1. Mount Auburn Hospital Adopts Kristen Swanson's Caring Theory
Kristen Swanson, RN, Ph.D, FAAN

2. 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

3. 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

4. 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 setting * Can incorporate with other nursing initiatives

5. Swanson’s Caring Processes

6. Swanson’s Key Definitions
Nursing:
Informed caring
for the
well-being of others
Person:
Unique dynamic beings with thoughts, feelings
and behaviors
Health:
A complex process of establishing new meanings restoring integration and emerging
into a sense of
renewed wholeness
Environment :
Any context that
influences or is influenced
by the patient.
Defined situationally

7. 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

8. 5 Caring Processes

9. Striving to understand an event as it has meaning in the
Knowing:
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
Feeling
Understood

10. Being with: Feeling Valued How do we accomplish 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
Feeling
Valued

11. Doing for others as they would do for themselves if it were at all
possible
How do we accomplish DOING FOR:
Doing for but doing no more than that
Anticipating others needs
Performing competently and skillfully
Preserving dignity
Feeling Safe
and
Comforted

12. Enabling: Feeling Capable How do we accomplish ENABLING:
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 themselves
Feeling
Capable

13. Maintaining Belief: Feeling Hopeful
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
Feeling
Hopeful

14. Using the Caring Theory
to mentor
our new nurses

15. Knowing Ways to demonstrate KNOWING:
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

16. Being with Ways to demonstrate 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

17. Doing For Ways to demonstrate 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 confidentiality

18. Serve as a developer, educator, and trainer of new staff
Enabling
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

19. Maintaining a positive attitude for long term success
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 encouragement
Creating and regularly communicating a vision for success

20. Using the Caring Theory
to provide
Patient Education

21. Knowing How to demonstrate KNOWING with patient education:
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

22. Being with How to demonstrate BEING WITH for patient education
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

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

24. Enabling 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
Giving patients the tools to promote self care

25. Maintaining Belief How to demonstrate 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

26. Using the Caring
Theory to Provide
Pain Management

27. Knowing 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 pain

28. 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

29. 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 themselves

30. Enabling How to demonstrate enabling with pain management
Explaining pain progression
Accepting the patient’s pain as described by the patient
Generating ideas or thinking through alternatives to manage pain
Teaching how to take care of their pain.
(take medication before pain escalates, coping strategies)

31. Maintaining Belief How to demonstrate Maintaining Belief with
pain management
Being optimistic about being able to make them comfortable
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

32. Applying the
Theory of Caring
to Practice