New Nursing Model Enhances Care, Reduces Stress

Enter most metropolitan hospitals and you’re confronted with a cacophony of sounds: pagers beeping, doctors, nurses, assistants talking, PA announcements echoing through halls and rooms—it’s a nonstop, stressful environment. One where nurses and staff can feel overworked, and where patients feel like numbers on a bed chart. 

 

Enter the nursing unit at Virginia Mason Hospital & Medical Center in Seattle during “quiet hour” and you’ll encounter just the opposite: dimmed lights, silenced pagers and hushed voices among nurses and staff. The hospital is among many nationwide that have recently adopted the Swanson Theory of Caring, which is designed to give nurses and healthcare staff a stress-reducing breather.

Developed by Kristen Swanson, RN, PhD, FAAN, dean of the University of North Carolina at Chapel Hill School of Nursing, the hour of serenity allows nurses and staff to care for one another and to catch up with their many tasks in a reduced-stress environment. 

 

The Swanson technique includes tracking yardsticks on how nurses improve care, efficiency and satisfaction for patients and staff. "As much as managing safe, competent care is essential, so too is the capacity to navigate relationships during stressful times," said Swanson. "It’s not [only] relationships with patients but [also] with our peer professionals."

 

The goal is for revitalized nurses to support each other, eliminate overlap and act proactively instead of simply reacting to patient discomfort. This improves patient care and efficiency, which ultimately reduces costs. 

 

Among the Swanson techniques are "Who am I?" boards, which list staff members' favorite foods and vacation places and challenge colleagues to guess who the person is. This helps staff—who are often separated by 3-day, 12-hour shifts—to get to know each other. Equally helpful are caring message boards, which allow nurses to post thank-you notes for switching shifts or helping them with a patient. Patient care teams are also encouraged to walk through each others’ work areas to learn, first hand, what that patient faces during treatment. Swanson also believes in "caring concierge carts" stocked with everyday items that give patients and families access to many of the comforts of home. Finally, the staff get together for 7 a.m. and 7 p.m. “care team huddles,” where staffing and systems issues are addressed, and letters from patients are read. 

Charleen Tachibana, RN, MN, senior vice president, hospital administrator and chief nursing officer believes the Swanson Theory has many merits. "There are still people who think you can either be caring, or efficient, but you can’t be both," says Tachibana. "The tools of VMPS have helped us eliminate waste and non-nursing activities that took nurses away from direct patient care. Our nurses spend more than 90 percent of their time at the bedside, compared with a national average of less than 50 percent. The Swanson Theory of Caring gives us the right context at the bedside to deliver the best care possible."

Plans are in the works to apply the Swanson Theory to ambulatory settings, satellites and physician partners at Virginia Mason. As a hospital administrator, it might  be worth your while to consider adopting some or all of Kristen Swanson’s techniques for your staff. 

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