You are on page 1of 32


Kristen Swanson, RN, Ph.D, FAAN

Today’s Goals
• Understand why the Department of
Nursing is adopting a Nursing Theorist

• Learn about Swanson’s Caring Process

• Discuss how Swanson’s Caring

Process can be applied to Practice
Purpose of a Nursing Theory
• Nursing Theory is a body of wisdom that is used
to support nursing practice.

• Nursing theory comes from experiential learning,

nursing research and non-nursing sources.

• It can provide a framework for practice.

For example - what to:
• ask
• observe
• focus on
• think about
Why Swanson ?
• 4 Theorist were researched by the CNS group and presented to
Nursing Leadership Council

• 2 Theorists (Watson and Swanson) were investigated further

since both had a caring focus

• Reasons Swanson was chosen:

* Definable
* In line with the hospital’s mission and goals
* Supports hospital’s patient experience initiatives
* Applicable to any nurse-patient relationship in any clinical
* Can incorporate with other nursing initiatives
Swanson’s Caring Processes
Swanson’s Key Definitions
Informed caring
for the
well-being of others Health:
Person: A complex process
Unique dynamic of establishing new
beings with thoughts, meanings restoring
integration and emerging
feelings into a sense of
and behaviors Environment : renewed wholeness
Any context that
influences or is influenced
by the patient.
What is Caring ?
Caring is the nurturing way of relating to a
valued other. This “valued other” is one whom you
feel a personal sense of commitment and responsibility
5 Caring Processes
Striving to understand an event as it has meaning in the
life of the other

How to accomplish KNOWING:

• Avoid assumptions
• Assessing thoroughly
• Being observant as to what is said
and not said
• Asking probing questions
• Seeking cues from the patient
• Being engaged with the patient
Being with:
Being emotionally present to the other

How do we accomplish BEING WITH:

• Being there when needed

• Conveying availability

• Sharing feelings

• Not burdening the patient with YOUR

feelings or experiences
Doing For:
Doing for others as they would do for themselves if it were at all

How do we accomplish DOING FOR:

• Doing for but doing no more than that

• Anticipating others needs

• Performing competently and skillfully

• Preserving dignity
Facilitating the other’s passage through events or transitions
by providing support and validation

How do we accomplish ENABLING:

• Informing and explaining

• Generating alternatives

• Validate and give feedback on progress

• Empowering others to care for

Maintaining Belief:
Sustaining faith in the other’s capacity to come through
events or transitions and face a future with meaning
How do we accomplish MAINTAINING BELIEF:

• Sustaining faith

• Hold patients in esteem

• Be hopeful but realistic

• Offer optimism

• Helping one find meaning by creating memories

• Recognizing the sacredness of someone’s experience

Striving to understand talents and skills and assessing their past
and present performance

Ways to demonstrate KNOWING:

• Getting to know their past experience and skill set

• Listening and seeking first to understand

• Staying open and suspending judgement

• Observing actions and asking open ended questions

• Investigating opportunities for learning

• Providing feedback
Being with
Demonstrates availability and conveying that a person’s
experience matters. Diversity is honored and promoted
Ways to demonstrate BEING WITH:

• Staying focused on the new person

• Acting with thought, not reacting

• Conveying emotions and expressing empathy

• Using words and gestures that suggest understanding

• Sharing feelings of where they are in their career

• Sharing feelings after a difficult situation

Doing For
Doing for new nurse as they learn how to do for themselves.
Providing a helping hand while preserving the dignity
of them as a nurse

Ways to demonstrate DOING FOR:

• Providing resources

• Responding to emergencies

• Anticipating when they need further support

• Providing privacy when giving feedback and maintaining

Serve as a developer, educator, and trainer of new staff
Encourage autonomy.

Ways to demonstrate ENABLING:

• Provide information proactively and consistently

• Teach skills and strategies to manage an assignment

• Developing learning guides and checklists

• Promoting teamwork and shared problem solving

• Validate progress through feedback

Maintaining Belief
Maintaining a positive attitude for long term success
as a Mount Auburn nurse

Ways to demonstrate Maintaining Belief:

• Building upon the strengths of the individual and showing

faith in their ability to perform

• Acting with honesty, respect, and regard for each other

• Respecting and valuing new employee’s worth and offering


• Creating and regularly communicating a vision for success

Striving to understand our patients. What is their literacy level,
language, culture, and age. Be sensitive to their disabilities
and the emotions this hospital encounter may be causing

How to demonstrate KNOWING with patient education:

• Identify any learning barriers or disabilities

• Who are they? What is their educational level, age, and

what language is spoken and read at home

• What are their learning preferences? Reading, listening,

video, return demonstration
Being with
Demonstrate your availability and desire for them to ask ?s
Tailor education for this patient as an individual

How to demonstrate BEING WITH for patient education

• Create a teaching environment that is safe, and responsive

to the patient’s unique needs: (ie.) Privacy, interpreters

• Spend time explaining things to the patient. Convey your

desire to make sure they understand

• Ask patients to repeat back what they learned to validate

their understanding
Doing For
Some education may need to be demonstrated and role modeled
before a patient can take the next step of returning the
How to demonstrate DOING FOR for patient education

• Explaining to patients what we are doing for them while they are
in the hospital and identifying when they are capable of
providing that care themselves

• Skill demonstration
Giving patients the tools to promote self care

How to demonstrate ENABLING:

• Confirming understanding by asking questions

• Offer patients resources to learn more about what they need

to learn

• Evaluate the patients ability to do for themselves.

Can they take their medications properly
Can they change their dressing
Do they know what to look for when they go home
Maintaining Belief
Being reassuring and hopeful that the patient will be able to
acquire the knowledge and skills needed to manage the
change in their health

How to demonstrate MAINTAINING BELIEF:

• Be the cheerleader

• Point out the patient’s progress

• Investigate alternatives to manage the patient care needs

when needed to promote a safe transition from the hospital

How to demonstrate KNOWING with pain management

• Thoroughly assess the type and level of pain

• Don’t make assumptions about the patient’s pain

• What does this pain mean to the patient

• Seek physiological cues to pain

• Be aware of cultural differences in the demonstration of

Being with
How to demonstrate Being with for pain management

• Convey availability

• Taking the time to listen to how their

pain is being managed

• Make sure they know you are there

for them to address their pain needs
Doing for
How to demonstrate Doing for with pain management

• Anticipate their pain needs to help them

help themselves

• Recognizing the patients pain level

and identifying what they need
help with

• Optimizing their environment to

maximize what they can do for
How to demonstrate enabling with pain management

• Explaining pain progression

• Accepting the patient’s pain as described by the
• Generating ideas or thinking through
alternatives to manage pain
• Teaching how to take care of their pain.
(take medication before pain escalates, coping
Maintaining Belief
How to demonstrate Maintaining Belief with
pain management

• Being optimistic about being able to make them


• Maintaining a hopeful attitude that

they will get through this painful event

• Helping patients through this painful

transition in their life

• Helping them find some meaning for

this experience