2. Ernestine Wiedenbach (August 18, 1900 -March 8, 1998) Born in Hamburg, Germany Family moved to New York in 1909 She greatly admired the private duty nurse who cared for her ailing grandmother Education 1922- B.A. from Wellesley College 1925 -R.N. from Johns Hopkins School of Nursing 1934 - M.A. from Teachers College, Columbia University 1946 - Certificate in nurse-midwifery from the Maternity Center Association School for Nurse- Midwives in New York

3. Ernestine Wiedenbach Profession 1952-Yale faculty as an instructor in maternity nursing 1954 -Assistant professor of obstetric nursing 1956 -Associate professor She taught at Yale along with Ida Orlando and Virginia Henderson She developed her model from her vast practical experience and education and after a long career at Yale. 1966 - Retired and moved to Florida

4. Her interest in nursing began with her childhood experiences with nurses She greatly admired the private duty nurse who cared for her ailing grandmother.

5. “ Nursing is a helping art.” “It is a goal directed, deliberate blending of thoughts, feelings, perceptions and actions to understand the patient and his condition, situation, and needs, to enhance his capability, improve his care, prevent recurrence of the problem and to deal with anxiety, disability or distress.” “It is a goal directed, deliberate blending of thoughts, feelings, perceptions and actions to understand the patient and his condition, situation, and needs, to enhance his capability, improve his care, prevent recurrence of the problem and to deal with anxiety, disability or distress.”

6.  A Philosophy  A Purpose  A Practice  An Art

7. Wiedenbach described philosophy as “an aggregate of personal beliefs, reflecting one’s attitude towards life or reality” The nurses' philosophy is their attitude and belief about life and how that effected reality for them motivates the nurse to act guides her thinking about what she is to do influences her decisions.

8. A nurse’s philosophy includes: An appreciation for life and seeing it as a gift Respecting individuals’ “dignity, worth, autonomy, and individuality” Relating beliefs to professional nursing responsibilities Philosophy underlies purpose, and purpose reflects philosophy

9. The nurse’s purpose is that which the nurse wants to accomplish through what she does The intention of the nurse’s action for the well-being of the patient who requires help It is all of the activities directed towards the overall good of the patient The nurse’s reason for being and for doing

10. The nurse’s practice are those observable nursing actions that are affected by beliefs and feelings about meeting the patient’s need for help Overt action, directed by disciplined thoughts and feelings toward meeting the patient’s need-for-help It is goal-directed, deliberately carried out and patient- centered.

11. Three aspects necessary for effective practice Knowledge encompasses all that has been perceived and grasped by the human mind; its scope and range are infinite Factual, Speculative or Practical Judgment Clinical Judgment represents the nurse’s likeliness to make sound decisions Sound decisions are based on differentiating fact from assumption and relating them to cause and effect Skills Represent the nurse’s potentiality for achieving desired results Comprise numerous and varied acts, characterized by harmony of movement, expression and intent, by precision, and by dexterous use of self May be classified as to: -Procedural skills -Communication skills

12. Components directly related to patient’s care: Identification Ministration Validation Component indirectly related to patient’s care: Coordination of Resources Reporting Consulting Conferring

13. Identification of patient’s need for help involves 4 steps 1. the nurse uses powers of observation to look listen for actual consistencies and inconsistencies 2. the nurse explores the meaning of the patient’s behavior with the patient 3. the nurse determines the cause of the patient’s discomfort or incapability 4. the nurse verifies whether the patient can resolve his problem or if the patient has the need-for help

14. Ministration of need help involves Making a plan to meet patient needs Presenting it to the patient Validation Clarification from the patient to determine whether he believes the need-for-help was met.

15. Application of knowledge and skill to bring about desired results Four main goals: understanding patients needs and concerns developing goals and actions intended to enhance patients ability directing the activities related to the medical plan to improve the patients condition

16. Nursing Nurses ascribe to an explicit philosophy Basic to this are: Reverence for the gift of life Respect for the dignity, worth, autonomy and individuality of each human being Resolution to act on personally and professionally held beliefs The human being strives towards self direction and relative independence

17. Person Each Person is endowed with a unique potential to develop self- sustaining resources People generally lean towards independence and fulfillment of responsibilities Self-awareness and self- acceptance are essential to personal integrity and self- worth

18. Nurse a functioning human being. not only acts, but thinks and feels as well Patient is any person who has entered the healthcare system and is receiving help of some kind, such as care, teaching, or advice someone receiving nursing care and health-related education

19. Caring Perception of people in need in relation to nursing action which is successful to nursing care Need-for-help any measure desired by the patient that has the potential to restore or extend the ability to cope with various life situations that affect health and wellness It is crucial to nursing profession that a need-for-help be based on the individual perception of his own situation

20. Nursing Skills Are carried out to achieve a specific patient-centered purpose rather than task- oriented Skills are made up of a variety of actions Characterized by: Harmony of movement Precision Effective use of self

21. Wiedenbach's prescriptive theory is based on three factors: The central purpose which the practitioner recognizes as essential to the particular discipline The prescription for the fulfillment of central purpose. The realities in the immediate situation that influence the central purpose.

23. Central purpose The quality of health a nurse desires to affect or sustain in her patient Specifies what she recognizes to be her special responsibility in caring for the patient Reflects the nurses philosophy for care which is essential to the nursing profession

24. Prescription The plan of care A directive to activity Specifies both the nature of the action and the thinking process The nursing actions may be: voluntary (intended response) involuntary (unintended response)

25. Realities Situations of nurse- patient interaction To provide nursing action Factors that consist the realities: Physical Physiological Psychological Emotional Spiritual

26. 5 Components of Realities 1. The agent – who is the nurse supplying the nursing action 2. The recipient – the patient receiving the action 3. The framework – situational factors that affect the nurse’s ability to achieve nursing results 4. The Goal – the end to be attained through nursing activity 5. The Means – the actions and devices through which the nurse is enabled to reach the goal

27. To resolve assumptions about the realities To specify the goals and objective To carry out nursing action based on the identified goals To engage in activities that contribute to self realization and nursing improvement.

28. Identification Ask questions, observe cues Can the patient meet own needs? Requires judgment & clarification Ministration Use knowledge, experience & skill Develop a mutual plan/goal Validation Are desired goal achieved? Was the nurse action helpful?

29. It is functional to the domain of nursing because the theory concepts are well defined. However it does lack the complete application of metaparadigm of nursing. Health is not defined nor discussed and environment is also not defined