Running head: CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

Critique of Watson's Theory of Human Caring

Jennifer J. Smith
Ferris State University

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

Abstract
Jean Watsons theory of human caring is used to guide research and professional nursing
practice. Watson developed this caring philosophy to help focus on the caring and healing
relationships between nurses and patients. This framework is widely used to integrate the
benefits of caring into clinical practice. This critique of Watsons theory will review the impact
that her model has on nursing practice and nursing education worldwide.

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

Critique of Watson's Theory of Human Caring

Jean Watson developed a middle-range nursing theory called the theory of human caring.
Her background in psychiatric-mental health nursing, educational psychology, and counseling
provided her with an interest in the development of this caring theory. According to Watson
(2008), my quest and my work have always been about deepening my own and everyones
understanding of humanity and life itself and bringing those dimensions into nursing (p. 1-2).
The theory of human caring focuses on the human component of caring and the moment-tomoment encounters between the one who is caring and the one who is being cared for, especially
the caring activities performed by nurses as they interact with others (Kearney-Nunnery, 2008,
p. 73). The significance of this theory is it has been extensively reviewed and adapted
worldwide. This paper will provide a description of Watsons theory including use in clinical
practice and use as a framework for patient assessment. In addition, an analysis of the theory
will be provided, theory research will be reviewed, and strengths and limitations will be
identified.
The core concepts of Watsons theory of caring are transpersonal caring relationship,
caring occasion/caring moment, caring (healing) consciousness, and clinical caritas processes
(Kearney-Nunnery, 2008). The following 10 caritas processes evolved from the 10 original
carative factors (Watson, n.d.):
1. Embrace altruistic values and practice loving kindness with self and others.
2. Instill faith and hope and honor others.
3. Be sensitive to self and others by nurturing individual beliefs and practices.
4. Develop helping trusting- caring relationships.

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

5. Promote and accept positive and negative feelings as you authentically listen to
anothers story.
6. Use creative scientific problem-solving methods for caring decision making.
7. Share teaching and learning that addresses the individual needs and
comprehension styles.
8. Create a healing environment for the physical and spiritual self which respects
human dignity.
9. Assist with basic physical, emotional, and spiritual human needs.
10. Open to mystery and allow miracles to enter. (Watson website, 2010)

The caritas processes are intended to offer a deeper comprehension behind the original carative
factors and as each nurse evolves provide guidance to achieve deeper dimensions of caring
consciousness (Watson, 2008).
Analysis of Model
Person
Watsons theory of caring centers around the transpersonal caring relationship between
the nurse and the patient (Kearney-Nunnery, 2008). This relationship develops when nurses use
the 10 clinical caritas. Prior to applying the 10 caritas in clinical practice nurses must first focus
on themselves. This model encourages nurses to provide self-caring and practices that assist in
their own evolution of consciousness for more fulfillment in their life and work (Watson, 2008,
p. 47). To establish a transpersonal caring relationship the nurse needs to make a conscious
effort to be present with the patient in that moment clearing their mind of all other distracting
thoughts. Their focus is on the whole person and developing a caring-trusting relationship.

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

Watsons model provides a framework for nursing education. Her 10 caritas processes
can be used as a guide to teach the theory of human caring and apply it to nursing practice.
According to Watson (2008), the foundation of nursing as a profession lies in human
relationships and caring [Caritas], that these qualities should form the epicenter of nursing
curricula, and that all other knowledge and skills necessary for nursing practice should take
account of these qualities (p. 259). Watsons clinical caritas number seven is engaging in
genuine teaching-learning experience that attends to unity of being and meaning, attempting to
stay within others frame of reference (Caruso, et. al., 2008, p. 128). Applying this caritas to
clinical practice can assist the nurse in providing an effective teaching strategy and result in
positive outcomes.
Environment
The relationship between love and caring creates an opening/alignment and access for
inner healing for self and others (Watson, 2008, p. 40). Applying the theory of human caring to
clinical practice promotes an environment of compassion, positive energy, and healing. In
Watsons (2008) caritas process number eight, the caring relationship and environment are
generated by the nurses heartfelt, loving presence, and the consciousness he or she holds,
helping shape the patients health and healing experience as well as the nurses own experiences
(p. 137). By applying the theory of caring in clinical practice the nurse can positively influence
the care of the patient and family by creating an environment of positive, spiritual energy. When
entering the room the nurse can focus on connecting with the patient, being present, and
developing a transpersonal relationship.
Health

