Nursing Theorist

Virginia Henderson

Theory PresentationBy Kirsten KulkarniNeeta MonteiroPierre Nkurunziza

Why this theorists model/theory?The Nightingale of Modern Nursing.Modern-Day Mother of Nursing.The 20th century Florence Nightingale.The first lady of NursingFirst truly international nurse

Nursing TheoristVirginia Avenel Henderson1897-1996

BackgroundBorn in Kansas City Missouri, in 1897Received a Diploma in Nursing from the Army School of Nursing at Walter Reed Hospital, Washington, D.C. in 1921Worked at the Henry Street Visiting Nurse Service for two years after graduation

BackgroundIn 1923, she started teaching nursing at the Norfolk Protestant Hospital in VirginiaIn 1929, she entered Teachers College at Columbia University for Bachelors Degree in 1932, and Masters Degree in 1934In 1939, she revised: Hamers classic textbook of nursing for its 4th edition, and later wrote the 5th edition incorporating her personal definition of Nursing (Henderson, 1991)

BackgroundJoined Columbia as a member of the faculty, remained until 1948Since 1953, a research associate at Yale School of NursingRecipient of numerous recognitionsHer work influenced the nursing profession throughout the worldA well known nursing educator and a prolific authorBackgroundHonorary doctoral degrees from the Catholic University of America, Pace University, University of Rochester, University of Western Ontario, Yale University (held honorary degrees from 13 universities).In 1985, honored at the Annual Meeting of the Nursing and Allied Health Section of the Medical Library AssociationDied: March 19th , 1996Theory historyHenderson did not intend to develop a theory of nursingShe attempted to define the unique focus of nursingShe emphasized on basic human needs as the central focus of nursing practice.Two events that lead to the creation of the definition of Nursing* Helped revise a Nursing textbook * She was concerned that many states had no provision for nursing licensureNursing defined by HendersonVirginia Hendersons definition of nursing was one of the first statements clearly delineating nursing from medicine: 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).

Hendersons philosophyShe emphasized the importance of increasing the patients independence so that progress after hospitalization would not be delayed. She described the nurses role as: *substitutive (doing for the person) *supplementary (helping the person) *complementary (working with the person)with the goal of helping the person become as independent as possible.Original purpose Improving patients outcomes by application of nursing processCollaborative carePatient centered careAmelioration of health in general

Virginia Hendersons 14 Components She categorized nursing activities into 14 components, based on human needs

Breathe normallyEat and drink adequatelyEliminate body wastesMove and maintain desirable posturesSleep and restSelect suitable clothes-dress and undressMaintain body temperature within normal range by adjusting clothing and modifying the environmentKeep the body clean and well groomed and protect the integumentAvoid dangers in the environment and avoid injuring othersCommunicate with others in expressing emotions, needs, fears, or opinionsWorship according to ones faithWork in such a way that there is a sense of accomplishmentPlay or participate in various forms of recreationLearn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities

Breathe normallyEat and drink adequatelyEliminate body wastesMove and maintain desirable posturesSleep and restSelect suitable clothes-dress and undressMaintain body temperature within normal range by adjusting clothing and modifying the environmentKeep the body clean and well groomed and protect the integumentAvoid dangers in the environment and avoid injuring othersCommunicate with others in expressing emotions, needs, fears, or opinionsWorship according to ones faithWork in such a way that there is a sense of accomplishmentPlay or participate in various forms of recreationLearn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities

Breathe normallyThe 14 components 1. Breathe normally

14 components 2. Eat and drink adequately

14 components3. Eliminate body wastes

14 components 4. Move and maintain desirable postures

14 components 5. Sleep and rest

14 components 6. Select suitable clothes- dress and undress

14 components 7. Maintain body temperature within normal range by adjusting clothing and modifying environment

14 components 8. Keep the body clean and well groomed and protect the integument

14 components 9. Avoid dangers in the environment and avoid injuring others.

14 Components 10. Communicate with others in expressing emotions, needs, fears, or opinions

14 Components11. Worship according to ones faith

14 components 12. Work in such a way that there is a sense of accomplishment

14 components 13. Play or participate in various forms of recreation

14 components 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

The 14 componentsPhysiological : The first 9 components Psychological: 10th and 14thSpiritual : 11th componentSociological : 12th and 13thComparison with Maslows Hierarchy of Needs

Internal Theory AnalysisRelative importance of concepts. Is each given equal weight?Each of the 14 components as described by Virginia Henderson are given equal importance. Nevertheless the patient may need assistance with only some of the components at a given time depending on the patients health condition. The Collaborative TeamHendersons Theory and the four major concepts 1. IndividualHave basic needs that are components of healthRequiring assistance to achieve health and independence or a peaceful deathMind and body are inseparable and interrelatedConsiders the biological, psychological, sociological, and spiritual componentsThe theory presents the patient as a sum of parts with biopsychosocial needs, and the patient is neither client nor consumerFour major concepts 2. EnvironmentSettings in which an individual learns unique pattern for livingAll external conditions and influences that affect life and developmentIndividuals in relation to familiesMinimally discusses the impact of the community on the individual and familySupports tasks of private and public agenciesFour major concepts

Environment (continued)Society wants and expects nurses to act for individuals who are unable to function independently. In return she expects society to contribute to nursing education.Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided.

Four major concepts3. HealthDefinition based on individuals ability to function independently outline in the 14 components.Nurses need to stress promotion of health and prevention and cure of disease.Good health is a challenge. Is the individual able to meet these needs independently?Good health is a challenge. Affected by age, cultural background, physical, and intellectual capacities, and emotional balance. Is the individual able to meet these needs independently?

