In four sections, this paper evaluates Watson’s transpersonal caring model by describing its key concepts, evaluating its main assumptions, and understanding how it applies to the nursing practice. Within the same framework, this paper explores the criticisms surrounding the theory, investigates how its concepts relate to one another; and assesses how the theory merges with the four meta-paradigms of nursing.
Jean Watson is a celebrated theorist because of her contribution to developing the transpersonal caring model. Born in West Virginia, US, Watson became a distinguished professor in nursing and a fellow at the American Academy of Nursing (CNC, 2012). Through her contribution to the practice, she also became a Dean of Nursing at the University of Colorado, Health Sciences Center. In her career, Watson accumulated six honorary degrees through her research in human caring and interpersonal relationships. Her 1988 theory, transpersonal caring model, outlines most of her contributions to nursing.
Opinions of other Authors about the Theory
The transpersonal theory has several “carative” factors that underlie its assumptions. Although these factors underscore the need to provide quality care, researchers have criticized the theory for relying on the “care” concept, which is vague and difficult to define (Crago, 2010). Stated differently, they say care is an intangible concept (Crago, 2010). Observers compare this criticism to similar criticisms about feminism. Using this framework, they say the “caring” concept, in nursing, is similar to women’s homemaking duty (Crago, 2010). Many cultures do not respect this contribution to family upbringing. This is why women have learned to take up more dominant and powerful jobs in the society. Critics have used the same analogy to define how the nursing practice has evolved because, for a long time, many societies considered nurses as “handmaidens” (Crago, 2010). However, this perception has changed. Today, people see nurses as professionals. Based on this analogy, critics have opposed Watson’s theory by saying her transpersonal model follows the feminist narrative, which makes it difficult for people to quantify the contributions of the profession to the nursing practice (Crago, 2010). The theory’s focus on the “person,” as the main care-giving denominator, is also another basis that some critics have used to oppose the findings of the model. They say so because Watson developed the theory within the context of infirmity and disease, thereby making it difficult for practitioners to use it in broader nursing disciplines, such as community health (Crago, 2010).
Problem addressed by the Theory
Watson developed the transpersonal theory to give solutions for care-giving problems in nursing. This purpose stemmed from extended periods when the profession lacked a framework to support and define health care quality. Therefore, the nursing practice has used the transpersonal theory to streamline health care services.
Core Concepts of the Theory
The transpersonal theory has different concepts that define how nurses and patients interact. This section of the report shows that the theory has operational concepts because it dictates nursing activities and expectations in the care setting. CNC (2012) says the first concept of the theory is the relational care that nurses have for themselves and others. CNC (2012) also says that this concept depends on love and values, as the moral foundations of care giving. The second concept is the transpersonal caring relationship, which suggests that all nurses should derive their inspiration from a strong spiritual quest to care for their patients. CNC (2012) defines the outcome of this process by saying it should show a moral commitment to enhance human dignity. Similarly, it says the process should show love and respect for patients by honoring the wholeness of mind, body, and spirit (CNC, 2012). The transpersonal theory also recognizes the “caring moment” as a core concept of its model. This concept defines a “caring moment” where people come together through useful and authentic interactions, which allow them to learn from one another. Naturally, through this process, they should “discover” themselves and new life possibilities that should improve their worldview. CNC (2012) says the third concept of the transpersonal theory is the meditative approach, which increases people’s consciousness to humanistic factors. In this analysis, Lyon (2010) adds that all nurses should ask themselves different questions about the care-giving process, including what it means to care for a patient, how to make a difference in a patient’s life, and how to express consciousness and commitment to patients.
Relationship of the Core Concepts
All the above concepts outline the best nursing behaviors and outcomes of the care-giving process. Particularly, they outline how caregivers should give professional care to patients and highlight the need for nurses to transcend their needs, or their environmental limitations, and focus on patients’ needs. Based on the focus highlighted by the above concepts, Watson consistently used the above concepts to outline the best operational behaviors and outcomes in the care setting. She also highlighted ten “carative” factors that complement the above concepts.
Ten “Carative” Factors
Watson says the transpersonal theory thrives on ten “carative” factors. The first factor involves practicing love and kindness in patient-nurse relationships. The second factor includes being authentically present in the care-giving process and the subjective world of the patient and the nurse (Gessner, 2011). The third and fourth “carative” factors encourage people to go beyond the “ego self” and to develop a trusting, authentic, and caring relationship. Comparatively, the fourth and fifth “carative” factors encourage nurses to show support when they express their feelings (CNC, 2012). The concepts also encourage people to be creative in the care-giving process. The seventh concept requires nurses to engage in genuine teaching-learning experiences, which show wholeness and meaning. The eighth concept encourages nurses to create a supportive environment where healing could occur. This concept gives impetus to the ninth “carative” concept, which allows nurses to give basic needs to their patients in the “supportive” healing environment (CNC, 2012). The last “carative” factor encourages caregivers to accept “mysterious” dimensions of the care-giving process. In other words, caregivers should accept spiritual outcomes, miracles, and other non-scientific outcomes during the care-giving process (CNC, 2012).
Description of Four Meta-Paradigms
The Watson theory recognizes the four meta-paradigms of nursing – human being, health, nursing, and society. It defines and relates them to the care-giving process as shown below.
- The human being: The transpersonal theory perceives human beings as the central drivers of the transpersonal model. The theory defines a human being as a recipient of quality care and respect. Similarly, it says caregivers should respect, nurture and help such people to get better. Generally, CNC (2012) says, “The above characteristics show a philosophical view of a person as a fully functional integrated self. Patients are viewed as greater than and different from, the sum of their parts” (p. 4).
- Health: Health is the goal of the transpersonal theory. Watson defines it as a combination of three possible outcomes – the absence of diseases, an adaptive-maintenance level of daily functioning, and a high level of overall, physical, mental, and social functioning (CNC, 2012).
