Using Data from Critical Care Nurses to Validate Swanson's Phenomenological Derived Middle Range Caring Theory

Article excerpt

Abstract: While nurses strive to establish an evidence-based profession, they need to advocate for the caring aspect of nursing. For centuries, caring has been synonymous with nursing, but the published research fails to consider personal experiences that impact the nurse's caring response. This study of critical care nurses' perceptions and experiences validates the centrality of caring. This study reinforces the belief that the caring response be recognized as an important clinical variable that influences a diverse range of outcomes, such as patient satisfaction and therapeutic benefit.

Key Words: Caring, Compassionate Behaviors, Critical Care Nurses

As the healthcare landscape becomes more complex and chaotic, the value of nursing must be demonstrated. Nurses can demonstrate their value through acts of caring. For centuries, caring has been synonymous with the profession of nursing. When Johnson & Johnson (2002) launched a campaign to attract more people into the nursing profession, the campaign's central message was that nurses have opportunities to touch lives, to offer comfort, and to care. This recruitment campaign included a television advertisement that proclaimed "Nurses Dareto Care." Johnson & Johnson's (2002) successful advertising blitz supported the belief that caring is the unique and unifying focus of the nursing profession (Leininger, 1988).


The professional nurse is expected to demonstrate critical thinking as a foundation for making decisions m nursing practice. The same nurse must also exhibit a strong sense of caring and compassion. A study by Mcllveen and Morse (1995), however, suggested that caring and comforting are secondary priorities in modern day nursing because of increased patient acuity and complex technology in hospital settings. These factors dramatically limit the time nurses have to demonstrate caring and compassionate behaviors for their patients.

For the nursing profession, the challenge has become one of survival. Because caring is identified as a core element of nursing practice, nurses must understand factors affecting their caring response. For more than a decade, nurse caring has been studied using exploratory, descriptive, phenomenological, philosophical, and model development approaches (Cronin & Harrison, 1988; Gaut, 1983; Leininger, 1981, 1983, 1984; Riemen, 1986; Valentine, 1989; Watson, 1979). Insights gained from previous research have been valuable to reaffirm that caring and comforting are an integral part of nursing care. But several unanswered questions remain.

Published research fails to consider the personal experiences that impact caring responses of nurses. This study addresses that problem specifically. As nursing continues to establish itself as an evidence-based profession, the need is equally great to advocate for the caring aspect of nursing. The caring response deserves recognition as an important clinical variable, influencing diverse care outcomes, such as patient satisfaction and therapeutic gain (Daniel, 1984).


Patistea (1999) suggests that the meaning and lived experience of caring is an area deserving further investigation. The objective of this research was to identify categories or patterns related to caring based on personal experiences of critical care nurses. Categories were identified from a questionnaire using content analysis methodology. Findings were then compared to Swanson's (1991) phenomenologically-derived, middle-range theory of caring. Swanson's theory was originally developed in the perinatal setting and identified five recurrent themes that were common while caring for patients. These themes arc a) maintaining belief, b) knowing, c) being with, d) doing for, and e) enabling.

The purpose of the present study was to identify categories or patterns related to caring among critical care nurses and determine if these categories and patterns validated Swanson's (1991) theory of caring. …