Virginia Henderson’s Nursing Theory Handout 1NURS 600, Fall 2008, Idaho State University

“The unique function of the nurse is to assist the individual, sick or well, in performance of those activities contributing to health or its recovery (or peaceful death) that he/she would perform unaided

if he/she had the necessary strength, will or knowledge. And to do this in such a way as to help him/her gain independence as rapidly as possible (Virginia Henderson, 1961).”

Vitae

“The Nightingale of Modern Nursing.” “Modern-Day Mother of Nursing.” "The 20th century Florence Nightingale.” Born in Kansas City, Missouri, in 1897, the 5th child of a family of 8 children. Spent her

formative years in Virginia. Received a Diploma in Nursing from the Army School of Nursing at Walter Reed

Hospital, Washington, D.C. in 1921. Worked at the Henry Street Visiting Nurse Service for 2 years after graduation. In 1923, she accepted a position teaching nursing at the Norfolk Protestant Hospital in

Virginia, where she remained for several years. In 1929, Virginia Henderson determined that she needed more education and entered

Teachers College at Columbia University where she earned her Bachelor’s Degree in 1932 and her Master’s Degree in 1934.

Subsequently, she joined Columbia as a member of the faculty, where she remained until 1948 (Herrmann, 1998).

Virginia Henderson served as a research associate at Yale University School of Nursing from 1953 until her death.

Sigma Theta Tau's International Nursing Library has been named in her honor. Died: March 19, 1996. “Virginia Avenel Henderson died March 19 at the age of 98. Her

ending had the warmth, style, and graciousness of her life. After partaking chocolate cake and ice cream and saying good-byes to her family and friends, she passed from one dimension to another. She experienced the peaceful death she desired for all mankind. She is buried in the family plot of the churchyard of St. Stephen's Church, Forest and Bedford County, Virginia (McBride et al, 1996)”

Achievements

Recipient of numerous recognitions for her outstanding contributions to nursing. Well known nursing educator and a prolific author. Received honorary doctoral degrees from the

University of Western Ontario University of Rochester Rush University Pace University Catholic University of America

Virginia Henderson’s Nursing Theory Handout 2NURS 600, Fall 2008, Idaho State University

Yale University Old Dominion University Boston College Thomas Jefferson University Emory University

Her stature as a nurse, teacher, author, researcher, and consumer health advocate warranted an obituary in the New York Times, Friday March 22. 1996. 

In 1985, Miss Henderson was honored at the Annual Meeting of the Nursing and Allied Health Section of the Medical Library Association.

The International Council of Nurses acknowledged that she belonged to the world in June 1985 when she was presented with the first Christianne Reimann Prize, recognizing that her span of influence knew no national boundaries. 

Contributions

In 1937 Henderson and others created a basic nursing curriculum for the National League for Nursing in which education was “patient centered and organized around nursing problems rather than medical diagnoses” (Henderson, 1991). 

In 1939, she revised Harmer’s classic textbook of nursing for its 4th edition, and later wrote the 5th edition, incorporating her personal definition of nursing (Henderson, 1991).

In 1978 the fundamental concept of nursing was revisited by Virginia Henderson from Yale University School of Nursing. She argued that nurses needed to be prepared for their role by receiving the broadest understanding of humanity and the world in which they lived.

O’Malley (1996) states that Virginia Henderson is known as the modern-day mother of nursing. Her work influenced the nursing profession in America and throughout the world

Virginia Henderson was one of the founding members of ICIRN (Interagency Council on Information Resources for Nursing) and a passionate advocate for the use and sharing of health information resources.

Although she was retired, she was a frequent visitor to nursing schools well into her nineties.

Publications from or about Virginia Henderson

Henderson, Virginia. "Excellence in Nursing." American Journal of Nursing 100 (October 2000): 961.

Henderson, V. (1960). Basic principles of nursing care. Geneva: International Council of Nurses.

Henderson, V. (1964). The nature of nursing. American Journal of Nursing, 64(8), 62-68.

Henderson, V. (1966). The nature of nursing: A definition and its implications for practice, research, and education. New York: Macmillan.

Henderson, V. (1969). ICN basic principles of nursing care. Geneva: International Council of Nursing.

Virginia Henderson’s Nursing Theory Handout 3NURS 600, Fall 2008, Idaho State University

Henderson, V. (1969). Excellence in nursing. American Journal of Nursing, 69(10), 2133, 2137.

Henderson, V. (1973). On nursing care plans and their history. Nursing Outlook, 21(3), 378-379.

Henderson, V. (1977). We’ve come a long way, but what of the direction? Nursing Research, 26(3), 163-164.

Hardy, M. E. (1978). Perspectives on nursing theory. Advances in Nursing Science, 1(1), 37-48.

