Nursing Theory Presentation: The Helping Art of Clinical Nursing By Arielle Pearson & Jacqueline Thomas

Ernestine Wiedenbach Ernestine Wiedenbach was born August 18, 1900 into a well refined and gentle manor family, the youngest of four daughters, that had immigrated from Germany when she was just a young child. Ernestine began her interest in nursing through positive influences that she encountered. As a child she watched how her sick grandmother was taken care of and then later was influenced after hearing accounts of hospital experiences from a family friend.

Nursing Background Wiedenbach graduated with a bachelor’s degree in liberal arts from Wellesley College in 1922 and then against her parents wishes enrolled into nursing school. Expelled from Post-Graduate Hospital School of Nursing while acting as a spokesperson for a student group grievances. Allowed to continue studies at Johns Hopkins School of Nursing after Adelaide Nutting contacted them on her behalf. Graduated Johns Hopkins School of Nursing in 1925. Worked at Johns Hopkins and Bellevue in New York 1934 obtained master’s degree from Teachers College, Columbia University along with a certificate in Public Health Nursing. Worked as a professional writer with the Nursing Information Bureau for the American Journal of Nursing. At age 45 enrolled into the School for Midwives. After graduating she practiced as nurse midwife and taught at Teachers College. 1952 appointed to the faculty of Yale University School of Nursing and later became the director of graduate programs in maternal-newborn health nursing.

Nursing Background After a long successful nursing career that included not only clinical practice but teaching and published works, Wiedenbach retired in 1966. At the time of retirement she had never been married or bared children. Ernestine Wiedenbach died March 8th, 1998 at the age of 97.

Nursing Theory “My thesis is that nursing art is not comprised of rational nor reactionary actions but rather of deliberative action” (Wiedenbach, 1964). Ernestine Wiedenbach created the theoretical idea of “The Helping Art of Clinical Nursing”. In the concept of Wiedenbach’s art of nursing, is the prescriptive theory.

The Prescriptive Theory The prescriptive theory contains three components: The nurse’s central purpose that they deem necessary for the particular speciality. The method required to fulfill the purpose. The realities that affect the purpose in the given circumstance (Petiprin, 2016).

Prescriptive Model Realities Central Purpose in Nursing Realities Prescription Realities Realities

Clinical Nursing Wiedenbach named three parts to clinical nursing: a philosophy, a purpose, a practice, and the art (Burst, 1998).

Philosophy Wiedenbach (1963) described philosophy as “an aggregate of personal beliefs, reflecting one’s attitude towards life or reality” (p. 55). A nurse’s philosophy includes: An appreciation for life and seeing it as a gift (Wiedenbach, 1963). Respecting individuals’ “dignity, worth, autonomy, and individuality” (VandeVusse, 1997, p. 43). Relating beliefs to professional nursing responsibilities (Wiedenbach, 1963).

Purpose The intention of the nurse’s action for the well-being of the patient who requires help. After deciding the need-for-help, the nurse will use her purpose to guide her actions in addressing the need (Wiedenbach, 1963).

Practice The work seen performed by the nurse that is guided by their feelings on addressing the patient’s need-for-help (Petiprin, 2016). Identifying the need-for-help, Providing the help that is required, and verifying that the help that was needed, was given (Wiedenbach, 1963).

Art “The secret of the helping art of nursing lies in the importance the nurse attaches to her thoughts and feelings and the deliberate use she makes of them as she observes her patient, identifies his need for help, ministers to his need, and validates that the help she gave was helpful” (Wiedenbach, 1963, p. 57).

Art Wiedenbach (1963) concludes that if the nurse is able to: be aware of their beliefs and feelings, acknowledge the significance of them, direct them towards their purpose and philosophy, ...then the nurse will be able to enhance their work and “experience enduring satisfaction from the helping service she has rendered” (p. 57).

Relating the Theory Arielle The theory focuses on the nurse defining the client’s need-for-help in order to provide care. The patient is defined as anyone who needs help even if they are not sick or injured (Petiprin, 2016). Home health nursing

Relating the Theory Arielle In the theory, importance is placed on the use of a nursing philosophy to guide goals and actions (Wiedenbach, 1963). The nurse is seen as someone who has their own thoughts and feelings and does not just merely act (Petiprin, 2016). My nursing philosophy includes balancing my work with my own personal life and well-being in order to serve other and provide optimal care.

Relating the Theory Jacqueline This theory is based on a nurses ability of interaction and action in helping patients based on what their own needs. “The nurse is a functioning human being who not only acts, but thinks and feels” (Petiprin, 2016). The patient can be anyone who steps into the healthcare field they do not have to have illness to receive health-related education (Wiedenbach,1964).

Relating the Theory My nursing philosophy: "To be a nurse is to give of not only your mind but of your whole heart. To encompass knowledge, compassion and empathy into something you were created to be not just something you were made to be." ​

Conclusion Summary of the theory: Wiedenbach (1963), describes nursing as a helping art that: Utilizes a nurse’s ideas, beliefs, and actions Prompted by a patient’s recognition of their need for help Founded on the nurse’s own philosophy Applied to carry out a certain purpose

Significant Contribution Ernestine Wiedenbach’s patient centered theory directly contributed to what we know today as the nursing process. The ANA states that the nursing process in one in which the nurse: Assess Diagnosis Plan’s outcomes via a care plan Implements the care plan Evaluates the effectiveness of the care plan continuously

Future Direction of Practice Looking forward we can take Ernestine Wiedenbach theory and evolve it more into the nursing practice of today. We can do this by holistically looking at our patients needs and concerns regarding their health during sickness and wellness. Consider: Complications & Recurrence Prevention Education

Potential Limitations Defined terms can be limiting. The patient, in this theory, is defined as someone who has an established need- for-help. Need-for-help is something desired by the patient based on how they perceive their circumstance. This cannot be applied to patients who are not cognizant of their situation, resistant to care, or don’t feel that they need help.

References ANA. The Nursing Process. Retrieved October 15th, 2016 from http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/Thenursingprocess.html Burst, H. (1998). In memory of Ernestine Wiedenbach. Yale Nurse: Yale School of Nursing Newsletter, 39- 41. Eichelberger, L. (2000). Nursing Theory Web Site. Retrieved from http://www.clayton.edu/nursing/Nursing-Theory/wiedenbachPetiprin, A. (2016). Wiedenbach’s Helping Art of Clinical Nursing. Retrieved from http://www.nursing-theory.org/theories-and-models/wiedenbach-the-helping-art-of-clinical-nursing.php Wiedenbach, E. (1964). Clinical nursing: A helping art. New York: Springer. Wiedenbach, E. (1963). The Helping Art of Nursing. The American Journal of Nursing, 63(11), 54-57. doi: 10.2307/3453018 VandeVusse, L. (1997). Sculpting a nurse-midwifery philosophy Ernestine Wiedenbach’s influence. Journal of Nurse-Midwifery, 42(1), 43-48. doi: 10.1016/S0091-2182(96)00107-3