- Society: Watson appreciates the society as the contextual framework for nursing care. She says caring is in all societies. However, she cautions people from believing that nursing care is an intergenerational practice (CNC, 2012). Instead, she says the practice is an environmental adaptation for communities to manage different health issues.
- Nursing: The transpersonal model recognizes the need to promote good human health. For example, it shows that nursing is important in preventing diseases, restoring health, and caring for the sick. Through these contributions, the transpersonal theory recognizes that nursing provides the holistic care that is central to its operations. From this recognition, unsurprisingly, the transpersonal theory defines nursing as “a human science of persons and human health-illness experiences that professional, personal, scientific, esthetic and ethical human transactions mediate” (CNC, 2012, p. 4).
The transpersonal theory is a deductive theory because Watson developed it as a human-based care. Therefore, it is not a scripted therapeutic response, but an ethical obligation that all nurses should commit to their patients. This way, Watson considers the theory as an art and a science (CNC, 2012). The logic behind this argument is the understanding that the stronger a nurse’s feelings towards a patient, and the care giving process, the better the outcome of the process. Therefore, the nurse and the patient are the main players in the transpersonal theory. Both players take part in “being” and “becoming,” which are the two main processes that underlie the theory. Using this analogy, Gessner (2011) equates the nurse to the “being” and the patient to the “becoming.” The transpersonal theory provides an opportunity for both parties to interact and learn from one another. Watson takes a deeper understanding of this relationship by saying that instead of developing mutual independence between the two people, their relationship should show a merger of souls. Based on this understanding, correctly, the transpersonal theory stems from inductive reasoning because it “grows” from the convictions and feelings of one nurse and spreads to a broader audience (patients). Therefore, unlike the deductive reasoning, which narrows down from generalized feelings to specific feelings, the inductive reasoning stems from specific moral obligations (of nurses) to a more generalized outcome of specialized patient care.
Assumptions of Theory
The transpersonal theory has only seven main assumptions. The first assumption says interpersonal relationships outline the basis of human care. Secondly, the theory assumes that nursing care always results in “carative” factors (Gessner, 2011). Consequently, these factors satisfy human needs. Thirdly, the transpersonal theory assumes that nursing care leads to human development through improved family and community relationships. Fourth, the theory suggests that caring should include accepting people for not only who they are, but also for whom they may become as well (CNC, 2012, p. 4). Fifth, the theory suggests that caring should give people the right environment for making personal decisions, without coercion. The theory also assumes that caring is more “healthogenic” than curing. This way, “care” complements curative health initiatives. Lastly, the transpersonal theory assumes that the concept is a central function of the nursing practice. Many researchers hold this view. For example, Elizabeth Condon supports this view through her article, “Critique, Resistance, and Action: Working Papers in the Politics of Nursing” (Crago, 2010, p. 2).
Clarity of the Theory
The transpersonal theory is more lucid than it is consistent. Watson clearly defines all the concepts and sub-concepts that underlie the theory. She also explains how they relate with one another. As opposed to using complex words, the theorist also uses “ordinary” language to explain important phenomena about the theory. She also demonstrates a strong propensity towards metaphorical expressions, which highlight the moral and ethical messages behind the transparency theory. Lastly, people do not need to read the theorist’s explanations, repeatedly, to understand what the she means. Therefore, the transpersonal theory is lucid.
How the Theory Would Guide Nursing Actions
The transpersonal theory helps to guide nursing actions through different ways. First, Gessner (2011) says it improves the curriculum development process by interjecting themes of caring and altruism in nursing care to create content-based courses. Such processes are important to nursing education because they reinforce humanistic views in patient care. However, for improved nursing outcomes, Gessner (2011) says it is important for educators to share the same beliefs of the model. Based on this assertion, Gessner (2011) says, “Most people postulate that many students learn caring by modeling so it is especially important that faculty members treat students respectfully and feel confident in their teaching roles” (p. 6). The same analysis shows how the transpersonal theory could improve patient care in the clinical setting by giving students an opportunity to learn from the interactions of patients and faculty members.
Gessner (2011) says the transpersonal theory has created a model shift in the nursing field. He says this shift has changed nursing care from the behaviorist model to the humanistic model. Here, caring is the central focus. Relative to this assertion, Gessner (2011) says, “Nursing has a social mandate towards shaping a health care system that is more efficacious, just, fair, and caring” (pp. 3-4) Since many scholars prefer this shift, they say the nursing model shows its beliefs in care-based nursing practices. Interestingly, although the transpersonal model has changed the nursing practice, care is a traditional concept of the profession. Gessner (2011) holds a similar view of the transpersonal theory and its contribution to the nursing practice. Particularly, he pays a close attention to how the theory applies to community health practices and says that it represents global community health practices on the same (community health and health promotion). Relative to this assertion, he says, “Concepts developed for individual-nurse interactions extrapolate to the community by discussing the suitability of the theory to guide community health nursing practices” (Gessner, 2011, p. 1).
This paper shows that the transpersonal theory is an evolutionary model of nursing. It has changed how nurses conduct their care-giving roles and how they have shifted the care-giving model by making it more patient-focused. Key concepts and tenets of the theory outline how nurses should behave within the care-giving environment. They also show the expected outcomes of the process. Although critics say the theory relies on ambiguous concepts, the transpersonal theory remains a pivotal model for giving quality nursing care.
CNC. (2012). Jean Watson’s Philosophy of Nursing. Web.
Crago, M. (2010). Who Cares?-My Nursing Theory. Web.
Gessner, G. (2011). Nursing Model: Jean Watson’s Caring Theory. Web.
Lyon, J. (2010). Watson’s Human Caring Theory. Web.