Care is the most important complex part of the patient’s recovery process. Nurses single out caring as the central and most challenging part of care since this part requires them to have a cultural background, high moral values , and emotional involvement. Caring is about people’s beliefs (nurse, patient, relatives) and the ability to understand. Caring is aimed not at the immediate treatment of a once-acquired injury but at the formation of value orientations of adaptation to a severe injury or illness. Caring is critical in conditions where the disease is prolonged in time, is incurable, and requires special adaptation skills from patients (and especially their families). By teaching patients how to care for their health and body in a new way, nurses form new habits and attitudes in patients. It is for these important reasons that caring is currently such an exciting topic for study and discussion.
The Modern Context
Nurses and physicians now work collaboratively with information technology and can often provide care from the comfort of their homes or offices. Nevertheless, no matter how information technologies improve and how much artificial intelligence is called to help doctors, patients, and doctors remain people who seek support and understanding. COVID-19 has shown that patients need certainty and attention that nurses cannot always provide in a pandemic. Sometimes, there is no time to spend explaining symptoms and possible outcomes of treatment. Another aspect of the current context and caring is the importance of a multiculturalist approach since the theory under consideration works within the cultural and religious diversity framework, which strongly affects each patient individually. The idea of caring always promotes only an individual approach, considering a person from a humanitarian point of view as a unique existential unit, the analysis of which is possible only by the phenomenological method. However, existentialism and phenomenology are not the only ways of viewing the patient within this theory: the social aspect reveals the patient as still part of a society where he, despite his illness, continues to function.
The initial developments of the theory under consideration grew out of philosophy, psychology, sociology, and partly pedagogy since nurses set a severe goal not only to support patients but also to teach them and their families to live with the disease. These developments later became the fundamental philosophy of caring (the author is Jean Watson). The nurses paid particular attention to existential philosophy, which raised questions about life and death, the meaning of life, and being thrown into being. Clinical and social psychology has allowed nurses to form a severe behavior background when communicating with patients. Sociology has been influential in viewing patients and their families as active parts of modern society. The fundamental issues of nurses were initially the topics of loneliness of patients, the lack of understanding among friends and family, and the lack of meaning in treatment or in living with an illness.
During the development of the theory, many specialists offered their views on the caring problem and shared their unique experiences (Kari et al.). One of the first professionals to tackle this problem was Jean Watson, a nurse who wanted to combine caring with psychology and philosophy. In the early 1970s, she was inspired by Emmanuel Levinas’s ethics, the Alien’s problem, and the ontology of Being. The acute problem of meeting the Alien and the inevitability of understanding its fate impressed Jean Watson, and she combined this problem with social psychology in her dissertation (released in 1979). Finally, the theory of Jean Watson took shape only by the mid-1990s. Another important figure in considering the historical background is Kristen Swanson, whose approach is the most practice-oriented (Kusumaningsih et al., 2019). Kristen Swanson worked during the 1980s with pregnant women who had experienced miscarriages. Working in the gynecology department has shown her that patient-nurse collaboration can positively affect recovery; her theory took shape definitively by 1991. In addition to the specialists mentioned above, there are many others, for example, Madeleine Leininger, whose theory is transcultural nursing.
Swanson’s View and the Structure of Caring
Concepts by Kristen Swanson, as you can see, are about the behavior of a nurse and are purely practice-oriented. The central idea is that caring is a process of doing something for the patient’s benefit. It is a complex process, divided into several stages, resulting in the patient’s condition being expected to improve. Maintaining belief is the essential concept of the initial attitude toward the patient from the hope for improvement in his condition (Kim et al., 2021). This concept is critical for the patient and the nurse, as it helps avoid burnout. Knowing refers not to scientific knowledge but to emotional intelligence and communication skills. A nurse must be able to analyze other people’s behavior and interpret their words. For example, when informing a patient that his cancer is incurable, it is vital for a nurse to correctly interpret his calmness or, on the contrary, anger and irritation.
Knowing is at the heart of sound nursing assessment and treatment planning. Being with is a demonstration of involvement in the problems of patients and emotional support. The nurse should treat the patient as a subject whose experience is unique and vital to the treatment. This concept stands for deep interaction between nurse and patient. Doing so is direct patient care (protection from harm, physical assistance, correct performance of medical procedures). Doing so often includes an act of emotional comfort and interaction with hysterical patients. Enabling is the final caring process that completes and allows the patient to engage in self-care.
Jean Watson’s concepts emphasize philosophy and abstract thinking, thus giving nursing practice special meaning. Most of the concepts she uses are not unique except for caring. The caring moment is the turning point of the conscious and voluntary choice of life and happiness, a call to the authenticity of life. Analysis of most of the concepts of Jean Watson demonstrates a solid connection with the philosophy of existentialism and phenomenology. It exposes the problem of the inadequacy of theory in situations where patients need very structured treatment with well-defined rules.
Other approaches imply their emphasis, which is unique to researchers. Several general concepts unite all approaches to this complex theory: persona, environment, assessment, and understanding. Kari Martinsen argues that sovereign life utterances include mercy, openness, and willingness to help. These are basic things necessary for the patient, in which no one has the right to refuse him. Professional judgment is how the patient’s situation is superimposed on the nurse’s previous experience. A collision with a new problem, combined with already lived circumstances, is a professional judgment supported by medical knowledge. Kari Martinsen puts care at the center of human existence, forming an ontology. Untouchable zone – the obligatory distance between the patient and the nurse. Madeleine Leininger’s concepts focused on society, culture, economic, political, and religious aspects. Language significantly influences patient care, as it forms people’s entire consciousness and perception (Moonpanane et al., 2021). An ethnohistory is the unique experience of the patient and their family, which must be respected. The surrounding context is the context of the patient’s maturation and formation as a person. Cultural care takes into account all the cultural diversity of patients, regardless of their literacy and adherence to religion.
