Running head: THEORY APPLICATION PAPER 1

Theory Application Paper

Rebecca Eimer

Old Dominion University

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Theory Application Paper

The concept of caring has been the core of the nursing profession since nursing

concepts were introduced by Florence Nightingale. It wasnt until Kristen Swanson research on

miscarriages, and exploring caregivers in neonatal intensive care units (NICU), that the research

of caring was developed. The Theory of Caring was then created, and the model proposed five

basic processes that consist of knowing, being with, doing for, enabling, and maintaining belief,

all in which gave meaning to the act of caring (Alligood, 2014, p.690). Caring is taking the

responsibility and commit commitment to nurture others, knowing is about avoiding assumptions

and understanding a life event of another, being with is to be emotionally open to anothers

reality, enabling helps guide and support a persons transition in life, and maintaining belief

involves believing in others. Swanson also led to an in-depth assumption of the theory, and

proposed that caring can also be categorized into four concepts including, person, nursing,

health, and environment. These four concepts enhanced on how caring affects the nurse-patient

relationship. According to Alligood, the Theory of Caring offers a clear explanation of what it

means for nurses to practice caring and helps to understand that good nursing is caring for

patients biopsychosocially as well as spiritually (Alligood, 2014, p. 693).

Benefits

The theory impacts the nursing professions caring practice in the clinical setting. The

theory offers a framework for enhancing contemporary nursing practice, education, and research

while bringing the discipline to its traditional values and caring-healing roots (Alligood, 2014,

p.696). Nurses are able to focus on the whole person concept and help build nurse-patient

relationships in various clinical settings. Furthermore, patient outcomes can improve and a

positive environment well be created if the theory is used. According to Kalfoss and Owen, the
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theory has been adopted by facilities as their own theory of care, it has been successfully applied

across a wide spectrum of nursing care, and overall can inform practice that lead to near practice

approaches as well as investigable factors that influence outcomes that are desired in nursing

practice (Kalfoss & Owen, 2015, p.983).

Limitation

Depending on a patients cultural background, the caring concepts can show or verbalize

difference types of feelings towards a specific culture. Some nurses might need to adjust the

way they practice for a specific culture in order to make them feel comfortable and not threated.

Furthermore, compassion fatigue can also be a limitation to Swansons theory because of the

negative effects that contribute to nurse caring. According Branch and Klinenburg, although

caring for others can be rewarding, there is also a toll on the healthcare worker from repeated

exposure to patients' pain and suffering (Branch & Klinenburg, 2015, p.161). This specific

limitation can cause poor quality of care and can increase accidents in the clinical setting as well

as increased medical errors. The correlation between compassion fatigue and caring can

indirectly affect nurses and led to stress, or nurse burnout. Additionally, empathic caregivers

indirectly experience the trauma of their patients, and their efforts to empathize and show

compassion often lead to inadequate self-care behaviors and increased self-sacrifice (Branch &

Klinenburg, 2015, p.161). Overall, the Theory of Caring can be a great nursing concept to

practice, but it also cause various limitation that not only effect patients but nursing staff as well.

Article

The article written by Mary Kalfoss, and Jenny Owe is about a systematic review on

Swansons Theory of Caring. The review researched meta-synthesis, concept analysis, and

narrative reviews of 35 articles on the theory. The finale sample ended with 25 articles, and the
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data analyzed was organized according to Swansons caring process. The systematic review

found empirical findings of knowing, being with, doing for, enabling, and maintaining belief

concepts that make up the caring theory. According Kalfoss and Owe, the findings of this study

showed that the descriptions of Swansons caring processes had semantic relevance and clarity

as a conceptual framework for nursing actions (Kalfoss & Owen, 2015, p.982). Furthermore,

the study discovered that Swansons theory did not offer clear guidance on ethical decisions, and

also didnt address how nurses value or ensure how to address ethical dilemmas. Overall, the

systemic review article showed that Swansons theory provides empirical indicators of caring

actions and that the theory does add the process of conceptualizing, understanding, and going

beyond empirical data.

Article Critique

The article review on Swansons theory could have extended the study for a longer period

of time, since the research was only done between the years 2003 to 2013. If the time period was

extended, the amount of literature reviewed could have doubled, and a broader insight might

have been concluded. In addition, the interpretation of the findings may have been enhanced by

inviting people with different expertise to discuss the interpretation of the findings, and by using

software programs to improve the construction of the data that was used (Kalfoss & Owen,

2015, p.984). Furthermore, the review did research Swansons theory with little bias, but could

have accurately reflected the meaning of the caring process with more data and nursing

knowledge.

