3-C FIRST
Nursing Presence: Process, Openness, and Transformation Within the Context of Swanson’s Caring Theory
Susan Driscoll MPH, MSN, ANP-BC, WHCNP-BC is an Adult Nurse Practitioner who specializes in women's health and is dedicated to working with underserved populations. She is currently pursuing a PhD in Nursing at Florida Atlantic University and is a Jonas Nurse Leaders Scholar. Her research focus is on women's health issues related to the Maya migrant farm worker communities of South Florida.
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Nursing Presence: Process, Openness, and Transformation Within the Context
of Swanson’s Caring Theory
Susan Driscoll MPH, MSN, ANP‐BC, WHNP‐BC
May 30, 2013
A NURSING SITUATION VIGNETTE
Lack of Presence:
Presence
A nurse’s presence is required to provide a healing environment
• Henderson, King, Orem, Parse, Roy, Nightingale, Peplau, Quinn, and Halldorsdottir
Examples of presence described in the caring literature
• Boykin & Schoenhofer (2001)
• Doona, Haggerty, & Chase (1997)
• Newman, Smith, Pharris, & Jones (2008)
• Parse (2012)
• Swanson (1991)
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Thesis
Attributes of nursing presence
• Process
• Openness
• Transformation
Paradigm
• Swanson’s caring theory
Swanson’s Caring Theory
• Inductive development
• Used in practice
• Validated in research
– Hanson (2004)
– Swanson (1999)
Swanson’s Caring Theory
• Caring has five essential processes
– Knowing
– Being with
– Doing for
– Enabling
– Maintaining belief
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Openness
“letting go”
“knowing the other as caring person”
“clear the field”
“bearing witness in solemn regard for the other”
“genuine conversation”
“call for nursing”
Openness
• Reflected in Swanson’s Caring Theory
– Knowing
– Doing for
– Maintaining belief
Process
“unfolding pattern that emerges”
“mutual process”
“unfolding in the “emerging now”
“consequences of presence go on to influence
its enactment in the future”
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Process
• Reflected in Swanson’s Caring Theory
– Knowing
– Being with
– Enabling
Transformation
“transforming for both patient and nurse in
revealing new vision and understanding”
“meaning changes with each unfolding living
experience”
“Hermenuetics”
Transformation
• Reflected in Swanson’s Caring Theory
– Enabling
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Presence
Doona, Haggerty, & Chase (1997)• An intersubjective encounter between a nurse and a patient in which the nurse encounters the patient as a unique human being in a unique situation and chooses to spend her/himself on the patient’s behalf. The antecedents to presence are the nurse’s decision to immerse her/himself in the patient’s situation and the patient’s willingness to let the nurse into that lived experience. As a consequence to nursing presence, both the nurse and the patient are changed. Both are affirmed as unique human beings, and the nurse is affirmed as a professional and the patient as a person in need (p. 12).
Knowing
Knowing
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Knowing
Knowing
Knowing
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Knowing
Knowing
Being With
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Being With
Being With
Being With
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Being With
Being With
Being With
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Doing For
Doing For
Enabling
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Enabling
Enabling
Enabling
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Enabling
Maintaining Belief
Openness
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Openness
Openness
Openness
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Openness
Openness
Process
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Process
Process
Process
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Transformation
Transformation
Transformation
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Transformation
Transformation
Transformation
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Transformation
Transformation
Presence
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Presence
References
Boykin, A. & Schoenhofer, S. O. (2001). Nursing as caring: A model for transforming practice. Sudbury, MA: Jones and Bartlett Publishers.
Doona, M. E., Haggerty, C. A., & Chase. (1997). Nursing presence: An existential exploration of the concept. Scholarly Inquiry in Nursing, 11, 3‐16.
Finfgeld‐Connett, D. (2006). Meta‐Synthesis of presence in Nursing. Journal of Advanced Nursing, 55(6), 708‐714.
Finfgeld‐Connett, D. (2008). Qualitative convergence of three nursing concepts: art of nursing, presence, and caring. Journal of Advanced Nursing, 63(5), 527‐534.
Hanson, M. D. (2004). Using data from critical care nurses to validate Swanson’s phenomenologically derived middle range caring theory. Journal of Theory Construction and Testing, 8(1), 21‐25.
Jarrin, O. F. (2012). The integrality of situated caring in nursing and the environment. Advances in Nursing Science, 35(1), 14‐24.
Newman, M. A., Smith, M. C., Pharris, M., & Jones, P. (2008). Focus of the discipline revisited. Advances in Nursing Science, 31(1), E16‐E27.
Newman, M. A. (2008). Transforming presence: The difference that nursing makes. Philadelphia, PA: F.A. Davis Company.
Parse, R. (2012). New Humanbecoming conceptualization and the humanbecoming community model: Expansion with sciencing and living the art. Nursing Science Quarterly, 25(1), 44‐52.
Swanson, K. (1991). Empirical development of a middle range theory of caring. Nursing Research, 40(3), 161‐166.
Swanson, K. (1999). Research‐based practice with women who have had miscarriages. Image: Journal of Nursing Scholarship, 31(4), 339‐345.