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Virginia Mason implements Swanson Theory of Caring on nursing units

Monday December 24, 2012
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Enter a nursing unit at Virginia Mason Hospital & Medical Center in Seattle at the right time of day and visitors will witness something they might not expect at a busy metropolitan hospital: serenity.

Lights are dimmed, pagers are silenced and nurses go about their work with hushed voices. Itís quiet hour at Virginia Mason and a chance for nurses to regroup amid a hectic shift. Itís one of the changes made to nursing units since the hospital adopted the Swanson Theory of Caring this summer.

The caring model, developed by Kristen Swanson, RN, PhD, FAAN, dean of the University of North Carolina at Chapel Hill School of Nursing, has been incorporated at hospitals and physician practices around the nation. It creates a way for nurses to care for each other and themselves.

Standards are measurable, and nurses are held accountable to meet them. Metrics are registered into the hospitalís production system so how nurses improve care, efficiency and satisfaction for patients and staff can be tracked. The theory elevates comfort to an importance level next to safety, Swanson said.

"As much as managing safe, competent care is essential, so too is the capacity to navigate relationships during stressful times," she said. "Itís not [only] relationships with patients but [also] with our peer professionals."

When energized nurses back each other, eliminate overlap and think ahead in terms of patient comfort, healthcare is more efficient and translates into cost savings, Swanson said. Virginia Mason nurses support each other and improve patient and family comfort with the Swanson theory. Examples include:

"Who am I?" boards: "Most of our staff work 12-hour shifts, so they are here three days a week; they donít get to know each other well," said Dana Nelson-Peterson, RN, MN, DNP(c), an administrative director for Virginia Mason. "The boards give clues such as favorite foods, favorite places to vacation and colleagues try to guess who the person is."

Caring message boards. Nurses can write each other notes and post them on a tribute board, expressing thanks for switching shifts, for helping them with a patient, etc. "[Itís] all the things that we think we say to each other but often go unnoticed or unspoken," Nelson-Peterson said.

Walking where patients walk: "The truth is many members of a patientís care team had never met each other let alone visited each othersí work areas," Nelson-Peterson said. Under the Swanson model, nurses walk through the area the patient walks to see exactly what that patient encounters in his or her treatment.

Caring concierge cart: Items such as reading glasses or cell phone chargers are made available for patients and families.

Caring huddles: During 7 a.m. and 7 p.m. huddles, the care team talks about staffing and systems issues, reads letters from patients and shares how the Swanson principles are being demonstrated, Nelson-Peterson said.

Virginia Mason plans to roll out the Swanson theory to ambulatory settings, satellites and physician partners, Nelson-Peterson said. Official results comparing baseline metrics, such as patient and staff satisfaction, will be completed in April. But indicators show itís already a success among care teams.

"They feel more of a sense of engagement with what weíre doing as an organization," she said.


Marcia Frellick is a freelance writer. Send letters to editorWest@nurse.com or post a comment below.