Can Someone Be a Nurse Without Jean Watson??

Nurses General Nursing

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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?

Suzy,

I am all for you. Do something that makes sense....PUHLEEZ!

I think it is interesting and congratulate you on your efforts.

Will we get to read it and burn it if we don't like it? (laugh)

Make some minor editing adjustments?

Just teasing, I think it's wonderful...finally somebody on the right track!

Originally posted by Susy K

I agree, except there are things nurses do that aren't measurable; ethics for one, caring the other.
Okay, but these are present in medicine as well; and somehow medicine doesn't seem to be having the kind of identity crisis that nursing is.
Also, it seems that nursing borrows alot of it's theories from other disciplines; why is that?
I think it's because nursing is essentially being a jack-of-all-trades. We have to know medicine AND pharmacology AND psychology AND social services AND dietary AND...well, you get the idea.

I'm not saying that caring or the art of nursing aren't important and a big part of what we do. I'm just saying that I think those things are virtually impossible to quantify or regulate or even teach. And to turn your question around, caring and ethics are part of medicine and other disciplines as well--so how come we're the only ones so bent on trying to define it and categorize it? And is that really where we should be concentrating our energies in developing a unified theory of nursing (if such a thing is possible)? Wouldn't it be better to construct a "base" of scientific theory first? When we're done with that, THEN we can kick back and have a glass of wine and get all metaphysical.

I have no answers, folks--I'm just here to ask the big questions. :chuckle

Originally posted by Susy K

...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?

My background prior to becoming a nurse is customer service. Within the customer service realm, I was formally trained in Franklin-Covey Time Management, Kaset Skills, and other Leadership/Customer Service based training courses. The names probably aren't familiar to many nurses, but a few may recognize Kaset as being the corporate trainers for Walt Disney and Federal Express. At one point, these two companies where leaders in customer service based on customer satisfaction.

My training in customer service has been marketable in my healthcare career. The aspects of my formal customer service training that have been most effective in my nursing career is negotiation, and Kaset's famous Human-Business Model, which simply says address a person's human needs before doing business interactions. For nursing, this would mean allowing a patient to verbalize needs and concerns before our assessment, treatments, carrying out order's, etc., or whatever else we need from them.

I have seen far too many nurses lacking the skills needed to even know how to remain a nursing professional, get the job done and not emesh with every patient that pulls at the heartstrings. This, in my opinion, takes more than over analyzed theories of caring and more than relying that instinct will pave a way to understanding needs. The average patient (reiterate "average") doesn't want a mother or father figure to nurture and cuddle them. They probably could care less if we care about them past the eight hours you'd spend with them. They do want to be treated professionally, with friendly, competent service. They want their problems resolved. When patients have a problem and need attention, they want to know that you will help them find a solution, even if you can't handle it yourself. They respond favorably to negotiating, rather than "no" or " I can't". Many times I've seen nurses give a patient a blank face to the simplest of problems or requests that require a certain amount of flexibility. I don't think its because they want to be aloof, I believe its because they have a whole lot of theory training, but ZERO problem solving skills beyond nursing outcomes, or the thought of following guideline to a tee.

So, do I think can one be a competent nurse and NOT care about her patients any more deeply than simply getting the job done? Yes and no. The word "care" can be subjection, person to person. There has to be a certain amount of compassion for our trade present to even be a nurse. I mean, look at what we do on a daily basis. I can care about how my nursing skills is effecting my patients, but not want to bond with that person on a emotional level. That would imply my competency and value of getting the job done, without caring on a deep level.

I hope I haven't played on words here. This topic is a little challenging to make a point effectively without addressing a gazillion other aspects of that point. With this being said, I hope you understand my point above.

here my 0.2 €-cents.

First time I read Watson's theory, it was a long, hard way.

But, I like her theory, although it is very, very philosophical and at some times (for my taste) too no, na. (we say that here, when you mean, no kidding)

One part of my teaching classes, is about the different theories, developed in the last century (now how does that sounds, he?).

It is impossible to know all of them, there are so many and a lot of them are not very often used. Because, they are theories and nothing else.

