This paper analyzes Swanson’s Theory of Caring and makes some comparison to Watson’s grand theory of caring and prove the relation of the theory in nursing according to the nurses’ beliefs and practices.
Caring has always been considered the basic concept in nursing since humans are recognized as social beings which means that they are bound to correlate with one another in their lives. Therefore, caring has become a universal phenomenon which has influenced the way human beings live relatively with one another and has made it an area which has interested nursing researchers who have studied and theorized it. Among the nursing researchers in the phenomenon of caring include the mid-range and grand theorists are Kristen Swanson and Jean Watson, in their Theory of Caring and Theory of Transpersonal caring respectively (Matsuoka, 2007). This paper analyzes Swanson’s Theory of Caring and makes some comparison to Watson’s grand theory of caring and prove the relation of the theory in nursing according to the nurses’ beliefs and practices
Swanson’s theory was founded in her interest to gain an in-depth understanding of the feeling of miscarriage in women, her experience, and studies in the field of nursing (Swanson, 2012). She defined caring as a nurturing form of relation to a treasured individual to whom a person is individually committed and responsible to them. Her theory surmises 5 caring processes. On the other hand, Watson perceives caring as science which should be the core tenet of nursing. She gives 4 considerations of caring (Matsuoka, 2007). The two theories are considered to be related as this essay determines.
- Caring as a process of knowing
- Endeavoring to comprehend occurrences since they have meaning in the other individual’s life shunning assumption (Matsuoka, 2007).
- Accessing the history of a person to care
- Seeking to establish a bond of emphatic and comprehension care
- Knowledge founded on observations, research and experience form care (Kalfoss & Owe, 2015).
- Caring a process of being with
- Being there for the other
- Stepping into the shoes of the other authentically and emphatically
- Provision of a physical, psychological, and emotive support
- Effectual communication
- A display of assertiveness, competence and advocacy (RCM, 2008).
- Caring as a process of doing for
- Acting as the other person would
- Provision of a comforting, anticipatory, and protective care (Jansson & Adolfsson, 2011).
- Caring as a process of enabling
- Facilitation of the passage of the other individual through plights
- Awareness of guidelines for care (Kalfoss & Owe, 2015).
- The process of maintenance of belief
- Fulfilling expectations of the other in real life
- Combination of all the other processes of caring
- Holding another person with high regards and believing in their capacity
- Hopeful attitude
- Support to attain, maintain, and regard experiences as vital for the other (RCM, 2008).
Watson’s theory is also related to Swanton’s as follows;
- Consideration of care as a manifestation of intents
- Appreciation of patterns
- Experiencing the infinite and invitation of creative advents (Matsuoka, 2007).
Nursing has drastically changed over the last one hundred years. It has grown because nurses care about the health and well-being of their patients. Throughout history, nurses have made an impact on the care that patients have received. Caring is the root of nursing. Jean Watson created a nursing theory to guide nursing in their caring for patients (RCM, 2008). Nursing is not just a set of skills, and caring is the basic component of nursing. In essence, Watson developed the theory of human caring in order to guide nursing to care for human beings. Caring has been the basis of nursing for generations (Smith et al., 2013). However, not everyone learns to care truly. Watson’s theory was created to guide nurses to developing a caring attitude. Watson’s theory places high regard on life and dignity. Nursing allows for growth and development of a person. Who a person is and who the person will become. The five principles structured in Swanson’s Theory of Care include being with, knowing, doing for, enabling, and maintaining belief (RCM, 2008). The theory is the most functional theory in the field of nursing; it elaborates and educates what is required of nurses.
The carative factors are concepts that satisfy human needs. The carative factors developed by Watson include: imparting faith-hope, cultivation of self-sensitiveness, establishing a help-trust relationship, enhancing expressed feelings, usage of problem solving methods in making decision, promotion of teaching-learning, and also enhance a supportive environment (Matsuoka, 2007). The first three of these caritas are the basis for Watson’s theory. The other seven are created from the first three. These caritas allow the nurse to treat the patient as a whole and to explore his or herself in the process. These guidelines allow nurses to first meet the basic needs of the patient, then to meet more advanced needs (Kalfoss & Owe, 2015). This allows the nurse to incorporate all aspect of life into caring for the patient.
Transpersonal caring occurs whenever a nurse sees a patient not like an object but as a human being. The nurse feels and shows concern towards the patient. Both a nurse and a patient search for implication for the illness and situation at hand (Jansson & Adolfsson, 2011). The aim of transpersonal care relationship focuses on preserving, improving and protecting an individual’s dignity, internal harmony, and humanity. The nurse is open to the needs of the patient’s feelings, thoughts, goals, environment, and beliefs (Kalfoss & Owe, 2015). The nurse sees that patient not as an object or a set of tasks that need to be completed. The nurse sees the patient as a human being who needs healing physically, mentally, and spiritually. The nurse and patient connect creating a moment that will affect the universe.
