Kristen Swanson’s caring theory resonates most with how I want to provide care as a nurse practitioner. I like this theory because it focuses on five characteristics that display the positive input a provider or caregiver can integrate in a patient’s life. The five characteristics are: maintaining belief, knowing, being with, doing for, and enabling (Martensson et al, 2021). Patients need to know that someone believes in them and supports their health and wellness journey. It is also extremely important for patients to be listened to, comforted, and supported. There may be progressions and regressions in health behavior (i.e. dieting and weight loss) and the patient needs to know they have someone on their side. My plan is to become a PMHNP so all of these characteristics are important for a patient to feel valued, heard, and understood.
Swanson’s caring theory has comparable initiatives to the National CLAS standards. The CLAS standards focus on improving health equity by improving communication, providing leadership and support, and working on continuous improvement initiatives to better the services available for patients (U.S. Department of health and Human Services, 2022). Both Swanson’s theory and the CLAS standards focus on providing holistic and patient-centered care. This requires that patient to be involved in the care plan and for the provider to understand the patient’s understanding, resources, and desire to participate in improving their healthcare.
Martensson, S., Hodges, E., Knutsson, S., Hjelm, C., and Brostro, A. (2021). Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students. Scandinavian Journal of Caring Sciences. https://doi.org/10.1111.scs.12927Links to an external site.
U.S. Department of Health and Human Services (2022). National Culturally and Linguistically Appropriate Services Standards. https://thinkculturalhealth.hhs.gov/clas/standardsLinks to an external site.
The Purnell Model for Cultural Competence is the theory that most resonates with me in my practice as a future nurse practitioner. This theory came into play in 1989 after Purnell took a group of nursing students to a hospital setting to perform clinical rotations. Most of the students were from white upper-class families, and the employees and patients at the hospital were from lower-class families. This was a cultural shock for both groups as they struggled to understand one another. Purnell then put together a model to help educate both the students and the hospital staff and patients on the importance of cultural diversity. This model has been used in many different practice sites, education, research, and administration. Other disciplines such as Physical and Occupational therapy have used this as well ( Butts & Rich, 2017).
This model explains that every culture is different, but one culture is not any better than another. There are differences and similarities within each culture. It proves that no matter the culture, if the patient is actively involved in his/her own care, the outcome is likely to be more positive. Every culture needs to be respected by the nurse practitioner, even if it is not the belief of the nurse practitioner providing the care. It is important for the nurse practitioner to be culturally competent and to continue to learn about other cultures. Different races often have differences in their cultural beliefs and practices. It is important for the nurse practitioner to be able to understand and adapt to that patient’s culture. It is also important for the nurse practitioner to have cultural competence, which means that he or she must be aware of his/her own thoughts and feelings. The nurse practitioner must accept the patient’s cultural beliefs and have some knowledge about the patient’s culture. The Purnell theory integrates the nursing paradigm because it includes many concepts of society across the globe and includes families, the person and the community as a whole ( Dian Ellina et al., 2022).
Pertaining to this theory, I am a white middle-class female who was born into poverty due to my parents not finishing high school. They worked in nurseries from daylight until dark for very little money due to not having an education. We lived in government housing up until I was 13 years old. My mother went back to school to obtain her GED which allowed her to get a better-paying job in a factory to provide for her children. My parents always pushed me to do better than them by encouraging my sister and me to get a high school diploma followed by a college education. My parents always wanted me to have a better life than they did. In this theory, I identify with once being the poor kid whose family could not afford all of the fancy things my peers had (although I never went without food, clothing, or shelter). I also identify with being the middle-class adult that I am today. I often encounter patients that are in poverty and I never have forgotten where I came from. I think I most identify with the family and personal parts of this theory.
This theory helps to meet CLAS standards to advance health equity in many ways. It helps the nurse practitioner to be able to provide the patient with respect and quality care that aligns with the patient’s specific culture. It stresses the importance of providing continuing education to nurse practitioners in order to help them better understand cultural differences. It teaches the nurse practitioner about the importance of self-awareness but also teaches that no one specific culture is right. It provides language assistive services through translators to help the patient and practitioner to better understand one another. It helps to provide written instructions in the patient’s language in order to help promote more positive outcomes. It encourages a partnership within the community to implement and evaluate policies to better provide for the patient (Office of Minority Health, n.d.).
Butts, J. B., & Rich, K. L. (2017). Philosophies and theories for advanced nursing practice (3rd ed.). Jones & Bartlett Learning.
Dian Ellina, A., Nursalam, N., Yunitasari, E., Putra, M., & Adiutama, N. (2022). Culturally based caring model in nursing services. Kontakt, 24(3), 212–218. https://doi.org/10.32725/kont.2022.027Links to an external site.
Think cultural health. (n.d.). U.S. department of health and human services. https://www.thinkculturalhealth.hhs.gov/clas/what-is-clasLinks to an external site.