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Running head: THEORY APPLICATION

Theory Application Paper:

Analysis of the Theory of Caring

Kevin Gross

Old Dominion University

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THEORY APPLICATION
Theory Application Paper: Analysis of the Theory of Caring

My journey to becoming a nurse along with my personal nursing philosophy has been

shaped and guided by several different influences. Whether it was my personal exposure to

nurses and how they cared for their patients while I worked as a paramedic, the images of nurses

portrayed on television, or the coursework that I completed to obtain my nursing license, each

had a way of impacting me and the way that I take care of my patients. However, nothing has

had more of an influence on how I function as a nurse than what I learned from the different

nursing theories and nursing models that I was exposed to while obtaining my Bachelor’s Degree

in Nursing (BSN).

The theory that I feel I adhere to most is the Theory of Caring by Kristen Swanson, RN,

PhD, FAAN. For her theory, Swanson defines caring as a nurturing way of relating to a valued

other toward whom one feels a personal sense of commitment and responsibility (Alligood,

2018, p. 553) Her theory was inductively derived from her research that she collected during her

doctoral studies working with a support group that focused on miscarriage following cesarean

birth. During her time there she began to realize that more people were concerned with talking

about their personal experiences with pregnancy loss than the health problems that led to the

loss. With that discovery, Swanson decided to learn more about the human experience and

responses to miscarriage (Alligood, 2018, p. 553). She learned by watching how individuals

dealt with and handled the challenges of miscarriage. She conducted research and interviewed 20

patients that had experienced a miscarriage. The findings from that work led to the development

of her caring theory. To further guide the development of the theory, Swanson reports that her

clinical experience and education made her acutely aware of the impact that caring had on the

lives of the people that she served (Alligood, 2018, p. 553) Swanson also attributes a major
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influencing factor in the development of her theory to the time she spent with her mentor, Jean

Watson, while she worked on her doctoral dissertation.

Swanson’s caring theory is structured around five caring principles that encompass the

overall definition of caring in the nursing profession. The five components are knowing, being

with, doing for, enabling, and maintaining belief. They progress in sequence and together they

make up the constructs of what caring is by its very nature. Knowing is the act of working to

understand the meaning of an event in the life of another. Looking at an event from the patient’s

perspective aids in formulating a caring relationship. To accomplish this task you must avoid

assumptions, maintain focus on the person being cared for, seek cues from the patient,

meticulously assess the situation, and the relationship must engage both the one caring and the

one for whom the care is given. Only then can you fully know what the patient is experiencing.

The process of being with means that you make yourself emotionally available to the other. It

also means that you are there for them in person physically and emotionally if they need you, and

it means that you can share your feelings with while remembering not to burden them in the

process. Being with someone in this manner helps build rapport and trust and fosters a caring

relationship. The process of doing for represents actions carried out for the individual that they

would normally do for themselves if the situation would allow it. The act of doing for consists of

several components. It includes anticipating needs, comforting, performing skillfully and

competently, and protecting the one being cared for including their dignity. Doing for another

helps maintain self-esteem and self-worth. The process of enabling can also be viewed as

educating. As defined by Swanson, enabling is facilitating the other’s passage through life

transitions and unfamiliar events by focusing on the event, informing, explaining, supporting,

validating feelings, generating alternatives, thinking things through, and giving feedback. The
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last process in her theory is the process of maintaining belief. Maintaining belief is sustaining

faith in the other’s capacity to get through an event or transition and face a future with meaning,

believing in other’s capacity and holding him or her in high esteem, maintaining a hope-filled

attitude, offering realistic optimism, helping to find meaning, and standing by the one cared for

no matter what the situation (Alligood, 2018, p. 554). Maintaining belief in the patient’s ability

to get through an event helps to give them hope and a purpose for which to fight. It helps them

understand that they are not alone and that they are supported throughout the event. Although

Swanson’s theory of caring was initially developed to help patients and families cope with the

difficulties from miscarriages, it has since been proven to be applicable to many health care

situations.

There are several benefits to using Swanson’s caring theory, one of which is that it is

virtually universal, meaning that it is easily applicable within or outside of nursing. The reason

for this is that the five concepts of caring that Swanson outlines are easy to understand and are

measurable so that achievement or failure of the concept can be identified (Alligood, 2018, p.

554). Another benefit to this theory is that it breaks the concept that there is normally a gap

between the development of a theory and when it is put into nursing practice. This is because

Swanson’s theory provides a perfect explanation of how the caring process is linked to a

patient’s overall well-being. The five concepts, grounded in a culture of maintaining belief,

combine nursing compassion (knowing and being with) and competence (doing for and

enabling), leading to the intended outcomes of patient healing and well-being (Tonges & Ray,

2011, p. 375).

