There are a great deal of middle range theories in the nursing medical world. Jean Watson’s Caring Theory and conceptual model of nursing has so much depth that it manages to have multiple middle range theories within her model . “The middle range theories of caring and comfort are different because they are expressive of nursing intention to make a difference for another with a direct link to caring in the human health experience.” (Liehr & Smith,2017, p. 51). Watson’s Caring theory is considered a grand theory because it allows the practicing nurse to apply meaningful experiences of care to patients; this ultimately provides the greatest structure for better patient outcomes. I find that being authentic and present with patients (Concept A) preconditions(Proposition) patients with the transparency of the medical thought process (Concept B). Non- medical people who come to the emergency room don’t know what to expect.
My current practice as a registered nurse is to be present by explaining the plan of care. Telling the patients what the plan is or why we’re drawing their blood or what diagnostic test to expect reduces revisiting the room to explain their care plan in bits and pieces. Patients don’t understand the flow of the emergency room and I always emphasize “we’re trying to rule out if you are in an ‘emergent situation’ ”. I find that being authentic and present when discussing all of these matters gives comfort to the patient. When I step out of the room I don’t want them wondering what is next. My return to their room is purposeful and in a timely manner. I would return with changes of care plan, blood work results, imaging results, and/or bowel or bladder movements. Anticipation is key for good work flow. If I don’t set these expectations early on with authenticity, patients become more irritable. As time passes in the new digital age, Watson’s theory may need to be adjusted. There are telehealth or telemedicine care that may result in patients feeling a lack of authentic expression of care simply because it cannot be transmitted electronically. Sitzman (2017) discusses “ new possibilities for establishing global caring/learning communities have emerged where transdisciplinary, multicultural, diverse cohorts from all over the world come together to learn about Watson’s caring science and share unique perspectives about caring experiences and applications (Two studies section, para. 1). All in all, at this stage in my career being present and authentic with my patients shows transparency with emergency medicine practices and implementation of care.
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