Rita Marisa Henriques Victor (Portugal)
I am a nurse and completed the 1st cycle of studies in 2009, a year of great job insecurity and major lack of job offers. Workmates and friends of mine went abroad but I stayed in my country, traveling from north to south knocking on countless doors hoping that one would open. Finally my day came… I made my first steps towards clinical practice. I faced the reality that I was not a student anymore and that the responsibility of any act or intervention would be mine… exclusively mine. The responsibility and the fear of making mistakes cast over my head like a dark cloud. knew that the person/family to whom I was providing care, was only expecting from me to do good, but never the failure. Thus, I felt the need to deepen my knowledge and seek help in the team, in the expert ranks of service.
To do it because “experience has taught me so” or because “it has always been done this way” is, most of the time, the response I heard the most. But I wondered – does not doing it this way already have a rationale behind it? According to Benner (2001), practical experience facilitates the interpretation of clinical situations and complex decision-making in nursing care, and the knowledge included in clinical expertise is the key to the progress of nursing practice and the development of nursing science. Practical knowledge is acquired over time.
However, over the years I have found that the world is constantly changing, what is true today is no longer tomorrow and what was yesterday is no longer today. The same happens in the transition between health and illness. Every day we are invaded by the “new,” something different and complex which makes us question, search for evidence and then plan and manage a certain intervention with the utmost safety, seeking the best results.
Maintaining up-to-date knowledge demonstrates the value of nursing and contributes to safe care.
Nursing philosophies, conceptual models and theories explain nurses’ action and aim at mobilizing or integrating theoretical knowledge into practice. Watson (2002, p. 63) states that “theory and practice live together, each one documenting the other”, thus understanding that it is necessary to acquire theoretical knowledge to apply it in practice, with practice being the main reason why theory is developed.
During these years of practice, I have been reviewing the difficulties of nurses profiling concepts related to the awareness of Nursing Theory. It is part of us as nurses to show society that nursing is a discipline and as such is studied, grounded and constantly changing and evolving with the world. Jean Watson’s theory – Theory of Human Care is a reference for me. Perhaps because it gives the simplest definition that has accompanied us since the 1st study cycle: nursing is the profession focused on human care because it is the profession that is dedicated to human care, in all its dimensions.
This fits into a philosophy, given the organization of knowledge in nursing, according to Kérouac et al. (1994). However, it has evolved over time being part of the transformation paradigm. Jean Watson’s theory is part of the Institute of Caring and proposes that nursing should be both humanistic and scientific. The Theory of Human Care, developed by Watson, is based on the concept of care and on existential phenomenological assumptions. It defines the four concepts of the nursing metaparadigm: health, care, person, and environment. Health refers to the harmony between mind, body, and soul. Caring is an art and science, a moral ideal and a transpersonal process which aims to promote “body-soul-spirit” harmony, using the ten factors of Caring. Person is a living form that grows and is composed of a body, a soul and a spirit. Finally, environment is the internal and external reality of the person. The nurse, in caring relationships, is seen as a co-participant in the process. They help people to find meaning, even in the face of disharmony and suffering, accompanying them in their decisions (Watson, 2002).
The theory of human/transpersonal care, developed by Jean Watson, brings contributions to the academy, in scientific studies, in the holistic view of clinical practice, leaving aside a biomedical thinking still present in current nursing (Evangelista et al., 2020). Savieto & Leão (2016) reinforce the need for nursing to improve its practice and evolve as a science considering Jean Watson’s theory. The theoretical basis and the appreciation of the relationship between nurses and patients contribute to improving care and, consequently, the patient’s recovery. The authors emphasize that an attentive look at the care practices together with their reflection contribute to the constant improvement of nursing care, allowing for an integral attention to the needs of those being cared for.
The care of the person in a critical situation is detailed and complex, a large part of the basic needs is compromised, as well as their spiritual and family dimension, which presupposes the development of theoretical, practical and relational competencies, requiring from the nurse more than knowing how to execute tasks, a continuous reflection and critical thinking with the necessary learning and knowledge of the discipline.
Here I am at the end of the first semester of my master’s degree with a specialization in Medical-Surgical: People in Critical Condition, seeking to transfer knowledge to my practice: diagnosing, planning interventions, conceptually based, evaluation and results, reflecting on them. Acquiring knowledge makes me richer, it allows me to reflect as a nurse and how it influences me as a person.
Alligood, M. R. , Tomey, A. M. (2020). Nursing theorists and their work work (5ª ed.). Lusociência
Benner, Patricia., Queirós, A. Albuquerque., & Lourenço, Belarmina (2001). De iniciado a perito : excelência e poder na prática clínica de enfermagem. Quarteto Editora.
Evangelista, C. B., Lopes, M. E. L., da Nóbrega, M. M. L., de Vasconcelos, M. F., & Viana, A. C. G. (2020). An analysis of Jean Watson’s theory according to Chinn and Kramer’s model. Revista de Enfermagem Referencia, 2020(4), 1–6. https://doi.org/10.12707/RV20045
Kérouac, S., Pepin, J., Ducharme, F., Duquette, A. & Major, F. (1994). La pensée infirmière. Conceptions e stratégies. Québec: Éditions Études Vivantes
Savieto, R. M., & Leão, E. R. (2016). Nursing assistance and Jean Watson: a reflection on empathy. Escola Anna Nery – Revista de Enfermagem, 20(1). https://doi.org/10.5935/1414-8145.20160026
Watson, J. (2002). Nursing: Science and Human Care. A Theory of Nursing: 1ª Ed. 2002, Lusociência
Watson, Margaret Jean Watson’s Theory and Philosophy of Human Caring/ Unitary Caring Science https://nursology.net/nurse-theories/watsons-theory-of-human-caring/
About Rita Victor
Rita Victor has been a nurse for the last 12 years with experience mostly in the internal medicine ward and currently dedicated to patients with end-stage renal failure with renal replacement technique – hemodialysis. Rita is taking a medical-surgical master’s degree – Person in Critical Situation- curricular unit Theories of Nursing, under the guidance of Professor Zaida Charepe (PhD), Instituto de Ciências da Saúde da Universidade Católica Portuguesa (Lisboa)