Caring Science & Human Caring Theory
Caring Science can be described as an evolving philosophical-ethical — epistemic field of study, that is grounded in the discipline of nursing and informed by related fields. The notion of Caring Science was posited in my first book: Nursing the Philosophy and Science of Caring (1979) Boston: Little Brown. Further explication evolved from the Theory of Human Caring and the 10 Caritas Processes® within the original Theory (Watson, 1985, 1999, 2006, 2008). Caring Science offers a meaningful philosophical foundation to nursing science, beyond conventional Western science. Caring Science acknowledges a relational ontology versus a separatist ontology. Caring Science embraces the whole person, the unity of mindbodyspirit as one in relation with environment at all levels.
Caring Science invites discovery and honoring of all the vicissitudes of humanity; honoring metaphysical phenomena such as Spirit, Sacred, Love, Consciousness, and Caring (Caritas). Caring Science places nursing’s phenomena within the Unitary Transformative paradigmatic thinking, accommodating phenomena such as non-local consciousness, transpersonal, transcendence, pattern, intentionality, sacred, and energy. These shared phenomena now converge across several extant nursing theories; all located within the unitary transformative paradigm in nursing literature. Likewise, while Caring Science is grounded in nursing scholarship, it now intersects with other disciplines in the academy, such as feminist studies, peace studies, education, ethics, and human service fields, e.g. social work, and healthcare professions generally.
Caring Science Measurement Tools
The Watson Caritas Patient Score® (WCPS) is a reliable and valid instrument used in hospitals and systems throughout the United States (and other parts of the world) to assess patient perspectives of caring practices of hospital staff.
Unitary Caring Science
Unitary Caring Science is a higher order of thinking beyond Caring Science. It is based on the ‘Ethic of Belonging (Philosophy of Levinas) and comes before the separatist Ontology of Being. Belonging, to infinite field of universal cosmic Love, is the ethical starting point for our ontology of Being. Our human experiences and journey through the sacred circle of life and death are shared within the infinite, universal field of Cosmic Love (Levinas, 1969, Watson, 2005, 2008, 2018). Unitary Caring Science invites an expanded and evolving world view of Unitary or ALL. It also is congruent with Roger’s Science of Unitary Human.
Unitary Caring Science research investigations embrace inquiries that are reflective, subjective and interpretative as well as objective-empirical — including forms of sacred action as form of inquiry. Unitary Caring Science inquiry includes and invites ontological, philosophical, ethical, spiritual, historical inquiry and other emerging fields of study.
The evolved Unitary Caring Science theory of Caritas/Veritas (Watson, 2018) embraces unitary phenomenon such as transpersonal, transcendence, energy, unity, pattern, consciousness (non-local), intentionality and holographic notions e.g. ‘the whole is the part and the part is in the whole’. Unitary Caring Science and transpersonal dimensions of the theory of human caring embrace healing arts and humanities, energetic healing practices as moral, timeless philosophically, value-guided praxis.
The Theory of Human Caring
History & Evolution
The Theory of Human Caring was developed between 1975-1979, while engaged in teaching at the University of Colorado; it emerged from my own views of nursing, combined and informed by my doctoral studies in educational-clinical and social psychology. It was my initial attempt to bring meaning and focus to nursing as an emerging discipline and distinct health profession with its own unique values, knowledge and practices, with its own ethic and mission to society. The work also was influenced by my involvement with an integrated academic nursing curriculum and efforts to find common meaning and order to nursing that transcended settings, populations, specialty, subspecialty areas, and so forth.
From my emerging perspective, I tried to make explicit nursing's values, knowledge, and practices of human caring that are geared toward subjective inner healing processes and the life world of the experiencing person, requiring unique caring-healing arts and a framework called "carative factors," which complemented conventional medicine, but stood in stark contrast to "curative factors." At the same time, this emerging philosophy and theory of human caring sought to balance the cure orientation of medicine, giving nursing its unique disciplinary, scientific, and professional standing with itself and its public.
The caring model or theory can also be considered a philosophical and moral/ethical foundation for professional nursing and part of the central focus for nursing at the disciplinary level. A model of caring includes a call for both art and science; it offers a framework that embraces and intersects with art, science, humanities, spirituality, and new dimensions of mindbodyspirit medicine and nursing evolving openly as central to human phenomena of nursing practice. I emphasize that it is possible to read, study, learn about, even teach and research the caring theory; however, to truly "get it," one has to personally experience it; thus the model is both an invitation and an opportunity to interact with the ideas, experiment with and grow within the philosophy, and living it out in one’s personal/professional life.
The ideas as originally developed, as well as in the current evolving phase, provide others a chance to assess, critique and see where, how, or if, one may locate self within the framework or the emerging ideas in relation to their own "theories and philosophies of professional nursing and/or caring practice."
10 Caritas Processes®
Sustaining humanistic-altruistic values by practice of loving-kindness, compassion and equanimity with self/others.
Being authentically present, enabling faith/hope/belief system; honoring subjective inner, life-world of self/others.
Being sensitive to self and others by cultivating own spiritual practices; beyond ego-self to transpersonal presence.
Developing and sustaining loving, trusting-caring relationships.
Allowing for expression of positive and negative feelings - authentically listening to another person's story.
Creatively problem-solving-'solution-seeking' through caring process; full use of self and artistry of caring-healing practices via use of all ways of knowing/being/doing/becoming.
Engaging in transpersonal teaching and learning within context of caring relationship; staying within other's frame of reference-shift toward coaching model for expanded health/wellness.
Creating a healing environment at all levels; subtle environment for energetic authentic caring presence.
Reverentially assisting with basic needs as sacred acts, touching mindbodyspirit of spirit of other; sustaining human dignity.
