On Jan. 1, Jean Watson, RN, PhD, AHN-BC, FAAN, University of Colorado professor and founder of the Watson Caring Science Institute, launched the Million Nurse Global Caring Field, an internationally synchronized event designed to enhance global meditation and caring consciousness. Nurses across the country and throughout the world joined in to create and radiate an energetic caring consciousness field of heart-centered love for self, others and the planet earth, according to the institutes website. The initiative is part of Watsons Theory of Caring that not only considers those being cared for, but also the caregiver. Although not widely used in New York and New Jersey, four local hospitals have incorporated it into their culture of caring.
At Bon Secours Charity Health System in Suffern, N.Y., the use of Watsons theory is in full swing. A week after the Jan. 1 event, the health system hosted a patient care summit at which Watson presented the theory and offered examples of how staff could use it in their everyday practice, says Jo-Ann Robinson, RNC, DNP, BC, APN, C, administrative director of professional practice and Magnet coordination for the health system.Jo-Ann Robinson, RN
It was truly a special day for more than 300 nurses and multidisciplinary staff members to learn and reflect on their own caring practices, Robinson says. Since these important events, the implementation of our professional practice model, including Jean Watsons theory, has provided a framework for clinical practice, transforming care at the bedside, and reignited the passion for caring.
Before the event, Bon Secours Charity Health System was well aware of the worth of Watsons theory. According to Lori Perlstein, RN, MA, BC, director of professional development, a group of 12 interdisciplinary leaders from across the health system met to determine ways to incorporate it into practice. Perlstein, Robinson, Regina Stafford, RN, DNP(c), director of ICU and telemetry at Community Hospital in Port Jervis, N.Y., and other members of health system administration incorporated the theory at all three Charity Health System hospitals as part of its relationship-based care model. Shortly thereafter, we added staff nurses to the team through an application process in sharing their story of caring and why they wanted to join the team, Perlstein says. The team then traveled to Richmond, Va., to hear Watson speak, and later were informed she would be able to attend Bon Secours Patient Care Summit.
The health systems Caritas Guiding Team consists of 24 interdisciplinary members who meet twice monthly to discuss ways to implement the model as a system, Robinson says. Once a month, I meet with staff and administration, including some members of the Caritas Guiding Team, at each of the three hospitals to plan and discuss strategies to implement it, she says. Perlstein and Stafford work alongside Robinson as co-chairs of the committee. Each campus subcommittee is similar to a big think tank where we brainstorm and have seen exemplary suggestions come from all levels of management and staff, which are shared throughout the system.Lori Perlstein, RN
Watsons theory also is part of Elmhurst (N.Y.) Hospital Medical Centers relationship-based care model. Nursing leadership at the New York City Health and Hospitals Corporation facility began to look for a nursing theory to implement as its foundation for nursing practice in 2003, according to Rosemary Hoffmann, RNC, perinatal clinical nurse specialist at the Queens, N.Y., hospital. Watson was invited to speak to staff, and convinced the hospital to choose her theory. She was approachable and charismatic, Hoffman says. In fact, I corresponded via e-mail on a regular basis with her, keeping her up-to-date and informed of our progress here at EHC.
After Watsons visit, Elmhurst nurses designed a flag that symbolizes nursings commitment to caring and the hospital subscribed to the CARE channel to bring soothing scenes and calming music to patient rooms. The facility also has a serenity room built specifically for staff, and offers classes on meditation, yoga, exercise and weight control, Hoffman says. A lighted waterfall recently was installed in the lobby to provide soothing sounds and visuals. As a whole, Elmhurst has moved into a philosophy of creating a caring environment, Hoffman says.
Like Bon Secours, Elmhurst also has an organization thats committed to Watsons theory. The Caritas Nurse Army was formed several years ago by a group of nurses who sought to foster caring through art acts, Hoffman says. We meet monthly to make, among other things, blankets for newborns and palliative care patients, she says. This year we began a special tribute to nurses who have died. We conduct a ceremony of remembrance and offer the symbol of a white rose to the family. And, like police and fireman traditionally do, we honor our own with a special and fitting ceremony.
Room for ReflectionRosemary Hoffman, RN
In 2005, St. Josephs Healthcare System in New Jersey initiated The Theory of Human Caring, a house-wide nursing endeavor, across all service areas. Watson served as a guest speaker for the initiative, says Lorraine Duggan, RN, MSN, ACNP, relationship-based care manager. Our Nursing Practice Council … chose Jean Watsons theory because it aligned with the mission of the Sisters of Charity of Saint Elizabeth who founded St. Josephs, Duggan says. Her theory is a wonderful way to help nurses become grounded in caring in the midst of daily stresses and to provide them with the continued ability to put patients and their families at the center of the relationship.
In support of the theory, Maria Brennan, RN, MSN, CPHQ, chief nursing officer of St. Josephs Healthcare System and vice president of patient care services at Saint Josephs Regional Medical Center in Paterson, created a Watson Room where nurses can go to relieve stress and meditate with aromatherapy, sounds of nature, soft lighting, vision books, crystals, a massage chair and foot massager.
Through its Relationship-Based Care Principles, St. Josephs recently introduced Watsons theory to its support staff and interdisciplinary services. This means that not only does nursing embrace the theory, but departments such as pharmacy, dietary, respiratory therapy and environmental services staff are learning about it as well, Duggan says. We have also added her Caritas processes to each of our policies and procedures and are currently revising our job descriptions and performance appraisals to include the Caritas processes.
Shelaine Willie, RN, a staff nurse at NYU Hospital for Joint Diseases, says elements of Watsons theory have always been in place at the Manhattan hospital, but werent fully adapted until 2003, with the development and implementation of its Professional Practice Model in Nursing.
On the 12th floor where I work, the principles of caring are incorporated into the nursing process as well as in the interdisciplinary approach to patient care, Willie says. Nurses take into account the vast array of cultures, with many different languages and belief systems, and they treat their patients with respect, privacy and dignity. The theory provides guidance to the nurses in demonstrating positive behavior changes that will enhance patients basic healthcare knowledge.
Hospitalwide, the staff at NYU Hospital for Joint Diseases understand the concept of working as a caring cohesive unit, Willie says. Disciplines from nursing to medicine to housekeeping to security play a vital role in helping the operations of the day flow efficiently.
Spreading the MessageLorraine Duggan, RN
These hospitals are just a handful of facilities using Watsons method in some variation. Each of them have initiatives they hope will get the message out about the usefulness of the theory. We have created a professional practice caring council, as well as a caring, healing committee that is centered around the theory, Duggan says. We also created a Million Nurse video to support Watsons Million Nurse Campaign for Global Healing.
Duggan and Robinson are trying to garner support and membership for a New York and New Jersey Caring Consortium to spread Watsons method to other local hospitals. It can be challenging to implement a professional practice model authentically into clinical practice and this consortium would provide support and a venue to collaborate on best practices, Robinson says. Interested nurses can contact her at [email protected] or 845-368-5644.Joyce Lemon, RN
Outside of the nursing community, little is known or shared about Watsons Caring Theory, says Joyce Lemon, RN, MSN, MPA, ambulatory services staff nurse at NYU Hospital for Joint Diseases. Caring concepts should be ranked with scientific knowledge and academic competency, but theyre not.