Application of Concepts from Jean Watson’s Caring Science
According to Alligood (2017), the theory of human caring by Jean Watson is mainly concerned about how nurses take care of their patients and the relationship between them. Watson posits that disease can be cured, but illness will still be present; hence health is not attained. The theory makes various assumptions, for example, the implementation of the carative factors during caring lead to human needs satisfaction. Some of the concepts in this theory include; transpersonal caring relationship, caring event, nursing, society, human being, self-etc. This paper aims to identify two concepts in Jean Watson’s theory that can be applied to improve the patient experience and satisfaction and develop ways of measuring the concepts and develop a proposition between them.
Identify an Outcome
One particular component that I have identified that needs improvement is the poor patient experience during their stays in the emergency department (ED) that I used to work at, which leads to patient dissatisfaction. From the survey done at the hospital, it was identified that an unacceptable amount of patients were not fully satisfied with the care and relationships they had with the nurses. I work in the aesthetics industry as a Botox and filler injector, and I have realized that this is an area that needs a deep connection between the nurse and the patient so as to meet the overall goals of the patient.
Karaca & Durna (2019) opined that the interaction between the nurse and the patient during the period of hospitalization have a significant effect on the overall patient experience. Patient satisfaction is often defined as the patient’s attitude and values towards the nursing care they received while in the hospital; this entails the nurse-patient relationship, communication, and meeting the patient’s needs for coming to the hospital. One main area that was highlighted that needs improvement is the patient-nurse relationship, which has been affected by the introduction of various health technologies, e.g., electronic health records, which has reduced the time and relationship that the nurses form with the patients and instead direct their focus towards using this technology. Currently, the relationship between the nurse and the patient is depreciating as nurses spend less time with patients and do not develop useful connections that would facilitate opening up and achieving the patient health goals. There is a need to improve patient experience and satisfaction by improving the relationship, communication, and interaction between nurses and patients.
The Concept in Watson’s Theory of Caring That Could Represent or Include the Outcome
It is imperative to improve the patient-nurse relationship and satisfaction in nursing practice, which will generally impact the overall patient experience. Patient satisfaction always acts as an indicator of quality nursing that more attention should be directed towards as it will affect the utilization of health services by the patient in the future. All hospitals need to develop criteria in which they can assess the experience of patients in the hospitals and come up with quality improvement programs that target patient satisfaction (Fatima et al., 2018).
In this example provided of the area that needs improvement, the outcome would be change in the nurse-patient relationship by establishing transpersonal caring relationships. The concept that has been identified is the transpersonal caring relationship, which is a significant element of the theory. A transpersonal relationship is always impacted by the nurse’s intentionality and caring consciousness, especially when entering another person’s life space or phenomenal field. In this relationship, the patient and nurse affect each other and goes beyond the ego, with the two connecting at a spiritual level. In transpersonal caring, there is a need to be authentic and becoming, which is the ability to be present to self and others in a reflective frame. The transpersonal nurse’s role becomes to center consciousness and intentionality on caring, healing, and wholeness, as illustrated in the Watsons Caring Science Institute (n.d).
According to Clark (2016), when the nurse and the patient come into a relationship beyond the ego, then the caring occasion ensues. In the caring occasion, the nurse and the patient take up various choices and actions and provides them with the opportunity to decide what to do with the moment or how to be in the relationship. In this relationship, there is a phenomenal field that is shared by both the nurse and the patient. Having a phenomenal field coupled with connecting at a spiritual level which can help improve the interaction between the nurse and the patient because they affect each other’s and influence each other’s actions and choices. The transpersonal relationship translates to two people meeting as one in an equal manner with a deep connection. It also has to be noted that transpersonal caring relationships are inclined towards the exploitation of non-ordinary states of consciousness, going beyond the ego. However, these states of consciousness have the ability to influence healing potentials. According to the WCSI (N.d), within a single caring moment, the whole caring-healing-loving consciousness energy is contained. The nurse’s caring-healing-loving consciousness is communicated to the patient, and it exists through and transcends time and space and can have superiority over the physical dimensions. Calong & Soriano (2018) elaborated that a transpersonal nurse will be able to have a great relationship with the patient where the caring and the cared for are interconnected, and will lead to a caring event which will improve the patient-nurse relationship and overall patient experience in the hospital.
