Samuel Merritt University School of Nursing

Contributors: Mark Beck and Marian Turkel 
October 23, 2018

Education/Theory Exemplar

Location – Samuel Merritt University School of Nursing, Oakland, CA Main Campus
Framework title – Watson’s Unitary Caring Science
Year Curriculum initiated – 2016
Key Faculty

Mark Beck RN DNP, MSN, BS –  Lead faculty for leadership and nursing science

Richard Macintyre PhD, RN, FAAN – Faculty in this program and other SMU programs.

Paulina Van, PhD, RN CNE – Program Chair

Manuel Torres, PhD – Assistant chair

Kate Shade, PhD, RN – Lead faculty for community health

Model

The program has two threads: the Nursing Science thread, and the Nursing Leadership thread. The theoretical grounding for the Nursing Science thread is Watson’s Theory of Human Caring. The Nursing Leadership thread is grounded in Duffy’s Quality Caring Model.

See more detail in  Beck, M. D. (2018). Fostering Metamorphosis Through Caring Literacy in an RN-to-BSN Program. In W. Rosa, S. Horton-Deutsch, & J. Watson (Eds.), A Handbook for Caring Science: Expanding the Paradigm (Chapter 18., pp. 257–276). New York: Springer Publishing Company.

Program Pillars

  • Discovering a vision
  • Finding your voice (and join the conversations on health care in this country)
  • Telling your stories
  • Owning your professional practice
Description of theoretical framework

Samuel Merritt University’s RN to BSN program is designed to help working RNs gain the knowledge, skills, and attitudes needed to change the way we deliver health care. As an RN to BSN scholar, you will start the program with a meditation course to help enrich your self-care practices. You will deepen your knowledge of the evidence and science that supports expert nursing care. You will hone your communication and teamwork skills. Because great swaths of our health care system are designed for the industry rather than patients, we will build your confidence and leadership skills to transform “delivery systems” into healing environments. It is a tall order, but the system won’t change without the leadership of registered nurses like you! You are the future of our profession.

The Samuel Merritt University (SMU) nursing program is one of the first of its kind in the nation to include mindfulness as a cornerstone of its curriculum. The first course Mindfulness Based Stress Reduction focuses on 4 areas of Transformation. Transformation with Self, Transformation with Others, Transformation with Health Care Team and Transformation with Organization/ Health Care System.  Watson’s Theory of Human Caring is integrated throughout the curriculum.

Description of the curriculum
  • Term 1 focuses on Caritas Process 1 – Embrace Altruistic Values and Practice of Loving Kindness with Self and Other, and Caritas Process 2 – Instill Faith and Hope and Honor Others.
  • Term 2 focuses on Caritas Process 3 – Be Sensitive to Self and others by Nurturing Individual Beliefs and Practices, and Caritas Process 4 – Develop Helping Trusting Caring Relationships.
  • Term 3 focuses on Caritas Process 5 – Promote and Accept Positive and Negative Feelings, and Caritas Process 7 Engage in Genuine Teaching and Learning.
  • Term 4 focuses on Caritas Process 6 – Creative use of Self and All Ways of Knowing, and Caritas Process 8 – Creating a Healing Environment at all Levels.
  • Term 5 focuses on Caritas Process 9 – Administering Sacred Nursing Acts of Caring-healing by Tending to Basic Human Needs, and Caritas Process 10 – Opening and Attending to Spiritual/Mysterious and Existential Unknown.

Two re-imaginings of traditional nursing curricula have transformed the nature of this program:

  • Re-imagining the 3 P’s (pathophysiology, pharmacology and physical assessment) by integrating these content areas into the biology of caring and the science of compassion, psychoneuroimmunology, and the neuroscience of change
  • Re-imagining leadership and nursing science – the quality of care becomes the quality of relationships based on Duffy’s Quality-Caring Model©, caritas coaching, and authentic presence.  Caring, compassion and connection is the “lingua franca” of nursing (meaning the common language)

For detailed description of the curriculum and the implementation of the framework, see Beck, M. D. (2018). Fostering Metamorphosis Through Caring Literacy in an RN-to-BSN Program. In W. Rosa, S. Horton-Deutsch, & J. Watson (Eds.), A Handbook for Caring Science: Expanding the Paradigm (Chapter 18., pp. 257–276). New York: Springer Publishing Company.

Evaluation

In Term 5 students submit a portfolio/nursing scholarly reflective journal of their journey focused on Woman’s Ways of Knowing. They write a Caritas Essay utilizing Carper’s Ways of Knowing. Students share their stories related to self-transformation, and transformation with patients, family and co-workers. Their written voice has changed from passive to active and a feeling of having internal power versus external power being placed upon them. Approximately 1/3rd of our students go on to graduate school.

Challenges

For many faculty this was a very new way of teaching and creating curriculum. Faculty also needed education on Watson’s Theory. As needed education was provided they became more comfortable with this new way of teaching.

Rewards

When RNs first enter the program many are angry about nursing, angry about their practice environment but they experience an amazing transformation when they share their thoughts and experiences in their journals as part of the last leadership course

The following is a quote a student shared:

“Having been a bedside nurse all these years, it’s a stretch for me to think in visionary terms. I tend to focus on what’s right in front of me. This program is widening my perspective on what my profession is all about. What’s stretching me the most is to think of myself as a leader. That’s a new direction for me.”