Virginia Hendersons Nursing Theory Handout 1 NURS 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 Bachelors Degree in 1932 and her Masters 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

Virginia Hendersons Nursing Theory Handout 2 NURS 600, Fall 2008, Idaho State University
Rush University Pace University Catholic University of America 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 Harmers 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. OMalley (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.

Virginia Hendersons Nursing Theory Handout 3 NURS 600, Fall 2008, Idaho State University
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. 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). Weve 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). Hendersons 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 Hendersons Nursing Theory Underpinnings of Theory

Virginia Hendersons Nursing Theory Handout 4 NURS 600, Fall 2008, Idaho State University
Virginia Hendersons background was developed during the era of nursing and medicine where patients needs were of primary concern. As such, her theory is often called a Needs Theory.

Characteristic of Virginia Hendersons 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. 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 Hendersons 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 ones faith. 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation.

Virginia Hendersons Nursing Theory Handout 5 NURS 600, Fall 2008, Idaho State University
14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. Nursings Metaparadigm Concepts Using Virginia Hendersons 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 11. Worship according to ones faith.

Sociological Aspects 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. Psychological Aspects 10. 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

Virginia Hendersons Nursing Theory Handout 6 NURS 600, Fall 2008, Idaho State University

Not specifically defined in Virginia Hendersons theory, but includes individuals 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 Hendersons 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 Hendersons idea of the nurses role consisted of three elements: Substitutive: the nurse does for the patient Supplementary: the nurse helps the patient Complementary: the nurse works with the patient Testability

Virginia Hendersons 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 Hendersons 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.

Virginia Hendersons Nursing Theory Handout 7 NURS 600, Fall 2008, Idaho State University
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 Hendersons 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 patients data to knowledge base of health and disease. Assess baseline for 14 components to aid in planning Identify individuals ability to meet own needs with or without assistance, taking into consideration strength, will, and knowledge Plan and document how the nurse can assist the individual, sick or well, back to independence Assist the individual in performance of activities to meeting needs necessary to maintain health, recover from illness, or to aid in peaceful death Successful outcomes of nursing care based on the speed with which or degree to which the patient performs independently the activities of daily living

Diagnosis Plan Intervention

Evaluation

Maslows Hierarchy and the Relationship to Virginia Hendersons Nursing Theory

Maslows Hierarchy Physiological needs

Virginia Hendersons 14 Basic Nursing Functions Breathe normally Eat and drink adequately Eliminate by all avenues of elimination Move and maintain desirable posture Sleep and rest

Virginia Hendersons Nursing Theory Handout 8 NURS 600, Fall 2008, Idaho State University

Select suitable clothing Maintain body temperature Keep body clean and well groomed and protect the integument Safety needs Belongingness and love needs Esteem needs Avoid environmental dangers and avoid injuring others Communicate with others Worship according to faith 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 Hendersons 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. 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 Hendersons Nursing Theory 1. Compare and contrast the theory of Virginia Henderson with her predecessor, Florence Nightingale, to whom she is often compared. Does Hendersons theory appear to follow Nightingales theory or are their deviations? Does Henderson appear to concentrate on the same basic principles as Nightingale?

Virginia Hendersons Nursing Theory Handout 9 NURS 600, Fall 2008, Idaho State University
2. Are there any aspects of Virginia Hendersons 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 Hendersons Nursing Theory Handout 10 NURS 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), 3748. 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.

Virginia Hendersons Nursing Theory Handout 11 NURS 600, Fall 2008, Idaho State University
Pointillism reflects the generalist theory of Virginia Henderson. Retrieved September 12, 2008 from http://nursing.clayton.edu/eichelberger/point illhenderson.JPG.