Marilyn Ray and Jean Watsons Theories Compared free essay sample

Marilyn Ray and Jean Watson’s Caring Theories Compared Winifred Hernandez National American University Abstract How is caring defined? In nursing, caring is an essential part of our profession. It is the foundation and initial approach used in our daily practice. There are many belief systems in which caring is examined. The two theories discussed in this paper are Marilyn Anne Ray’s Theory of Bureaucratic Caring and Jean Watson’s Theory of Human Caring. The Theory of Bureaucratic Caring was generated in a complex organization, while The Theory of Human caring defines caring in more of a scientific way. The definition of caring for each have some similar characteristics, but these two theorist methodologies are quite different. This paper will interpret these two theories of caring, apply them to practice, and then explore both their similarities and their differences. Marilyn Ray and Jean Watson’s Caring Theories Compared Have you ever wondered why you went into nursing? Is it because of the salary? Is it because you needed a change? Is it because you wanted to put your best foot forward and utilize your positive energy to help others? Whatever the reason, caring is an integral part of nursing that cannot be ignored. Nursing today, is more complex than ever. The constant change in technology and increased duties in patient care can be quite overwhelming. One must have a beneficial understanding of what caring is in order to be an effective nurse. Caring, as a central concept, has led to the development of several theories. Marilyn Anne Ray’s Theory of Bureaucratic Caring originated as a grounded theory first (caring in a complex organization), then as a holographic theory, which showed the growth and development of the nature of nursing over time. The purpose of Rays dissertation study was to generate a theory of the dynamic structure of caring in a complex organization (Turkel, 2007). Ray spent approximately 8 months in a local hospital studying caring in all aspects; from nutrition to materials handling, nursing clinical units to administration. This study involved 200 participants. The key question asked of participants was, What is the meaning of caring to you? (Turkel, 2007). The st udy performed involved observation of patient care, direct questioning and interviews. Ray’s research exposed the dilemma that these health care workers battled with between the corporate â€Å"red tape† and serving the caring needs of their patients. Caring within the corporation had its constraints and differences. Caring was perceived very different throughout the hospital and in their practice settings. For instance, administrators expressed caring in terms of economics. They believed that patient satisfaction was viewed as a return on investments. ICU nurses expressed caring in more vulnerable way. Their patients were very sick not able to care for themselves. Patients were in need of the highest quality and quantity of care. Physicians saw caring for their patients in a more technological way. Hospice staff members conveyed caring as a part of the compassion and spirituality given to their patients (Turkel, 2007). Substantive Theory called Differential Theory was born. Later, the Theory of Bureaucratic Caring was established. The Theory of Bureaucratic Caring denoted the changing caring structure within this complex organization. Many variables affected nurse- patient relationships. Political and economic elements were dominant; followed by education and the relationship itself (Parker Smith, 2010). The nursing staff was also influenced with the culture within the complex organization. This culture contained political, economic, legal and technological bias. Later, Ray revisited this theory and then revealed it as holographic. Not only was caring at the center, but spiritual and ethical considerations must be also. Holographic is best described as the whole and part being interconnected (p. 473, Parker Smith). Ray’s Theory of Bureaucratic Caring provides evidence that supports the spiritual and ethical components of nursing. It addresses nurse’s moral obligations to others (Marriner-Tomey, Raile, 2006). This theory adopts the nature of nursing as caring, guided by spiritual and ethical caring in relationship to legal, economic, technological and other factors empowering nurses to think more holistically and build their nursing care upon this. The â€Å"soul of nursing† is to seek the good of self and others through compassionate caring. Nurses who have strong sense of self and caring provide holistic patient care are more grounded in caring values (Turkel Ray, 2004). According to Ray, the relative elements of nursing practice generally occur within the organization that functions on bureaucratic or systematic principles. These elements or characteristics are listed in the table below: 1. A fixed division of labor 2. A hierarchy of offices 3. A set of general rules that govern performances 4. A separation of the personal from the official 5. A selection of personnel on the basis of technical qualifications 