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

The theory of caring model focuses on more than just physical health or wellness and
emphasizes the importance of tending to the mind-body-spirit of the person. Nursing practice is
directed towards helping persons gain a higher degree of harmony within the mind, body, and
soul and maintaining health (Kearney-Nunnery, 2008, p. 74). A study by Erci et al. (2003)
concluded that Watsons caring model can be recommended as a guide for nurses to improve
their ability to be more effective in providing care to patients with hypertension, by decreasing
blood pressure and increasing quality of life. The model can be integrated into direct patientfamily care and the model gives self-responsibility to the patient for self-health (Erci et al.,
2003, p. 137).
Nursing
Bringing together caring and love in the nursing profession enhances healing for the
nurse and the patient. According to Watson (2008), nursing helps sustain human dignity and
humanity itself while contributing to the evolution of human consciousness, helping to move
toward a more humane and caring moral community and civilization (p. 40). Nurses need to
make a conscious effort to focus on relationship base care and not just the procedures, tasks, and
demands of clinical practices. It is easy to become so involved in technology and the physical
person that the person as a whole is overlooked and an opportunity to connect with another
human being is missed.
One of the concepts unique to Watsons theory is the need for the nurse to focus on selfcare including mind, body, and soul. As a beginning, we have to learn how to offer caring,
love, forgiveness, compassion, and mercy to ourselves before we can offer authentic caring and
love to others (Watson, 2008, p. 41). The nurse needs to be healthy physically and spiritually to
be effective in genuine human caring and connecting with another person. Watsons theory

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

allows nurses to accept and realize the importance of taking care of themselves and make it a
priority so they are able to develop transpersonal relationships with their patients. This allows
nurses to care for their colleagues as well as themselves.
The use of Watsons theory can sensitize the nurse to perceive, recognize, and process
information in a systematic way and can help put order and meaning to chaotic situations
(Caruso, Cisar, & Pipe, 2008, p. 127). Nurses can use Watsons model as a framework for
patient assessment by using her clinical caritas to really get to know the patient. This enables the
nurse to recognize problems before they become complex problems and promotes patient safety
(Caruso et al., 2008).
Theory Application
Watsons theory of human caring can be used in a variety of clinical settings. A Watson
study of health-related outcomes by Smith, Kemp, Hemphill, and Vojir (2002), examined the
effect of massage and nurse interaction on pain, sleep quality, symptom distress, and anxiety for
patients with cancer. Smith et al. (2002) found that anxiety improved for the patients in both
groups supporting the theory that nursing presence in any form may decrease anxiety.
One of the strengths of Watsons theory is the amount of research studies completed
specific to her theory. Smith (2004) reviewed 40 research studies related to Watsons theory
including seven international studies confirming the international appeal. Smith (2004)
concluded that Watsons theory of transpersonal caring and the empirical work related to it have
made a significant and lasting impact on nursing science (p. 16). Another strength is Watsons
framework is not limited to any nursing specialty since it focuses on the core of nursing and not
the trim (Alligood & Tomey, 2010). One weakness of her theory is that some consider it
complex and difficult to understand due to her elaborate wording requiring the reader to read the

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

information several times to grasp her concepts (Alligood & Tomey, 2010). Nurses who want or
need explicit directions on how to achieve a genuine caring-healing relationship may not feel
comfortable applying Watsons caring theory in clinical practice (Alligood & Tomey, 2010).
In summary, Watsons theoretical concepts, such as use of self, patient-identified needs,
the caring process, and the spiritual sense of being human, may help nurses and their patients to
find meaning and harmony in a period of increasing complexity (Alligood & Tomey, 2010, p.
102). Applying Watsons theoretical framework to professional nursing practice can enhance
positive outcomes for patients, increase nurse satisfaction, and improve patient satisfaction. In
our challenging economical times and healthcare reform, incorporating Watsons theory of
caring into clinical practice is important to nursings disciplinary source to its noble
heritagethat invites and welcomes the energy of universal caring and love back into our lives
and world (Watson, 2008, p. 40). Through research, understanding Watsons theory helps the
nursing profession gain knowledge and insight into the importance of integrating holistic
interventions into patient care.

CRITIQUE OF WATSON'S THEORY OF HUMAN CARING

References
Alligood, M. R., & Tomey, A.M. (2010). Nursing theorists and their work (7th ed.). Maryland
Heights, MO: Mosby Elsevier.
Caruso, E. M., Cisar, N., & Pipe, T. (2008). Creating a healing environment: An innovative
approach for adopting Jean Watsons theory of human caring. Nursing Administration
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Erci, B., Sayan, A., Tortumluoglu, G., Kilic, D., Sahin, O., & Gungormus, Z. (2003). The
effectiveness of Watsons Caring Model on the quality of life and blood pressure of
patients with hypertension. Journal of Advanced Nursing, 41(22), 130-139.
doi:10.1046/j.1365-2648.2003.02515.x
Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing (4th ed.).
Philadelphia, PA: F.A. Davis Company.
Smith, M. (2004). Review of research related to Watsons theory of caring. Nursing Science
Quarterly, 17(1), 13-25. doi: 10.1177/0894318403260545
Smith, M. C., Kemp, J., Hemphill, L., & Vojir, C. P. (2002). Outcomes of therapeutic massage
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doi:10.1111/j.1547-5069.2002.00257.x