory goes a bit deeper than simply "caring" - more so than "caring" about any other job. But "caring" as far as honestly caring about the patient as you would your mom or dad.

Do you think someone CAN be an effective nurse WITHOUT having so much an emphasis on loving her patients?

[ZASHAGALKA, RN]

Which brings me back to my answer to the original question:

Can you be a nurse without Jean Watson?

Yes. The right question is: Can you be a nurse IN SPITE of Jean Watson? And again, Yes.

Part of learning to be a nurse out of school is learning to assimilate what was important and dump the trash on the curb. Too much of nursing education is trash. And most of the busywork paperwork once in nursing: it's the theory garbage designed to fill space on the chart and fool JCAHO that our ivory towered theorists have any relationship to the real world.

They don't.

It's a game, and every nurse that wastes precious time during an admission or 'update' on these useless records knows it's not about satisfying any reasonable objective for patient care: it's about playing the game.

And the downside of this 'fake' language we've designed, pretending it to be our 'base of knowledge', is that our other team members cannot understand us, and so dismiss us. So, in an attempt to appear 'professional', we've sold out any legitimate demonstration of professionalism.

Someday, nurses will say what they mean, let others know what they know, and actually use it openly instead of pretending and hiding our true roles lest we dare trod on sacred ground. Those nurses will look back at us mystified that we deprived ourselves of our rightful place for so long.

Until then, well, of course, there is Jean Watson and her type. . .

~faith,

Timothy.

[Tweety, BSN, RN]

To me life is about taking in information and assimilating it into how I live my life and leaving the rest.

But I think it's helpful to have a running definition and theories about how others view nursing and how they do nursing. For instance, someone say "you have to be caring to be a nurse". Well, what does that mean and how it is manifested in daily practice....please don't tell me "duh, just use your common sense". Or "nursing is science based", well, how do I use science at the bedside in taking care of patients. "Nusrsing is an art", what do you meant, how is that defined? Is it just tasks such as here's how to place a stethescope on a patient to listen to lung sounds, here's how to start an IV?"

So how do you teach what it is that nurses do? I want to learn all that I can, and assimilate into my own daily nurses practice. I'm not going to dismiss a learned persons life work as Ivory tower BS without practical significance.

On the other hand, I'm certainly not going to subscribe to any theory as to how I practice, it's going to be my own unique practice. If someone were to ask me what that is, I would have to probably use a lot of gobbledygook speak to get the point across. To me my nursing is not a theory, yet I'm also not a robot going through the motions and it's helpful to learn how others view nursing.

I think it is very important to have a wide variety of nursing theoriest that we are required to study. These people are passionate about nursing, passionate about their studies, and it's not trash.

A respectful humble opinion of course. :)

[ZASHAGALKA, RN]

Tweety, I'm sure you are right, in many key respects. And I guess theorists have thier place.

I just wish more of them had something to say that was actually practical at the bedside.

I think the problem is that the politics of academia limit the practical usefulness of what an academic can say and be well-received by THAT community. And the process of the necessity to choose an "academic" point of view tends to have the result of making such observations mutually exclusive to reality. Hence the ivory tower.

~faith,

Timothy.

[Tweety, BSN, RN]

Tweety, I'm sure you are right, in many key respects. And I guess theorists have thier place.

I just wish more of them had something to say that was actually practical at the bedside.

I think the problem is that the politics of academia limit the practical usefulness of what an academic can say and be well-received by THAT community. And the process of the necessity to choose an "academic" point of view tends to have the result of making such observations mutually exclusive to reality. Hence the ivory tower.

~faith,

Timothy.

Can't argue with you there Timothy. I get very frustrated with nurse academia language, especially in nursing diagnosises, but understand it's just a way to teach and describe, but their limitations are frustrating.

A lot of what we learn in nursing school, nursing acedemia and co-reqs like History, English, etc. have no practical significance at the bedside. I'm not willing dimiss theory and other studies that don't fit in with my daily life as bedside nurse as trash.

[BETSRN]

Which brings me back to my answer to the original question:

Can you be a nurse without Jean Watson?

Yes. The right question is: Can you be a nurse IN SPITE of Jean Watson? And again, Yes.

Part of learning to be a nurse out of school is learning to assimilate what was important and dump the trash on the curb. Too much of nursing education is trash. And most of the busywork paperwork once in nursing: it's the theory garbage designed to fill space on the chart and fool JCAHO that our ivory towered theorists have any relationship to the real world.

They don't.

It's a game, and every nurse that wastes precious time during an admission or 'update' on these useless records knows it's not about satisfying any reasonable objective for patient care: it's about playing the game.

And the downside of this 'fake' language we've designed, pretending it to be our 'base of knowledge', is that our other team members cannot understand us, and so dismiss us. So, in an attempt to appear 'professional', we've sold out any legitimate demonstration of professionalism.