36Four major concepts4.NursingTemporarily assisting an individual who lacks the necessary strength, will, and knowledge to satisfy one or more of the 14 basic needs.Assists and supports the individual in life activities and the attainment of independenceNurse serves to make patient complete, whole or independent. Four major concepts Nursing (continued)Hendersons classic definition of nursingCarry out physicians therapeutic plan. Individualized care is the result of the nurses creativity in planning care.Four major concepts Nursing (continued)Use nursing researchCategorized Nursing: nursing careNon nursing: ordering supplies, cleanliness and serving foodIn the nature of Nursing that the nurse is and should be legally an independent practitioner and able to make independent judgments as long as s/he is not diagnosing, prescribing treatment for disease, or making a prognosis, for these are the physicians function.

Four major conceptsNursing (continued)Nurse should have knowledgeIn the nature of Nursing, nurse role is, to get inside the patients skin and supplement his strength will or knowledge according to his needs.Four major conceptsNursing (continued)Nurse has responsibility to *assess patients needs *help individual meet their need *provide a safe environment

Assumptions The major assumptions of the theory are:Nurses care for patients until patient can care for themselves once again. Patients desire to return to health (not explicit).Nurses are willing to serve and that nurses will devote themselves to the patient day and night.Nurses should be educated at the university level in both arts and science.

External AnalysisSemantic clarityThe terminologies that are used in this theory are clear, easily understandable and simple.Structural ClarityThere is no model to represent this theory.SimplicityThis theory is simple and easy to use

External analysisGeneralizabilityThis theory is applicable to people of all age groups, cultures, gender, health conditions and different settings. AccessibilityInformation regarding this theory is accessible, but newer theorists have since then developed ideas that are built from the concepts proposed in this theory.(An example of this is Orem s basic needs theory)External AnalysisHow is this theory applicable to nursing clinical practice or education or administration? PracticeAssists nurses in everyday experiencesServes as a guide in the nursing processProvides a rationale for effective decision making and implementationNursing care evaluation criteriaFacilitates communication among the health care team membersIdeas are developed and words are definedEnhance autonomy

External AnalysisEducationProvide a general focus for curriculum designGuide curricular decision makingResearchOffers a framework for generating knowledge and new ideasHelps discover knowledge gapsGives a foundation for other theories

Bibliography of Virginia Henderson1956 (with B. Harmer)- Textbook for the Principles and Practices of Nursing1966- The Nature of Nursing. A definition and its implication for practice, research and education1991- The Nature of Nursing Reflections after 20 years1950-1970- Analysis of Nursing Theory Images of NursingThe development of Hendersons definition of Nursing School of thoughts in Nursing theories1950-1970 Need TheoristsInteraction Theorists Outcome TheoristsAbdellahKingHendersonOrlandoJohnsonOremPeterson and ZderadLevinePaplauRogersTravelbeeRoyWiedenbachAnalysis of Nursing Theories According to 1st School Focus ProblemHuman BeingA set of needs or problems

A development being

PatientNeed DeficitOrientationIllness, diseaseRole of nurseDependent on medical practice

Beginnings of independent functions

Fulfill needs requisitesDecision makingPrimarily health care professionalHendersons Theory BackgroundHendersons concept of nursing was derived from her practice and education, therefore her work is inductiveShe called her definition of nursing her Concept (Henderson 1991)(Henderson, 1991)

Hendersons Theory BackgroundHendersons Theory and Nursing ProcessSummarization of the stages of the nursing process as applied to Hendersons definition of nursing and to the 14 components of basic nursing care. Nursing process -- Nursing InterventionNursing assessment -- Nursing implementationNursing diagnosis -- Nursing EvaluationNursing plan

Characteristic of Hendersons TheoryInterrelation of conceptsConcepts are borrowed from other disciplinesHer definition and components are logical and the 14 components are a guide for the individual and nurse in reaching the chose goalTheories should be relatively simple yet generalizable- Hendersons theory can be applied to individuals of all agesCharacteristics of Hendersons theoryTheories can be the bases for hypotheses that can be tested- Her definition of nursing cannot be viewed as a theory, therefore it is not possible to generate testable hypotheses.However some questions to investigate the definition of nursing and the 14 components may be useful.

Characteristics of Hendersons TheoryTheories contribute to and assist in increasing the general body of knowledge within the discipline through research implemented to validate them - Her ideas of nursing practice are well accepted throughout the world as a basis for nursing care. However, the impact of the definition and components has not been established through research. Characteristics of Hendersons TheoryTheories can be utilized by practitioners to guide and improve their practice-Ideally the nurse would improve nursing practice by using her definition and 14 components to improve the health of individuals and thus reduce illness.UsefulnessNursing education has been deeply affected by Hendersons clear vision of the function of the nurse.Published in nursing textbooks from 1930s -1960s.Still important in evaluating nursing care in the 21st centuryHendersons other concepts have been used from 1930s to present.LimitationsLack of conceptual linkage between psychological and other human characteristicsNo concept of the holistic nature of human beingThe relationship between the components is unclearLacks inter-relate of factors and the influence of nursing careLimitations (continued)Assisting the individual in the dying process she includes that the nurse helps, but there is little explanation of what the nurse does.Peaceful death is curious and significant nursing rolePurposes of Nursing TheoriesIn practiceIn EducationIn ResearchPersonal practiceConclusionHenderson provides the essence of what she believes is a definition of nursing She didnt intend to develop a theory of nursing but rather she attempted to define the unique focus of nursingHer emphasis on basic human needs as the central focus of nursing practice has led to further theory development regarding the needs of the person and how nursing can assist in meeting those needs.Her definition of nursing and the 14 components of basic nursing care are uncomplicated and self-explanatory.References62