But for a good discussion, that is one of the ways I like to teach, they are good.

We use, for the basic nursing skills, either Roper or Orem's ADL.

For me and (from the feedback my collegues and I get from the students) the brandnew students, the "easiest" way to understand where to put in your nursing skills.

Where I have big problems though, are the nursing diagnosis from the NANDA. They are pretty "strange" put (especially in their German translation!) and I have troubles with them, because they only diagnose the defencies (sp?) of a patient.

Now, most patients, have ressources too, how small they may be.

These diagnosis are too negativ for me.

So what do you use in your hospital or healthcare centres?

Thanks for a great thread, Susy!! Renee

Susy writes: "I really want to construct a philosophy of nursing that can actually define the profession; one that does so without the academic/philosophical jargon, one that allows a nurse to take that and adapt it to individualize her practice, and one that address the nurse as a whole: her scientific, empirical knowledge that IS measurable, and the pieces of nursing that are hard to define and measure - like the art of nursing."

I found Dorothea Orem's self-care deficit theory to be good on this. I'm not sure it's really possible to build a philosophy of nursing without academic/philosophical jargon, but Orem's theory is a good place to start.

Jim Huffman, RN

http://www.NetworkforNurses.com

Specializes in LDRP; Education.
Originally posted by Stargazer

Okay, but these are present in medicine as well; and somehow medicine doesn't seem to be having the kind of identity crisis that nursing is.

Good point. So why DO we have an identity crisis? I guess maybe I should take a gander at medicine's philosophy and look at how we can adapt it to nursing. I also think nursing tries to separate itself from medicine, as it's own profession. Is it? Or is it really not?

Basically, I think most theories are outdated. When I read how Nightingale started nursing, it was very feminist, and created so women could contribute to society. Those days are gone now. We need to take back the profession, construct curricula that aren't based on the 80's Women's Way of Knowing work and move on!

By the way James, I am still reading that link you provided. I am utterly embarrassed as a professional nurse to see some of these theories floating around. Clairvoyance????

:imbar

Specializes in LDRP; Education.
Originally posted by Glad2behere

Suzy,

Will we get to read it and burn it if we don't like it? (laugh)

Make some minor editing adjustments?

Definitely! I bounce most of my ideas of allnurses.com anyway; it provides food for thought. It's amazing how many people here can invoke a thought-provoking discussion sometimes!

Just to add a little more fuel to the fire, and I in no way mean to be controversial, but I think you are really on to something here Suzy, in helping nurses.

Ironically, the nursing process itself has more merit from a practical standpoint, and can be applied to any task, not just nursing. It is problem and goal oriented, though I have never been impressed with the MEASURE criteria used to verify it's outcomes.

What we need is not another glorified ceremonial litany about how much we do and how good we feel about and how good does the patient feel...leave out the lollipops and the hallucinations of grandeur.

What we do need is a concise reasoning, measurable as Stargazer said, with emphasis on what we really do, and what GOALS we have. The medical profession has succeeded in doing exactly this, and all nursing has had to follow suit, inventing mirages of self-validation as a profession because nursing has been DEFINED by other professions, not us...we just think we have and we are being allowed to inhale the fumes of our own self-indulgence. Granted, we are legally limited to the extent that we project an isolated philosophy by the confines of what we are legally limited to do in the care setting. However, I submit the argument that nursing schools focus more on technical aspects, develop a regimen of instruction involving much more scientific background and knowledge, and develop differentiation within our own incorporating these ideas. Yes, there has been a move toward this, as nurses become more and more different...comparing a pedi nurse to a burn nurse...no way. Two different things. I only wonder if these differentiations were caused more by a desire to relieve legal complications arising from incompetence rather than forwarding the professionalism of that particular group of nurses...so the lawyers and the docs told us to do it.

We also have a bright shiny spot out there, I think, and in support of competence asa result of better training from a scientific basis we need only look at a few of our own. CRNAs

Proof in the pudding. I think that is measurable outcome.

Specializes in LDRP; Education.

