Swanson’s Theory of Caring in Nursing


Nursing theory aims at providing the support of practice and generating the knowledge of nursing. A theory is an organized framework of concepts and practices designed to guide the practice of nursing. It is essential as it helps realize what people know and should know. In addition, a theory assists in distinguishing a basis for practice (Kubiak & Sandburg, 2011). A clearly defined theory body in nursing ensures improved patient care, enhanced communication between nurses, improved status of nurses, and proper assistance in nursing education and research. Hence, nursing theory is essential as it helps managers, patients, and different health care professional identify the nurses’ contribution to the healthcare service.

Caring is the core of nursing; however, it cannot be measured. Therefore, nursing theory is vital for analyzing and explaining the work of nurses. It provides nurses with identity and makes people recognize what nurses do and evaluate their contribution to the healthcare industry. Finally, it helps nurses understand their purpose and role (Colley, 2003, p. 34).

Swanson’s Theory of Caring is a middle range theory that was empirically developed on the basis of several phenomenological studies. The theory has been adopted by numerous health care facilities due to its guidance possibilities to the nursing services (Ray, 2011). A middle range theory is narrow in scope and serves as a link between the practice and other theories. It represents abstraction concepts and enhances further research on the basis of theories and strategies of a nursing practice.

Thus, nursing theory is important for both nursing and practice due to its functions and scope. Swanson’s Theory of Caring presupposes the use of caring as a nurturing way of relationship with a person toward whom another one feels commitment, support, and responsibility. Caring lies in the core of the nursing phenomenon.


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Nursing Theory, Relevance to Practice, and its Influences

It is essential for nurses to study nursing theory as it provides proper knowledge, guides, educates, enhances power and awareness, as well as provides autonomy in terms of profession (Ingram, 1991, p. 351). In addition, nursing theory ensures a good basis for the professional practice in the health care industry and assists in developing new analytical skills thus enabling professionals act in accordance with defined standards and regulations.

There is a close relation between nursing theory and nursing practice. Nursing theory provides the basis for the nursing practice, guides intervention and evaluation of nursing care, helps explain and predict nursing experiences, as well as helps measure the nursing care quality. Along with that, it ensures the collection of reliable data concerning the client’s health status, decision making process within a proper setting, and its effective implementation. Therefore, the nature of nursing theory and nursing practice raises questions, which are generated within the philosophical nursing discourse.

Nursing models and their use in nursing also raise confusion. The problem is that the words theory and model are often treated as interchangeable ones. However, in nursing, models are created by the theory authors, with the aim of showing their theoretical beliefs. According to Johnson and Webber (2005), a model should capture central themes and theoretical relations in a way to help guide nurses in their practice. At the same time, Amendolair (2011) stated that a model is a demonstration of the link between theory and practice. Hence, nursing models are useful as they assist in the successful application of nursing theories into nursing practice. Finally, they provide a general idea of the thinking process indicating how a nursing theory may be effectively introduced into nursing practice (Colley, 2003, p. 34). Thus, the primary advantages of having and implementing a clearly defined body of theory in the nursing practice is improved communication between nurses and health care professionals, improved patient care, enhanced nursing status, and guidance for further research.

Kristen Swanson’s Theory of Caring

In the modern clinical settings, most nurses struggle to manage the expectation pressures of their professional roles. Unfortunately, it is easy to lose sight of the true nursing role.  According to Amendolair (2011), caring is the basis of nursing as it defines the nurse’s professional identity. With shortened hospital stays, overwhelming workload demands, frequent disruptions in workflow, and increased acuity level, nurses rarely have the luxury of forming a “deep knowledge of each patient through continuous, close and long lasting contact” (Kubiak & Sandburg, 2011, p. 653). In most cases, nurses are busy as they have to keep their patients physically safe, avoid adverse events, etc. Nurses must define what caring means to them and evaluate ways of incorporating caring into their practice.

