Implementing Watson's Caring Science
An Academic Clinical Partnership for a Transformative Approach to Nursing Retention and Development
Supported by the Bedford Falls Foundation, the Implementing Watson’s Caring Science initiative at Vanderbilt University School of Nursing and Vanderbilt University Medical Center is built to address nursing retention challenges.
Caring Science has recently been identified as a discipline-specific organizing foundation to integrating the American Association of Colleges of Nursing’s The Essentials: Core Competency for Professional Nursing Education. Additionally, incorporating Caring Science into nursing education and practice has been identified as a strategy for preparing the next generation of nurses with strong leadership skills, resilience, self-care and well-being (Horton-Duetsch et al 2025).
Statement of Need
Currently, the United States is experiencing a critical nursing retention crisis. According to the 2025 NSI National Health Care Retention & RN Staffing Report, 22.3% of newly hired RNs leave within their first year, and nearly one-third (31.9%) of all RN separations are first-year nurses. The average cost of turnover for a staff RN is $61,110, resulting in annual hospital losses of $3.9M–$5.7M. This crisis threatens health care quality and stability. Current challenges include:
- A majority (61.4%) of hospital employees who leave have less than two years of service
- Staff RN turnover averaging 16.4% nationally, ranging from 5.2% to 36.4% depending on hospital size and specialty
- Burnout, workload, career advancement, and scheduling conflicts are among the top reasons RNs resign
- Persistent disconnect between nursing education and the emotional demands of bedside practice
Integrating Caring Science principles into nursing education and practice can help to empower nurses to gain a stronger professional identity by enhancing clinical reasoning, increasing self-awareness and increasing emotional intelligence. Caring Science can help to transform the practice environment by fostering self-awareness in nurses and create a connection to care values focusing on creating a caring environment. Additionally, integrating Caring Science into the clinical practice environment can help to improve nurse engagement, reduce turnover rates, improve patient care, enhance team functioning and improve job satisfaction.
Key Personnel
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Pamela Jeffries
Caritas Leader, Dean, VUSN, Co-Lead, VUSN
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Ruth Kleinpell
Vice Dean; Interim Senior Associate Dean for Research; Professor
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Gloria Littlemouse
Assistant Professor, VUSN and Watson Caring Science Fellow-Scholar, Caritas Coach, Caritas Leader, Project Director, VUSN
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Karen Keady
System Chief Nursing Officer, Co-Lead, VUMC
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Marilyn Dubree
Caritas Leader, Senior Vice President Clinical Enterprise Administration, VUMC
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Catherine Ivory
Associate Nurse Executive, Associate Professor, VUMC
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Kimberly DeFreece
Program Manager, VUSN
Caring Science Council
The Vanderbilt Caring Science Council monitors the ongoing progress of the academic/clinical Caring Science partnership.
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Cara Tuttle
Director of the Project Safe Center
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Karen Hande
VUSN Faculty
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David Haynes
VUMC Patient/Family Advisor
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Judy Jenkins
Retired VUMC Employee
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Terrell Smith
Retired VUMC
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Scott Tierno
Caritas Coach, Senior Director of Unitek Learning-Academic Leadership