Running head: Personal Model for Joan Kronlein

Personal Model and Professional Development Joan Kronlein RN 1994 NUR 324/Fogarty Ferris State University

Personal Model for Joan Kronlein Abstract The personal model of Joan Kronlein closely resembles the theory of human caring by Jean Watson. The personal model draws from experiences and religious training, including Bible

scriptures. The work area is very task oriented. The potential benefits of the use of theory and the nursing process in this work area is discussed.

Personal Model and Professional Development

Personal Model for Joan Kronlein

This paper will review the philosophy and assumptions of my nursing practice, including a correlation of my philosophy to part of Jean Watsons theory of human caring. A comparison of Bible verses and a few components of Jean Watsons theory clarify my use of this theory. The focus of the nursing process will be on interpersonal relationships. A description of my work environment will follow, with comments on how Jean Watsons theory can enhance that environment. By reviewing and correlating my practice to theory, I hope to attain greater understanding and power in practice. The search for nursings knowledge is a very involved process. Although many of the theorists have a spiritual aspect to their theories, it is not enough. Jean Watsons theory of human caring comes closest to my philosophy. My basic philosophy can be summed up in one sentence from the Bible, in everything, do to others what you would have them do to you (Thompson, Matt. 7:12). Nursing is a divinely inspired profession. The interpersonal aspects of knowledge are found in the Bible. I assume that God and the Holy Trinity, Jesus lives and died for me, and the Bible, are the truth. I base my whole life and nursing career on these assumptions or truths. People may find this archaic, but religion greatly influences my model for nursing. I have read about the theorists and can identify with and acknowledge Jean Watsons theory of human caring as closest to my model of nursing, in regards to interpersonal relationships. The whole of Jean Watsons theory is difficult to understand, but the interpersonal aspects are easily assimilated. I have been brought up to think of others before myself. I feel an ingrained sense of caring towards my patients, which is not an active thought. Jean Watson states, I define human caring in nursing as a moral idea, in the sense that the nurse carries (or perhaps should carry) a caring consciousness in mind during every nursing transaction (Watson, 1990, p. 281). Jean

Personal Model for Joan Kronlein Watson puts into words that which I could not define. An interpretation of Watsons transpersonal caring is described as put yourself in their shoes and think what it would feel like to have lived their experiences. Watson describes energy as the entity that is affected by each nurse to client interaction. Watsons theory draws from old knowledge, that of the Bible. As found in the Bible,

Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal (Thompson, 2 Cor. 4: 16-18). The unseen in Watsons theory is the energy or transpersonal moment of caring. The meaning in these verses can be interpreted in different ways, depending on who is reading them. I have not decided that tis energy is the basis of this verse, but it certainly seems to apply. A giving takes place that affects the parts in ways each person and not predict. Someone said to me a long time age, that everything you do affects someone else, so make it count. I think in terms of giving a little piece of myself, my soul, to the client in each interaction. Not every interaction results in the feeling that this has been done, but the most rewarding interactions are when this interchange of souls happens. This is the energy that Watson describes. Most of Watsons examples deal with people who has AIDS. This population has not the physical body to rely on, so they search for meaning to life through loving relationships and being loved and cared for. This search leads to some aspect of healing, namely the spiritual self. She describes the interactions in human terms, even though she is describing a spiritual experience. As described above, I can clearly identify the similarities between her theory and my philosophy.

Personal Model for Joan Kronlein

Another aspect of Watsons theory is authentic caring (Watson, 1990, p. 295). I see this as unconditional love, which is a predominate theme throughout the Bible. As stated, My command is this: Love each other as I have loved you (Thompson, John 15:12). Watson is not asking nurses to practice a technique for interpersonal communication, but to really care. To care from the heart in all situations is the basis of Watsons theory. It is ability that some, but not all, nurses have. I believe this caring philosophy can be learned with the proper education. The use of the Watson theory in the nursing process is all encompassing. The nursing process contains components of assessment, planning, goal setting, intervention, and evaluation. Watson writes that one of the basic components of a caring science for nursing, in the context of human science theory is an epistemology that allows not only for empirics but also for advancement of esthetics, ethical values, intuition, and process delivery (Barnhart, Bennett, Porter, & Sloan, 1994, p. 155). In other words, the science and quest for knowledge of human caring includes not only the practical, but the arts, ethics, phenomena, and processes. Watson writes, Caring consists of carative factors that result in the satisfaction of certain human needs (Barnhart, Bennett, Porter, & Sloan, 1994, p. 153). This statement gives the basis for the nursing process. Caring takes into account the physiological needs as well as the spiritual. On the lowest levels of functioning, an assessment asks questions about biophysical systems. The next set of questions deals with the psychological needs, such as achievement and affiliation. The next set asks self-actualization questions such as inter/intrapersonal needs and past history of those relationships. This assessment is not all inclusive, but just an overview of how to incorporate Watsons theory into nursing practice.