Caring is subjective, and there are many interpretations of this term. The way a person demonstrates caring behaviors is influenced by the unique disposition qualities, values, personal history, and previous experiences with caring. The concept of caring is not easily measured in terms of outcomes. The Swanson’s Theory of Caring has appeared to help nurses deliver care that will promote the patient’s dignity, respect the patient, and empower the patient.

The Swanson’s Caring Model comprises five concepts or processes, such as knowing, doing for, being with, enabling, and belief maintenance. This model is a visual description of what caring means and how nurses exhibit caring in their everyday practice (Amendolair, 2011). For a nurse, belief maintenance means that the nurse believes in the patient’s ability to overcome their unique circumstances and having an optimistic view that their patients are capable of having meaningful future. Knowing in relation to the caring theory is the attempt to understand from the patient’s perspective what events have meaning to them and what the event signifies. Being with is simply the act of being emotionally present with another person. Doing for is the actions that the nurse performs when the patient is incapable of doing them for themselves. Finally, enabling indicates that nurses’ actions will empower the patient to resume their own self-care independently or learn new self-care skills so they will no longer be dependent on the nurse or others to provide care for them. The structure and main concepts of the Swanson’s Theory of Caring supports the definitions of caring and states that “caring is a nurturing way of relating to a valued other person, towards whom one feels a personal sense of commitment and responsibility” (Swanson, 1991, p. 165).

All conceptual theories and models in nursing represent a nursing metaparadigm including a person, environment, health, and nursing. A person or a patient is respected, assisted, and understood and is treated as “a fully functional integrated self” (Ryan, 2005, p. 27). Health means harmony with the body, soul, and mind. However, it is a perception that may vary among people. Therefore, nurses should consider health from the perspective of a concrete patient. A nurse is considered to be an inevitable part of the environment and a person who ensures the environment of caring and healing. Finally, nursing practice concentrated on assisting the patient to get a high harmony degree within the body, soul, and mind. According to the theory, harmony may be achieved through the development of caring and transpersonal relationships.

Nursing Leadership, Nursing Education, Nursing Informatics, and Health Policy

As many professions, nursing requires leadership. Leaders empower nurses, make changes in the health care delivery, manage working situations, make decisions, and ensure that nurses play their role in the change process. Nursing leadership implies understanding how to make visions, respect patients, and treat them with dignity. Achievement of a proper vision requires a paradigm shift in health care policies, nursing informatics, nursing education, philosophy, and priorities.

Caring is an essential constituent of the nursing care delivery. However, many nurse educators experience the issue of teaching scope and value of caring as a vital part of nursing practice. As the theory makes an emphasis on the transpersonal and interpersonal processes, it represents a clear and effective model in understanding the caring concept. Education still plays an important role in the development and improvement of care, nursing theory, and practice.

In the modern health systems, technology takes a high position in the work of nursing and nursing education. Therefore, there is a need to study the role of informatics in the educational programs. The theory indicates that nursing informatics is essential for the field of nursing and should be integrated automatically as it helps improve the outcomes of care quality. As a nurse, I have experienced situations, when nurses failed to properly access information from the health care system due to lack of informatics awareness. Poor awareness prevents nurses from providing accurate information and assisting the patient in solving his/her health-related problems. Therefore, in this situation, the nurse had to ask another nurse for a help.

Finally, the theory states that the norms and values of nursing should come into agreement with health policies. Effective nurses should clearly understand health policies. Swanson’s Theory of Caring represents the need in constant education of nurses, use of informatics in the sphere of nursing, and emphasizes the need in health policy.


Swanson’s Theory of Caring is considered to be the most universal and flexible middle-range nurse caring theory. It ensures improved practice and leads to new nursing approaches. In addition, it helps investigate factors that impact the nursing outcomes and the effectiveness of nursing practice. Carting is the basis of the theory and depends on the previous experience, values, qualities, and others. The theory represents a nursing metaparadigm including a person, environment, health, and nursing. Swanson identifies five processes of caring, which share the common features of caring relationships in nursing. It has been used within multiple clinical settings in the world. Swanson’s Theory of Caring has proven to be valuable, reliable, valid, and clinically relevant nursing practice, education, and research.

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