By Jean Watson, PhD, RN, AHN-BC, FAAN, LL (AAN).
Founder/Director Watson Caring Science Institute, a non-profit organization.
Distinguished Professor/Dean Emerita University of Colorado Denver, College of Nursing.
Doi: 10.32549/OPI-NSC-22
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Abstract:
This manuscript offers a reflective pause to consider an overview of Unitary Caring Science as a philosophical-theoretical discipline-specific, professional nursing practice/praxis model for human caring nursing. It provides the background of the 10 Caritas Processes, considered universals of human caring phenomena and practices. The underlying starting point for unitary caring science is informed by an ‘Ethic of Belonging ‘- that is, we all belong to the infinite field and sacred circle of life itself. – belonging to the cosmic energy of universal Love. Thus our ‘Belonging’ becomes before our separate ‘Being’. So, in this foundational unitary starting point – ‘ethics comes before ontology’. With this philosophical-ethical foundation nursing practice moves from technical industrial forms of practice to Praxis, that is discipline specific, value guided, informed, knowledgeable, moral practice (praxis). This shift transcends technology and objective task- focused- physical care, to critiquing, repatterning practices from tasks and skills to Caring -Healing Arts and micro-practices that allow for human face- to- face, heart- to- heart – energetic human caring touch and transpersonal caring moments that unite.
Key words: Unitary Caring Science, Praxis, Caritas Processes, Disciplinary.
Introduction
This manuscript offers a reflective pause to consider an overview of Unitary Caring Science as a philosophical-theoretical discipline-specific, professional nursing practice/praxis model for human caring nursing. It provides the background of the 10 Caritas ProcessesÔ, considered universals of human caring phenomena and practices. The underlying starting point for unitary caring science is informed by an ‘Ethic of Belonging ‘- that is, we all belong to the infinite field and sacred circle of life itself. – belonging to the cosmic energy of universal Love. Thus our ‘Belonging’ becomes before our separate ‘Being’. So, in this foundational unitary starting point – ‘ethics comes before ontology’. [1,2].
With this philosophical-ethical foundation nursing practice moves from technical industrial forms of practice to Praxis, that is discipline specific, value guided, informed, knowledgeable, moral practice (praxis). This shift transcends technology and objective task- focused- physical care, to critiquing, repatterning practices from tasks and skills to Caring -Healing Arts and micro-practices that allow for human face- to- face, heart- to- heart – energetic human caring touch and transpersonal caring moments that unite.
This disciplinary focus for Nursing science serves as a guide toward an evolved quantum worldview for Unitary Caring Science. This evolved unitary caring science worldview (quantum universe) is in sharp contrast to the industrial -fragmented, dominant, separatist worldview of Western science and the current ‘modern’ hospital, product- line system of care delivery. This conventional, outdated industrial worldview is informed by a separatist ontological worldview, whereby everything is separated out from the whole. Whereas within a quantum universe, and a unitary caring science lens, everything is connected; all humans are connected with reality of a shared globe, which unites, transcending differences.
Method
This is a theoretical exposition manuscript using a descriptive exploratory method to highlight the evolving disciplinary scientific development of nursing, from conventional technical physical, objective mindsets to theory guided moral, philosophically guided praxis, informed by Watson’s Theory of Human Caring and universals of human caring: The 10 Caritas Processes Ô; and new criteria of Caritas literacy evidenced through micro-practices.
Unitary Caring Science
The underlying starting point for unitary caring science is informed by an ‘Ethic of Belonging ‘- that is, we all belong to the infinite field and sacred circle of life itself. – belonging to the cosmic energy of universal Love. Thus our ‘Belonging’ becomes before our separate ‘Being’. So, in this foundational unitary starting point- ‘ethics comes before ontology’ [1-2]. With this philosophical-ethical foundation nursing practice moves from technical industrial forms of practice to Praxis, that is discipline specific, value guided, informed, knowledgeable, moral practice (praxis).
Unitary Caring science moves from dominate empirical objectivist, epistemological methods to expanding, emancipatory forms of inquiry; asking new questions about what counts as knowledge. With this philosophical-ethical foundation nursing practice moves from technical industrial forms of practice to Praxis, that is discipline specific, value guided, informed, knowledgeable, moral practice (praxis). This shift transcends technology and objective task- focused-physical care, to critiquing, repatterning practices from tasks and skills to Caring -Healing Arts and micro-practices that allow for human face- to- face, heart- to- heart – energetic human caring touch and transpersonal caring moments that unite.
