How Caritas is reshaping leadership and education
- The Caritas Leadership Program (CLP) is a six-month virtual course based on Dr. Jean Watson’s Caring Science and 10 Caritas Processes.
- The program covers six main themes: authentic leadership, deep listening, connection and belonging, holding space, building community, and taking meaningful action.
The multifaceted crisis in healthcare threatens patient outcomes and system sustainability. The American Nurses Foundation’s Mental Health and Wellness Survey revealed that 80% of nurses report experiencing significant stress, directly impacting patient care delivery. A national nurse turnover rate exceeding 27% compounds these challenges; according to NSI Nursing Solutions, Inc. (NSI), each percentage point increase costs the average hospital $262,300 annually. In addition, the U.S. Department of Health and Human Services projects a shortage of 450,000 RNs by 2025, a staffing crisis directly linked to increased medical errors and poor patient outcomes.
According to AMN Healthcare, 72% of surveyed nurse leaders report feeling exhausted, and one-third have considered quitting. At the same time, NSI reports that 34% of new nurses leave within the first year, and an additional 23% leave within 2 years, adding to nurse leaders’ burden.
We must support nursing leaders as they navigate these challenges. We must stay true to the caring covenant that calls us into this profession and asks that we holistically and intentionally tend to each patient placed in our care. As a profession, we’re at a retention and quality crossroads, which requires us to rethink our approach to leadership. Traditional efficiency-focused leadership doesn’t always secure a satisfied nursing workforce or consistently foster excellence in healthcare delivery. The Watson Caring Science Institute’s Caritas Leadership Program™ (CLP) offers a promising framework. (See About CLP.)
About CLP
The Caritas Leadership Program (CLP), a 6-month virtual course launched in 2021 and based on Watson’s Unitary Caring Science theory (www.watsoncaringscience.org/jean-bio/caring-science-theory/10-caritas-processes), offers leaders and educators practical skills and a chance to recharge, whether they work in a hospital setting, the community, or a classroom. Participants meet twice a month, alternating between large groups and small sessions.
The program builds on recent scholarly work, which applies Watson’s theory to nursing administration and leadership, and meets new education standards, such as the American Association of Colleges of Nursing’s The Essentials: Core Competencies for Professional Nursing Education. Through guided conversations—including role modeling discussions with executive Caritas leaders, conversing within interactive learning circles, and sharing experiences—participants explore how to lead more authentically and from nursing’s core values.
CLP covers six main themes:
- Authentic leadership
- Building community
- Connection and belonging
- Deep listening
- Holding space
- Taking meaningful action
Why CLP?
CLP has demonstrated a significant impact on healthcare leadership development since its inception in 2021. With over 200 graduates representing a range of clinical healthcare institutions and academic nursing programs, pre- and post-program assessments have evaluated CLP’s effectiveness. Initial outcome measurements indicate the following achievements:
- Caring practices: Participants see evidence of the Caritas Processes 40% more often in their daily work.
- Changing education: 75% of teachers incorporate these ideas into their classes, and three nursing schools are updating their leadership courses.
- Evolved leadership skills: 75% now use more advanced relationship-centered communication, and 80% feel more confident leading authentically.
- High satisfaction: 90% of participants loved the program.
- Personal growth: 85% of participants feel more connected to why they chose healthcare, which literature shows reduces intention to leave the profession.
- Real-world impact: 60% of organizations started new caring-focused initiatives.
CLP in action
Trinity Health, a healthcare system with over 90 facilities across 26 states, participated in one of the first CLP cohorts, sending 30 leaders from nursing, patient experience, and one of its academic nursing schools. The program’s timing in late 2021 proved life-changing for many of these leaders, who were exhausted by the rigors of the COVID-19 pandemic.
Some Trinity participants focused on transforming the healthcare environment in their departments, while others also chose two methods to support and spread the growth emerging from CLP. First, they created a Caritas Community of Practice to gather and support the cohort of 30 leaders while continuing the learning and sharing within the group. They then redesigned their inpatient care delivery model. The leaders integrated Watson’s Caring Science principles and the Caritas Processes into Trinity’s team-based virtual nursing care model (Virtual Connected Care), which became a key vehicle for fostering human connection, team cohesiveness, and resilience throughout the health system. The Trinity leaders continue to evaluate the effects on employee engagement and patient satisfaction.
