Can Someone Be a Nurse Without Jean Watson?? - page 11

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... Read More

  1. by   llg
    I'm going to try to resond to several recent posts in this one:

    To rncountry: I really appreciated the breadth and depth of your familiarity with so many philosophers. I must confess, it has been more than a few years since I read most of their work and my memories of the details are a bit foggy.

    I must point out something. You wrote that you are not very familiar with Jean Watson's work. Well, like a lot of people, you have a made a very wrong assumption about it. Having personally taken a course from her and having spent 5 years at the same school, I am confident in saying that she does NOT say that nurses should care intimately about all of their patients in the same way that they care for family members, etc. Nor does believe that nurses should "give until they drop" or anything like that. People who interpret her work in that way are terribly wrong and doing Dr. Watson a great injustice.

    I personally, do not agree with everything Dr. Watson says and does. Some of the more "far out" aspects of her work are a little too "far out" for me, too. However, I recognize that her work includes much that is valuable and worth exploring further.

    To WashYaHands: Thank you for that description of the CNS role. It's a role that not many people understand.

    To NurseMark25: Your response to my post implied that I don't support NP's, CRNA's, etc. I do support them and said so in my post. I simply said that they are not the ONLY possibilities for advanced practice. Throughout my career, I have been very supportive of my friends and colleagues in those roles.

    Finally, please do NOT refer to me as "Dr. llg." I have never referred to myself in that way. I don't use the Dr. title very often as I work in a setting where everyone is on a first name basis. In fact, most of the people I encounter during the day do not even know that I have a PhD. I hesitated to mention here on this list because I know some people are prejudiced again those of us with lots of formal education. However, I thought that my study under Dr. Watson was relevant to the discussion and that I should be honest and open in joining in.

    And as for "looking down my nose" at bedside staff nurses and/or nurses without advanced education -- that's simply not true. You are making assumptions about me based on very little information. In fact, my boss is a diploma grad who never went back to school and we get along just great -- because I HAVE stayed grounded in actual nursing practice and I am CONSTANTLY fighting for solutions that are "practical in the real world" and not just "hoity-toity words" or "politically correct" in academia. Did you ever stop and think why I am working in a hospital and not working as a university professor?

    What is really ironic about your misjudgments is that one of my big areas of interest (that I lecture on and am writing an article about) is "learning by experience." My position is that experiential learning and "book learning" are both valuable and should be recognized as legitimate and encouraged. Unfortunately, not many nurse educators and/or staff development instructors are very knowledgable about experiential learning. I am leading efforts to promote experiential learning at my hospital. So, now maybe you can see, that your image of me as someone who values ONLY book learning and advanced academic degrees would be laughable to those who actually know me.

    By the way ... while I still do ocassional teaching in the NICU, I took on new responsibilities this past year. The core focus of my job is to bridge the gap between the academic and practice worlds (thus, my keen interest in this thread). My boss saw my passion for the topic and created my position for me. I provide her with the link to the academic world, with which she has little experience. I also do special projects for her, research things relevant to the nursing shortage, help find better ways to do things, etc. She uses my talent for exploring and analyzing things to strengthen her decision-making. She also uses my experience as a CNS to sometimes get needed change through the system.

  2. by   hpyrn
  3. by   Stargazer
    Oh, fer cryin' out loud.

    People who read this board regularly know Susy is an experienced L&D nurse and clinic nurse.
  4. by   Glad2behere
    Either would be nice.

    The basis of the debate here has condensed down to where the priorities are in nursing and what is really important to the patient to justify our profession.

    What is the criteria any profession uses to elevate itself in the public's perception to cross the line from appreciation to need?

    Here is my take: competence, efficiency, quality, and timeliness.

    These characteristics support the concept of ultimate caring. If these concepts are available, caring is not an issue, it is a GIVEN.

    If you were a patient, which would you rather have, a cracker-jack IV starter that was so smooth you didn't even flinch, or my scenario posted above?
    Nursing is caring when we perform competently, efficiently, with quality in a timely manner. The caring feature is a result of the mothering instinct carried over and expounded and we have beat it to death....yet we are not one inch closer to explaining it, we haven't even yet come to an admission it may not need explaining, that it is a simple concept provable and not much different than the social behaviors recognized in a Chimp colony.

    These are social behaviors intrinsic to many species yet nursing theorists are making the statement that somehow nursing has a monopoly on it.

    Let's face it, docs care, lawyers care, firefighters care, policemen care, teachers care, ministers care, Socrates and Plato and Aristotle cared, and I bet Bret Favre does too. I know Troy Aikman does. Do we care any more than any of the above?

    Caring is a starting point, just as mothering is. It is a basic fact.
    When caring is extended to its rationale objective, and that is to produce whatever needs are needed by another, then it has satisfied its reason for existence.

    From a business standpoint: "If it absolutely, positively, has to be there overnight!" FedEx. What does this statement say?
    I care enough about you and your dollar that you can trust me implicitly to address this need and solve this problem for ands or buts. You will FEEL good about this. The same with Southwest Airlines. These two business entities have advanced themselves through competency, quality, efficiency, and timeliness. Caring is an innate portion of their philosophy that fosters these concepts and look how much they have benefitted, the results are the measurement. Yet know one ever hears about how much they care, when obviously they do, and it is no secret. A discussion of it is not merited and is foolhardy.

    What I am saying here is that caring is not unique to nursing. It is documentable everywhere. We have no monolpoly, our caring is no different than anyone else's. If we REALLY cared we would up the ante and secure educations much more relevant to what is expected, then we can acquicese new frontiers.