It takes 100 years for a profession to mature as a distinct discipline; nursing is at a critical turning point in its history as it reached the centenary of Nightingale in 2010. Either nursing advances as a distinct discipline, with its distinct values, phenomena, theories, and worldview to honor its covenant with humanity to address the whole person/whole system needs for all, or it succumbs to being a very fine technological practice, within an evolved, totally transformed world of caring, health and healing. Within our Western system of healthcare, we have yet to actualize the Nightingale model of Nursing – calling upon nature and natural caring processes for healing, beyond treatment and curing. As nursing engages in its own advancement as a distinct discipline for caring-healing/health, we create a circle of knowledge development; moving from theory, to informed conscious, intentional caring/healing practices to research and forms of inquiry and new forms of caring healing evidence and person- population- specific outcomes.
Results
Unitary Caring Science an evolved model of Nursing Praxis
Caring science (and now unitary caring science (Watson, 2018) has been evolving over the past 30 years, based upon the advancement of Watson’s Theory of Human Caring and developments of Human Caring Science,beyond Western medical science [3 – 8]. Whereby Western medical science focuses on objective, distant empirical, physical phenomenon, separating wholes into parts for study and for diagnosing and treatment plans and program, caring science focuses on human caring –healing, wholeness, health, including subjective, inter-subjective, non-physical, energy patterns and processes, as well as physical phenomena, with focus on whole person, whole health, personal meaning, context, relations and vicissitudes of human complexity.
Discussion
The next section identifies and discusses commonalities of unitary caring science praxis. For example, Universal Values; Shared Language of human caring; Global Premises; Caritas Literacy, Micro-practices as evidence of new criteria of authentic human caring practice/praxis.
Unitary Caring Science is based upon Universal Values of Humanistic-Altruism – as a sacred calling since Nightingale, nursing exists for purpose of offering compassionate caring, healing and health care for all. This foundational value system guides the expanded worldview for caring science, a consciousness beyond physical Western worldview – emphasizing the reality of a relational worldview whereby everything is connected, acknowledging we are now living in a quantum universe. Thus Caring Science theory can be approached, studied and practiced, as a philosophy, an ethic, a theory and/or an evolved model of unitary science.
Universal Shared Language-Nursing
If one is to study the Theory of Human Caring formally, then the language of the theory becomes important to use to capture the phenomenon of human caring.
Without language to capture the caring phenomenon of what nurses are practicing every day, nursing becomes invisible. As part of a postmodern world it is acknowledged if you do not have your language, you do not exist.
The language of human caring has been named and described through the 10 Caritas Processes™, which provide the structure and language of the Caring Science Theory of Human Caring. These Caritas Processes have been validated as reflecting universals of human caring, in that they apply to our shared humanity and all cultures and beliefs around the world. They have been validated for patient care relevance in countries and continents globally, for example, in the Middle East, Asia Pacific, China, South American, South Africa, Europe, Thailand, Japan and Latin American countries.
Meaning of Caritas
Caritas comes from the Latin word meaning to cherish, to appreciate, to give special, if not loving attention to. It represents charity and compassion, generosity of spirit. It connotes something very fine. Indeed, something precious that needs to be cultivated and sustained [7]
Watson’s theory of Transpersonal caring and the 10 Caritas Processes is one theory that can help to advance, discipline specific theory-guided nursing practice.
The 10 Caritas Processes ™ serve as the basis for ‘universals of human caring ‘, whereby our Being is connected and we all Belong to nature and our shared humanity around the globe. In other words we all Belong to the infinite field of Universal Cosmic Love [1, 6 -8].
An ethic and relational ontology and Ethic of Belonging, is in direct contrast to the dominant Western science ethic and ontology of separation. Thus, when nursing acknowledges and acts from a consciousness of the ethic of ‘Belonging’, the whole human and all the vicissitudes of shared humanity are honored. When the nurse and embraces concepts such as Caritas and Love, combined with universals of human caring, we have to acknowledge that we have an evolved model of science. Unitary Caring Science is the scientific context the 10 Caritas Processes™ as ‘universals of human caring’ – universals that unite humankind, transcending differences across cultures, religions, customs, borders, boundaries and geographic locations in the world.