6. Equal treatment of all employees or standards of fairness 7. Employment viewed as a career by participants 8. Protection of dismissal by tenure (p. 478, Parker Smith) In administration, nurse leaders have the moral responsibility to facilitate self-care renewal and healing in the organized culture to foster caring and trusting relationships (Turkel Ray, 2004). This involves having the ability of their nursing staff to actually have the time for patient care and not rush the emotional aspect. Staffing, resources and supplies must be adequate. We must apply to everyday practice all elements of the Holographic Theory of Bureaucratic Caring to each and every patient (Bailey, 2009). Understanding and applying these concepts will provide a consistent universal approach to caring for the patients. In summary, Ray expresses that when caring is defined as an art or science, neither is adequate to signify current practice. â€Å"Nurses must be able to understand and articulate the politics and economics of nursing practice and health care† (Parker Smith, 2010, p 490). Having this information, nurses will be able to challenge and change the system. Jean Watson’s Theory of Human Caring defines caring as a science which includes arts, sciences and humanities. The goal of nursing is centered on helping patients to gain a higher degree of harmony within the body, mind and soul. This is achieved through caring transactions (Vance, 2003). It involves the transpersonal caring relationship viewing the patient as a whole, regardless of the disease process (Parker Smith, 2010). Nurses seek to connect and embrace patients through caring and healing. Caring takes place immediately after a nurse meets and greets a patient. It is the belief that nurses care for patients in the hope that they will participate in their immediate recovery process (Parker Smith, 2010). Watson’s beliefs are that there are 2 basic ideas in the science of caring in nursing. The first is that caring has existed in society throughout history. People have cared for each other from generation to generation. The second idea is that there is an inconsistency occurring between nursing practice and theory which results in a disconnect between scientific and humanistic principles in the nursing profession. Nursing is a caring profession. Watson’s Theory of Human Caring displays a genuine concern and love for nursing, humankind and the planet (Jonas- Simpson, 2007). Her belief in the contribution that nurses can make is inspirational. Watson discusses caring for healing and the impact of her model on nursing and other disciplines (Clarke, Watson Brewer, 2009). The Theory of Human caring was developed by Watson between 1975 and 1979. Watson believed that nursing’s values required unique caring in a framework called â€Å"carative factors†. Carative factors complement traditional medicine but stand out in contrast to â€Å"curative factors† (Parker Smith, 2010). The Table below depicts the 10 Carative Factors from Watson’s Theory of Caring: 1. Humanistic-altruistic system of values 2. Faith-hope 3. Sensitivity to self and others 4. Helping-trusting, human care relationship 5. Expressing positive and negative feelings 6. Creative problem-solving caring process 7. Transpersonal teaching-learning 8. Supportive, protective, and/or corrective mental, physical, societal  and spiritual environment 9. Human needs assistance 10. Existential-phenomenological-spiritual forces (p. 354, Parker Smith, 2010) Watson emphasized the fact that when caring and love is included in all aspects of nursing, it is then, and only then, we uphold a regard to life and all living things (Parker Smith, 2010). The carative factors define how a human maintains health or dies a peaceful death (Marriner-Tomey Raile, 2006). Conclusion The patient population is complex and diverse in all aspects of nursing. I have been a labor and delivery nurse for almost 10 years. Having a strong sense of caring in order to establish the nurse patient relationship of trust and support is needed. You are the patient advocate. They will seek you for guidance, knowledge, comfort, support and understanding. Integrating your skills and accountability is the approach to give. From experience, continued education has helped me to achieve this. It is important to utilize the resources and other disciplines available for optimal patient outcomes. With your commitment, a sense of well-being a feeling of optimism, and hope will surround the patient. It is important to have a strong foundation and awareness for caring in our occupation. The dedication of a nurse-patient relationship is necessary for healing. Genuine care and concern will cater to the needs of the person as a whole (Stickley Freshwater, 2002). Effective nursing requires a deeper understanding of caring and its application to humankind. Although the Theory of Bureaucratic Caring and the Theory of Human Caring somewhat differ, each of these theories emphasize caring is an integral part of the recovery process. The ultimate goal is to put into practice the best suitable caring plan of care that will lead to wellness for all.