Welcome to the GroupH_N207.Nursing Theory WikiEdit

Table of Contents

1.1.1 Introduction to the Theorist

1.1.2 Construction of the Theory

1.1.3 Basic Concepts Involved

1.1.4 Hierarchical Level I

1.1.5 Hierarchical Level II

1.1.6 Hierarchical Level III

1.1.7 Hierarchical Level IV

1.1.8 Hierarchical Level V

1.1.9 Delivery of Care

2.1.1 Key Behavioral Characteristics

2.1.2 Five levels of Rounding

2.1.3 Conclusion

2.1.4 Publications and References

The Carolina Care Model (The Swanson Theory)Edit

Kristen M. Swanson, RN, PhD, FAAN; She is the Dean of the College of Nursing, Alumni Distinguished at the University of North Carolina, and an Associate Chief Nursing Officer on Academic Affairs at UNC Hospitals. She is also an Alumnus of the Robert Wood Johnson Foundation Nurse Executive Fellows Progam and a member of the American Academy of Nursing. Before that, she held the University of Washington Medical Center Term Professorship in Nursing Leadership and a chairperson of the Department of Family and Child Nursing at the University of Washington School of Nursing.

Renowned for her research contribution on:

- Pregnancy Loss

- Swanson Theory of Care (Internationally used to guide research, education, and practice)

- Carolina Care Model is grounded on Caring Theory

The Evaluation Knowledge of caring in Nursing resulted in 5 Hierarchical Levels mainly:

Level I : Capacity for Caring. Does the Nurse have what it takes to be caring?

Level II : Concerns and Commitments. Is the Nurse committed to relating in a caring matter?

Level III : Conditions: Does the environment support capable, committed Nurses to practice caring?

Level IV : Caring Actions : Does practice consists of actions that are based on knowing, being with, doing for, enabling, and maintining belief in Patients?

Level V : Caring Consequences : Does acting in a caring manner promote intended outcomes?

The Commitment of UNCH Nurses lies : What matters most are : my patient, my team, my hospital, my community, and my profession.

3 types of Conditions that affect Caring according to Swanson are:

  1. Patient related
  2. Nurse related
  3. Organization related : Several components encompasses Organizational conditions are:
  • Leadership
  • Compensation and rewards
  • Professional relationships

Swanson describes Nursing as "Informed Caring for the well-being of others".

  1. Maintaining Belief - sustaining faith in the capacity of others to transition and have meaningful lives.
  2. Knowing - Striving to understand events as they meaning on the life of the other.
  3. Being with - Being emotionally present to the other.
  4. Doing for - Doing for the other what they would do for themselves if possible.
  5. Enabling - Facilitating the capacity of others to care for themselves and family members.

Carolina Care - A consistent set of behaviors to increase patient satisfaction in partnership with other support services essential to delivery of care.

Key Behavioral Characterisitcs (Carolina Care Model):

  1. Multilevel Rounding - Regular Rounds on patient possitively affects satisfaction and perception of quality of care in patients. This includes 5 levels of rounding namely:

R - are you comfortable? (Pain)

O - other side (Positioning)

U - use the bathroom (Toileting)

N - Need anything?

D - door/curtain open or closed (Privacy)

S - safety (Call bell within reach, hazards removed)

  2.  Words and Ways that work - Individualized conversation and communicate important pieces of information in their own words. The purpose of this is to inform and explain situations that will enable patients to be active participants of their care.

 3.  Relationship/Service Components - The most important components of the Carolina Care Model includes:

  • Moment of Caring - Nurses are encouraged to sit with their patients for 3-5 minutes to ask and talk about how they are coping with their illness.
  • No Passing Zone - No Nurses should pass by a patient's call bell regardless of the assigned tasks/patient care. This was designed to convey the availability of Nurses to do for all patients in the Ward.
  • Partnership with Support Services - The extension of words and ways who have frequent contact with patients.
  • Blameless Apology - This acknowledges the patient's concerns, communicates apology without placing blame, and making sure that the problem will be addressed appropriately.


The University Hospital has designed a care delivery model that includes The Swanson Theory into practice. A study was done after the implementation of the Carolina Care Model and the results were improvements with regards to Patient Care. That the importance of caring is relevant in the Nursing Profession and if it is, what are the activities of care that can be contributed to caring as a job characteristic? The Improvement of Caring Theory has the potential to change Nursing Perspective in the future ahead.


1. Lewin K. Field Theory in Social Science: Selected Theoretical Papers. London: Tavistock; 1952.

2. Swanson K. Empirical development of a middle range theory of caring. Nurse Res. 1991;40(3):161-166

3. Swanson k. Nursing as informed caring for the well-being of others. IMAGE. 1993;25(4):352-357

4. Watson J. Caring theory as ethical guide to administrative and clinical practices. Nurse Adm Q. 2005;30(1):48-55

5. Swanson K. What's known about caring in nursing: a literary meta-analysis. In: Hinshaw AS, Feetham S, Shaves J, eds. Handbook of Clinical Nursing Research; Thousand Oaks, CA: Sage; 1999:31-58

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