Virginia Henderson Theory-helena

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VIRGINIAAVENEL HENDERSON THEORY

BY MRS.HELENAR.JOSEPH,M.SC(N),

ASSOCIATE PROFESSOR,

SDM INS,SATTUR,DHARWAD.INDIA


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AUTOBIOGRAPHY

Virginia Avenel Henderson was described in somany names. Some called her The Nightingale ofModern Nursing. Others named her as Modern-DayMother of Nursing and The 20th Century Florence

Nightingale. She was born on november 30, 1897 inKansas, Missouri .

In 1918, she entered the Army School of Nursingin Washington, DC, and in 1921, she received hernursing diploma. She worked at the Henry Street

Visiting Nurse Service for 2 years after graduation.Henderson, very much wanted to teach nursing,therefore accepted her first instructor position in 1924at the Norfolk Protestant Hospital in Virginia.


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ACHIEVEMENTS


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ACHIEVEMENTS

She is a recipient of numerous recognitions for her

outstanding contributions to nursing.

well known nursing educator and a prolific author.

received honorary doctoral degrees from the Catholic

University of America, Pace University, University of

Rochester, University of Western Ontario,Yale

University

warranted an obituary in the New York Times,Friday March 22. 1996.

honored at the Annual Meeting of the Nursing and

Allied Health Section of the Medical Library

Association In 1985.


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CONTRIBUTIONS

In 1937 Henderson and others created a basic nursing curriculum for theNational League for Nursing in which education was patient centeredand organized around nursing problems rather than medical diagnoses

(Henderson,1991)

In 1939, she revised: Harmers classic textbook of nursing for its 4thedition, and later wrote the 5th; edition, incorporating her personaldefinition of nursing (Henderson,1991)

Although she was retired, she was a frequent visitor to nursing schoolswell into her 90s. OMalley (1996) states that Henderson is known as themodern-day mother of nursing.

Her work influenced the nursing profession in America and throughoutthe world. The founding members of ICIRN (Interagency Council on

Information Resources for Nursing) and a passionate advocate for theuse and sharing of health information resources.

In 1978 the fundamental concept of nursing was revisited by VirginiaHenderson from Yale University School of Nursing (USA).


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PUBLICATIONS

1956 (with B. Harmer)-Textbook for the

principles and practices of Nursing.

1966-The Nature of Nursing. A definition and its

implication for practice, Research and Education1991- The Nature of Nursing Reflections after 20

years

Analysis of Nursing Theory Images of Nursing,

1950-1970


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THE DEVELOPMENT OF HENDERSONS

DEFINITION OF NURSING

Two events are the basis for Hendersons developmentof a definition of nursing.

First, she participated in the revision of a nursing

textbook. Second, she was concerned that many stateshad no provision for nursing licensure to ensure safeand competent care for the consumer.

In the revision she recognized the need to be clearabout the functions of the nurse and she believed that

this textbook serves as a main learning source fornursing practice should present a sound and definitivedescription of nursing. Furthermore, the principles andpractice or nursing must be built upon and derivedfrom the definition of the profession.


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Henderson's focus on individual care is evident in that

she stressed assisting individuals with essential

activities to maintain health, to recover, or to achieve

peaceful death. She proposed 14 components of basic

nursing care to augment her definition. In 1955,

Hendersons first definition of nursing was published

in Bertha Harmers revised nursing textbook. To her the unique fucntion 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.


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MAJOR CONCEPTS


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MAJOR CONCEPTS


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1.INDIVIDUAL

Have basic needs that are

component of health. Requiring assistance to achieve

health and independence or apeaceful death.

Mind and body are inseparable

and interrelated. Considers the biological,

psychological, sociological, andspiritual components.

The theory presents the patient

as a sum of parts withbiopsychosocial needs, and thepatient is neither client norconsumer.


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2.ENVIRONMENT

Settings in which an individual learnsunique pattern for living.

All external conditions and influencesthat affect life and development.

Individuals in relation to families

Minimally discusses the impact of the

community on the individual andfamily.

Supports tasks of private and publicagencies Society wants and expectsnurses to act for individuals who areunable to function independently. In

return she expects society to contributeto nursing education.

Basic nursing care involves providingconditions under which the patient canperform the 14 activities unaided


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3. HEALTH

Definition based onindividuals ability to functionindependently as outlined inthe 14 components.

Nurses need to stresspromotion of health andprevention and cure of disease.

Good health is a challenge. Affected by age, culturalbackground, physical, andintellectual capacities, andemotional balance Is theindividuals ability to meetthese needs independently?


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4. NURSING

Temporarily assisting an individual who lacks the necessary strength, willand knowledge to satisfy 1 or more of 14 basic needs.

