theories currently being used in the field of nursing today. While each has their respective positive and negative points, all are useful in certain nursing settings, and can assist nurses in their positions. This paper will discuss two of those theorists, Jean Watson and Jean Piaget. Each theory will be discussed and explained, and examples of how each can be applied in the field of nursing will be discussed. This paper will show that both theories, though very different, can be useful in the field of nursing.
The Theory of Human Caring, created by Jean Watson, was originally developed based on Watson's experiences as both a teacher and in the nursing profession. According to Watson, the theory was created to explain those values of nursing that differ from the values of "curative factors," those of doctors and specialists. The Theory of Human Caring is devised based on the explicit values, practices, and knowledge of human caring that are geared toward the subjective ideas of inner healing, rather than the outer ideas of common theories, and was developed with nurses specifically in mind (Watson, 1979).
The Theory of Human Caring begins by discussing the 10 major carative factors, now generally thought of as "Clinical Caritas Processes" (Watson, 1996). These 10 factors or processes are what Watson believes to be are the key "core" of nursing. These are the aspects of nursing that allow those professional men and women to assist patients in the healing process, and allow nurses to ensure healthy relationships with those patients. Additionally, the carative factors are those aspects of nursing that go beyond the functional tasks and settings of nursing, and go above the focus on disease and treatment. Watson believes that nurses should not be defined by those aspects of the field, but rather, by their mission to society, that of transpersonal caring (Watson, 1996).
When the theory was originally developed, there were ten "carative factors" defined in the theory (Watson, 1979). In later years, as Watson has refined her theory, those have become the ten clinical caritas processes (Watson, 1996). The first is that of the formation of a humanistic-altruistic system of values by the nurse. This idea, in Watson's later development of the clinical caritas process, became the idea that nurses practice love and kindness and calmness when dealing with patients. Secondly, the nurse instills hope and faith in the patient. This idea later became the ability of the nurse to be authentically present in the life of the patient, allowing the patient to sustain a deeper belief system and subjective viewpoint about life. Third, the nurse has the ability to cultivate a sensitivity to one's self and those around them. In the later versions of the theory, this idea became the ability of the nurse to go beyond the self, and to cultivate their own spiritual being. Fourth, the nurse is able to develop a helping and trusting relationship of care. This idea remained stable through revisions of the theory, with the added component that those relationships are authentic in nature, built to benefit both patient and the nurse (Watson, 2000).
Fifth, according to Watson, nurses have the ability to promote and accept both positive and negative feeling expression. In other words, nurses support and witness their patient's expressions, and understand that those expressions are a connection with the spirit of the patient. Sixth, nurses systematically use problem solving in the caring process. In the later theory, this idea transgressed to the nurse's ability to creatively use themselves and their knowledge to engage in caring and healing practices (Watson, 2000).
The seventh component of the theory discusses the ability of the nurse to promote teaching and learning. In a broader sense, this idea relates to the concept that nurses can teach and learn with their patients in a way that keeps both of them in their respective places, without putting stress or strain on either side. Eighth, nurses provide a supportive, protective, and corrective mental physical, societal and spiritual surroundings for the patient. According to Watson's later expansion, this idea was meant to convey the ability of the nurse to heal at all levels, including those of the non-physical, such as comfort, wholeness, and dignity. The ninth component of the theory discusses the nurse's ability to assist patients in human need gratification, always with care and unity, providing a sense of wholeness. Finally, the theory discusses the nurse's place in the allowance for spiritual forces, meaning their ability to care for the soul and spirit of the patient (Watson, 2000).
In addition to the above basic core ideas of the role of the nurse, Watson also discusses the idea of transpersonal caring relationships. These relationships convey a concern for the world and the spirit of the nurse's patient (Watson, 2000). These relationships help to move the patient beyond their pain and suffering, and allow them to tap into their own healing potential. Watson also discusses the ability of the nurse to use that caring to go beyond the illness and disease, and to focus on the healing and wholeness issues of the patient. As a part of that relationship, there are moments where the nurse and patient bond together and it is that bonding, which is a result of the ten processes above and the transpersonal relationship, which allows the healing of the patient (Watson, 1988).
A study in Turkey in 2000 studied the relationship between nurses practicing Watson's method of nursing and the effects of those practices on patients with hypertension. In the study, 52 patients were tested to determine the original levels of hypertension. Over the following 3-month period, nurses skilled in the Watson method visited the patients once a week to check their levels. At the end of the three-month period, the patients were again tested for their blood pressure levels and quality of life. The study concluded that there was a significant relationship between patients treated by nurses skilled in the Watson method, and both a decrease in hypertension as well as an increase in overall general well-being (Erci, et al., 2000).
The use of the Watson theory has wide implications. First, as research has shown, nurses who care for the ill using the 10 carative processes Watson describes tend to the whole human being, not just the ill patient. This can help raise that patients levels of self-esteem and hope, as well as make them better. Further, the use of genuine care and concern by nurses with ill patients can ease the mind of the patient, furthering the healing process. Examples of this theory in motion include nurses who have open discussion with their patients about spiritual matters, nurses who show care and concern in all areas of the patients' life, and nurses who spend quality time with patients, helping them to understand not only their illness, but also themselves.
Jean Piaget also had a theory that is helpful in the realm of nursing. In the Piaget theory, development is achieved in stages, and all people pass through all stages in the same order. The stages in the theory are the sensorimotor stage, where mental structures develop the mastery of concrete objects. The second stage is that of the preoperational stage, where children learn their mastery of symbols. The third stage is the concrete operational stage, where children learn reasoning skills and numbers. Finally, in the formal operational stage, children learn how to think in abstract concepts (Evans, 1973).
Piaget's theory of intellectual development hinges on three main ideas, those of assimilation, accommodation and equilibration. First, children must assimilate new events into preexisting ideas, which is assimilation. As children have new experiences, they must classify them in terms of those ideas they already know. Next, children must be able to alter those existing ideas to fit the new information. This dual process, according to Piaget, is what allows the child to form schema, or constructs about the world. Until the new information or situation is assimilated or accommodated, the child is unable to find balance. This disequilibrium can cause the child to behave in ways abnormal to themselves. Once they are able to assimilate the new situation, they are able to achieve balance again (Evans, 1973).
The Piaget theory applies to nursing well, in that it is easy to see how an ill child is in a state of disequilibrium. Until the child, or any person, is able to assimilate and accept the information they are receiving, they will not behave in a way that is characteristic of them. Thus, as a nurse, one must be able to assist the person in assimilating any and all information, as well as making sure their needs are taken care of. Since learning, according to Piaget, is a conscious process, and relies on the participation of the learner, the nurse must recognize this, and be able to assist in that learning process (Evans, 1973).
As a nurse, one must be able to combine both theories in a way that…