Futton, J. S. (1987). Virginia Henderson: Theorist, prophet, poet (biography). Advances in Nursing Science, 10(1), 1-9.

Henderson, V. (1990). Excellence in nursing 1969 [Classic article]. American Journal of Nursing, 90(4), 76-77.

Henderson, V. (1991). The nature of nursing--Reflections after 25 years. New York: Macmillan.

Halloran, E. J. (Ed.). (1995). A Virginia Henderson reader: Excellence in nursing. New York: Springer.

Halloran, E. J., & Thorson, M. J. (1996). Henderson’s unique functions of nurses. In J. J. Fitzpatrick & A. L. Whall (Eds.), Conceptual models of nursing: Analysis and application (3rd ed., pp. 77-88). Stamford, CT: Appleton & Lange.

Alexander, J. E., DeMeester, D. W., Lauer, T., Tomey, A. M., Neal, S. E., & Williams, S. (1998). Virginia Henderson: Definition of Nursing. In A. M. Tomey & M. R. Alligood (Eds.), Nursing theorists and their work (4th ed., pp. 99-111). St. Louis: Mosby.

Virginia Henderson’s Nursing Theory

Underpinnings of Theory

Virginia 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.”

Characteristic of Virginia Henderson’s Theory

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.

Assumptions of Theory

Clients have unmet needs.

Virginia Henderson’s Nursing Theory Handout 4NURS 600, Fall 2008, Idaho State University

The values and practice that nursing is built upon must result from the definition of the profession.

“[The nurse] is temporarily the consciousness of the unconscious, the love of life for the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the infant, knowledge and confidence for the young mother, the [voice] for those too weak or withdrawn to speak.”

Nurse should be considered an independent member of the total health care team, and the nurse should only perform nursing functions, neither performing the diagnosis, prescription, and prognosis functions of a physician or any tasks such as serving food and cleaning that were not directly related to helping the patient with the fourteen basic nursing functions.

Virginia Henderson’s Fourteen Basic Nursing Functions include:1. Breathe normally. 2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable postures. 5. Sleep and rest. 6. Select suitable clothes-dress and undress. 7. Maintain body temperature within normal range by adjusting clothing and

modifying environment 8. Keep the body clean and well groomed and protect the integument 9. Avoid dangers in the environment and avoid injuring others. 10. Communicate with others in expressing emotions, needs, fears, or opinions. 11. Worship according to one’s faith. 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. 14. Learn, discover, or satisfy the curiosity that leads to normal development and

health and use the available health facilities.

Nursing’s Metaparadigm Concepts Using Virginia Henderson’s Nursing Theory

Person/Human Being/Client Concept Physiological Aspects

1. Breath normally.2. Eat and drink adequately.3. Eliminate body wastes.4. Move and maintain desirable postures.5. Sleep and rest.6. Select suitable clothes - dress and undress.7. Maintain body temperature within normal range by adjusting clothing and

modifying the environment. 8. Keep the body clean and well groomed and protect the integument.9. Avoid dangers in the environment and avoid injuring others.

Spiritual Aspects

Virginia Henderson’s Nursing Theory Handout 5NURS 600, Fall 2008, Idaho State University

11. Worship according to one’s faith.

Sociological Aspects12. Work in such a way that there is a sense of accomplishment.13. Play or participate in various forms of recreation.

Psychological Aspects10. Communicate with others in expressing emotions, needs, fears, or

opinions.14. Learn, discover, or satisfy the curiosity that leads to normal development

and health and use the available health facilities.

Environment Concept Everything that is outside of the patient but is connected to the patient is

considered the environment & the environment should support the 14 fundamental needs.

Includes all external conditions and influences that affect life and development. Supports tasks of private and public agencies. Basic nursing care involves providing conditions under which the patient can

perform the 14 activities unaided.

Health Concept Not specifically defined in Virginia Henderson’s theory, but includes individual’s

ability to function independently as outlined in the 14 components, and balance in life.

“The mind and body being separable, a person must maintain physiological and emotional balance. An individual requires assistance in order to achieve health and independence or a peaceful death. Individuals will achieve or maintain health if they have the necessary strength, will or knowledge. The individual and family should be viewed as a unit.”

Nurses need to stress promotion of health and prevention and cure of disease. Good health is a challenge. Affected by age, cultural background, physical, and intellectual capacities, and

emotional balance Impact on health by working of various social issues.

Nursing Concept Virginia Henderson’s Definition of Nursing: “The unique function of the nurse is

to assist the individual, sick or well, in performance of those activities contributing to health or its recovery (or peaceful death) that he/she would perform unaided if he/she had the necessary strength, will or knowledge. And to do this in such a way as to help him/her gain independence as rapidly as possible.”