Assists and supports the individual in life activities and the attainment ofindependence.

Nurse serves to make patient complete whole", or "independent."

Henderson's classic definition of nursing:

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

The nurse is expected to carry out physicians therapeutic planIndividualized care is the result of the nurses creativity in planning forcare.

Use nursing research

Categorized Nursing : nursing care Non nursing: ordering supplies, cleanliness and serving food.

In the Nature of Nursing that the nurse is and should be legally, anindependent practitioner and able to make independent judgments as longas s/he is not diagnosing, prescribing treatment for disease, or making aprognosis, for these are the physicians function.


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4. NURSING

Nurse should have knowledge to practice individualizedand human care and should be a scientific problem solver.

In the Nature of Nursing Nurse role is, to get inside thepatients skin and supplement his strength will orknowledge according to his needs.

And nurse has responsibility to assess the needs of theindividual patient, help individual meet their health need,and or provide an environment in which the individual canperform activity unaided

Henderson's classic definition of nursing

"I say that the nurse does for others what they would dofor themselves if they had the strength, the will, and theknowledge.But I go on to say that the nurse makes thepatient independent of him or her as soon as possible."


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HER THEORY AND THE NURSING PROCESS


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CHARACTERISTIC OF HENDERSONS THEORY

Theories can interrelate concepts in such a way as to

create a different way of looking at a particularphenomenon.

Concepts of fundamental human needs, biophysiology,culture, and interaction, communication and isborrowed from other discipline.E.g.. MaslowsHierarchy of human needs; concept of interaction-communication i.e. nurse-patient relationship

Theories must be logical in nature.

Her definition and components are logical and the 14

components are a guide for the individual and nurse inreaching the chosen goal.

Theories should be relatively simple yet generalizable.

Her work can be applied to the health of individuals ofall ages.


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Theories can be the bases for hypotheses thatcan be tested. Her definition of nursing cannot

be viewed as theory; therefore, it is impossible togenerate testable hypotheses.

However some questions to investigate thedefinition of nursing and the 14 components maybe useful.

Is the sequence of the 14 components followed bynurses in the USA and the other countries?

What priorities are evident in the use of thebasic nursing functions?

Theories contribute to and assist in increasingthe general body of knowledge within thediscipline through the research implemented tovalidate them.


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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.

Theories 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.

Theories must be consistent with other validated

theories, laws, and principles but will leave openunanswered questions that need to be investigated.


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PHILOSOPHICAL CLAIMS

The philosophy reflected in Henderson's theory is an

integrated approach to scientific study that would

capitalize on nursing's richness and complexity, and

not to separate the art from the science, the "doing" of

nursing from the "knowing", the psychological from the

physical and the theory from clinical care.


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VALUES AND BELIEFS

Henderson believed nursing as primarily complementing thepatient by supplying what he needs in knowledge, will orstrength to perform his daily activities and to carry out thetreatment prescribed for him by the physician.

She strongly believed in "getting inside the skin" of her

patients in order to know what he or she needs. The nurseshould be the substitute for the patient, helper to thepatient and partner with the patient.

Like she said...

"The nurse is temporarily the consciousness of theunconscious, the love of life for the suicidal, the leg of theamputee, the eyes of the newly blind, a means of locomotionfor the infant and the knowledge and confidence for theyoung mother..."Henderson stated that Thorndikesfundamental needs of man (Henderson, 1991, p.16) had aninfluence on her beliefs.


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HENDERSONS THEORY AND NURSING

PROCESS

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.


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NURSING PROCESS HENDERSONS 14 COMPONENTS AND DEFINITON

OF NURSING

Nursing Assessment Hendersons 14 components

Nursing Diagnosis Analysis: Compare data to knowledge base of health and disease.

Nursing plan Identify individuals ability to meet own needs with or without

assistance, taking into consideration strength, will or knowledge.

Nursing implementation Document how the nurse can assist the individual, sick or well.

Nursing implementation Assist the sick or well individual in to performance of activities in

meeting human needs to maintain health, recover from illness, or to aid

in peaceful death.

Nursing process Implementation based on the physiological principles, age, cultural

background, emotional balance, and physical and intellectual capacities.

Carry out treatment prescribed by the physician.

Nursing evaluation Hendersons 14 components and definition of nursing

Use the acceptable definition of ;nursing and appropriate laws related to

the practice of nursing.The quality of care is drastically affected by the preparation and native

ability of the nursing personnel rather that the amount of hours of care.

Successful outcomes of nursing care are based on the speed with which

or degree to which the patient performs independently the activities of

daily living


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USEFULNESS

Nursing education has been deeply affected by

Hendersons clear vision of the functions of nurses.