Someday, nurses will say what they mean, let others know what they know, and actually use it openly instead of pretending and hiding our true roles lest we dare trod on sacred ground. Those nurses will look back at us mystified that we deprived ourselves of our rightful place for so long.

Until then, well, of course, there is Jean Watson and her type. . .

~faith,

Timothy.

I love your responses, Timothy! You're a nurse after my own heart. :kiss

[BETSRN]

used NANDA in school and haven't seen a NANDA dx in actual practice yet. i'm back in school and back to the insanity of nursing theory.

I have to day that I hadn't used an actual nursing diagnosis until I began doing per diem work for a local VNA. It is so stupid. I'm not too sure why we have to bother.

[Works2xs]

Tweety, I'm sure you are right, in many key respects. And I guess theorists have thier place.

I just wish more of them had something to say that was actually practical at the bedside.

I think the problem is that the politics of academia limit the practical usefulness of what an academic can say and be well-received by THAT community. And the process of the necessity to choose an "academic" point of view tends to have the result of making such observations mutually exclusive to reality. Hence the ivory tower.

~faith,

Timothy.

People come from all walks of life into this field. There are as many individual contexts and viewpoints as there are people. At the very least, such academic discussions can provide a common framework through which two people from disparate backgrounds can discuss issues. I might personally subscribe to all or none of a particular theory. But by having a grasp of it's content I can use that information to express my ideas in terms of a particular theory to someone who's more familiar with that theory than what my background might otherwise offer.

As with any social, moral or "soft" theory, there may be grains of information that resonate with how we view the world of what we do and how we do it. It's up to the reader to understand the context and concepts being presented and then to integrate those ideals (or even their opposite) into our personal orificenal of understanding. The more we explore, research, and learn, the larger the pool of reasoning we can draw upon. Not only in making our own decisions but in how we communicate those ideas to others in the field.

As individuals, it is up to us to gather this information and process it into meaningful application. If we must sit through lecture and class, for no other reason than the time and expense spent on becoming familiar with such material, we owe it to ourselves to find the way to integrate what's been presented. I suppose in a free society you have to choice to eschew such an effort. It just strikes me as disingenuous to place the blame on academia for a personal refusal to integrate a learning experience into the personal encyclopedia that's otherwise known as experience.

As for the language, I don't understand why the nursing profession would NOT want to develop its own lexicon for describing the concepts and work. This board is rife with posts about how the profession isn't the same as that of other health care professionals. As with any knowledge based profession, nursing has grown to encompass much more that it did even 50 years ago. The more specialized the practice, the greater the need to use profession-specific terminology and themes to describe what's going on. It's a natural, necessary progression. Pressure to stop such a process is just self limiting in a rather Orwellian sort of way.

So next time you think that history class was a waste in light of bedside care, just reflect on how you provided your care. Perhaps your Gen-X-self used your knowledge of post WWII America, it's popular/political influences, and different slant on individual roles, to relate just a tad better to that aging baby-boomer in your care. Maybe all that stuff you classify as a possible waste is really having a subtle influence on who you are, what you do, and how you apply your skills.

[ZASHAGALKA, RN]

So next time you think that history class was a waste in light of bedside care, just reflect on how you provided your care. Perhaps your Gen-X-self used your knowledge of post WWII America, it's popular/political influences, and different slant on individual roles, to relate just a tad better to that aging baby-boomer in your care. Maybe all that stuff you classify as a possible waste is really having a subtle influence on who you are, what you do, and how you apply your skills.

I love history, I'm a buff, and it's never a waste.

And I don't oppose discovering our own language. But not to the exclusion of the common language of our peers. It makes us appear as children, speaking in pig-latin to distinguish ourselves from the group. We're so cool.

When a significant chunk our our paperwork and proposed practice is not only considered useless by our other health care professionals, but also by our own nursing peers, then how have we increased our value and understanding?

I'm all for a common base of knowledge to assimlate various backgrounds, but not when that common base inhibits our care and our advancement as peers. Current nursing theory doesn't 'liberate' us; it paints us in a corner from which we cannot escape.

Take the BSN vs. ADN debate. One of the reasons this is a useless debate is because it's has no pratical application to our advancement. You have to be an ANP to move to where all nurses should be: limited prescriptive authority (at least 'in-house') and true collaboration.

Maybe you can argue that ANP should be the entry level into nursing. I doubt you'd get an adequate number of bedside nurses at that level of education. In the meantime, our own theories hold back the bedside nurse.

If this is our language, my vote is to either adopt a serious, professionally motivated language that has common interfaces with our peers, or to, at a minimum, stop pretending that pig-latin makes us 'unique'.

The major problem with our 'theory' is that it starts with the assumption that we must be so different from our other healthcare professionals that they cannot relate to us. We've spent too much time defining how we are different, and not enough time defining how we are complimentary.