Description of the Theory
The theory is based on a holistic approach to the patient’s health, thereby making the nurses’ attention focused on global recovery and improving the quality of life. Nurses should not be guided only by performing procedures because this is only a tiny part of the patient’s needs. Quality treatment consists of education, support, help, and sensitive observation, the field in which the patient gains independence and learns to make decisions about his health.
Patients not only get injured under different circumstances, but before illness and injury, they live different lives. The theory considers a diverse approach to patients with varying levels of literacy and religiosity. These aspects ultimately affect their life orientations and their attitude toward physicality. The idea is based not only on helping patients but also on helping nurses avoid burnout during challenging times. By creating a quality ontology around health and physicality, nurses heal patients for a long time.
Martin Heidegger’s Fundamental Ontology
The fundamental ontology of Martin Heidegger explains the act of caring as an act of touching, being, and feeling life. He deduces the identity of caring for others with caring for oneself, thereby making the act of caring inevitable and dooming people to live with each other. Caring is a correct understanding (or striving for a proper understanding) of one’s place in the world.
Karl Marx’s Philosophy of Praxis
Nurses can and should understand caring as a social phenomenon affecting more than just two people. The patient does not disappear from society when he becomes ill, but he feels social moods even more vividly when isolated. The nurse re-forms with her behavior and necessary actions a new social ontology around the patient until he returns to his former life.
Ethics of the Alien (Other) and the Ontology of Emmanuel Levinas
The moralistic ethics of Emmanuel Levinas assumes an equal relationship between the patient and the nurse, that is, the complete absence of hierarchy. It opens up the opportunity and obligation for nurses to act empirically and altruistically toward patients. In addition, the suffering Other, according to Levinas, necessarily attracts a person’s attention and receives help from him only by being nearby.
Phenomenology of Edmund Husserl
Edmund Husserl advocates sensual living and involvement in life. He refuses to separate the soul and body, which, on the one hand, reinforces the holistic position but, on the other, still contradicts the theory of Katie Eriksson. The separation of soul and body is fraught with religious ideas that contradict the scientific approach of Edmond Husserl. Medical science, like any other, must become more flexible and not close in on itself, necessarily paying attention to everyday things.
Phenomenology of Maurice Merleau-Ponty
The phenomenology of Maurice Merleau-Ponty is more strongly than others connected with the problem of the body in the world. Nurses deal with very diverse bodies, which are reflections of a person’s relationship with the world. The philosopher brings to its climax the idea of the significance of the body as a direct participant in communicative and social processes. These views help nurses understand any bodily conditions and avoid any, even the slightest, disgust.
The theory of caring can help many researchers in different fields, as it contains many aspects. Cultural studies about racism, sexism, or other types of discrimination will be adequate for this theory. Theory can serve as an excellent example of the intersection of different disciplines in medicine, thereby attracting the attention of specialists from the humanities and social sciences.
This theory is well applied to medical practice despite the presence of abstract reasoning and a philosophical foundation. Nurses can use this theory in all areas of patient care, but the most interesting may be home visits to patients. These works will help them to fully see the atmosphere of other people’s lives, their values, and their views.
Suggestions for additional research
Proposals for further development of the theory can serve as research in the field of nurse burnout and the possibility of supporting each other by setting meaningful life guidelines. Cultural caring would help nurses cope with complex cases of a language barrier with patients.
Further research of the described problem at the intersection with philosophy will help to create new approaches based on the caring theory. It must always be remembered that excessive involvement in the philosophical issues of nursing will probably make the results not applicable in practice.
In the future, a practical application of ethics in this regard could be the creation of high-quality surveys to determine the level of satisfaction with the care of nurses. It is also essential to decide on which patients most need this care. This theory must necessarily be presented to all medical students as one of the central ones in general in the problem of medical ethics. Another practical application in the future may be the specification of the theory for certain groups of diseases since the care there will be very different.
The complex theory presented is still receiving much research attention, forcing nurses to give new interpretations and combine them with their unique experiences. It is an excellent opportunity to improve further the theory of caring for the benefit of patients, teaching them not only to avoid diseases but also to treat life with high value.
Kim, S., Kim, G. U., Lee, W., & Park, J. (2021). Developing an Internet-Based trauma recovery nursing intervention based on Swanson’s theory of caring for trauma recovery. International Journal of Environmental Research and Public Health, 18(13). Web.
Kusumaningsih, D., Hariyati, R. T. S., & Handiyani, H. (2019). Improving mentor’s competencies in nursing mentorship program through role empowerment by Swanson’s theory of caring. Enfermería Clínica, 29, 166–171. Web.
Mårtensson, S., Hodges, E. A., Knutsson, S., Hjelm, C., Broström, A., Swanson, K. M., & Björk, M. (2020). Caring behavior coding scheme based on Swanson’s theory of caring – development and testing among undergraduate nursing students. Scandinavian Journal of Caring Sciences, 35(4), 1123–1133. Web.
Moonpanane, K., Kodyee, S., Potjanamart, C., & Purkey, E. (2021). Adjusting the family’s life: A grounded theory of caring for children with special healthcare needs in rural areas, Thailand. PLOS ONE, 16(10). Web.
Wei, H., Hardin, S. R., & Watson, J. (2021). A unitary caring science resilience-building model: Unifying the human caring theory and research-informed psychology and neuroscience evidence. International Journal of Nursing Sciences, 8(1), 130–135. Web.
Wei, H., & Watson, J. (2019). Healthcare interprofessional team members’ perspectives on human caring: A directed content analysis study. International Journal of Nursing Sciences, 6(1), 17–23. Web.