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?

[Tweety, BSN, RN]

Timothy there are many different theories being taught. I don't recall the nursing professing banding together and forcing any one theory down anyone's throat.

I personally don't subscribe to any one theory. However, being of an inquisitive and scientific mind, I can understand the desire of some folks to define "what is it nurses do?".

Of course there's alway the standby "all nurses do is pass meds and do assessments and paperwork". Perhaps we should leave it at that without forcing students to read any Irovy tower theory.

So, we hint at what we mean so that it is other health care professionals that can 'Ah Ha' the solutions and take the credit for what nurses do as professionals everyday.

Not sure what you're saying here.

[elcue]

I think one of the ethical mandates of nursing is to care FOR every patient as if you cared ABOUT them. That is to say, we have all certainly been assigned to care for an unlikable patient here and there, but as professionals we still provide proper care.

A poster above feels that all nurses care about people, and I agree with that. None of us could do this if we didn't care about people in general.

[elcue]

Timothy, I like the way you think!

[PANurseRN1]

I don't need any nursing theorist to tell me what my common sense tells me.

[jojotoo, RN]

I'd rather have a superbly skillful nurse that didn't give a d--n about me than a touchy feely airhead that acted like my best friend.

[MrsMommaRN]

as a nurse i beleive you should treat each patient with unconditional positive reguard. you don't need to love each person as you would your family, but care about providing competent care while advocating for your patient:twocents:

[GadgetRN71, ASN, RN]

Not only is your 'theory' a wonderful working model, it benefits from not having it handed down from on high by ivory tower elitists more interested in controlling nursing then defining it.

Great theory. I use it myself. And, I didn't need Jean Watson to dictate to me the spritual parameters of this wonderfully concise theory.

Nursing theory should stick to science and let its practitioners deal with the spirituality that EACH of us bring to the profession, as individuals. In fact, I argue that it is both a fundamental impossibility to define that individual spirituality for the masses of nurses AND the very process of doing so does more to diminish the 'professional' nature of nurses then any other factor.

Thanks to 'nursing theory', we are relegated to power diminishing language and devices. We can't say what we mean, because we would violate the limits placed on us by the Ivory Tower, limits in turn that were placed on us in the very old days, when doctors taught nurses how to be nurses and instituted these very same disempowering devices.

So, we hint at what we mean so that it is other health care professionals that can 'Ah Ha' the solutions and take the credit for what nurses do as professionals everyday.

Can you be a good nurse without Jean Watson: if you really really try, you can be a good nurse DESPITE Jean Watson.

~faith,

Timothy.

Yeah, what he said!! This also off topic but Timothy, I love that quote at the bottom of your signature-I may have to steal it and have it placed on a coffee mug!

[Aaron86]

Edit: Go me for dredging up a 7 year old post!

I certainly hope I can be a nurse without Jean Watson. Because i have never heard of her.

Sure you have to care about your patients to some degree, otherwise you probably wouldn't suffer through the worst the nursing profession has to offer. But i don't buy into any sort of "all you need to be is all-caring" approach.

Those nursing "theories" have got to be the biggest waste of educational time. I couldn't even quote you a nursing theory since its all a bunch of bunk in my opinion. Not a true scientific theory at all.

[rngolfer53]

Hooray for all you nurses that believe one can be a nurse without caring for a patient as if they were your mommies and daddies! Finally, it is so refreshing to see nurses that do not have that sentimental non-sense feeling about their jobs! I work in an ER. I rarely care for a patient for more than 2 or 3 hours at a time. I don't know these people. I am not capable of caring for a patient who is a complete stranger. You see, it takes a while for people to build a relationship to have that kind of caring. I care about doing my job well and I care about my paycheck that comes about every two weeks. I care that my patients see a professional before them, someone they can trust their lives with. I care that I do not make mistakes in the care of a patient. So I care about my work, and in an acquaintance sort-of-way, I care about the person as a human.

I have problems with nursing theorists. They try to make nursing or describe nursing in such a way that is downright ludicrous. There was one theorist that I read about that described nursing as the interaction of balls of energy that interact with each other,share energy, and affect each other.... blah, blah, blah. I laughed my -ss off after I read this. PLEASE! How does that have anything to do with nursing??? How does this help me triage a patient in active CHF coming in through the front ER doors? How does it help me understand whether or not a patient may be having a reaction to a drug I gave? how does it help me interpret abnormal lab tests so that I can let the physician know something is up with my patient??? Nursing needs to be more like medicine... scientific, yet still have more of a human touch to it. Do you know what would happen if I attached myself to patients like that quack nursing theorist suggests? I see death almost every day that I work... if I cared for my patients like I do my mom or my dad, I would never come back to work! Nursing burnout would be worse. A degree of detachment from a patient allows a nurse to be more objective, calculated, and cool-minded... assets that are very important in a field such as ours.

I do not mean to offend anyone here. But if nursing were more like medicine, we would all be sticking together, working in unions, making great pay with great benefits, having great nurse-patient ratios, and running the hospitals. Instead, we have this stupid theory of caring that causes us to be selfless, take less pay, get disrespected, and get stepped on. No thank you!

I'm kind of in a similar situation, in that I'm a hospice nurse who does after hours in-home calls, usually for symptom management and time of death. It's rare that I see a Pt more than once, and twice is about the limit. I'm usually not there for more than 2-3 hours, but while I'm there I have the luxury of dealing only with that Pt/family.

I find that in many cases, what the family really needs is to be relieved of the burden of taking care of their loved one in a crisis. They need someone who at least projects a level of confidence and competence. They can relax and turn the care of their loved one over to you. They're very often emotionally spent.

