Can Caring Be Taught???
Keith Rischer RN, MA, CEN, CCRN
Nursing’s Historical Legacy of Caring
“The spirit in which she does her work makes all
the difference. Invested as she should with the
dignity of her profession and the cloak of love for
suffering humanity, she can ennoble anything
her hand may be called upon to do, and for work
done in this spirit there will ever come to her a
recompense far outweighing that of silver and
gold….
Caring Defined…
“Swanson defines…“Caring is a nurturing
way of relating to a valued other
toward whom one feels a personal
sense of commitment and
responsibility”
“Practicing in a caring manner leads
to the nurse’s well being, both
personally and professionally.
Personal outcomes of caring
include feeling important, accomplished, and whole.
Professionally practicing caring leads to enhanced
intuition, empathy, clinical judgment and work
satisfaction.”
Kristen Swanson RN, PhD, FAAN
How This Caring Theory Came to be…
 I. 20 women who miscarried
“What constituted caring in the instance of
miscarriage?”
 II. 19 careproviders in the NICU
“What is it like to be provider of care in the NICU”
 III. 8 high risk young mothers who received LT public
health nursing intervention
“How did you recall and describe your nurse-patient
relationship after intervention?”
Swanson’s Framework of Caring
 Knowing (Empathetic Understanding)
Striving to understand an event as it has
meaning in the life of the other
Avoiding assumptions
Centering on the one cared for
Assessing thoroughly
Seeking cues
Engaging the self
Swanson’s Framework of Caring
 Being With (Emotionally Present)
Being emotionally present to the other
Being there
Conveying availability
Sharing feelings
Not burdening
Swanson’s Framework of Caring
 Doing For (Enact For)
Doing for the other as he/she would do for
oneself…but no more
Anticipating their needs
Performing competently/skillfully
Preserving dignity
Swanson’s Framework of Caring
 Enabling (Empowering)
Facilitating the other’s passage through life
transitions and face a future with meaning
Informing/explaining
–patient education
Validating-giving feedback
Generating alternatives-thinking it
through
Swanson’s Framework of Caring
 Maintaining Belief (Esteem)
Sustaining faith in the other’s capacity to get
through an event/transition and face a future
with meaning
Believe in/holding in esteem
Maintaining a hope filled attitude
Offering realistic optimism
Application in Clinical Setting
CLINICAL WEEK #1
I.Knowing (Empathetic Understanding) Striving to understand an event as it has meaning in the life of the other
Choose at least 2 to
implement
Nursing Caring Interventions
Evaluation (Client Response)
1. Avoiding Assumptions
2. Centering on the one cared
for
*Did my cares when time was best for client
*Allowed client quiet time with minimal interruptions
*Always verbalized to client what I was coming in for
next and told him if there was anything more I could
help him with to feel free to ask
*Allowed client to maintain sleep/rest
*Client did not feel like a burden when using
call light
*Felt that this conveyed trust between client
and nursing student
*After surgery I was conveying availability-this was
*Client felt as if I really cared for him and that
he was not alone
*He felt that he could trust me and was a little
more relaxed to know someone was there
*Non-verbal cues-client was less anxious and
was able to remain comfortable to rest
3. Assessing thoroughly
4. Seeking cues
5. Engaging of self
important for the client who was experiencing pain
*I was able to get warm blankets and ice water for my
client to ensure comfort
*I ensured the client that I was there and could help him
with anything he needed
Application in Clinical Setting
II. Being With (Emotionally present) Being emotionally present to the other
Choose at least 2 to
implement
1. Being there
2. Conveying availability
3. Sharing feelings
4. Not burdening
Nursing Caring Interventions
Evaluation (Client Response)
*Talking to client and sitting at eye level
*Placing a hand on the client’s shoulder to let them
know that you care and are “present”
*Taking time to explain what you are doing and answer
questions and make sure client fully understands
*Allow pt. to express feelings without putting
judgements on them
*Client was able to talk to me on a more
*Stating, “is there anything else I can do for you…I
have time?”
*Do not approach client in a rushed nature
*Periodically assessing client and asking how they are
doing without making them put on their call light
and feel like they are a burden
*Client gets needs met immediately and
personal level
*Putting hand on shoulder was comforting
and caring-helped client realize I was
“there”
*Client ws able to put trust in me and know
what to expect and let him know what
was next
*Client expressed sensitive topics with me
about being overweight and was able
to not worry about feeling judged
does not feel rushed
*Client does not feel like they are being a
pain because they know that they are
not bugging you when you are busy
*Does not feel rushed and they feel that they
have time to ask questions or review
personal nature of self more readily