By Shannon Demboski, Tracie Strand and David Gregson

“The Nightingale of Modern Nursing”

Born in Kansas City, Missouri, in 1897 Diploma in Nursing from the Army School of Nursing at Walter Reed Hospital, Washington, D.C. in 1921 In 1923, started teaching nursing at the Norfolk Protestant Hospital in Virginia In 1929, entered Teachers College at Columbia University for Bachelor’s Degree in 1932, Master’s Degree in 1934 Joined Columbia as a member of the faculty, until 1948 Since 1953, a research associate at Yale University School of Nursing -

She recieved honorary doctoral degrees from the Catholic University of America, Pace University, University of Rochester, University of Western Ontario, Yale University Recipient of numerous recognitions Died: March 19, 1996

Henderson recognized the unique funtions of the nurse were: to assist the individaul, the sick, the well assist patients to be able to perform activities contributing to health or its recovery help the patient perform functions they could not do

Virginia Henderson's defined nursing as follow: "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).

Henderson's philosophy empasizes the functions of the nurse along with a list of basic patient needs that are to be the focus of nursing care Henderson's main focus was on patient care and increasing independence Henderson theory was developed on 14 basic needs for her patients Her concepts were based on Maslow's Hierarchy of Needs

"While a nurse's job is to care for patients, it also helps patients to able to care for themselves when they leave the health care facility" (Nursing Theories and Models p.1). Maslow relative to Henderson: 14 Components of of her need theory mirrors Maslow's Hierarchy of needs by her humanism approach. Henderson also felt patient's once independent, a patient could accomplish these needs. Conversely, the nurse was there to facilitate this process when the pateint was unable to accomplish this in a compromised state. Henderson Goal: Henderson wasn't concerned with a personal nursing theory per se, rather define a unique nursing practice in the care of patients.

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.

Virgina 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". 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 the science and art on which it seems effective health care services of any kind is based."

Breathe normally Eat and drink adequately Eliminate body wastes Move and maintain desirable postures Sleep and rest Select suitable clothes-dress and undress Maintain body temperature within normal range by adjusting clothing and modifying the environment

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

Understanding the Nursing Process AssessmentCompare patient’s data to knowledge base of health and disease. Assess baseline for 14 components to aid in planning DiagnosisIdentify individual’s ability to meet own needs with or without assistance, taking into consideration strength, will, and knowledge PlanPlan and document how the nurse can assist the individual, sick or well, back to independence InterventionAssist the individual in performance of activities to meeting needs necessary to maintain health, recover from illness, or to aid in peaceful death EvaluationSuccessful outcomes of nursing care based on the speed with which or degree to which the patient performs independently the activities of daily living

Maslow's Hierarchy and the Relationship to Henderson's Theory Virginia Henderson’s 14 Basic Nursing Functions Physiological 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 needsAvoid environmental dangers and avoid injuring others Belongingness and love needs Communicate with others Worship according to faith Esteem needsWork at something providing a sense of accomplishment Play or participate in various forms of recreation Learn, discover, or satisfy curiosity Self actualization needs None

Human Being-each patient has specific needs, individualizing care to meet the needs of each patient to promote health and optimal functioning. Environment-the environment plays an important role in patient participation and enhances optimal functioning Health-providing care to patients who are unable to accomplish specific functions unassisted, while working toward restoring the patient to the highest level of functioning. Nursing-nurses need to address the patients needs and develop a plan using the nursing process

Promotion of Wellness: "According to Henderson, nurses need to prevent disease and promote health" (Nursing Theories and Models p.1). Preventative Medicine: Henderson was ahead of her time advocating prevention, recognizing healthy life style changes and promoting these changes. Wellness Concepts: Henderson believed nurses had to teach patients certain concepts to promote health and embrace this teaching. These included, but not limited to diet, rest, exercise and also help patients with psychosocial recovery visa supporting spirituality and combine these concepts in a holistic approach.

"Henderson supported nursing research, but believed that it should be clinical research" (O'Malley, 1996). Support of Henderson that she Embraced: Much of the research before her time had been on educational processes and on the profession of nursing itself, rather than on; the practice and outcomes of nursing, and she worked to change that" (Journal of Advanced Nursing pp.7,103-09). Criticisms: The critical analysis of her model was a void existed between physiologic and other human characteristics. Further, there is no linkage between holistic human nature and her role relationships. 14 Components Unclear: If the assumption is made that the 14 components is prioritized, the relationship is unclear. For example, she states that nurses have a role in helping the patient accept end of life care, it's not clear how this occurs.

In Practice:Nurses serve to guide assessment, interventions, and evaluation of nursing care. Evidenced Base Practice: Provide a rationale for collecting reliable and valid data about health status of clients. Rationale: By defining data and validating information implementation of care ensures quality nursing care. Methods: Helping to build common nursing terminology to use while communicating with other health professionals ideas and information are defined. These methods are reinforced through education and research.

Henderson Analysis: Henderson supported and used Maslow Hierachy of needs in her needs theory via the14 components by a humanism approach. She sought to refine nursing practice by collaborating with other professionals and through a defined language between nursing. She emphasized the advocacy of patients by nurses while patients were ill until they could do this for themselves. She was a proponent of education and wellness teaching. She believed, ahead of her time, prevention is the best medicine. Henderson was a unclear link between holistic human nature and role relationships, she worked diligently to change nursing process and research thus building evidenced based practice concepts in the nursing care model.

You are a nurse working on a rehab unit. Mrs. Smith was just admitted to your unit after a brief stay at the hospital following surgery. The patient is an alert and oriented, she is an 86 year old female who had a fall at home, resulting in fractures. Your patient was admitted with a left hip hemiarthroplasty and a right arm fracture. The patient is required to wear a sling at all times and is non-weight bearing to the right arm. The patient is able to put weight on the left leg as tolerated. Prior to the fall, the patient was able to care for herself and was continent of bowel and bladder. During her hospital stay, Mrs. Smith had a foley catheter. The catheter was removed 2 days ago and the patient has been unable to void on her own. She will need bladder scanned and st. cath every 6 hours if no void. The patient will be participating with physical therapy daily to regain strength and eventually return home. Since Mrs. Smith is unable to accomplish some of the basic needs, the nursing staff will have to assist with her cares. Virginia Henderson’s needs theory can be applied to this patient situation. Henderson theory focuses on 14 basic components based on basic human needs. The main concept of her theory are to assist the patient accomplish what they are unable to do on her own and restore the patient to optimal functioning. Which components from Henderson’s needs theory are of highest priority for the nurse to focus on? Do you think how the nurses interact and respond to the patients’ needs, will allow Mrs. Smith to recover quicker?

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