Obviously, I can't usually form some emotional bond with these folks in the minimal time I'm with them--broken up even more by calling for orders, etc. I do a lot of education, and try to engage the family by asking about their dying Pt. What did he like to do, etc.

Some Pts and families I "click" with, and with others there will always be a gulf, no matter what. I do my best to provide the best care I can, regardless. Just like most nurses do.

When I go home, I pretty much forget about work. Sure, I review my decisions--could I have done something more or different? That's part of being a professional, just as is improving one's knowledge base.

But, I don't take home emotions with me. I don't "care" I suppose, that deeply. Emotions come and go rapidly, so "caring" in that sense is unsupportable as a driving force for doing the work of nursing. Not to speak of being the autobahn to rapid burnout. To me, caring is no more or less than a mental commitment to do the best I can, regardless of my transient emotional reaction to the situation I find when I knock on the door.

[nursemike, ASN, RN]

I'd rather have a superbly skillful nurse that didn't give a d--n about me than a touchy feely airhead that acted like my best friend.

I know I'm quoting a pretty old response, but it applies to a fairly recent experience. Awhile back, my father had some fairly extensive surgery and went from recovery to ICU. Had a bad time coming out of anesthesia--hallucinations, major anxiety--but was fine within hours. Stayed in ICU a couple of days on stepdown status because stepdown beds were short.

Dad says, and means, he would rather die than go back to the ICU. I only met one of his nurses--the better one, per my Dad. She was technically very good, but her people skills were poor. He was treated as a case. I, visiting, was treated as a nuisance. When he was transfered to stepdown, I met several nurses who made me proud to be a nurse. I don't imagine any of them loved my dad as I do, but they cared for him as I would have cared for their family, they listened to his concerns and needs, and never gave the impression they didn't have time for him. Their technical skills were fine, too.

Like other posters, I'm not real concerned about "caring models." I don't feel I need a theory of caring and compassion. But I do feel caring and compassion are central to what I do. I work on a neuro floor, so I need to be attuned to subtle changes in mental status. Is my patient lethargic, or just sleepy? Is he agitated, or just disgruntled? I feel like a feeling of connection helps me with these assessments.

It's a balancing act. I've found that I can't be a fully effective nurse with my dad. I'm too involved. I have a human inclination to see what I want to see. During a recent CHF exaccerbation, I was beside myself, because I knew he was in trouble, but he wouldn't listen to me until it was almost too late. So, in addition to a degree of lack of detachment, there's a lack of authority. One reason I almost always address patients as "Mr." or "Ms." is that I think it clarifies that our relationship is professional. But I also think I need to be emotionally available, even with patients who aren't particularly looking for that. Just because they don't need their hand held at 2130 doesn't mean they won't at 0300, and in any case, I think my emotional connection helps me access my intuition.

I'm all for the science, but my patients aren't machines, and I'm not a mechanic. What they feel and think is a key element of their condition, and that's true for any patient, not just neuro.

I've "fallen in love," with patients, (not literally, but some just touch something from the moment you meet them) and I've had some I didn't like very much. Sometimes I've had to look pretty hard to find something about them to care about. Lately, it seems like I've had a run of "drug seekers." It takes real effort not to let one gobble up your whole shift and short-change your other patients. It gets tiresome repeating, "No, I can't give you any morphine. Would you like a Tylenol?" A big part of the stress, I'll admit, is that I feel badly for them, and I want to be their advocate, but not the advocate they want me to be. I will not badger the doc for narcs, no matter how much they badger me. But I do get that chronic pain is depressing, and depression adds to the pain. I was taught that people with chronic pain don't show it like someone with an acute onset. Living with fibromyalgia, say, is living. You sleep, you laugh, you go out to smoke, and you're still in pain. Maybe so. But I've noticed that people with chronic pain have a hard time tolerating even minor acute pain. I bump my toe, say "Ouch!" and go on about my life. I have lots of emotional reserves to cope with a momentary hurt. I'm not coping with pain all the time. Some of my PITAs don't have that, and a wrinkled sheet is agony. So, I still sigh when their call light goes off, but I try very hard to see things from their side and I do care about them. Hell, I love my dad, and he also drives me nuts, sometimes...

I'm running on about this because I've been thinking about a couple of these "drug seekers," who've mentioned that the doctors think they're drug seekers, and in hindsight I've realized that what I need to be doing is teaching them how not to look like drug seekers. I need to be on their sides, because I'm their nurse, but I can't change the doctor's mind (especially when I think he/she is right). So, next time, I'm going to try to involve the patient in collaborating to get appropriate relief. Actually, I've done that with patients with acute pain on PCAs that "weren't working." I tell them to hit the button every time they're in pain, because the number of times they hit the button is data I can show the doctor, and then maybe he will order that bolus of dilaudid they're been wanting, or at least adjust their settings.

I can't speak for anyone but me, but I think I do as much "critical feeling" as "critical thinking." And I think and feel that's how it should be.

[Freshman RN]

no you cannot just be a competant nurse, these are the nurses that as sued and complained about. Fake it!

[JomoNurse]

My theory instructor said that "most of these theories are crap." When we got to Jean Watson, my instructor literally said "Just know she cared. She cared... a lot. Next." :-)

In my opinion, I don't even know why some of these theories are given any mention at all. They make nursing seem like a brainless joke.

Who was that crazy lady that thought you could "channel" good vibes into your patients through hand motions? Whack job. I would literally LOL if I saw a nurse doing that. Patient's need dilaudid to feel good vibes - not some crazy nurse waving her hands in the air.