Relationships: Rediscovering the Caring Science of Nursing
Estrellita Karsh, who generously funds the annual Karsh Visiting Professorship, joins Jean Watson before the event.
As the Karsh Visiting Professor in Nursing, Jean Watson, PhD, RN, AHN-BC, FAAN, welcomed everyone to the annual Karsh lecture with a unique way to help attendees approach the lecture with open minds and hearts: the use of a singing bowl from Nepal calibrated to the vibrations of the human heart. As she touched the bowl, bringing from it a soothing sound that reverberated throughout the Bornstein Amphitheater, she invited nurses to open their hearts and be fully present.
"Take us back to the heart of our humanity and of our profession," she said.
With that opening, Watson encouraged nurses to think not just in terms of change, but in terms of an overall transformation of the profession of nursing.
"According to the Institute of Medicine, change refers to an improved version of what you've already done," she said. "That's the mindset of the traditional system. But transformation is something you dream up; it involves everyone in co-creating a totally new system through innovation, courage and risk-taking. This transformation starts within each of us."
Over the next hour, she spoke about the caring science of nursing and ways that nurses can open themselves to create a healing connection with their patients.
Watson referenced Florence Nightingale's statement that nursing is a calling. "It is a covenant that this profession has with humanity," Watson said. "It is not a customer-service profession."
She also explained that healing is an inner process, not just an outer treatment, and that it is cultivated through a "biogenic" relationship - one that is life-giving and life-receiving for those involved. "We're working with the life force of another person, and we never know how we're affecting it," she said.
During the lecture, Watson reviewed the 10 "Caritas," or caring processes (at right), to help nurses transform the care they provide by opening up and creating healing relationships with their patients.
The first step in the Caritas/caring process is to practice kindness and equanimity with ourselves so we can cultivate it with others. "How do we do that?" she asked. "By deep breathing and bringing feelings of generosity, gratitude, compassion to your heart. Then, gently radiate those feelings beyond you."
Many nurses practice this before entering a patient's room to help enable the faith and hope of their patient, she said.
Another caring practice refers to allowing the expression of both positive and negative feelings. "Listening to another person's story might be one of the greatest healing gifts we can give," she said, noting that nurses can often help not by trying to fix, but by simply listening.
The 10th caring practice calls for nurses to allow for "mystery and miracle," to accept that we don't have all the answers. "This is what allows for transformation," Watson said.
Handwashing as a Healing Ritual
Watson spoke of an example from a hospital in Denver that treats hand-washing as a ritual. There, staff regard hand-washing not only as critically important to patient safety and care, but also as a moment to:
- Quiet a busy mind
- Wash away an old experience
- Reconnect to core values
- Bless and release the last person/situation they encountered
- Purify sacred space for authentic presence
- Open to the ability to give and receive next person/situation
Jean Watson uses a singing bowl from Nepal to help nurses approach her lecture with open minds and hearts.
About Jean Watson, PhD, RN, AHN-BC, FAAN
Jean Watson is a distinguished professor and dean emerita at the University of
Colorado Denver College of Nursing and Anschutz Medical
Center, where she
held an endowed Chair in Caring Science for 16 years. She is the founder of the
original Center for Human Caring in Colorado
and is a fellow of the American
Academy of Nursing.
She previously served as dean of Nursing at the University Health
and is a past president of the National League for Nursing. Her latest activities include founder and director
of the non-profit Watson Caring Science Institute.
The 10 Caritas Processes
1. Practice of loving kindness and equanimity with self and others
2. Enabling faith and hope, being present authentically
3. Sensitivity to self and others; ongoing spiritual development
4. Developing authentic, trusting and caring relationships
5. Allowing expression of positive-negative feelings; listening to another's story
6. Moving from creative-based problem solving to strength-based caring process
7. Relational teaching and learning; inner-subjective meaning
8. Creating healing environments; becoming the Caritas field
9. Assistance with basic needs; sacred acts
10. Being open to existential, spiritual unknowns: allow for mystery and miracle