VIRGINIA HENDERSON

Introduction

 “The Nightingale of Modern Nursing”

 “Modern-Day Mother of Nursing.”
 "The 20th century Florence Nightingale."
 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.
 Worked at the Henry Street Visiting Nurse Service for 2 years after graduation.
 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, remained until 1948.
 Since 1953, a research associate at Yale University School of Nursing.
 Recipient of numerous recognitions.
 Honorary doctoral degrees from the Catholic University of America, Pace University,
University of Rochester, University of Western Ontario, Yale University
  In 1985, honored at the Annual Meeting of the Nursing and Allied Health Section
of the Medical Library Association.
 Died: March 19, 1996.
 In 1939, she revised: Harmer’s classic textbook of nursing for its 4th edition, and
later wrote the 5th; edition, incorporating her personal definition of nursing
(Henderson,1991)

Theory Background

 She called her definition of nursing her “concept” (Henderson1991)

 She emphasized the importance of increasing the patient’s independence so that
progress after hospitalization would not be delayed (Henderson,1991)
 "assisting individuals to gain independence in relation to the performance of activities
contributing to health or its recovery" (Henderson, 1966).
 She categorized nursing activities into 14 components, based on human needs. 
 She described the nurse's role as substitutive (doing for the person), supplementary
(helping the person), complementary (working with the person), with the goal of
helping the person become as independent as possible.
 Her definition of nursing was:

"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).
The 14 components

 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 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.

The first 9 components are physiological. The tenth and fourteenth are psychological
aspects of communicating and learning The eleventh component is spiritual and moral
The twelfth and thirteenth components are sociologically oriented to occupation and
recreation

Henderson’s theory and the four major concepts

1. Individual

 Have basic needs that are component of health.

 Requiring assistance to achieve health and independence or a peaceful death.
 Mind and body are inseparable and interrelated.
 Considers the biological, psychological, sociological, and spiritual
components.
 The theory presents the patient as a sum of parts with biopsychosocial needs.

2.  E n v i r o n m e n t

 Settings in which an individual learns unique pattern for living.

 All external conditions and influences that affect life and development.
 Individuals in relation to families
 Minimally discusses the impact of the community on the individual and
family.
 Basic nursing care involves providing conditions under which the patient can
perform the 14 activities unaided
3. H e a l t h

 Definition based on individual’s ability to function independently as outlined

in the 14 components.
 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 Is the individual’s ability to
meet these needs independently.

4. Nursing

 Temporarily assisting an individual who lacks the necessary strength, will and
knowledge to satisfy 1 or more of 14 basic needs.
 Assists and supports the individual in life activities and the attainment of
independence.
 Nurse serves to make patient “complete” “whole", or "independent."
 The nurse is expected to carry out physician’s therapeutic plan Individualized
care is the result of the nurse’s creativity in planning for care.
 “Nurse should have knowledge to practice individualized and human care and
should be a scientific problem solver.”
 In the Nature of Nursing Nurse role is,” to get inside the patient’s skin and
supplement his strength will or knowledge according to his needs.”
Question #3:

A nursing theory is a set of concepts, definition, relationship, and assumptions or

propositions derived from nursing models or form other disciplines and project a
purposive, systematic view of phenomena by designing specific inter relationship
among concepts for purpose of describing, explaining, predicting, and prescribing.
Nursing Theory is an organized and systematic articulation of a set of statements
related to questions in the discipline of nursing. It’s provide the foundations of
nursing practice, help to generate further knowledge and indicate in which direction
nursing should develop in the future. Theory is important because it helps us to decide
what we know and what we need to know. It also helps to distinguish what should
form the basis of practice by explicitly describing nursing. The benefits of having a
defined body of theory in nursing include better patient care, enhanced professional
status for nurses, improved communication between nurses, and guidance for research
and education.

The main exponent of nursing is caring it cannot be measured, it is vital to have

the theory to analyze and explain what nurses do. As medicine tries to make a move
towards adopting a more multidisciplinary approach to health care, nursing continues
to strive to establish a unique body of knowledge. This can be seen as an attempt by
the nursing profession to maintain its professional boundaries. The issue is blurred
further because the boundaries between nursing and medicine are never static. For
example, as nurses increasingly extend their scope of practice by performing tasks
previously carried out by doctors, many of their own traditional roles are being passed
on to healthcare assistants. However, because these boundaries are constantly
changing, perhaps it is more important than ever that nurses are able to define their
position and their role. By providing nurses with a sense of identity, nursing theory
can help patients, managers and other healthcare professionals to recognize the unique
contribution nurses make to the healthcare service (Draper 1990). A formal definition
of nursing theory also provides nurses with an understanding of their purpose and role
in health care.

In clinical practice where nursing theory has been employed in a clinical setting,
it’s primary contribution has been facilitation of reflection, questioning, and thinking
about what nurses do. Because nurses and nursing practice are often subordinated to
powerful institutional forces and traditions, the introduction of any framework that
encourages nurses to reflect on, think about, and questions what they do provides an
invaluable service. In research, nurses have repeatedly insisted that nursing research
identifies the philosophical assumptions or theoretical frameworks from which it
proceeds. That is because all thinking, writing, and speaking is based on previous
assumptions about people and the world. New theoretical perspectives provide an
essential service by identifying gaps in the way we approach specific fields of study
such as symptom management or quality of life. Different theoretical perspectives can
also help generate new ideas, research questions, and interpretations.
 Theory, Research and Practice are the cornerstones of the nursing profession. The
relationship of these three cornerstones are reciprocal and cyclical. Clinical practice
generates research questions and knowledge for theory. Research guides our practice
and build knowledge through theory development. Theory guides research and
improve practice. According to some articles they describe the relationship among the
three cornerstones of nursing Practice, research, and theory and discuss the theory-
practice gap as an impediment to theory-based practice. Effective nursing practice
requires the application of knowledge, skills, caring, and art to care for patients in an
effective, efficient, and considerate way. An important part of the knowledge used in
making nursing clinical decisions is produced by research findings. Ideally, all patient
care decisions should be based on research-evidence. Research findings are used to
develop a protocol and the protocol is followed in daily nursing practice.

The primary purpose of theory in the profession of nursing is to improve practice

by positively influence the health and quality of life of patients. The relationship
between theory and practice is reciprocal. Practice is the basis for the development of
nursing theory whereas nursing theory must be validated in practice. An ongoing
challenge to the nursing profession is to keep the important relationship between
research, theory and practice in force. Practice invariably will spark questions that
lead to research ideas, and the answers to those questions will translate into theories
that will guide nursing practice based on evidence.