    Has anyone in nursing really asked the question "Can caring be taught?", "Is it teachable?" "If it can, differentiate between that and acquiring new social skills."
  5. by   Q.
    Originally posted by Stargazer
    Oh, fer cryin' out loud.

    People who read this board regularly know Susy is an experienced L&D nurse and clinic nurse.
    Thank you.

  6. by   Q.

    You actually went down a path that a few of my friends in my class and I did.

    In reading a book, I believe it was Developing a Philosophy of Nursing by Kikuchi and Simmons, the point was made that health is something that nurses safeguard. It was also discussed how "health" can mean different things to different people, based on their circumstance or surroundings. We wondered then, if in developing a philosophy of nursing, we should take into account the nurses' view of health or the public's?

    And so your post made me think: should we define a nurse based on what the public wants or based upon what WE know?

    So far I like your idea alot.

    And as far as caring: yes I firmly agree with you. Nursing does not hold the patent on that, I believe. In fact I know some non-nurses who appear more devoted to their job than I! We also discussed if caring CAN be taught, and in measurable terms. So far, my answer to that is a resounding NO.
    Last edit by Susy K on Sep 18, '02
  7. by   semstr
    I don't think knowledge about nursing theories, - research etc. is something for "those" nurses (LOL, I am not one of them) with advanced degrees.
    We start with simple basics in our diploma-program over here, also because the students should be able to (with our help) at least look at an abstract, then read the whole article about whatever nursingitem, and see the abstract and the article are completely different. Now this is just an example, happens quite a lot though.
    What we try to teach in our research-classes, is first of all, critical reading of articles and being able to tell, what is not 100% ok.
    We do not set the goal, that our students should be able to analyze, that would be to high. That is something for further studies.

    And I can't take post 132 very serious on this thread, must reapeat myself again, this is one of the very best I ever was able to join!
    Susy, there is hardly anything in English on this ladies, but I am trying to translate their basic views, will take a few more days though.
    Take care, Renee
  8. by   Stargazer
    Originally posted by Glad2behere
    Here is my take: competence, efficiency, quality, and timeliness.

    These characteristics support the concept of ultimate caring. If these concepts are available, caring is not an issue, it is a GIVEN.

    Nursing is caring when we perform competently, efficiently, with quality in a timely manner.

    ...we are not one inch closer to explaining it, we haven't even yet come to an admission it may not need explaining
    Wow. I just found these concepts so powerful I wanted to separate them out and look at them again.

    And as the sister of a cop and a firefighter, I think you make an excellent point: members of these professions obviously care--they risk their lives daily to protect the public. Yet I don't see them agonizing over developing a theory to explain it.

    Interesting ideas, thanks.
  9. by   Q.
    Originally posted by semstr
    Susy, there is hardly anything in English on this ladies, but I am trying to translate their basic views, will take a few more days though.
    Take care, Renee
    LOL Don't bust yer balls, Renee! I thought you had them handy or something.
  10. by   llg
    I agree wholeheartedly with Glad2behere when she points out that nurses aren't the only people who care. That's one of the main problems with making "caring" the centerpiece of any definitions of nursing. It should also be pointed out that none of the theorists who focus on caring mean to imply that other professions don't care -- at least none that I have ever met or read.

    That doesn't mean that the concept of caring isn't important to nursing or not worth exploring.

    Also, while studying with caring theorists in Colorado, revisions and refinements to Dr. Watson's work were always being discussed. In fact, Dr. Watson herself said to us in her class that, if she were doing it over again, she would not have stopped at 10 "carative" factors. Even she readily admits that her original work is not a complete list of all aspects or types of caring. Anyone who treats the list as "gospel" is not being consistent with Dr. Watson's own views of her theory.

    Finally, "technical competence" was generally agreed by the students to be a definite part of caring -- one that should have been more prominent in the original work. I don't know of any caring theorist who believe that technical competence is unimportant. It is assumed as a necessary foundation to practice in a caring manner.

  11. by   llg
    I thought I should tell the story (as told to those of us in one of her classes) of how her theory and first book came to written.

    She had been in faculty meetings at which they were trying to re-organize their undergraduate curriculum. Now, I know that may seem like a ridiculous activity to some people -- but it has to be periodically. Every now and then a school has to re-assess itself and decide what it is going to teach and how it is going to organize its classes. Most students come into a program needing some structure around which to organize all the information they receive.

    She didn't say exactly what it was that made her angry about the meeting, just she was very dissatisfied with it and frustrated. So, she sat down and wrote out what she felt was a better way to organize the information -- a way which brought out aspects of nursing that had previously been rarely discussed.

    So, you see, it did not originate as a specific description for specific direct-patient-care acts. It was originally intended as a broad framework around which to base a course of study.

  12. by   Q.

    But couldn't we assume that Watson's theories are really just givens in the "helping" professions?
  13. by   llg
    Susy K,

    I'm not sure exactly what you mean by your question.

    I think the fact that caring exists can be assumed in many; many professions. I think it is also safe to say that all professions include some individuals who "care" very little.

    That doesn't mean that it is not worthwhile to study the nature of caring and how to BEST USE it to help others. Just because caring is a common phenomenon doesn't mean there is no need to understand it fully. Have you read the chapter on Kristen Swanson yet? In her work, she has built on Watson's early work on caring and is developing intervention strategies based directly on her (Swanson's) theory of caring. Her work is a demonstration of how Watson's early work can be put to practical use.