Creating positive and effective workplaces
CLP helps all nurse leaders—clinical (chief nursing officers, chief operating officers, unit/team leaders) and academic (deans, faculty)—move beyond traditional metrics of staff satisfaction and engagement to prioritize a deeper sense of well-being and belonging. Participant testimonials indicate that learning with and from various leadership perspectives has enhanced the program’s value.
Self-reflection, a vital component of the program, empowers nurse leaders to grow and evolve holistically. This introspective approach allows them to stay connected to their core values and the compassionate motivations that initially drew them to healthcare.
CLP has the potential to catalyze organizational shifts, paving the way for more nurturing work environments better equipped to handle the complex challenges of modern healthcare delivery. By teaching compassion and self-awareness alongside leadership fundamentals, the program helps leaders stay true to their calling while also fostering resilient healthcare cultures that honor caregiver wellbeing and excellence in patient care.
Disclosure: Sara Horton-Deutsch and Christine Griffin work part-time for Watson Caring Science Institute and receive payment for facilitating the Caritas Leadership Program™. Jean Watson is the founder/director of the Watson Caring Science Institute, a 501(c)(3) organization.
Sara Horton-Deutsch is a professor and director of the University of San Francisco and Kaiser Permanente Partnership and faculty associate at the University of San Francisco and the Watson Caring Science Institute in San Francisco, California. Christine Griffin is a Caritas Coach/Caritas Leader and executive director chief wellbeing officer at Children’s Hospital Los Angeles in Los Angeles, California. Jean Watson is the founder/director of the Watson Caring Science Institute in Boulder, Colorado. Gay Landstrom is senior vice president and chief nursing officer at Trinity Health in Livonia, Michigan.
American Nurse Journal. 2025; 20(6). Doi: 10.51256/ANJ062529
References
American Association of Colleges of Nursing. The Essentials: Core Competencies for Professional Nursing Education. aacnnursing.org/essentials
AMN Healthcare. Survey of hospital nurse leaders: Roles, challenges, and workforce solutions. 2024. amnhealthcare.com/contentassets/6bc4f2d23e9d48f5aedd17b0a4f055ff/amn-survey-nurseleaders-2024-final.pdf
ANA Enterprise. Mental health and wellness survey 4. 2023. nursingworld.org/practice-policy/work-environment/health-safety/disaster-preparedness/coronavirus/what-you-need-to-know/survey-4/
Gallup. From suffering to thriving. 2024. gallup.com/workplace/349484/state-of-the-global-workplace.aspx?thank-you-report-form=1
Gunawan J, Aungsuroch Y, Watson J, Marzilli C. Nursing administration: Watson’s Theory of Human Caring. Nurs Sci Q. 2022;35(2):235-43. doi:10.1177/08943184211070582
Hernandez G, Hills M, Cara C, Watson J. Caring science-informed leadership. In: Wei H, Horton-Deutsch S, eds. Visionary Leadership in Healthcare: Excellence in Practice, Policy and Ethics. Indianapolis, IN: SIGMA; 2022; 251-83.
Nursing Solutions, Inc. 2024 NSI National Health Care Retention & RN Staffing Report. nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf
U.S. Department of Health and Human Services. Nurse workforce projections, 2022-2037. bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nursing-projections-factsheet.pdf
Watson J. Unitary Caring Science: The Philosophy and Praxis of Nursing. Boulder, CO: University of Colorado Press; 2018.
Watson J, Porter-O’Grady T, Horton-Deutsch S, Malloch K, D’Alfonso J. Quantum caring leadership: A new ontology into practice. In Wei H, Horton-Deutsch S, eds. Visionary Leadership in Healthcare: Excellence in Practice, Policy and Ethics. Indianapolis, IN: SIGMA; 2022; 231-49.
Key words: Caring Science Leadership, Caritas, Watson’s Theory of Human Caring, nursing leadership
