Kristen Swanson’s Theory Of Caring

About the Caring Theory

This theory states that caring proceeds in a sequence of five categories: knowing, being with, doing for, enabling, and maintaining belief. When applied to nursing practice, each of these five stages stimulates the caregiver’s attitude and improves the overall patient well-being. The theory aims at helping nursing personnel to deliver care that promotes dignity, respect, and empowerment.  This model was framed to ensure consistent caring behaviors which would, in turn, improve patient satisfaction. Definitions & Concepts:

• Caring: a nurturing way of relating to a valued other towards whom one feels a personal sense of commitment and responsibility. More specifically, caring is growth and health-producing (nurturing) occurs in relationships (relating) to the one cared-for (a valued other); individualized and intimate (personal), with a sense of commitment (passion), accountability and duty (responsibility). Together with this, nurturing is delivered as a set of interrelated processes that evolve from the nurse’s own convictions, knowledge, and interaction with a patient. The caring process: being with, doing for, enabling, and maintaining belief, moreover, are grounded in real nursing behaviors.
• Maintaining Belief: an orientation to caring begins with a fundamental belief in persons and their capacity to get through events and transitions and face their future with meaning. Importantly, this conviction is the base or foundation for the practice of nursing care. Besides, whatever health conditions the patient is facing, a nurse believes in her/his the capacity and power to accept or welcome upcoming days with meaning. Such an orientation intensifies his/her commitment to serve humanity in general, and each patient specifically. For this reason, Swanson describes maintaining belief as holding others in esteem and believing in their ability to achieve their goal. It involves accepting others in high regard and more importantly with a hope-filled attitude. Meanwhile, the nurse also assists them in recapturing a positive outlook on their experiences. Along with this, a humanistic view, harmonious balance, hope, love, compassion, and spiritual orientation, affix magnificence to the process of maintaining belief. The recognition of a person as a spiritual being who has faith in God – a supernatural being, a life force-with a dynamic quest for a transcendent relationship, is central to the concept of maintaining belief. This acknowledgment of the uniqueness and individual differences of patients help nurses to respect each and every one of them as the creation of God.
• Knowing: in knowing, one perceives events according to the meaning they have in the life of the other. It involves a thorough assessment of all the aspects of a patient’s condition and reality, engaging the self or person-hood of the nurse as well as the patient, in a caring style of approach. The important nursing behaviors for knowing are; a humanistic view of the other, nurturing, understanding of his/her situation, analysis, and interpretation, compassion, empathy, insight, academic cognition and imagination, assessment and communication skills, respect for individual differences and recognition of the other as a significant being. When the process knowing occurs there develops a bond of empathy and understanding between the care provider and the care recipient. By being physically and mindfully present, in view of knowing one’s patients, a nurse displays attentiveness, commitment, deeper involvement and going beyond the routine. While emphasizing a respectful and non-judgmental attitude towards the uniqueness of persons, knowledge of clinical practice, well-developed skills in assessment, data gathering, clinical reporting, documentation, and communication – both verbal and non – verbal. A comprehensive initial assessment is very vital to knowing. They include the assessment of physical psycho-spiritual and existential needs, with careful attention to patients’ perceptions, beliefs, values, wishes and family traditions. The course of knowing also includes esteem for demographic differences such as age, gender, marital status, education, and social influences from cultural backgrounds, health care experiences, length of stay, environmental and economic resources.
• Being-with: being with, as well as being emotionally present conveys to patients the message that they and their experiences are significant to the nurse. Similarly, emotional presence is a technique by which the nurse shares the meanings, feelings and lived experience of the one-cared for. The nurse assures the patients of her readiness and willingness to be in their reality. it’s a side-by-side physical presence of clearly conveying one’s availability. Basically, the message is, “you are not alone, what happens to you matters to us and we are here for you”. Actually, being with, is giving time to the other for authentic presence, attentive listening, and reflective responses. Since being with is regarded as a personal relationship, emotional adaptability and progressive availability to patients in both joyful and painful experiences goes further than knowing. Consequently, the impact of being with is measured not only by interpersonal warmth and friendly interaction but also by proficient nursing practice. Therefore, nurses are to be interested in authentic presence as well as standard nursing practice. Moreover, sensitive and kind-hearted nursing caregivers through interpersonal compassion place themselves into the shoes of patients to get into their thoughts and feelings. In a nutshell, the qualities of being with include mutual trust, availability, mutual linking, faithfulness, patience, and compliance. In being emotionally present, a health professional attempts to calm fears through their action of making themselves present to the patients. As said above, being with, encapsulates traits like showing interest, concern and commitment, compassion and empathy, sympathy, honesty, sincerity, and sensitivity. Additionally, other key factors in being with are protective and anticipative behaviour in avoiding harm and danger. Being with also consists of daring, being firm and doing even things that the patient does not like.
• Doing for: the real meaning of doing for is found in the definition of nursing: The unique function of a nurse is to assist the individual, sick of well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that s/he would perform unaided it s/he had the necessary strength, will, or knowledge and to do this in such a way as to help her/him gain independence as rapidly as possible. In other words, doing for refers to the activities in which a nurse engages with patients for what they would do for themselves if at all it were possible to them. Doing for as seen in the above definition, involves on the part of the nurse, measures that are performed on behalf of a patient’s long term welfare. They include comforting patients, anticipating their needs, performing procedures skilfully, protecting them from harm and ultimately preserving their human dignity. Furthermore, such an approach also encompasses professional competence, professional attitude, professional presentation, and caring capacities. The features of professional competence take into consideration nurses’ education and training, clinical knowledge, personal qualities, enduring adjustment, learning, skill mix, and self-confidence. Professional competency is seen in the capacity for detecting, preventing, listening, anticipating, educating, advocating, monitoring and practicing surveillance which can produce both positive and negative outcomes. Rendering reassurance, support, comfort, acceptance, legitimacy, confidence, healing, reduction of injury and suffering also comprise the various facets of professional competency. However, the formal signposts to professional competency such as technical skills regarding procedures, tests and medication administration, effective management symptoms, minimizing toxicity and relief of pain form the various facets of professional competence. The cornerstone of a nurse’s professional competency is comfort giving, which includes promptness in response, listening and giving time to speak, using touch, prayer eye contact, and verbal reassurance.
• Enabling: facilitating the other’s passage through life transitions and unfamiliar events. As in the case of doing for, enabling fosters an environment of self-healing. Such an enabling process enhances the patient’s capacity to heal, actualize oneself and in particular practice self-care. Moreover, self-care animated by intrinsic motivation, self-determination and competence are the results of empowering that means, a nurse by positively altering one’s self-concept, knowledge, attitude and skill–level empowers patients in order to facilitate healing. Even more, the external environment such as provisions of safety devices, removal of physical, social or emotional threats or obstacles also contributes to the healing process. Here, patients are partners, with knowledge and self-management skills. The cornerstone of enabling is appropriate communication with patients and their families. This involves regular and frequent contacts with patients, qualified by empathy and sensitivity to family dynamics, cultural and religious beliefs and previous experience, along with the nature of illness. Communication also embodies providing information, explanation about the given care, medications, tests, and the overall condition of the patient. Written materials, phone calls, emails, internet use, independent learning with software and counseling could also be encouraged as well in the process of enabling the patients. Nursing care, ultimately involve enabling patients to carry out self care. The process of enabling entails training, informing, illuminating, supporting during painful experiences, guiding in issues through helping to generate alternatives, offering advice and authenticating patient reality. With regards to enabling, the objective is a patient’s enduring well-being.