Clinical Issue

A nurse working with neonates, and their families in a NICU is rewarding but at times

can be stressful. They are various serious clinical issues in a NICU, but a clinical issue that is the
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hardest to deal with at times is end-of-life decision making of a neonate. The health care team

can experience an emotional burden on saving a life that can result in physical and mental

disabilities of the neonate in the future. Families have to make a hard decision to withhold or not

withhold treatment not realizing the future impacts that may result. Nursing staff may sometimes

may not understand the emotional decision families make and families can also sometimes

express anger or frustration toward medical staff. Nevertheless, the consist battle of what is the

right thing to do is never ending, and nursing staff can try to relive the negative or ill feelings

from family members in order to help decrease the issues among the healthcare team. According

to Eden and Callister, ethical issues related to decision making for premature infants are

becoming more difficult, and conflicts between families and health-care providers about whether

to continue or withdraw life support for critically ill infants are not uncommon (Eden & Callister,

2010, p.30). Overall, nurses can help guide parents that go through these life-changing issues by

using the Theory of Caring to help direct their actions.

The Theory of Caring can guide a parents feelings on the death of their child, and it can

also help with any other important medical decisions they might have to make. Nurses can start

by using the care process of knowing, which will assist the nurse to avoid assumption on what

they think a parent may be feeling, and instead focus on being with them when a decision needs

to be made. The nurse can use these concepts to help them listen better, and so they can help

parents share their feelings openly. Doing for concept will guide a NICU nurse to comfort

parents skillfully, and enabling will assist the nurse to focus on the event, allowing them to

support the family or assist them through there thought process. Maintain belief can guide how a

nurse verbally communicates with a family, and it will also sustain the faith as well as give hope

to the parents of a neonate in a life or death situation. Moreover, all five caring processes will
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guide a nurses actions when delivering patient care to familys ill neonate or caring for parents

emotionally.

Personal Philosophy

My own personal philosophy consists of practicing nursing care with compassion and a

holistic mind frame. Nurses have a purpose to serve others, educate, and carry the responsibility

to be a trusteed health professional. The Theory of Caring describes the importance of the nurse-

patient relationships, and overall has the same values as ones personal philosophy of promoting

the whole person. Healing others by following simple guidelines of caring correlates with my

personal philosophy of nurturing individuals the best you can. Caring with compassion

demonstrates the ideal nursing care, and needs to practice in various clinical settings in order to

give the best quality of care to all patients.

Learning & Conclusion

The understanding of the Theory of Caring has expanded ones knowledge on the

importance of the caring definition in ones nursing practice. This theory has so much potential to

be used in every setting in the nursing field, and in other medical professions as well. It was also

learned that the theory promotes traditional values in the healing process and can ultimately

enhance the nursing practice in any type of clinical setting. The main model concepts of

knowing, being with, doing for, enabling, and maintaining belief collectively simplifies the act of

caring. Furthermore, it was learned that building therapeutic relationships is extremely important

in all nursing care experiences, and following the caring process in the theory aids the direction

of nurse caring. The Theory of Caring process consists of well-organized concepts that are

patient focused. Overall, this assignment has opened a new way of thinking about care-based

nursing and the positive benefits that it can have on all generations of patients.
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References

Alligood, M.R. (2014). Nursing theorists and their work (8th ed.). St. Louis, MI: Elsevier.

Branch, C., Klinkenberg, D. (2015). Compassion fatigue among pediatric healthcare providers.

The American Journal of Maternal/Child Nursing, 40(3), 160-166. Retrieved from

http://www.nursingcenter.com/pdfjournal?AID=3096951&an=00005721-201505000-

00006&Journal_ID=54021&Issue_ID=3096829

Eden, L., Callister, L. (2010). Parent involvement in end-of-life care and decision making in

the newborn intensive care unit: an integrative review. The Journal of Perinatal

Education, 19(1), 29-39. doi 10.1624/105812410X481546

Kalfoss, M., Owe, J. (2015). Empirical verification of swansons caring processes found in

nursing actions: systematic review. Open Journal of Nursing, 5, 976-986. Retrieved

from http://dx.doi.org/10.4236/ojn.2015.511104
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I pledge to support the Honor System of Old Dominion University. I will refrain from any form
of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a
member of the academic community it is responsibility to turn in all suspected violators of the
Honor Code. I will report to a hearing if summoned.
Name: _____Rebecca Eimer___
Date: _____6 April 2017_______
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Guidelines Rubric Comments Points

Earned

Select a specific Summary of the theory 10%

nursing
philosophy, Describe the benefits/relevant
conceptual model usefulness of the theory. 5%
or theory
Describe the limitations of the theory.
discussed in this
5%
course.
Identify one Briefly summarize the focus of the
nursing journal article.
article from the 10%
literature that Critique the application or testing of
discusses the the theory in the article. 10%
theory selected.
Must use a journal
article that was not
already assigned
in this course.
Relate theory to Describe a clinical practice issue in
clinical practice. your work or clinical education
setting.
10%
Examine how the selected theory
would guide your actions and
decisions in the delivery of nursing
care related to this issue. 15%
Relate theory to Explain the significance/value of this
personal theory to your own personal
philosophy. philosophy of nursing. 10%
Discuss learning. Examine how this assignment
contributed (or not) to your
understanding of nursing theory. 5%
Spelling, grammar, punctuation, body is no longer than 5
pages
10%
APA format 10%

Final Grade
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