Opening to spiritual, mystery, unknowns-allowing for miracles.
Transpersonal Caring & the Caring Moment Defined
Transpersonal caring relationships are the foundation of the work; transpersonal conveys a concern for the inner life world and subjective meaning of another who is fully embodied, but transpersonal also goes beyond the ego self and beyond the given moment, reaching to the deeper connections to spirit and with the broader universe. Thus transpersonal caring relationship moves beyond ego-self and radiates to spiritual, even cosmic concerns and connections that tap into healing possibilities and potentials. Transpersonal caring seeks to connect with and embrace the spirit or soul of the other through the processes of caring and healing and being in authentic relation, in the moment.
Such a transpersonal relation is influenced by the caring consciousness and intentionality of the nurse as she or he enters into the life space or phenomenal field of another person, and is able to detect the other person’s condition of being (at the soul, spirit level). It implies a focus on the uniqueness of self and other and the uniqueness of the moment, wherein the coming together is mutual and reciprocal, each fully embodied in the moment, while paradoxically capable of transcending the moment, open to new possibilities.
Transpersonal caring calls for an authenticity of being and becoming, an ability to be present to self and other in a reflective frame; the transpersonal nurse has the ability to center consciousness and intentionality on caring, healing, and wholeness, rather than on disease, illness and pathology.
Transpersonal caring competencies are related to ontological development of the nurse’s human competencies and ways of being and becoming; thus “ontological caring competencies” become as critical in this model as “technological curing competencies” were in the conventional modern, Western nursing-medicine model, now coming to an end.
Within the model of transpersonal caring, clinical caritas consciousness is engaged at a foundational ethical level for entry into this framework. The nurse attempts to enter into and stay within the other’s frame of reference for connecting with the inner life world of meaning and spirit of the other; together they join in a mutual search for meaning and wholeness of being and becoming to potentiate comfort measures, pain control, a sense of well-being, wholeness, or even spiritual transcendence of suffering. The person is viewed as whole and complete, regardless of illness or disease.
Transpersonal Caring Moment
Transpersonal Caring Moments, Caring Occasions
A caring occasion occurs whenever the nurse and another come together, beyond ego, with their unique life histories and phenomenal fields in a human-to-human connection. The coming together in a given moment becomes a focal point in space and time. It becomes transcendent whereby experience and perception take place, but the actual caring occasion has a greater field of its own in a given moment. The process goes beyond itself yet arises from aspects of itself that become part of the life history of each person, as well as part of some larger, more complex pattern of life.
A transpersonal caring moment involves an action and choice by both the nurse and the other. The moment of coming together presents them with the opportunity to decide how to be in the moment and in the relationship, as what to do with and during the moment. If the caring moment is transpersonal, each feels a connection with the other at the spirit level, thus it transcends time and space, opening up new possibilities for healing and human connection at a deeper level than physical interaction. I quote:
...we learn from one another how to be human by identifying ourselves with others, finding their dilemmas in ourselves. What we all learn from it is self-knowledge. The self we learn about …is every self. IT is universal – the human self. We learn to recognize ourselves in others…(it) keeps alive our common humanity and avoids reducing self or other to the moral status of object.
Transpersonal Caring (Healing) Consciousness
The dynamic of transpersonal caring (healing) within a caring moment is manifest in a field of consciousness and intentionality. The transpersonal dimensions of a caring moment are affected by the nurse’s consciousness and heart centered presence in the caring moment, which in turn affects the field of the whole. The role of consciousness with respect to a holographic view of science has been discussed in earlier writings and include the following points: (Watson 1985, 2008, 2018).
The whole caring-healing-loving consciousness energy is contained within a single caring moment.
The one caring and the one being cared for are interconnected; the caring-healing process is connected with the other human(s) and the higher cosmic energy of the universe; the heart-centered, caring-healing-loving consciousness of the nurse is communicated to the one being cared for; caring-healing-loving consciousness exists through and transcends time and space and can be dominant over physical dimensions.
Within this context, it is acknowledged that the process is relational, connected and beyond physical plane. It transcends time, space, and physicality. The process is intersubjective with transcendent possibilities that go beyond the given caring moment – open to infinity of Cosmic universal Love; mystery, miracles, the mystical, unknowns.
Guiding Questions for Systems using Caring Science Theory
If one chooses to use the caring perspective as theory, model, philosophy, ethic or ethos for transforming self and practice, or self and system, the following questions may help:
Unitary World View: “Human Resides in Unitary Field of Consciousness”
The Future of Nursing
Nursing’s future and nursing in the future will depend upon nursing maturing as a distinct health, healing and caring health discipline; that which has always represented across time, but now is beginning to be more fully actualized. Nursing, thus ironically, is challenged to stand and mature within its own Caring Science/Unitary Caring Science paradigm and theories, while simultaneously having to transcend itself and share worldview and scholarship with other disciplines.
The future already reveals that all health care practitioners will need to work within a shared framework of caring-healing relationships; integral medicine; healing arts, micro and macro embodied caring-healing practices, and energy models of self-healing. Practitioners’ caring/healing consciousness and knowledgeable skills will be required to engage in the spiritual, non-physical, energetic dimensions of caring/healing.
Thus, nursing is at its own crossroad of possibilities, among world views, paradigms, centuries and eras. It is invited and required to build upon its heritage and latest evolution beyond Western science and technology. Nursing is transcending itself for a post hospital era, providing healthcare for All, through its universal covenant with humanity. Nursing, the largest health profession on earth, holds the future promise of contributing to a grass roots, global moral community of caring/healing and peace for our world.
Visionary Award for Caring Science Leadership, Integrative Health & Medicine Conference, October 2015