Personal Model for Joan Kronlein The planning phase is performed with the client or significant other. This gives responsibility for health or wellness to the client. Planning always includes a plan for the formation of an interpersonal relationship with the nurse or significant other or both. Interventions will be identified with the client, even if they are protective or corrective interventions. Interventions will also include as much teaching as the nurse and client identify. The philosophy of human caring, a large component of interpersonal skills, and the need for those skills in maintaining health, is certainly taught. Long term goals can be for the maintenance of a caring interpersonal relationship or the formation of one or both. Short term goals can encompass the more concrete aspects of the diagnosis or the lower level needs as opposed to the higher, self-actualization needs.

Evaluation of goals will take place with the emphasis on why goals were or were not met. This process will reflect on the particular nurse involved and whether or not that nurse is able to form an interpersonal relationship with the client. This will give the nurse an escape if, for factors such as family stress or illness, that nurse is unable to have an interpersonal relationship. From the outset, the client will have the responsibility to keep the nurses informed if the relationship needs changing. This forming of interpersonal relationships happens without active planning by either party. Watsons theory is based on this phenomenon. I work in a neonatal unit. This is very stressful to both the families involved and the nurses. The primary care model has been used sporadically in this intensive care unit, but with no consistency. The Watson theory can only be implemented for the families due to the inability of the neonate to participate in their own care. I feel the Watson theory of human caring can be very useful in this setting. I have noted that families cope much better when they are able to form an interpersonal relationship with a nurse. In other words, they hit it off with a particular nurse. It

Personal Model for Joan Kronlein is not a conscious thought on the part of either the family or the nurse. A problem arises when

different family members have a different nurse they have attached to. When trust is formed it is hard for families to trust two different nurses. This is especially true in the initial week of care when families are in an emotional spin of ups and downs. The problem of the double relationship is generally sorted out without conscious thought. One nurse generally relinquishes the relationship. This can happen as fast as a few hours to a few weeks. In the following weeks, if the outlook is not so grim and the infant is doing better, the mode of interpersonal relationship changes. Many interpersonal relationships can form without problems. The families have the ability, want, and need to trust more than one nurse. The nurses call this part of the infants stay and how the families are reacting, the settling in for the long haul phase. The relationships can change with the initial caring nurse replaced by another. There is always something of the initial relationship left over. Watson described this as the phenomenal field (Barnhart, Bennett, Porter, & Sloan, 1994, p. 155), or that experience in a caring relationship that changes one or more of the parties; something they always remember. I do not have difficulty in forming interpersonal relationships in the neonatal unit. I believe this is due to my philosophy as stated in the beginning of this paper; however, many of my colleagues do not practice this same philosophy. The implementation of the Watson theory has the potential to be viewed with skepticism because it involves letting oneself be vulnerable to the hurt or suffering of others. Many nurses I work with do not want their hearts involved. The excuse that they have been hurt before and they are protecting themselves from burnout, is just that, and excuse to not work hard at something. I receive much flak from coworkers because of my ability to like and understand most families. I generally have the ingrained ability to do this. The general population of nurses in this unit has worked there for many years. They are very task

Personal Model for Joan Kronlein oriented. Their job satisfaction is from knowing the right steps to a certain task. My hope in implementing Watsons theory is a total shift in thinking from what the nurse is going to get out of the relationship, to what can the nurse give, and what the client or family can give. Use of the Watson theory in practice will change the focus from tasks to a more holistic view. This nursing area is a brick wall, but one that can be overcome. I realize there are many aspects to the Watson theory that I do not understand, but am willing to learn. I am in the beginning stage of theory usage. I am only using part of one theory that fits. Taking into consideration my philosophy and Watsons theory, I do not feel in conflict when utilizing this theory in my practice. I am indebted to Jean Watson for putting into words the type of practice I do, which gives it meaning and focus. I now have the ability to communicate this theory to others in my practice, and in terms my coworkers will understand,

given the appropriate theory education. The priorities of my care can now be seen as appropriate by my coworkers, which they are often not. Because Watsons theory clarifies and focuses my practice, I feel a sense of autonomy and power about my practice that I did not previously feel. In summary, this paper has described my philosophy and the correlation with a small part of Jean Watsons theory of human caring. Descriptions of the use in the nursing process in the context of this theory have been described. Implementation of this theory in my work environment could have profound effects on focus, autonomy, power, energy, and interpersonal relationships for families and coworkers.

Personal Model for Joan Kronlein References Barnhart, D. A., Bennett, P. M., Porter, B. D., & Sloan, R. S. (1994). Jean Watson: philosophy and science of caring. In A. Marriner-Tomey (Ed.), Nursing Theorists and Their Work (3rd ed.).(pp. 148-162). St. Louis, MO: Mosby

Thompson, F. C. (Ed.), (1983). The Thompson chain-reference Bible (NIV). Indianapolis, IN: B. B. Kirkbride Bible Co., & Grand Rapids, MI: Zondervan Bible Publishers. Watson, M. J. & Neil, R. M. (1990). Watsons theory of caring in nursing. In M. E. Parker (Ed.), Nursing Theories in Practice. (pp. 275-301). New York, NY: National League for Nursing