Example Essay On Nursing Theory

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Swanson’s Nursing Theory Essay Example

Importance of Nursing Theory

Nursing philosophy was largely overlooked after Florence Nightingale initially defined nursing in 1860 with her authoring of Notes on Nursing: What it is, What it is Not (Zborowsky, 2014). (Zborowsky, 2014). Nursing theory and models expanded dramatically starting in the 1950s (McCrae, 2012). (McCrae, 2012).

Early nurse theorists recognized the need to separate the profession from medicine and the traditional “handmaiden status”; the method to doing this is via theory by creating nursing as a “thinking profession (McCrae, 2012). (McCrae, 2012). Continuing to build nursing theory and define the nursing profession is what will safeguard and define nursing as a profession rather than a discipline.

The objective of this study is to analyze the relevance of nursing theory for the nursing profession, to explain Kristen Swanson’s Theory of Caring, how this theory fits all four acknowledged connections of the nursing metaparadigm and its application to the work of the nurse practitioner.

Example Essay On Swanson’s Nursing Theory


Importance of Nursing Theory for the Nursing Profession

Nursing theory is fundamental to the practice of nursing on many levels. Theories serve to define the discipline and play a vital part in research and idea development helping to uncover additional elements of nursing for study (Im and Chung, 2012). (Im and Chung, 2012). Generating theory consolidates the nursing profession and ensures new roles are established and built on a “critically assessed scientific base” (Power, 2016, p.42).

Nursing is never static; responsibilities are growing offering care traditionally done by physicians. Nursing theory guarantees a direct relationship to research making application at the practice level more feasible as well as providing the evidence foundation required for future theoretical growth (Warelow, 2013).

Theory is vital in advancing the profession of nursing and “protecting and retaining the emphasis and clarity of nursing’s specific contribution to health care” (Wilson et al. 2015, p.146). In today’s interdisciplinary context of healthcare, the nursing profession continues to try to establish and retain its professional limits as well as grow its body of knowledge (Warelow, 2013).

The study of nursing theory facilitates the application of theory to daily practise and patient/client relationships. Through the study of nursing theory, graduate students reflect upon experiences from their practice and how the application of theory benefited the treatment of patients or how the lack of understanding, in theory, inhibited the person-nurse interaction. According to Hatlevik (2011), the instruction of nursing students in applying reflective skills directly promotes the coherence of theoretical knowledge to practice.

Swanson’s Theory of Caring

Kristen Swanson initially established the Theory of Caring with the introduction of Five Caring Processes in 1991 with the published Empirical Development of a Middle Range Theory of Caring, then developed and restructured the caring processes in 1993 and 1998 (Wands, 2011; Amendolair,2012) (Wands, 2011; Amendolair,2012). The five caring processes highlighted include keeping believing, knowing, being with, acting for, and enabling.

The process of retaining belief is a “fundamental belief in humans and their potential to make it through events and changes and confront a future with meaning” (Wands, 2011 p.182) (Wands, 2011 p.182). Nurses who keep believing in their patients assist patients to establish trust in themselves that they can get through whatsoever scenario, by bringing hope to them. “Knowledge is the anchor that binds nursing/nursing principles to the lived reality of people served (Swanson, 1991, p.164)” (Amendolair, 2012, p.15). Knowing entails studying and seeking to comprehend events and their effects on people (Wands, 2011).

Being with the patient, providing time to the patient, and offering presence is Swanson’s third care phase. Giving of one’s time and self sends a message to the patient that they are important (Wands, 2011). The fourth step of acting for others is to preserve life and dignity via loving deeds (Amendolair, 2012). Doing for is guessing what a person would do if they had the ability to do it for themselves.

Finally, Swanson defines enabling as “facilitating the ability of the other to develop, heal, and/or practice self-care (p.164).” (Wands, 2011, p.184). Enabling patients gives them the skills and confidence they need to care for and provide for themselves. Swanson’s Theory of Caring, as well as studies on caring, is based on these processes (Wands, 2011).

The Nursing Metaparadigm and the Theory of Caring

Fawcett presented the widely recognized metaparadigm notions of person, nurse, environment, and health (Alimohammadi, Taleghani, Mohammadi & Akbarian, 2014). Swanson’s theory of caring includes five phases that address all aspects of the metaparadigm: person and health, person and environment, health and nurse, and person, environment, and health. Maintaining believing and being with satisfies the person-environment-health metaparadigm, knowing is the person-environment, health-nurse is readily tied to doing for, and enabling meets Fawcett’s nursing metaparadigm’s person-health notion.

In the person-environment-health relationship, maintaining belief and being with is a crucial step. Maintaining faith in the individual gives encouragement and hope that he or she can and will get out of their present circumstance (Amendolair, 2012). Being with is maybe the most misunderstood aspect of nursing, yet it is also the most crucial (Wands, 2011).