Swanson’s theory has focused on coaching nurses on how to handle themselves in different situations. In the health sector, it comprises of nurses, patients, and health. Therefore through the theory, nurses are provided with insight on how to deal with patients and their families while ensuring they feel cared and supported (Jansson & Adolfsson, 2011). The Swanson’s theory contains methods that not only helps the patients and their families through the recovery process but also guides the nurses with methods that will assist the family both emotionally and physically. When the five principles are integrated in the nursing practice, they fuel caregiver’s attitude and improve services provided to patients including their wellbeing.
The theory describes nurses as the natural caregivers. The five principles include knowing entailing how nurses strive to understand situations since they are of importance to the other individuals (Matsuoka, 2007). Doing for encourages nurses to reciprocate to the other, actions they would appreciate. Being with encourages empathy, demands communication and the listening ability. Enabling motivates the caregivers to support the ability of others to care for themselves and their close ones (Matsuoka, 2007). Maintaining belief states that nurses should have the capability to maintain faith that other individuals will transition and lead a valued life.
The theory has emphasized on both the clients and nurses importance in the health sector. It appreciates the value of not only the client but also the nurses. The theory discourages the idea of having assumptions while dealing with a patient. In the process of knowing, the nurse and patient find common ground that provides a high degree of harmony designing transpersonal caring relationship (Kalfoss & Owe, 2015). Transpersonal caring relationship values the significance of both the patient and nurse. Additionally, the theory elaborates caring as an action by combining nurses’ compassion and competence whose outcomes are the patients’ well-being.
The nurses being leaders of the patients’ health expect to affect their client lifestyle positively by ensuring their needs are satisfied and receive quality care. The nurses connect with patients through understanding their emotions (pain, sadness, depression) (Kalfoss & Owe, 2015). Through interacting and connecting with nurses, patients anticipate exceptional results. In the principal of doing for and being with, patients anticipate timely check-ups and nurses being close-by (Jansson & Adolfsson, 2011). The nurses can offer comfort, support, and comfort for the patients during the regular rounds. The hourly rounds enable nurses to observe and address patients concerns adequately.
Additionally, during enabling principle, nurses communicate with their patients with the intention of improving satisfaction. During the communication, patients are granted the opportunity of being active participants in caring for themselves (Smith et al., 2013). According to the theory, during hospitalization, nurses are required to spend at least three to five minutes with the patients talking to them about how they are coping and if possible, touching their hand or arms lightly for assurance, comfort, and support (RCM, 2008). Nurses are not expected to disregard patients’ opinions, calling, or suggestions. Patients and nurses should have frequent contact to certify they (nurses) are emotionally available. When nurses discover a patient has done a mistake, they are required to correct the issues without blaming the patient while initiating ways to rectify the error (Andersen & Spiers, 2016). Creating time for patients and actively caring for them conveys the availability and presence of nurses, providing patients with the sense of control of their surroundings.
Through the theory, a mutual responsibility is crafted, clients and nurses decide on the role to undertake in health matters. The patients and nurses work towards a common objective of ensuring a healthy community. The clients’ resources and capabilities are viewed as of great importance because they assist in understanding oneself and appreciating the importance of others (Kalfoss & Owe, 2015). Communication creates a stable community, and it is directed towards transitioning others’ life and protecting them.
My personal caring moment occurred recently. I am a nurse employed in a long-term acute care hospital. I take care of patients who continue to need specialized care and do not meet the requirements to stay in an acute care hospital, but require more than a nursing home or home care can provide. I recently took care of a patient who came to use with severe ischial and coccyx wounds. This patient had been a through much in her short life. She was in a motor vehicle accident ten years ago, suffering a pelvic crushing injury. The patient later had bilateral amputations to both legs at the hip. She has suffered from anxiety and depression since the accident. She has remained physically healthy since the recovery from her amputations. This is the first time she has developed a wound. She had been treating the wound at home until sepsis set in, and she had to be taken to the local emergency room. The patient had had a change in level of consciousness at that time.
I entered the room to provide my morning care of assessing the patient, collecting vital signs, and administering medications. Upon entering the room I noticed that the patient seemed withdrawn. She was looking down at her blankets, clutching them tightly in her hands, and would not make eye contact. She had few personal items about her, and the television was off. She did not speak unless spoken to. I asked her how her first night went and if she was having any pain. She gave short answers and did not make eye contact. I explained what I was there to do and asked if she needed anything before I started with my exam. She began to cry. I held her hand and asked what I could do. She stated she was scared and didn’t know if she would ever be able to go back home. I continued to hold her hand as she cried. I asked her why she felt she would not be able to go back home, and she explained how she had never had a wound like this and didn’t know how she would care for herself. She was concerned that she would not get a motorized wheelchair that she had ordered because she wasn’t home for them to deliver it. I explained that I was there to help her to get better and stronger. I also told her that I would talk to her case manager personally to see what we could do about her wheelchair. She seemed more at ease after our discussion. I explained what each of her medications were for and asked if she needed anything for pain. I changed her dressings and explained each step I was taking to do it properly. I then left the room and immediately called her case manager to discuss the wheelchair situation. I discussed the plan of care for her with her physician so that I could reinforce the information with my patient.