The principles of Hendersons theory were published in

the major nursing textbooks used from the 1930sthrough the 1960s, and the principles embodied by the

14 activities are still important in evaluating nursing

care in thee21st centaury.

Others concepts that Henderson (1966) proposed havebeen used in nursing education from the 1930s until

the present O'Malley, 1996)


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LIMITATIONS

Lack of conceptual linkage between physiological andother human characteristics.

No concept of the holistic nature of human being.

If the assumption is made that the 14 components

prioritized, the relationship among the components isunclear.

Lacks inter-relate of factors and the influence of

nursing care.

Assisting the individual in the dying process shecontends that the nurse helps, but there is little

explanation of what the nurse does.Peaceful death is

curious and significant nursing role.


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APPLICATION:IMPLICATIONS FOR PRACTICE

The nurse who sees herself as reinforcing the patient

when he lacks will, knowledge, or strength will make

an effort to know him, understand him, get inside his

skin, as I have said. This process of putting oneself in

anothers place is always difficult and only relatively

successful. It requires a listening ear and constantobservation and interpretation of nonverbal behaviour.

It also demands of the nurse self-understanding and

the recognition of emotions that block her concentration

on the patients need and helpful responses to those

needs. It calls for a willingness so that a mutualunderstanding may develop between a nurse and a

patient.


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The nurse who wants to understand and help each

patient will welcome opportunities to see and talk with

his friends and family. If the cause of his illness is to beknown, if his independence is to be established and a

recurrence prevented, the nurse who participates in all

these aspects of comprehensive care must work with

and through others. Her greatest contribution may be to

help a member of the family to understand what the patient needs from him or her.

No matter what the setting, the nurse who is

reinforcing, or supplementing the patient will help him

perform all the 14 fundamental or basic human needs.She will make with the patient, his family and other

members of the health team some sort of individualized

plan, or daily regimen, that meets the wide range of

human needs.


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The rehabilitation of all patients in the hands of the

nurse begins with her first service to him. With this

point of view, and if she has a wide range ofcompetence, the nurse can be the prime rehabilitative

agent. Such a nurse judges her success with each

patient according to the speed with which or the degree

to which he performs independently the activities that

make, for him, a normal day. This primary function ofthe practicing nurse must be performed in such a way

that it promotes the physicians therapeutic plan. The

means helping the patient carry out prescribed

therapeutic treatments or administering the treatmentherself.


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Finally, to close the discussion of how my definition

affects practice, I point out that the nurse who sees her

primary function as a direct service to the patient will find an immediate reward in his progress toward

independence through this service. To the extent that her

practice offers this reward, she will be satisfied; to the

extent that the situation deprives her of it, she will be

dissatisfied. And she will use whatever influence she hasto foster conditions that make social rewards for practice

at least commensurate with those for teaching and

administration.


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IN PRACTICE: Assist nurses to describe, explain, and predict

everyday experiences. Serve to guide assessment, interventions, and

evaluation of nursing care.

Provide a rationale for collecting reliable and valid dataabout the health status of clients, which are essential

for effectiv e decision making and implementation. Help to describe criteria to measure the quality of

nursing care.

Help build a common nursing terminology to use incommunicating with other health professionals.

Ideas are developed and words are defined.

Enhance autonomy (independence and self-governance)of nursing through defining its own independentfunctions.


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IN EDUCATION:

Provide a general focus for curriculum design

Guide curricular decision making.


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IN RESEARCH:

Offer a framework for generating knowledge and new ideas. Assist in discovering knowledge gaps in the specific field of

study.

Offer a systematic approach to identify questions for study;select variables, interpret findings, and validate nursinginterventions.

Approaches to developing nursing theory

Borrowing conceptual frameworks from other disciplines.

Inductively looking at nursing practice to discovertheories/concepts to explain phenomena.

Deductively looking for the compatibility of a generalnursing theory with nursing practice.

Questions from practicing Nurse about using Nursing theory


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REFLECTIONS

WE MAY NOT BE ABLE TO FORMULATE ACONCEPTUAL FRAMEWORK AND MAY NOT BECOME

A GREAT NURSING THEORIST. BUT AS A NURSEWHO SELFLESSLY SERVE MANDKIND, WE ARE A

NATURAL HERO. TO CARE IS OUR HABIT, OURCOMPASSION IS PRICELESS, THE STRENGTH WE

POSSESS IS NEVER ENDING.SPENDING OUR LIVESIN SERVICE TO OTHERS,

WE CAN SOMEHOW SAY, WE MADE A BIGDIFFERENCE IN THEIR LIVES IN OUR OWN LITTLE

WAY.ALLOW US TO SHARE SOME EXPERIENCES THAT

WOULD SOMEHOW

REFLECT THE MAR K WE HAVE LEFT IN THEM.

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