Through time the needs to be a nurse and the definition of nursing has changed slightly through time. The one characteristic that seems to be consistent through time is a nurse should be caring. Jean Watson incorporated a theory- The Theory of Human Caring. Watson (2002) developed a theory in which nursing is centered around helping the patient achieve a higher degree of harmony within mind, body, soul, and this harmony is achieved through caring transactions involving a transpersonal caring relationship. According to Watson, caring consists of carative factors that result in the satisfaction of certain human needs.
All of these factors are the related to the basis of caring in which effective caring promotes health and individual or family growth (“Jean Watson’s Philosophy Of Nursing”, N. D). Watsons Transpersonal Caring Relationship describes how the nurse goes beyond their routine assessment, but expresses concerns toward the persons deeper meaning in correlation to their own health care experience. The nurse’s caring awareness becomes crucial for the connection and understanding of the person’s perspective. The feelings that are attached to nursing are endless.
Constantly meeting new people from different life stories as well as getting to know them as well as their families not only as a patient but a person with their own uniqueness. Every day at work I always try to pick out one thing I will remember about one person, whether it be their eye color, their job, their family interaction, or just something that will set them apart from the other “patients. ” There are then of course those patients that you just have a connection with and you seem to remember everything about them, as if they are a part of your life, even though not here physically but their memories do live on.
My first week on my own as a nurse after orientation, I was blessed to have met J. S. He was a man that has served in the Navy and his wife has told many stories from World War II and other endeavors he had encompassed during his lifetime up to the time I have met him. The stories alone present you with a hero in front of you and I was so blessed to have met him. I introduced myself as he was unable to speak but had a faint smile that appeared mysterious and these piercing blue eyes that would just capture you and freeze you in the moment. He had suffered from a stroke a couple months back and couldn’t bounce back.
He was aphasic, used a communication board, had a g- tube, and was mostly bed ridden. I worked the noc shift and would make my rounds but found overtime I would spend more and more time in the room with him just communicating with him through yes and no questions and with the use of the communication board. After about three weeks of always having him as my patient, both our eyes would light up with smiles when we would see one another knowing that it would be another night of learning about one another and getting to know each other well.
It was then one night I came in to see that all his orders have changed, no g-tube was to be running and that all his medications are to stop. There was no significant change of condition to have put him on hospice for no reason. It was this night that was the first night that he had no smile. He appeared in deep thought and seemed so sad. He just wanted to sleep that night and my heart was just so broken seeing him so sad. It was this moment and feeling that I had my caring moment with J. S. nd felt that he was just more than a patient to me, but someone I felt that I truly genuinely cared about.
After being on hospice for about two weeks he still seemed to have maintained his “happiness,” until one night I noticed he appeared to be in deep thought again. I asked if anything was wrong in which he nodded in which he then rubbed his stomach. I asked if he was hungry which he then again nodded. Seeing someone that was still able to communicate and stating their hungry knowing they have nothing coming in just didn’t seem right whatever way I looked at it.
I then asked if stopping all his medications and food source, something he wanted. He shook his head no and began to tear up, I then began to feel tears rolling down my face and all I could do was hug him. Seeing a man of his age, knowing what he have overcame in his life, crying was like seeing a falling angel. It is not suppose to happen! I knew it was wrong but what could I do against his wife being his DPOA. About a week later he passed, the day prior, I told him I’ll be thinking of him often, he then pointed to himself, then to his watch, then to me.
Made me feel good knowing he said he was going to watch over me. Watson defines the person as a being-in-the world who hold three spheres of being- mind, body, and spirit- that are influenced by the concept of self and who is unique and free to make choices (Cara, 2003). J. S was a hero not only in my eyes, but to eyes of his family and with his life experiences, it painted an untouchable figure. His mind was strong and you could see that through his smile despite all that is going on at that moment, his body- sure it wasn’t what it has lways been, but it is a body that has been through so much and has still survived to where he is at that moment.
His spirit is pure and angelic like. According to Cara (2003), she stated that Watson defines the person’s health as a subjective experience. Health also corresponds to the person’s harmony, or balance, within the mindbodyspirit, related to the degree of congruence between the self as perceived. J. S experienced Watson’s form of person when I asked if stopping all his medications and food source, something he wanted.
Shaking his head no and begining to tear up, made my heart stop. It only leaves me to wonder, if he was able to speak, what would he say? His emotions spoke volumes and you can just see the fright in his eyes. According to Siztman, all 10 caring caritas are based on the concept that all life is interconnected. Each caring exchange is made up of shared energy between the people that are present during that interaction. The following are Watson’s (2001) translation of the carative factors into clinical processes that were used during my interaction:
1. Practice of loving kindness and equanimity within context of caring consciousness. 4. ) Cultivation of one’s own spiritual practices and transpersonal self, going beyond ego self, opening to others with sensitivity and compassion. 5. ) Developing and sustaining a helping-trusting, authentic caring relationship. 9. ) Assisting with basic needs, with an intentional caring consciousness, administering “human care essentials,” which potentiate alignment of mind, body, spirit, wholeness, and unity of being in all aspects of care; tending to both the embodied spirit and evolving spiritual emergence. 0. ) Opening and attending to spiritual-mysterious and existential dimensions of one’s own life-death; soul care for self and the one-being-cared-for. I have always liked J. S from the moment I met him (C1), and it seems as if we had an instant connection the first time we met (C4). Having gotten to know J. S and seeing him so sad without a smile, I knew something was wrong. Knowing they stopped his feedings and medications, he acknowledged that wasn’t what he wanted (C5 and C10). Realizing that his hunger what was making him sad, broke my heart (C5, C9, C10).
Before passing and still being able to acknowledge me and stating he would watch over me(C10), felt as if I now posses a guardian angel. I never knew that a complete stranger would have such a strong impact on my life. I know as nurses we should develop a sense to fix and care for people who we know absolutely nothing about. I learned that it is ok to feel that way about a patient and getting to know them more than just a room number, disease, or as a patient impacts them just as much. Having J. S. xpress that he was going to watch me after he passes in a sense made me nervous, but I too felt a sense of comfort since I do believe in the higher power. I must say, a regret that I do have is not speaking up for him. One duty for the nurse is to be an advocate for our patient, it was this moment that made me who I am today, the person that stands up for the patient! I feel like if I had mentioned something to the extent that he didn’t want that, he could possibly still be here. Sure, it was a life of lying in bed, but it was his life!
Every day as nurses, we always encounter strangers and it’s almost expected as a nurse that you would change someone’s life. It’s a lot of pressure knowing we can make such an impact. The unexpected thing is when a patient makes an impact on our lives and heart or even when an exchange stands out so much it’s as if you relive the moment each time you think of it. Knowing that there was a caring moment helps me remember why I chose this profession. Jean Watson’s theory of human caring has made such an impact on my life as a nurse. I can only hope for more moments that impact my heart as J. S. has done.