The Concept in Watson’s Theory of Caring That Includes the Practice
The specific practice in this setting that could be beneficial is improving the nurse-patient relationship through sustaining humanistic-altruistic values by the practice of loving-kindness, compassion, and equanimity with self and others. This is a component of the ten Caritas factors. Through the application of the Caritas factors, the nurse can be open to connectedness with others, respect and listen to others, pay attention, treat the patients with love and kindness, and highlight that each person is unique in their ways. Additionally, the nurse can model self-care and caring for others and accept others the way they are (Tonin et al., 2017). The nurse’s carrying out these activities will help improve the nurse-patient relationship and, additionally, improve the care that the nurse provides to the patient. The practice of loving, kindness, and equanimity within the context of the caring consciousness process is considered to be relational, connected, and beyond the physical dimensions. Consequently, it transcends time-space and physicality. Through this, the nurses will be able to sustain the humanistic and altruistic values that are factors within the nurse-patient interaction and can also improve the overall patient experience (Pajnkihar et al., 2017).
According to Settecase & Whetsel (2018), all the carative factors enhance and supports the patient’s caring experience. They are mostly viewed as nurse-patient interactions that function in improving the experience of the actual caring event. Suppose the nurses adopt the loving, kindness, and equanimity approach, it will be a useful practice towards enhancing the patient’s interaction and overall experience and hence improving this outcome.
Measuring the Concepts and the Operational Definition
Transpersonal care in this context will be defined as the nurse and the patient’s ability to form a deep relationship beyond the ego and at the spiritual level where they are both affected by each other, and the relationship transcends in time and space and creates new opportunities for healing. The relationship is to be considered as being together where each party is equal. The Caritas factor of kindness, loving, and equanimity is to be defined as showing love, being kind, offering self, respecting others, showing concern for others, and helping the patients achieve a balance between the soul, mind, and body.
Measuring these two concepts is essential to assess the impact, redefine the approach, or develop a different practice. To effectively measure the two concepts, there will be a need to develop a questionnaire or a repertoire of statements that the patient can respond to effectively and assess if the nurse had a transpersonal caring relationship and if the nurses showed love, kindness, and equanimity to the patients. This will determine if the concepts in practice are effective or are being implemented by the nurses correctly.
Additionally, the Watson Caritas patient score (WCPS) is a reliable tool that can be used to measure the patient perspectives of caring practices. The tool contains five critical questions that evaluate the authentic nurse’s practices, such as providing care with loving and kindness, which is the concept of interest in this context. These instruments can be employed effectively to measure the two concepts (WCSI, n.d). The proposition between the two is; establishment of a transpersonal caring relationship facilitates the practice of sustaining humanistic-altruistic values by the practice of loving-kindness, compassion, and equanimity with self/others.
Alligood, M. (2017). Nursing theorists and their work-e-book. Elsevier Health Sciences. https://doi.org/10.1080/15323269.2018.1400848
Calong, K., & Soriano, G. (2018). Caring behavior and patient satisfaction: Merging for satisfaction. International Journal of Caring Sciences, 11(2), 697-703. http://www.internationaljournalofcaringsciences.org/docs/9_soriano_original_10_2.pdf
Clark, C. (2016). Watson’s human caring theory: Pertinent transpersonal and humanities concepts for educators. Humanities, 5(2), 21. https://doi.org/10.3390/h5020021
Fatima, T., Malik, S.A. and Shabbir, A. (2018), “Hospital healthcare service quality, patient satisfaction and loyalty: An investigation in context of private healthcare systems”, International Journal of Quality & Reliability Management, Vol. 35 No. 6, pp. 1195-1214. https://doi.org/10.1108/IJQRM-02-2017-0031
Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care. Nursing open, 6(2), 535-545. https://doi.org/10.1002/nop2.237
Pajnkihar, M., McKenna, H. P., Štiglic, G., & Vrbnjak, D. (2017). Fit for Practice: Analysis and Evaluation of Watson’s Theory of Human Caring. Nursing science quarterly, 30(3), 243–252. https://doi.org/10.1177/0894318417708409
Settecase, C., & Whetsel, M. (2018). Caring in the Nurse-Patient Relationship through the Caritas Lens: An Integrative Review. Cultura del cuidado, 15(2), 34-66. https://doi.org/10.18041/1794-5232/cultrua.2018v15n2.5111
Tonin, L., Nascimento, J., Lacerda, M., Favero, L., Gomes, I., & Denipote, A. (2017). Guide to deliver the elements of the Clinical Caritas Process. Escola Anna Nery, 21(4). https://dx.doi.org/10.1590/2177-9465-ean-2017-0034
Watsons Caring Science Institute (WCSI) (n.d). Caring science measurement tools. Retrieved from https://www.watsoncaringscience.org/jean-bio/caring-science-theory/research/watson-caritas-patient-score/
Watsons Caring Science Institute (WCSI) (n.d). Caring science & human caring theory. Retrieved from https://www.watsoncaringscience.org/jean-bio/caring-science-theory/#
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