Virginia Henderson’s idea of the nurse’s role consisted of three elements: Substitutive: the nurse does for the patient

Virginia Henderson’s Nursing Theory Handout 6NURS 600, Fall 2008, Idaho State University

Supplementary: the nurse helps the patient Complementary: the nurse works with the patient

Testability

Virginia Henderson’s theory is testable. Each of the fourteen basic nursing functions can be transformed into a hypothesis, and subsequent testing can be provided.

Limitations of Virginia Henderson’s Theory

Lack of conceptual linkage between physiological and other human characteristics. No concept of the holistic nature of human being. If the assumption is made that the fourteen basic nursing functions are prioritized, the

relationship among the components is unclear. Weak on interrelation of the fourteen basic nursing functions and the influence of

nursing care. Assisting the individual in the dying process she contends that the nurse helps, but

there is little explanation of what the nurse does. “Peaceful death” is a curious nursing role compared to other theories of the time.

Nursing Process and the Relationship to Virginia Henderson’s Nursing 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 science and art on which it seems effective health care service of any kind is based.”

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

Virginia Henderson’s Nursing Theory Handout 7NURS 600, Fall 2008, Idaho State University

Maslow’s Hierarchy and the Relationship to Virginia Henderson’s Nursing Theory

Maslow’s Hierarchy Virginia Henderson’s 14 Basic

Nursing FunctionsPhysiological needs 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

Keep body clean and well groomed and protect the integument

Safety needs Avoid environmental dangers and avoid injuring others

Belongingness and love needs

Communicate with others

Worship according to faith

Esteem needs Work at something providing a sense of accomplishment

Play or participate in various forms of recreation

Learn, discover, or satisfy curiosity

Self actualization needs  None

Required Readings Related to Virginia Henderson’s Nursing Theory

Practice Embler, P. (2006, June). Midwifery and conceptual models of nursing: a comparison.

Midwifery Today, Retrieved September 27, 2008, from CINAHL with Full Text database.

Virginia Henderson’s Nursing Theory Handout 8NURS 600, Fall 2008, Idaho State University

Research Halloran, E. (1996). Virginia Henderson and her timeless writings. Journal of

Advanced Nursing, 23(1), 17-24. Retrieved September 27, 2008, from CINAHL with Full Text database.

Discussion Questions Related to Virginia Henderson’s Nursing Theory

1. Compare and contrast the theory of Virginia Henderson with her predecessor, Florence Nightingale, to whom she is often compared. Does Henderson’s theory appear to follow Nightingale’s theory or are their deviations? Does Henderson appear to concentrate on the same basic principles as Nightingale?

2. Are there any aspects of Virginia Henderson’s theory that you did not already promote for your patients? Are there aspects that are frequently neglected in the medical setting? How will you, as an advanced practice nurse, address these components?

Virginia Henderson’s Nursing Theory Handout 9NURS 600, Fall 2008, Idaho State University

References

Chinn, P.L. & Kramer, M.K. (2008). Integrated knowledge development in nursing. (7th Ed.). St. Louis: Mosby.

Chitty, K.K. Black, B. P. (2007). Professional nursing: Concepts & Challenges, (5th Ed.). St. Louis, Missouri: Saunders Elsevier.

Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories, (2nd Ed.). Philadelphia: F.A. Davis.

Fuld Institute for Technology in Nursing Education (Producer). (1988). Virginia Henderson definition of nursing [Video]. (Available from http://library.loyno.edu/services_collections/streaming/?id=32).

Henderson, Virginia. "Excellence in Nursing." American Journal of Nursing 100 (October 2000): 961.

Henderson, V. (1964). The nature of nursing. American Journal of Nursing, 64(8), 62-68.

Henderson, V. (1969). Excellence in nursing. American Journal of Nursing, 69(10), 2133, 2137.

Hardy, M. E. (1978). Perspectives on nursing theory. Advances in Nursing Science, 1(1), 37-48.

Futton, J. S. (1987). Virginia Henderson: Theorist, prophet, poet (biography). Advances in Nursing Science, 10(1), 1-9.

Halloran, E. J. (Ed.). (1995). A Virginia Henderson reader: Excellence in nursing. New York: Springer.

McEwen, M. & Wills, E.M. (2007). Theoretical basis for nursing, (2nd Ed.). Philadelphia; Lippincott.

Nursing theories, a companion to nursing theories and models. (n.d.) Retrieved September 29, 2008 from http://currentnursing.com/nursing_theory/Henderson.htm

Perry, A. Potter, P. (2005). Fundamentals of Nursing, (6th Ed.). St. Louis, Missouri: Mosby.

Pointillism reflects the generalist theory of Virginia Henderson. Retrieved September 12, 2008 from http://nursing.clayton.edu/eichelberger/point illhenderson.JPG.