The Ten Caritas Processes™ – (From Jean Watson – used with permission)
The Ten Caritas Processes provide a common language for nursing to discover, ‘see’, explore, further develop and authentically live out through practice, using these processes as a guide to personal/professional life practices.
They include the following:
- Sustaining Humanistic –altruistic values by practice of loving kindness, compassion and equanimity with self/other.
- Being Authentically present, enabling faith/ hope/belief system; honoring subjective, inner life-world of self/other.
- 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 = Caritas Praxis.
- Engaging in transpersonal teaching-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-healing presence.
- Reverentially assisting with basic needs as sacred acts; touching unity of mind-body-spirit of other; sustaining human dignity.
- Opening to spiritual mystery, unknowns – Allowing for miracles.
No matter what country; what culture; what customs; what religion; what borders and boundaries – geographic, political or otherwise, these 10 Caritas Processes™ hold across the globe as common denominators for humanity and their need for human caring for health and healing.
These Caritas Processes have been philosophically and theoretically validated in diverse countries and cultures worldwide, including, for example Islamic –Muslim Middle East Cultures – Iran and Saudi Arabia, Turkey, Jordan, Palestine, Israel, Lebanon; European Countries – Italy, Spain, France, Portugal, Poland, Switzerland, United Kingdom, Greece, Germany; Africa – South Africa; Latin& South America – Spanish- Speaking, countries, such as Mexico, Venezuela, Colombia, Costa Rico, Panama, Peru, Chile, Bogota., Cuba; In Asia Pacific countries such as Thailand, Japan, China, Taiwan, Korea, Singapore, Macau, Hong Kong, Philippines, among others; States throughout USA and North America – Canada, Quebec.
These processes are universal because they represent a professional covenant nursing has with humanity worldwide. These processes are built upon Global Human Caring Values.
*– Universals Premises human caring worldwide:
* reprinted with permission University Press of Colorado [7].
- Human caring and Love are the most universal, the most tremendous and the most mysterious of cosmic forces. They comprise the primal and universal psychic energy for survival [9].
- Often, this wisdom and these needs are overlooked. Although we know people need each other in loving and caring ways, often we do not behave well toward each other. If our humanness and humanity is to survive and if we are to evolve toward a more loving, moral community and civilization, we need to become more caring and loving to nourish our humanity and evolve as a civilization and live together on Planet Earth. [9].
- Because nursing is a caring profession, its ability to sustain its caring ideals, ethics and philosophy for professional practices affect the human development of civilizations and nursing’s mission to society. Sustaining a caring ethical ideal affect the human development of civilization and determines nursing’s contribution to society.
- As a beginning we have to learn how to offer caring, love, forgiveness, compassion, and mercy to ourselves before we can offer authentic caring, tenderness, compassion, love, and dignity to others. [8,9].
- Nursing has always held a human care and caring stance with respect to people and their health-illness-healing concerns.
- Knowledgeable, informed, ethical human caring is the essence of professional nursing values, commitments and competent actions. It is the most central and unifying source to sustain its covenant with society and ensure its survival [10].
- Human caring at the individual and group/community level has received less and less emphasis in the healthcare delivery system, but now has to be restored if systems are to survive as ethically and scientifically responsible and accountable to society, and if nursing is to survive as a distinct profession and discipline to fulfill it social mandate.
- Caring values of nurses and nursing have been submerged. Nursing and society are therefore in a critical situation today in sustaining human caring ideals and a caring ethic and ideology in practice. The human caring role is threatened by increased medical technological-economic- bureaucratic and managerial institutional constraints in this post- post-modern era of dramatic and chaotic, unprecedented change in human history. At the same time there has a proliferation of radical treatments and cure techniques to save lives, often without regard to costs or loss of meaning to human existence.
- Human caring can be most effectively demonstrated and practiced only interpersonally. The inter-subjective human processes keep alive a common sense of shared humanity. It teaches us how to be human by identifying ourselves with others, whereby the humanity of one is reflected in the other. However, paradoxically, caring consciousness transcends time, space, and physicality and affects the evolving consciousness of humanity at large. [8,12].
- The caring moment is where the Caritas processes are lived out. The moment is transpersonal in that it has a field of its own which is greater than the occasion itself. As such the process also becomes transcendent because it goes beyond itself and of each person and becomes part of some larger, deeper complex pattern of life[8].
