Care theory improves patient care

When nurses and nursing students first encounter the Human Care Theory, they are sometimes amazed or overwhelmed by the words and phrases utilized by its writer, nursing theorist Jean Watson, RN, PhD, AHN-bc, FAAN, professor at UW. Colorado, Denver College of Nursing. A look at Watson’s website (www.WatsonCaringScience.org) will only add to the confusion. She talks about Love with a capital L, sells singing bowls (a form of standing bell utilized in meditation) and promotes the Million Nurse Global Care Field Project that she believes will radiate – a field of World Energy Awareness Care for Global Healing and Health for Everything.?

But when nurse managers and staff nurses describe how they use Watson’s theory of their clinical practice, its ideas are immediately familiar: listening to patients, seeing the person behind the disease, being attentive to what the person is doing at that moment, teaches care for yourself.

Nurses who imagine in Watson’s theory say this is meant to function a reminder that their primary goal as health care employees isn’t to take vital signs, fill out forms, or insert IVs, but to assist real, living people heal and be comfortable.

Giving words to ethics

Watson estimates that, in a technique or one other, about 100 hospitals have adopted her theory of care as a guide to practice, most within the last five years. About 20 of them cooperate directly together with her on an ongoing basis, participating in meetings of her International Caritas Consortium in facilities throughout the country. Some use this theory totally on their nursing units, while others implement it throughout the hospital.

“This isn’t something new?” says Randy Williams, RN, MSN, MBA, skilled practice coordinator at Wake Forest University Baptist Medical Center in North Carolina, which has adopted Watson’s theory as its guide to clinical practice. “It’s just putting words to the things we do every day.”

Watson’s theory has evolved for the reason that late Seventies, when she first developed it in response to what she said was a growing gap between the science of medication, with its emphasis on technology and the treatment of disease, and the art of healing, which emphasized the entire person and the private relationship between the caregiver and the patient.

“Goes beyond patient-centered care”? – says Watson. “It gets to the heart of human-human relations.”

As more hospitals pursue Magnet status or seek ways to guide health care delivery, an increasing variety of hospitals are adopting nursing theories? including Watson? to assist define and recognize what nurses do.

Watson is considering making a technique to measure the outcomes of putting his theory into practice and should design an affiliation or accreditation system through his Caring Science Institute. She created a Care Assessment Tool that enables patients to rate their experiences based on statements akin to: “My caregivers consistently provide care to me by demonstrating loving kindness.” Some hospitals are working on pilot projects, collecting data not only on patient satisfaction, but in addition on how nurses care for themselves.

Ellen Gruwell, RN, MSN, labor and delivery nurse at St. Joseph in Orange, California, says Watson’s theory complements the hospital’s core values ​​of dignity, service, excellence and justice. Nurses are encouraged to spend time with their patients and establish emotional and spiritual connections with them, he says. “We have permission to do this. It’s part of who we are.

“Her theory speaks very well to the nurse at the bedside?” says Anne Foss-Durant, RN, NP, MBA, chief nursing officer at Kaiser Permanente Antioch (California) Medical Center, where human care theory has guided nursing practice for 2 years. In recent years, health care has develop into so complex that many nurses feel they’re too busy or stressed to recollect why they selected nursing, she says. Watson speaks of comfort, compassion and self-care to nurses who feel their job is proscribed to filling out forms and administering medications, she says. According to her, care theory gives nurses a voice. It focuses on “centering” and ?being within the moment? transforming practices like handwashing into rituals that allow nurses to stop, concentrate, and be present for the patient.

In addition to direct patient care, some hospitals incorporate Watson’s theory into their education, hiring, job descriptions, and human resources programs. Some have created meditation rooms where nurses and other staff can go once they need a moment for quiet reflection. Some people use “caritas trainers”. who help nurses learn and interpret the ten parts of Watson’s theory.

Many hospitals encourage nurses to inform stories about how they practiced some a part of Watson’s theory. For example, Williams says, a nurse at Wake Forest recently talked a couple of patient who had spoken harshly to her because he wasn’t being discharged as quickly as he wanted. Instead of getting upset, she responded politely and offered to walk him from the hospital after he was discharged. As they walked, the patient began to cry and apologize, saying that his wife had recently died and he was frightened that his daughter would must wait to select him up. The nurse assured him that she was there for him. “She created a caring, healing environment?” this environment is herself? in order that the patient can get better? says Williams.

At Winter Haven Hospital (Fla.), some nurses formed nondenominational prayer circles and created and displayed posters depicting various caritas activities. They light candles, bang singing bowls and share moments of concern? initially of meetings. “We are known in this area as Jean Watson Hospital.” says Mary Jo Schreiber, RN, MSN, chief nursing officer at Winter Haven.

John C. Lincoln North Mountain Hospital in Phoenix hosts volunteer meetings called “circle of light.” include a mirrored image session through which participants speak about what brought them to healthcare and the special moments they’ve had with patients. “It’s amazing how sharing these stories creates such a bond between people in a group.” says Barbara B. Brewer, RN, MALS, MBA, PhD, director of skilled practice at Lincoln. “My goal is to help them remember why [they went into healthcare] and give them energy again.?

Skeptics? questions

Nursing leaders say not everyone immediately embraces the theory of care. Some people have problems with the language or wonder how to find time to practice it. Some people believe this means they should be so emotionally attached to patients that they cannot make objective decisions about their care. These are misinterpretations, say nurses familiar with Watson’s work. Care doesn’t mean the nurse may be incompetent? quite the opposite, they say. A nurse who cares ensures that patients do not experience medical errors or other mistakes. When Watson talks about loving patients, he means having a universal love for humanity and seeing them as people, Williams says.

What about the most common concern about nursing care? no time ? Foss-Durant notes that when nurses really listen to patients, they tend to spend less time running to the room to answer an audio signal. “If you can connect with the patient, you will become more effective because you won’t guess what the patient needs.” she says.

Some nursing leaders say Watson’s theory may not work for everybody. But they add that having a dominant theory of nursing care to guide practice might help a facility, especially in difficult economic times or when morale is low.

Schreiber recalls a time at Winter Haven when nearly 40% of the hospital’s nursing positions were unfilled. Some wondered whether the hospital’s culture of care could survive, he says, however the introduction of Watson’s theory reminded staff and administrators of their higher goals. “Do you need structure to remember who you are and why you are there?” she says. “This theory of care is ingrained in the DNA of Winter Haven Hospital.”