Swanson’s caring theory is not without limitations. Although Swanson has tested and

applied her theory to several different case studies (primarily involving pregnancy loss) and
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proven its usefulness, it has not been fully tested by other theorists. Therefore, it has not yet been

proven to be as applicable as it is perceived to be. Another weakness to this theory is that it was

developed and tested without including any male participants. The theory was tested using case

studies primarily based on pregnancy loss and motherhood.

I recently reviewed an article titled, “Finding Meaning Through Kristen Swanson’s

Caring Behaviors: A Cornerstone of Healing for Nursing Education”. The article shows how

Swanson’s caring theory can be put to practical use to improve upon student satisfaction. It uses

the five caring concepts outlined by Swanson to cultivate meaningful, healing relationships with

her students. In the article, the author goes through each of the five caring concepts and outlines

exactly how they can be applied to the learning environment so that the teaching is tailored not

only to the specific class that is being taught, but to the specific students whom are part of the

class. Doing so promotes a nurturing environment where mistakes are encouraged and promoted

as vehicles of learning (McKelvey, 2018, p. 8). The author demonstrates that applying this theory

to her teaching pedagogy improved upon the grades of her students as well as their overall

satisfaction with the course and learning.

This article did a superb job demonstrating the use of Swanson’s caring theory in the role

of a nurse educator. The author broke down each of the five caring behaviors and provided

specific details as to how each behavior can be applied to the classroom environment. Through

her examples it became evident to me that this theory, as previously mentioned, is applicable to a

variety of environments, not only within the clinical setting.

A clinical situation where this theory was applied involved a patient that I recently took

care of in the Emergency Department. The patient presented with a fever and severe shortness of

breath. She was only speaking in one- to two-word sentences. She was alone and I could
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ascertain that she was frightened because of the circumstances. Using Swanson’s theory, I got to

know that she was concerned that she was infected with the recent virus and was worried she

would not survive. I learned what helped her to relax at home such as playing music, and I

played it for her. I let her know that I was going to be with her, and that I understood her fears. I

showed her how to contact me using the call light if I was not in the room. I strived to do for her

what she would normally do if she was not ill, such as, helping her with her elimination needs,

repositioning, as well as eating or drinking, making sure she knew that she was not a burden. I

enabled her to feel more at ease with the process by informing her of all the steps in her care so

that she was not surprised and knew what to expect. I maintained belief in her by reminding her

that she is strong and that she will get through this event with my help and the help of my team.

Swanson’s caring theory is one to which I can relate. I am a caring and compassionate

person and I am eager to nurture the well-being of everyone I encounter both at work and in my

personal life. Learning more about this theory allowed me to solidify the foundation of my

nursing practice by giving me structure from which to cultivate my caring actions. The five

caring behaviors will serve as a guide for me to follow so that my patients will feel supported

and cared for with authenticity and dignity.

This assignment reinforced my knowledge of nursing care through research on

Swanson’s caring behaviors. It showed me the importance of having clear structure to your care

practice while tailoring the care to your specific patients. It also showed me that utilizing

nursing theory can help to develop meaningful, healthy relationships with patients and peers

alike. I look forward to applying what I learned through this assignment as I work toward

enhancing my nursing philosophy.

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References

Alligood, M. R. (2018). Nursing theorists and their work (9th ed.) St. Louis, MO: Elsevier.

McKelvey, M. (2018). Finding meaning through Kristen Swanson’s caring behaviors: A

cornerstone of healing for nursing education. Creative Nursing, 24 (1), 6-11.
DOI:10.1891/1078-4535.24.1.6
Tonges, M., & Ray, J. (2011). Translating caring theory into practice: The carolina care model.

Journal of Nursing Administration, 41 (9), 374-381.

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Guidelines Rubric Comments Points
Earned

Select a specific Summary of the theory 10%

nursing philosophy,
conceptual model or Describe the benefits/relevant usefulness
theory discussed in of the theory. 5%
this course. Describe the limitations of the theory.
5%
Identify one nursing Briefly summarize the focus of the
journal article from article. 10%
the literature that Critique the application or testing of the
discusses the theory theory in the article. 10%
selected. Must use a
journal article that
was not already
assigned in this
course.
Relate theory to Describe a clinical practice issue in your
clinical practice. work or clinical education setting.
10%
Examine how the selected theory would
guide your actions and decisions in the
delivery of nursing care related to this
issue. 15%
Relate theory to Explain the significance/value of this
personal philosophy. theory to your own personal philosophy
of nursing. 10%
Discuss learning. Examine how this assignment
contributed (or not) to your
understanding of nursing theory. 5%
Spelling, grammar, punctuation, body is no longer than 5
pages 10%
APA format 10%

Final Grade

Theory Application Paper: Guidelines and Rubric

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Honor Code

I pledge to support the Honor System of Old Dominion University. I will refrain from any form

of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a

member of the academic community it is responsibility to turn in all suspected violators of the

Honor Code. I will report to a hearing if summoned.

Kevin Gross