Swanson’s Theory of Caring: How Nurses Can Put It in Practice

Swanson’s theory of caring emphasizes the role of genuine connection in the nurse-patient relationship. Developed by Dr. Kristen M. Swanson, this theory outlines five fundamental processes — maintaining belief, knowing, being with, doing for, and enabling — that guide nurses in delivering holistic care. The goal of this theory is to empower, empathize with, and support patients on their healing journey.

Kristen Swanson’s caring model is now used in many hospitals and physician practices. Want to learn how to create this type of environment for your patients? Read on to learn the core concepts of Kristen Swanson’s theory of caring and how you can apply it in your practice today.

Kristen Swanson. Source: Washington State Nurses Association

Swanson’s Theory of Caring: 5 Process Stages

This middle-range nursing theory revolves around the fundamental importance of caring in nursing practice. Let’s take a look at the five key processes that are involved in the Swanson Theory of Caring. Examples provided illustrate the practical application and profound impact of this theory in nursing practice.

1. Maintaining Belief

Summary: Having faith in the patient’s capacity to get better, fostering hope and optimism.

Example: A nurse may apply this principle by emphasizing the patient’s resilience and inner strength, reinforcing the belief that they have the capacity to adapt and overcome the challenges associated with their condition.

2. Knowing

Summary: Actively listening to understand the patient’s experiences and needs.

Example: A nurse might apply this principle by taking the time to learn about a patient’s cultural background, personal preferences, and values. This helps the nurse address the patient’s unique needs and desires, allowing for more personalized and culturally sensitive care delivery.

3. Being With

Summary: Offering emotional support, comfort, and companionship by staying present with the patient.

Example: When a patient is undergoing a particularly painful or distressing medical procedure, a nurse could apply this principle by staying by the patient’s side throughout the process, offering a reassuring presence, holding the patient’s hand, and providing words of comfort.

4. Doing For

Summary: Providing physical care and assistance to meet the patient’s needs.

Example: A nurse could apply this principle by assisting a patient with activities of daily living, such as bathing, dressing, and grooming.

5. Enabling

Summary: Empowering the patient to engage in their own care and decision-making, promoting independence and autonomy.

Example: A nurse might apply this principle by educating a diabetic patient on how to monitor their blood sugar levels, administer insulin injections, and adhere to a healthy diet and exercise regimen.

Swanson Theory of Caring: Summary

In nursing practice, Swanson’s five stages of caring shape high-quality care. Believing in the patient’s ability to heal is crucial, along with listening to what they need, and helping them meet those needs. Yet, the ultimate goal is for patients to regain the capacity to care for themselves, so empowering them to take charge of their needs is essential.

Who Is Kristen Swanson? The Woman Behind the Theory

Who’s the famous nurse behind the theory? Dr. Kristen Swanson earned her nursing degree from the University of Rhode Island in 1975 and her master’s degree in nursing in 1978 from the University of Pennsylvania. Initially, her research and practice focused primarily on pregnancy issues, such as miscarriage, as she created the framework to help her patients heal through this traumatic event.

She later obtained her PhD in Nursing from the University of Colorado and has held various academic positions throughout her career. In addition to her work on caring theory, Swanson pursued academic interest in the science of grief and loss, palliative care, and nursing education. Her contributions have been integrated into obstetric education models and physician practices nationwide.

Additionally, she has published many articles and books, and has given a range of lectures since the 1980s. To this day, her practices influence nursing care, obstetric education, and healthcare practices nationwide.

The Impact of Swanson’s Theory of Caring Impact

Swanson’s theory changed the trajectory of nursing and has impacted other scholars across the world, serving as a catalyst for significant advancements in the field. Here are two examples:

• The Carolina Care Model, built on Swanson’s theory, made a big difference for patients at University of North Carolina (UNC) hospitals. After 6 years of using the modeltheory, patient satisfaction rose, as they reported noticeable improvements in their privacy, emotional support, personal needs, and pain control.
• Wang and Hsu used Swanson’s theory to help a lung cancer patient with spiritual distress. Applying the theory elevated care standards and efficiency in the facility, and helped to provide effective spiritual care for terminally ill patients.

Theory of Caring: Frequently Asked Questions

What is the concept of “knowing” in Swanson’s theory?

There are five steps in the process outlined in Swanson’s theory of caring. Knowing is all about the deep understanding you develop about your patients, including their medical history, unique perspectives, preferences, and needs.

For example, during a prenatal visit, a nurse midwife can practice “knowing” by asking an expectant mother about her previous childbirth experiences, her cultural beliefs surrounding childbirth, and her preferences for labor and delivery.

What is the concept of “doing for” in Swanson’s theory?

In Swanson’s Theory of Care, “doing for” refers to the actions and tasks that nurses take to meet the needs of their patients. It involves providing physical care, assistance, and support to address the patient’s immediate needs. For example, a postoperative nurse can practice this principle by assisting a patient with activities of daily living, such as bathing, dressing, and mobility, to promote their comfort and recovery.

What role do soft skills play in Swanson’s theory?

In this theory, soft skills such as empathy, active listening, communication, and compassion, play a critical role in fostering therapeutic relationships between nurses and patients. These skills enable nurses to understand and address the holistic needs of patients, and provide care that’s not only clinically effective but also emotionally supportive and patient-centered.

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