Spending one-on-one time with the patient while being emotionally present establishes a trusting connection that encourages patient and nurse reception and information sharing (Wands, 2011). By recognizing the individual, developing trust, offering hope, and being emotionally present, these principles contribute to the metaparadigm, enhancing the nurse’s relationship with the person-health-environment.

These two processes are holistic in nature because they sustain belief and being while acknowledging the individual as a whole, including all aspects of their health and surroundings. This interaction is always in motion; one influences the other, and so on.

Knowing means understanding and valuing the patient’s lived experiences. Swanson discusses types of knowing that relate to the person-environment in 1998. Avoiding assumptions, fully examining, finding clues, focusing on the individual receiving care, and engaging personhood are the subcategories (Wands, 2011). Avoiding assumptions requires the nurse to have a thorough grasp of themselves and their own ideas so that they may “know the other from a position of meaning and purposeful intention” rather than making assumptions about them (Wands, 2011).

The nurse must examine the situation carefully and look for signs that will assist her to grasp the person-environment interaction. What is the patient’s appearance? Is the body language consistent with the spoken cues? These are only a few examples that might help the nurse better comprehend the patient and their life events by looking into the person-environment metaparadigm. The nurse will be better able to empower the patient to change the environment to fulfil their immediate health and wellness requirements as a result of this inquiry and knowledge.

Nurses are most familiar with the process of doing for (Wands, 2011). In the process of doing for, the health and nursing metaparadigm is applicable. This is one of nursing’s responsibilities: caring for patients who are unable to care for themselves, resulting in improved health. Doing for involves more than technical abilities; it also necessitates experience and scientific evidence-based knowledge to back up judgments and actions. “Care,” as defined by Swanson (1991, p.164), is “comforting, anticipatory, protective of the other’s needs, and conducted effectively and professionally” (Wands, 2011).

Swanson defines enabling as “empowering the patient to manage with their condition by educating, explaining, supporting, and offering feedback about the illness, allowing them to make informed choices about their treatment” (Amendolair, 2012). The individual is then given information about resources and given the authority to make the required adjustments to enhance their health and promote wellbeing. Empowerment via enabling helps people discover purpose and courage to carry on with their choices, whatever they are.

Swanson’s idea of caring supports caring as the core phenomenon of nursing (Ahern, Corless, Davis & Kwong, 2011). Theory might seem abstract and difficult to put into practice, resulting in a mismatch between caring science theory and caring practice for practitioners (Ranheim, Karner & Bertero, 2012). Swanson’s caring theory, being a middle-range theory, lends itself to straightforward adoption and application in nurse practitioner-patient interactions.

Example Essay On Swanson’s Nursing Theory


Swanson’s Theory of Caring Applied to Nurse Practitioners

Being a good nurse practitioner requires an understanding of care as the primary phenomenon of nursing. A nurse practitioner (NP) provides patient-centred care by using Swanson’s five caring processes. Patient-centred care allows and empowers patients to make the required choices and activities to improve their health.

Maintaining belief, knowing, being with, acting for, and enabling the patient-NP connection is a vital aspect of establishing a trustworthy, respectful relationship. The readiness of NPs to interact with patients and listen carefully (knowing and being with) to construct treatment regimens (doing for) while giving instruction and health promotion (enabling), all while preserving faith in the patient, characterizes the NP-patient relationship.

Swanson’s five phases of care have been employed in my own professional experience. In 2004, I was the nurse caring for a new mother who had been diagnosed with HELLP, which resulted in fetal death. After the delivery of her stillborn baby, she was brought to our ICU. I was assigned to the mother since I had just gone through something similar. I was able to connect with her in ways that others couldn’t. I was able to give her and her family hope by keeping faith in her ability to recover. Knowing her through knowing about her worries, her hopes for the baby, and her goals for the future.

Holding her hand or hugging her and sobbing with her was all it took to be with her. Doing for her what she couldn’t due to IV lines and weakness at the moment. Providing her with tools to cope with child loss and sorrow, as well as a notebook in which she may vent her anger, anguish, and helplessness. Through it all, I was able to provide her with skills to assist her to make sense of what had occurred, rather than providing closure since I feel there is none when a child is lost.

Ahern et al. (2011) looked after a 38-year-old Caribbean lady who had had invasive and diagnostic treatments for neoplasia. She was diagnosed with high-grade dysplasia when depressed and grieving the death of her parents. She came to the clinic after skipping two sessions and shared her anxieties and worries about the diagnosis and the procedure’s agony. The operation was thoroughly described to her in order to allay her anxieties.

She was unable to complete the treatment, unfortunately. The authors speculate that if a holistic advanced nursing practice paradigm had been used, the clinical result would have been different. Swanson’s caring theory and its five care processes, which include preserving believing, knowing, being with, acting for, and enabling, were included in the clinic’s holistic approach for their advanced practice nurse model.