This is why it is nurses that cry about 'multidisciplinary' approach. The other healthcare professions don't need to beg for a place at the table, they carve it out for themselves. We don't.

In the name of professionalism, we sold our professionalism. It reminds me of the VA nurses union that couldn't legally strike and sold out their right to picket for peanuts. With absolutely no power, they nevertheless constantly asked me to join. But, when they DID picket prior to selling it away, they always got media-driven results. So, why are the powerless now? The decided to be. . .

And so have we.

I strongly recommend Nursing Against the Odds by Suzanne Gordon. It discusses in great length why nursing hasn't risen to the stature of our true roles.

~faith,

Timothy.

[snowfreeze, BSN, RN]

Caring and being a patient advocate can be simular. I care enough to figure out what is truly in each of my patients best interest. We all walk down a different path in life; Jean Watson walked down hers and I walk down mine, charting diligently as I go.

[BETSRN]

People come from all walks of life into this field. There are as many individual contexts and viewpoints as there are people. At the very least, such academic discussions can provide a common framework through which two people from disparate backgrounds can discuss issues. I might personally subscribe to all or none of a particular theory. But by having a grasp of it's content I can use that information to express my ideas in terms of a particular theory to someone who's more familiar with that theory than what my background might otherwise offer.

As with any social, moral or "soft" theory, there may be grains of information that resonate with how we view the world of what we do and how we do it. It's up to the reader to understand the context and concepts being presented and then to integrate those ideals (or even their opposite) into our personal orificenal of understanding. The more we explore, research, and learn, the larger the pool of reasoning we can draw upon. Not only in making our own decisions but in how we communicate those ideas to others in the field.

As individuals, it is up to us to gather this information and process it into meaningful application. If we must sit through lecture and class, for no other reason than the time and expense spent on becoming familiar with such material, we owe it to ourselves to find the way to integrate what's been presented. I suppose in a free society you have to choice to eschew such an effort. It just strikes me as disingenuous to place the blame on academia for a personal refusal to integrate a learning experience into the personal encyclopedia that's otherwise known as experience.

As for the language, I don't understand why the nursing profession would NOT want to develop its own lexicon for describing the concepts and work. This board is rife with posts about how the profession isn't the same as that of other health care professionals. As with any knowledge based profession, nursing has grown to encompass much more that it did even 50 years ago. The more specialized the practice, the greater the need to use profession-specific terminology and themes to describe what's going on. It's a natural, necessary progression. Pressure to stop such a process is just self limiting in a rather Orwellian sort of way.

So next time you think that history class was a waste in light of bedside care, just reflect on how you provided your care. Perhaps your Gen-X-self used your knowledge of post WWII America, it's popular/political influences, and different slant on individual roles, to relate just a tad better to that aging baby-boomer in your care. Maybe all that stuff you classify as a possible waste is really having a subtle influence on who you are, what you do, and how you apply your skills.

You know, we go on and on about theory and what we bring to the bedside............when did schools stop teaching about disease processes and illness, signs and symptoms, etc. bedside care is also about critical thinking and the ability to pick up on subtle nuances and changes in a patient's condition. If we don't kow about particular illnesses and pathophysiology, how are we going to be safe, skilled practitioners?

You know, I went to a hospital program (but also have a Bachelor's degree). While I think that a liberal arts education is a great thing, I am the nurse I am because of the training I received in illness, wellness, technical skills, etc. I am the nurse I am because of WHO I AM, not because of my educatiion in nonsensical theories and old fashioned crap.

We constantly sit around and complain when our patients speak little or no English and yet we want the nursing profession to have a language of its own????Please, let's stop trying to be so professional in such a useless way.

[Tweety, BSN, RN]

I have to day that I hadn't used an actual nursing diagnosis until I began doing per diem work for a local VNA. It is so stupid. I'm not too sure why we have to bother.

I think so we can recognize problems and what to do about them. I learned a lot from the nursing inventions under the diagnosises.

But to have to write these diagnosises using specific language "as evidenced by" ect. in school is just maddening.

[Tweety, BSN, RN]

This is why it is nurses that cry about 'multidisciplinary' approach. The other healthcare professions don't need to beg for a place at the table, they carve it out for themselves. We don't.

~faith,

Timothy.

Isn't developing our own theory, language, taking charge of our own education and advocating for an entry level nursing's attempt to carve out a place for ourselves? Rather than have the place set for us by other disciplines, particularly doctors? I'm not quite understanding that on one hand you denounce theory, education, etc. and then denounce nursing for not carving out our own place at the table.

Are you saying a multidisciplinary approach is not a good approach, that we should just separate ourselves from the other profressions and do our own thing?

Those other profressions come to the table with "this is who we are, this is what we do, and this is how we contribute to the overall care, and how we can together make a better outcome".

Is nursing not doing this? Should nursing not do this?

Thanks.