By Shannon Demboski, Tracie Strand
and David Gregson
“The Nightingale of Modern Nursing”
•
Born in Kansas City, Missouri, in 1897
•
Diploma in Nursing from the Army School of Nursing
at Walter Reed Hospital, Washington, D.C. in 1921
•
In 1923, started teaching nursing at the Norfolk Protestant
Hospital in Virginia
•
In 1929, entered Teachers College at Columbia University
for Bachelor’s Degree in 1932, Master’s Degree in 1934
•
Joined Columbia as a member of the faculty, until 1948
•
Since 1953, a research associate at Yale University School of
Nursing -
•
She recieved honorary doctoral degrees from the Catholic
University of America, Pace University, University of
Rochester, University of Western Ontario, Yale University
•
Recipient of numerous recognitions
•
Died: March 19, 1996
•
Henderson recognized the unique funtions of the nurse
were:
•
to assist the individaul, the sick, the well
•
assist patients to be able to perform activities contributing
to health or its recovery
•
help the patient perform functions they could not do
Virginia Henderson's defined nursing as follow:
"The unique function of the nurse is to assist the individual,
sick or well, in the performance of those activities contributing
to health or its recovery (or to peaceful death) that he would
perform unaided if he had the necessary strength, will or
knowledge. And to do this in such a way as to help him gain
independence as rapidly as possible" (Henderson, 1966).
•
Henderson's philosophy empasizes the functions of the
nurse along with a list of basic patient needs that are to be
the focus of nursing care
•
Henderson's main focus was on patient care and increasing
independence
•
Henderson theory was developed on 14 basic needs for her
patients
•
Her concepts were based on Maslow's Hierarchy of Needs
"While a nurse's job is to care for patients, it also helps patients to able
to care for themselves when they leave the health care facility"
(Nursing Theories and Models p.1).
•
Maslow relative to Henderson: 14 Components of of her need
theory mirrors Maslow's Hierarchy of needs by her humanism
approach.
•
Henderson also felt patient's once independent, a patient could
accomplish these needs. Conversely, the nurse was there to
facilitate this process when the pateint was unable to accomplish
this in a compromised state.
•
Henderson Goal: Henderson wasn't concerned with a personal
nursing theory per se, rather define a unique nursing practice in
the care of patients.
•
Her definition and components are logical and the fourteen
basic nursing functions are a guide for the individual and
nurse in reaching the chosen goal.
•
Her work can be applied to the health of individuals of all
ages.
•
Her ideas of nursing practice are well accepted throughout
the world as a basis for nursing care.
•
Virgina Henderson's background was developed during the
era of nursing and medicine where patient's needs were of
primary concern. As such, her theory is often called a
"Needs Theory".
•
Henderson views the nursing process as "really the
application of the logical approach to the solution of a
problem. The steps are those of the scientific method."
•
"Nursing process stresses the science of nursing rather than
the mixture of the science and art on which it seems
effective health care services of any kind is based."
•
Breathe normally
•
Eat and drink adequately
•
Eliminate body wastes
•
Move and maintain desirable postures
•
Sleep and rest
•
Select suitable clothes-dress and undress
•
Maintain body temperature within normal range by
adjusting clothing and modifying the environment
•
Keep the body clean and well groomed and protect the
integument
•
Avoid dangers in the environment and avoid injuring others
•
Communicate with others in expressing emotions, needs,
fears, or opinions.
•
Worship according to one’s faith
•
Work in such a way that there is a sense of accomplishment
•
Play or participate in various forms of recreation
•
Learn, discover, or satisfy the curiosity that leads to normal
development and health and use the available health
facilities
Understanding the Nursing Process
Assessment
Compare patient’s data to knowledge base of health and disease. Assess baseline
for 14 components to aid in planning
Diagnosis
Identify individual’s ability to meet own needs with or without assistance, taking
into consideration strength, will, and knowledge
Plan
Plan and document how the nurse can assist the individual, sick or well, back to
independence
Intervention
Assist the individual in performance of activities to meeting needs necessary to
maintain health, recover from illness, or to aid in peaceful death
Evaluation
Successful outcomes of nursing care based on the speed with which or degree to
which the patient performs independently the activities of daily living
Maslow's Hierarchy
and the Relationship
to Henderson's Theory
Physiological needs
Virginia Henderson’s 14
Basic Nursing Functions
Breathe normally
Eat and drink adequately
Eliminate by all avenues of elimination
Move and maintain desirable posture
Sleep and rest
Select suitable clothing
Maintain body temperature
Safety needs
Belongingness and love needs
Esteem needs
Keep body clean and well groomed and protect the
integument
Avoid environmental dangers and avoid injuring
others
Communicate with others
Worship according to faith
Work at something providing a sense of
accomplishment
Play or participate in various forms of recreation
Learn, discover, or satisfy curiosity
•
Human Being-each patient has specific needs,
individualizing care to meet the needs of each patient to
promote health and optimal functioning.
•
Environment-the environment plays an important role in
patient participation and enhances optimal functioning
•
Health-providing care to patients who are unable to
accomplish specific functions unassisted, while working
toward restoring the patient to the highest level of
functioning.