Theory might seem abstract and difficult to apply in practical situations. The graduate nurse provides care to patients by having a thorough grasp of theory and its consequences in patient care. According to McCrae (2012), a respectable profession requires the capacity to produce and apply theory.

Swanson’s middle-range caring hypothesis is evidence-based, based on interactions between patients and professional nurses. Her idea lends itself to simple implementation in today’s evidence-based health care system since it provides actual data. “Developing nursing knowledge and establishing nursing as a professional career requires theory” (Power,2016, p.45).

By retaining believing, knowing, being with, acting for, and enabling, nurse practitioners practice caring philosophy, resulting in a comprehensive approach to patient-centred care. The author recognizes that all five processes of Swanson’s theory of care and the nursing metaparadigm are connected to each of the four metaparadigms after contemplation and analysis. All five processes, like the nursing metaparadigm, build on one other; none are independent of the others.

Swanson's Nursing Theory
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Example Essay On Swanson’s Nursing Theory


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Frequently Asked Questions (FAQs)

 Nursing Theory
Example Essay On Swanson’s Nursing Theory: Kristen Swanson’s Nursing Theory

1. What are the assumptions of Swanson’s Theory of Caring?

Swanson’s (1991) middle range Theory of Caring was built on the Caring Model, which argued that five essential activities (knowing, being with, doing for, enabling, and preserving belief) provide significance to behaviors characterized as caring.

2. Is Swanson’s Theory of Caring a grand theory?

It is at the heart and soul of nursing. Watson’s late 1970s (1975-1979) human caring theory is a broad theory that encompasses eleven carative variables. Swanson’s caring theory, a middle-range theory that encompasses five caring processes, was first suggested in 1991.

3. What caring process from Swanson’s Theory of Caring strives to understand an event as it has meaning in the life of the other?

Nursing theory is divided into three stages, starting with abstract concepts and progressing to more particular concepts with each level. Grand nursing theories, middle-range nursing theories, and practice-level nursing theories are the three primary groups of nursing theories.

Additional content on nursing theory.


  • Ahern, R. L., Corless, I. B., Davis, S. M., & Kwong, J. J. (2011). Infusing Swanson’s Theory of caring into an advanced practise nursing model for an infectious diseases anal dysplasia clinic. The Journal Of The Association Of Nurses In AIDS Care: JANAC22(6), 478-488. doi:10.1016/j.jana.2011.06.010
  • Alimohammadi,N., Taleghani, F., Mohammadi,E., & Akbarian,R. (2014). The nursing metaparadigm concept of human being in Islamic thought. Nursing Inquiry 21(2), 121-129. doi:10.1111/nin.12040
  • Amendolair, D. (2012). Caring model: putting research into practice. International Journal for Human Caring 16(4), 14-21.
  • Im, E. & Chang, S.J. (2012). Current trends in nursing theories. Journal of Nursing Scholarship 44(2), 156-164. doi:10.1111/j.1547-5069.2012.01440.x
  • Hatlevik, I.K.R. (2011). The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of Advanced Nursing 68(4), 868-877. doi:10.1111/j.1365-2648.2011.05789.x
  • McCrae, N. (2012). Whither nursing models? The value of nursing theory in the context of evidence-based practise and multidisciplinary health care. Journal of Advanced Nursing 68(1), 222-229. doi:10.11111/j.1365-2648.2011.05821.x
  • Power, L. (2016). Nursing theory and the delivery of compassionate care. Nursing Standard 30(24), 41-46.
  • Ranheim, A., Karner, A. & Bertero, C. (2012). Caring theory and practice entering a simultaneous concept analysis. Nursing Forum 47(2), 78-90. doi:10.1111/j.1744-6198.2012.00263.x
  • Wands, L.M. (2011). Caring for veterans returning home from middle eastern wars. Nursing Science Quarterly 24(2), 180-186. doi:10.1177/0894318411399450
  • Warelow, P.J. (2013). Changing philosophies: a paradigmatic nursing shift from Nightingale. Australian Journal of Advanced Nursing 31(1), 36-45.
  • Wilson, R., Godfrey, C.M., Sears, K., Medves, J., Ross-White, A. & Lambert, N. (2015). Exploring conceptual and theoretical frameworks for nurse practitioner education: a scoping review protocol. JBI Database of Systemic Reviews and Implementation Reports13(10), 146-155. doi:10.11124/jbisrir-2015-2150
  • Zborowsky, T. (2014). The legacy of Florence Nightingale’s environmental theory: nursing research focusing on the impact of healthcare environments. Health Environments Research and Design Journal 7(4), 19-34.

Swanson's Nursing Theory

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