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CHAPTER 7 Jean Watson 89

Summary at 36 weeks, is self-pay, and receives Maternity
Jean Watson began developing her theory while she Medicaid when she presents in labor. She cannot
was assistant dean of the undergraduate program at speak English and uses her husband, Daniel, as an
the University of Colorado, and it evolved into plan- interpreter, who states that he could read and write
ning and implementation of its nursing PhD pro- but that she cannot. She and Daniel have moved to
gram. Her first book started as class notes that the area for factory work, so they have little social
emerged from teaching in an innovative, integrated support from family and friends, and Maria stays at
curriculum. She became coordinator and director of home to care for their three children. Maria’s sister-
the PhD program when it began 1978 and served in-law is caring for their three children while Maria
until 1981. While serving as Dean of the University of is in the hospital. Although they are Catholic, they
Colorado, School of Nursing, a post-baccalaureate do not presently belong to a church. Her medical
nursing curriculum in human caring was developed history is unremarkable, and her prenatal history is
that led to a professional clinical doctoral degree normal. Her first two children were delivered in
(ND). This curriculum was implemented in 1990 Mexico, and her last child was delivered 1 year ago
and was later merged into the Doctor of Nursing at another hospital in the United States.
Practice (DNP) degree. Watson initiated the Center As the nurse-midwife caring for Maria, Watson’s
for Human Caring, the nation’s first interdisciplinary theory leads me to view Maria and her family holis-
center with a commitment to develop and use knowl- tically, wherein the body, mind, and soul are inter-
edge of human caring for practice and scholarship. related. I remember to incorporate the carative
She worked from Yalom’s 11 curative factors to for- factors, caring consciousness, intentionality, and
mulate her 10 carative factors. She modified the caring-healing practices, and to go beyond proce-
10 factors slightly over time and developed the caritas dures, tasks, and techniques to create a mentally,
processes, which have a spiritual dimension and use physically, and spiritually healing environment,
a more fluid and evolutionary language. while assisting with basic needs. Watson’s theory
helps me realize the importance of being authenti-
cally present and developing and sustaining a help-
CASE STUDY
ing, trusting, caring relationship with Maria and
The following case study was adapted from Valerie her husband. At 0045 today, I attend Maria for her
Taylor’s (2008) clinical example for a presentation spontaneous vaginal delivery of a healthy infant girl,
in Advanced Nursing Synthesis for the Nurse- Lilia, who has an Apgar score of 8 and 9. Maria’s
Midwifery Concentration, East Carolina University labor is uneventful, although she is treated for group
College of Nursing (reprinted with permission). B infection. After the delivery, I place Lilia on
You are a recently graduated master’s-prepared Maria’s abdomen for skin-to-skin touch and help
nurse-midwife working in a small 100-bed hospital, Maria with positioning for breastfeeding. Maria and
and you are committed to applying Watson’s theory Daniel gaze at Lilia as she latches on for the first
to practice by building a nurse-midwife-patient breastfeeding. After initial bonding, infant Lilia is
relationship resulting in therapeutic outcomes. Be- transported to the newborn nursery; her exam is
cause you are new, you are slowly promoting the normal and without problems. When the nurses
theory with staff, co-midwives and physicians. note that Lilia has not wet a diaper in over 6 hours,
Today you are excited and challenged to integrate the neonatologist determines that Lilia has a kid-
Watson’s theory into your midwifery care of Maria, ney problem, and she has to be transported to the
a 23-year-old Hispanic female, gravida 4 para, Level III regional hospital for additional tests and
TPAL 4004 (meaning term, preterm, abortion, and evaluation.
live births in her pregnancy history), who presents From your initial plan of care, you know how
in labor at 39 weeks gestation. She transfers into important it is to maintain a reciprocal dialogue
your group’s practice from the health department among the interpreter, obstetrician, neonatologist,
Continued