•
Nursing-nurses need to address the patients needs and
develop a plan using the nursing process
•
Promotion of Wellness: "According to Henderson, nurses need to
prevent disease and promote health" (Nursing Theories and
Models p.1).
•
Preventative Medicine: Henderson was ahead of her
time advocating prevention, recognizing healthy life style changes
and promoting these changes.
•
Wellness Concepts: Henderson believed nurses had to teach
patients certain concepts to promote health and embrace this
teaching. These included, but not limited to diet, rest, exercise and
also help patients with psychosocial recovery visa supporting
spirituality and combine these concepts in a holistic approach.
"Henderson supported nursing research, but believed that it should be
clinical research" (O'Malley, 1996).
•
Support of Henderson that she Embraced: Much of the research
before her time had been on educational processes and on the
profession of nursing itself, rather than on; the practice and
outcomes of nursing, and she worked to change that" (Journal of
Advanced Nursing pp.7,103-09).
•
Criticisms: The critical analysis of her model was a void existed
between physiologic and other human characteristics. Further,
there is no linkage between holistic human nature and her role
relationships.
•
14 Components Unclear: If the assumption is made that the 14
components is prioritized, the relationship is unclear. For example,
she states that nurses have a role in helping the patient accept end
of life care, it's not clear how this occurs.
•
In Practice:Nurses serve to guide assessment, interventions, and
evaluation of nursing care.
•
Evidenced Base Practice: Provide a rationale for collecting reliable
and valid data about health status of clients.
•
Rationale: By defining data and validating information
implementation of care ensures quality nursing care.
•
Methods: Helping to build common nursing terminology to use
while communicating with other health professionals ideas and
information are defined. These methods are reinforced through
education and research.
•
Henderson Analysis: Henderson supported and used Maslow
Hierachy of needs in her needs theory via the14 components by a
humanism approach.
•
She sought to refine nursing practice by collaborating with other
professionals and through a defined language between nursing.
•
She emphasized the advocacy of patients by nurses while patients
were ill until they could do this for themselves.
•
She was a proponent of education and wellness teaching. She
believed, ahead of her time, prevention is the best medicine.
•
Henderson was a unclear link between holistic human nature and
role relationships, she worked diligently to change nursing process
and research thus building evidenced based practice concepts in
the nursing care model.
You are a nurse working on a rehab unit. Mrs. Smith was just admitted to your
unit after a brief stay at the hospital following surgery. The patient is an alert
and oriented, she is an 86 year old female who had a fall at home, resulting in
fractures. Your patient was admitted with a left hip hemiarthroplasty and a
right arm fracture. The patient is required to wear a sling at all times and is
non-weight bearing to the right arm. The patient is able to put weight on the left
leg as tolerated. Prior to the fall, the patient was able to care for herself and was
continent of bowel and bladder. During her hospital stay, Mrs. Smith had a
foley catheter. The catheter was removed 2 days ago and the patient has been
unable to void on her own. She will need bladder scanned and st. cath every 6
hours if no void. The patient will be participating with physical therapy daily to
regain strength and eventually return home. Since Mrs. Smith is unable to
accomplish some of the basic needs, the nursing staff will have to assist with her
cares. Virginia Henderson’s needs theory can be applied to this patient
situation. Henderson theory focuses on 14 basic components based on basic
human needs. The main concept of her theory are to assist the patient
accomplish what they are unable to do on her own and restore the patient to
optimal functioning. Which components from Henderson’s needs theory are of
highest priority for the nurse to focus on? Do you think how the nurses interact
and respond to the patients’ needs, will allow Mrs. Smith to recover quicker?
Chitty, K.K. & Black B.P. (2011). Professional nursing: Concepts and
challenges (6th ed.) Maryland Heights, MO: Saunders
Current Nursing. (2012). Nursing theories: Virginia henderson's needs
theory. Retrieved from
http:/currentnursing.com/nursing_theory/Henderson.html
Halloran, E. J. (1996). Virginia henderson and her timeless writtings.
Journal of Advanced Nursing, 7, 103-109. 23, 17-24
Henderson, Virginia. The Nature of
Nursing.Macmillan USA. 1996. 1. Retrieved from: http://nursingtheroy.org/theories-and-models/henderson-need-theory.php
Henderson, Models of Nursing Needs Theory 2012
Retrieved from: http://nursing-theory.org/theories-andmodels/henderson-need-theory.php
Nursing Theorist, Virginia Henderson 2012
Retrieved from:http://vahenderson2010.blogspot.com/2010/hertheroy-and-nursing-process,html
George, J.B (ed.) (1995). Nursing Theories: the base for professional
nursing practice (4th ed). Northwalk CT Appleton & Lange
Henderson, Virginia. Nursing Theory 2011. Retrieved from:
http://nursing-theory.org/nursing-theorists/Virginia-Henderson.php
Halloran, E. J. (1996), Virginia Henderson and her timeless writings.
Journal of Advanced Nursing, 23: 10-17. doi: 10.1111/j.13652648.1996.tb03130.x