First of all, I read James Huffman's article 2 times. It was embarassing. I am bringing that article to class on Thursday night to challenge my professor. THIS professor fits the "cult indoctrination" mentality to a tee. Last Thursday some of us were simply saying, after reading an article critique on Neuman, that we didn't "buy" the emphasis on caring, etc. Our prof clearly didn't even respect our opinion. So...THIS article I bring forth will surely cause an uproar! I will keep you posted if I get kicked out of the grad program! :eek:

I have a feeling though, Glad2behere, that if I write just as you propose, I will be faced with MUCH opposition. Luckily a lot of the theorists are Boomers or older who hopefully won't be publishing as much anymore, but it's ironic that these same nurses who demanded nursing be recognized for it's academic merit and scholarly endeavors, either dismisses that very aspect of nursing or tries to reinvent the wheel (Rogers' twisted physics).

I do like hearing from all of you here, though, in bouncing off ideas about a USEFUL nursing theory, if we have a theory at all. Like the article stated, biology doesn't have a "theory," maybe we shouldn't either.

Specializes in Community Health Nurse.

The name of this thread is: Can Someone Be A Nurse Without Jean Watson?

Well.........I AM PROOF OF THAT seeing that I NEVER once heard of JEAN WATSON. :chuckle Thank God my being a dang good nurse wasn't dependent on 'WHAT' nursing theorist I knew or didn't know. :lol2: :D

Specializes in LDRP; Education.

Ha Renee, very funny!

With the way Watson is emphasized in the literature, you would think that someone really COULDN'T be a nurse without her.

Specializes in Community Health Nurse.

Hi Suzy......guess I'll have to check out this woman to see what she's all about, although I still like my own philosophy of nursing over any other......See post #44 above.....I am in complete agreement with "The Zoe Theory".....also "The Renee Theory". :nurse:

In my own personal professional opinion on nursing theorists though, I must say that I do not subscribe to any nursing theory I've ever read for one reason........I cannot be a nurse without first being myself. In being myself.....I am bringing the BEST theory to nursing that I could possibly bring to the field of nursing because my theory of being "ME" doesn't imitate someone else's ideal of what a nurse should or shouldn't be.

It's great to read and learn about how other nurses theoretically view nursing as a whole.....however.....if I didn't already have within me the compassion and passion for helping people in life, I would have never entered nursing.

You see Suzy.......I had pretty much raised three children before I even went to college. I had worked in the capacity of many different types of jobs......Realtor, Sales Clerk, Cashier, Typist, Assistant Teacher, Assistant Girl Scout Leader, Aerobics Instructor, Sunday School Teacher of children and young adults, Vacation Bible School Director, Bookkeeper, Amway Distributor, Adult Bible Study Teacher, Video Store Sales.......so many more.

It was through all the years PRIOR to my becoming a nurse, that I was being groomed for the occupation of nursing.....my spirit was being groomed.......my patience was being sharpened.......my ability to relate to the public and to people of many cultures and races was being defined......and so forth.

At the age of 35, when I graduated from college, I was MORE THAN READY to give back to society what I had been previously groomed to do......and that was being the best darn nurse I knew God had prepared me to be.

It was because of my many growth spurts emotionally, mentally, spiritually, and physically that I graduated the school of life having learned from many hardknocks along the way that kept me from feeling any sense of frustration as I cared for a very sick population of people as a nurse. Without those prior years of 'GROOMING'.....I would NOT have been the excellent nurse that I know I am.

NO THEORIST could have prepared me for all of that. You see, It is not in the theory that one learns to be a nurse, it is a lifetime process of growth as a human being......as an individual......as one who is exposed.....sometimes against one's will......to the many facets of life OUTSIDE our own COMFORT ZONE of what we would prefer to stay in....yet, for the benefit of not only ourselves, but for others......CHANGE happens to us....and we are literally forced to grow from its impact on our lives.

Some succumb to that growth spurt......some regress. THIS is the BEST nursing.......the BEST life's theory.....to me......personally speaking......Amen! :nurse:

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