A short while later, I returned to my patients room with the information that I learned. She was impressed that I went through “all that trouble for her.” I stated that that was what I was here for, to care for her. I explained that I talked to her case manager, and she gave me a number to the wheelchair company and I called them personally to make arrangements for its delivery. I also explained in depth the plan the physician had for her and her care. I explained to her that she was only with us for a few weeks for antibiotics to combat the infection and to assist her in caring for her wounds. After I had given her the information, her face lit up, and she began to cry again. This time the tears were for happiness. She said that no one else would explain what was going on and that I went above and beyond her expectations. I told her I saw that she was hurting and scared, and I tried to do what I could to ease her mind. After that day, she requested me as her nurse. She did not want anyone else to care for her. It touched my heart that I could do so much for her and that she wanted me to continue to provide care for her. I felt at that moment that we reached a caring moment. We both set in motion a moment that had touched both of us and will continue to have an impact on our lives.
I learned that I do care deeply for my patients. I want to see them succeed and be at peace. I learned that by going the extra mile for a patient can bring comfort to them. I learned that simple things such as talking and holding a patient’s hand can make them feel important and loved. Humans are not uncaring people. They are not made of stone. They laugh, hurt, cry, and love. That is what make us the same. Hospitals are such sterile worlds that humanity is often lost. If I can bring even an ounce of that into my work, it can make a world of difference. I feel that my patient perceived my care in a positive way. She requested that I remained her nurse. She felt at ease talking with me about her fears and expectations. She trusted me to care for her and meet her needs. She trusted me enough to discuss aspects of her life. We discussed her depression and hardships she has had to face over the years. I developed an understanding of the life experiences that have made her who she is today. I am not sure what I could have done to enhance the caring moment. I wish that I could have spent more time with her. She is an amazing person who has overcome so much in her short life. It was an honor to know and care for her.
I used Watson’s human caring theory to create a caring moment. I treated my patient as a person who deserved to be valued and loved. I held her hand and listened to what she felt was important. I showed empathy and compassion. I attended not only to her health needs but the needs that put her mind at ease. I created an environment of trust and compassion. I treated the patient as a whole. I cared for her body by administering proper medication and attending to her wounds. I cared for her mind by discussing with her depression and easing her mind of worrying factors. I cared for her spirit by showing her that I cared and that she was valued.
The carative factors that were utilized in this caring moment are: imparting faith-hope, cultivation of self-sensitiveness, establishing a help-trust relationship, enhancing expressed feelings, usage of problem solving methods in making decision, promotion of teaching-learning, and also enhance a supportive environment (Matsuoka, 2007). I feel that I did meet other requirements of carative factors, however, these standout to me. In forming a humanistic-altruistic value system, I regarded my patient’s needs. I did not look at the simple numbers like her vital signs but looked at the person. I saw that she was withdrawn and scared. I saw that she needed someone to see her not just another body in a room. She is a human being with thoughts and feelings of her own. I instilled faith-hope in my patient by going above and beyond nursing skills. I listened to issues that were bothering her and did my best to find information for her. I relayed this information that gave her hope that all would be well. I cultivated sensitivity to my patient’s needs and perceptions that were important to her. I held her hand as she cried. I listened to her fears and desires, without making judgment. I shared in her stories and life experiences. I developed a helping-trust relationship. My patient requested my care. She trusted that I could provide the care that she needed. My patient trusted me enough to allow me into her life and to share her thoughts and feelings. I developed this by listening and acting on what I perceived as important to her. My patient saw my effort and love. I created an environment where she could express herself.
To sum up, Watson’s theory of human caring guides nursing to care not only for the physical aspect of patient maladies but to care for the person as a whole. Using Watson’s theory allows nurses to take nursing to another level and truly connecting with the patient instead of seeing the patient as an object. Caring and love have been the foundation of nursing since nursing began and will continue to shape nursing into the future. The Swanson’s Theory of Care denotes nurses as the leaders and natural caregivers in health matters. Nurses are equipped to create a connection with patients providing comfort, care, and support. Nurses provide empathy and understanding in situations while ascertaining their availability when they are required. Moreover, the theory underpins that patients and nurses are partners in the recovery process.