Caritas Literacy
These universals of human caring and values, which support them, also raise the notion of Caritas Literacy. For example, some of the current social-system and political structures in health care and in our world, governance can be considered ‘illiterate’ with respect to human caring and universals of shared humanity as one world, one humanity. “Illiteracy consists of task-conscious practices; use of lower vibration objectifying language, ‘scientizing’ of human emotions and expressions and repressive, insensitive dehumanizing, dividing – separating actions and policies, crafting a commodification of caring and people” [11,12].
The opposite of Illiteracy is Caritas Literacy which is based upon the evolved consciousness and intentionality of nurses and nursing to shift from medical science/technology to caring –healing for self/other. Caritas literacy is based upon
A special way of Being – Ontology as to how to Be a loving, caring, compassionate human being. Literacy involved wisdom and dimensions of the art and artistry of our being, not just dominant science dimensions of objectivity, where humans get reduced to moral status of objects. Literacy and Caritas evokes heart intelligence, of level of moral efficacy and a lifelong journey of self-healing, self-growth and deliberate spiritual evolving practices. The Caritas Processes serve as ontological and ethically guided Caring Praxis – Praxis conveys informed practice, an oneness of Knowing/Being/Doing/Becoming Caritas – bringing compassion and love back into our life our work, our world – moving beyond traditional skill/task- based technically dominated practices.
The next section provides some global guidelines for Caritas Literacy.
Caritas Literacy Global:
- Ethics of Face – The only way we can sustain our humanity at this point in human history is through the face to face connection [1,7]. It is through the face-to-face connection – we ‘see’ the other; when we look into face of other, it mirrors the infinity of human soul and reflect back the infinity of our own soul, which unites us in our shared humanity.
- Caritas Heart MethodologyÓ – the human heart sends more messages to the brain than the brain sends to the heart; caring, compassion, love, beauty, truth all reside in our heart; when we radiate higher vibration feelings, such as love, caring, compassion from our heart, we affect the whole field of our work and world of humanity as one heart/one world uniting.
- Human Touch – human touch and intentional energetic touch is one form of healing; nurses engage in touch as a dominant form of human caring. We never know how we are touching the life of another person; when we touch someone else, we also are being touched.
Caritas Literacy Micro-practices for Sustaining a Caritas Relationship: Adapted from Watson, [7] – with permission.
- Pause before entering the patient’s room;
- ‘Read the field’ to detect energetic field of space and humans;
- ‘Be present’ – authentically
- Seek to ‘see’ ; to ‘hear’ person, beyond the diagnosis, treatment, disease;
- Suspending role and status, honoring each person their unique gifts and skills;
- Speaking and listening without judgment, working from one’s heart –centered space, working toward shared meaning and common values;
- Listening with compassion and open heart without interrupting; listening to another’s story as perhaps as one of the greatest healing gifts;
- Learning to be still, to center self, while able to dwell in silence, hold silence for reflection, contemplation and clarity;
- Recognizing that transpersonal Caritas Presence and practices transcend the ego-self and connect us human spirit to human spirit to where our life and work are divided no more;
- Honoring the reality that we are part of each other’s journey- we are all on our own journey toward healing as part of the infinity of the human condition. When we work to heal ourselves, we contribute to healing the whole.
Conclusions
This paper has provided an overview of Unitary Caring Science and how it differs from conventional Western Science, based upon the Ethic and Ontology of Belonging versus a worldview of Separation of humanity. This evolved view as foundation for the discipline of nursing, unites our oneness with each other and Planet Earth. The Theory of Transpersonal Human Caring and 10 Caritas Processes are embedded within the evolved ethic and worldview of Unitary Caring Science and includes universals of human caring. Foundational values that underpin the evolving quantum, world view of unitary caring science was presented. Global Caritas literacy practices are identified, such as Ethics of Face; Heart to Heart connections and Human Touch are introduced, along with more specific micro-practice/praxis guidelines for Caritas literacy. These basic, simple micro-practices, bring theory to life in concrete ways to sustain human caring and healing for nursing’s covenant with humanity. It can be concluded, based upon the global experiences and programs of the author, the 10 Caritas Processes are relevant to all humans and are important universals for sustaining an evolved civilization for humankind.
Conflict of Interest
The author declares there is no conflict of interest regarding publication of this paper.
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