Theoretical Foundations in NURSING

By: Jayson G. Celerio RN, MANNurse Educator

FOURTEEN BASIC HUMAN NEEDS MODEL

“I say that the nurse does for others what they would do for themselves if they had the strength, the will and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible.”

- VIRGINIA HENDERSON

Henderson’s contribution to the nursing profession is the identification of the fourteen (14) basic human needs upon which nursing care is based.

She viewed the patient as an individual requiring help toward achieving independence and has envisioned the practice of the nursing profession as wholly independent from the practice of medicine.

Her prior experience in the field of rehabilitation nursing helped her refine her model of nursing as a profession with autonomous functions.

She defined Nursing in terms of the function of the nurse, to wit:

“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. (Harmer and Henderson, 1955)

Henderson also specifies the conditions that need nursing assistance. These conditions are what she refers to as the fourteen needs. (Henderson, 1972).

1. Breath normally 2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable posture. 5. Sleep and rest. 6. Select suitable clothing. 7. Maintain body temperature. 8. Keep body clean and well-groomed and protect the

integument. 9. Avoid environmental dangers and avoid injuring others. 10. Communicate with others in expressing emotions, needs,

fears, or opinions. 11. Worship according to faith. 12. Play or participate in various forms of recreation. 13. Work at something providing a sense of accomplishment. 14. Learn, discover, or satisfy curiosity that leads to normal

development and health and use of the available health facilities.

Henderson supported emphatic understanding and believes the nurse must “get inside the skin” of each patient in order to know what he needs. She believes that nurses work interdependently with other members of the healthcare team and not just with the members of the medical profession.

Henderson identified three levels of nurse-patient relationships in which the nurse acts as any of the following:

1. A substitute for the patient – doing for the patient (substitutive)2. A helper to the patient – helping the patient (supplementary)3. A partner with the patient – working with the patient (complementary)

CONCEPTS AND DEFINITIONS

The patient is an individual who requires help toward independence.

The nurse assists the individual, whether ill or not to perform activities that will contribute to health, recovery or peaceful death that the individual would perform unaided if he had necessary strength, will and knowledge.

Table shows the incorporation of Henderson’s Needs and Nursing Process as presented by

Torres (1986).

Dominant themes in Henderson’s Concept of nursing; formalization of patient agency them and subsumption of health themes. From Nursing Development Conference Group – concept Formalization in Nursing Process and Product (p. 56, Little, Brown, & Co., 1973).

The process of nursing strives to do this as rapidly as possible. The goal of nursing is independence. Central to nursing that seeks to help patients toward independence is emphatic understanding and unlimited knowledge. Emphatic understanding grounded in genuine interest will Lead to helping the family understand what a patient needs.

Nurses will seek and promote research, education and work settings that facilitate this goal. The nurse manages this process independently of physicians. The nurse is and should be legally an independent practitioner and able to make independent judgments as long as he or she is not diagnosing, prescribing treatment for disease or making prognosis. The role and functions of professional nursing vary with the situation.

Theory Assertions PERSON

› Viewed as a holistic being that is composed of physical, psychological, sociological and spiritual dimensions that are defined by their corresponding needs.

Physiological needs include – 1. Breath normally 2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable posture. 5. Sleep and rest. 6. Select suitable clothing. 7. Maintain body temperature. 8. Keep body clean and well-groomed and protect the integument. 9. Avoid environmental dangers and avoid injuring others. 10. Communicate with others in expressing emotions, needs,

fears, or opinions.

Psychological needs of every human include learning and discovering or satisfying the curiosity that leads to normal development and health and using available health facilities.

Spiritual needs include worshipping according to one’s faith.

Sociological needs are working in such a way that there is a sense of accomplishment and playing or participating in various forms of recreations.

HEALTH is viewed based on the individual’s

ability to function independently as outlined in the 14 components. Nurses need to stress promotion of health and prevention and cure of disease. Good health is considered a challenge and is effected by age, cultural background, physical and intellectual capacities and emotional balance. Various issues can impact on health.

NURSING The nurse is viewed as one who serves

to make the patient “complete”, “whole” or “independent”. Nurses assist physicians in the implementation of various therapeutic plans, with consideration of highly individualized care. Nurses, according to her, also utilize research to advance their way of practicing nursing.

ENVIRONMENT The nurse provided nursing care to

individuals in relation to families. This is the concept of environment

which functions to support the tasks of private and public agencies. The society expects nurses to act for individuals, who are unable to function independently. Thus, basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided or independently.

Application of the TheoryHenderson’s work is essential to clinical nurse

today, especially within the context of bedside nursing. With the major shift in emphasis of nursing care today, nurses should be able to use Henderson’s model in caring for the patient. The patient’s ability to perform the 14 basic human needs should be assessed before considering the kind of nursing care function you will be administering. It is essential to determine if you will be performing as a helper, a doer or substitute or a partner. Nursing interventions are implemented according to the 14 basic human needs of the patent. The degree of performance, involvement of the patient and level of nurse activity will be dependent on the specific role the nurse will be playing.

Thank you!!!Have a nice

day!