VIRGINIA HENDERSON (1897-1996)

Needs Theory November 8, 2021 ~ THEORETICAL FOUNDATIONS IN NURSING

I. METAPARADIGN IN NURSING
 For Henderson, the practice of nursing as independent from the practice of physicians and
acknowledged her interpretation of the nurse’s role as a synthesis of many influences.
a) Nursing
 Henderson’s definition of nursing was considered as the “signature’ of the profession”
 According to Henderson, nurse must promote the treatment plan prescribed by
physician.
 The nurse must act independently but in coordination with the therapeutic plan
although he or she is a part of the health care team.
 Another special role of nurse is to help both sick and well; care must include people
from all walks of life, from well to sick, and from new born to dying.
 The care given by nurses must empower the client to gain independence as rapidly as
possible.
 A nurse must be knowledgeable in both biological and social sciences and must have
the ability to assess the basic human needs.
b) Person
 Henderson referred to a person as a client.
 A person is an individual who requires assistance to achieve health and independence
in some cases, a peaceful death.
 Henderson introduced the concept of mind and body of a person as inseparable; for a
person to function the utmost, he or she must maintain physiological and emotional
balance.
c) Health
 For Henderson, health is the quality of life and is very basic in order for a person to
function fully.
 Health is a vital need and it requires independence and interdependence.
 It is also a multi-factor phenomenon therefore, it is influenced by both internal and
external factors which play independent and interdependent roles in achieving health.
  She emphasized tat prioritizing health promotion is more important that care of the
sick.
d) Environment
 It is essential for a healthy individual to control the environment however, if illnesses
occur, this could be affected. It is the responsibility of the nurse to help the client
manage his surroundings in order to protect them from harm or injury.
 The nurse must be aware of different social customs and religious practices to assess
dangers.
 They must provide physicians data about the safety needs of the client, observations,
and judgement regarding the needs for this is the basis in prescribing protective
devices.
 It is also the responsibility of the nurse to recommend changes regarding construction
of building, purchase of equipment, and maintenance to minimize the chances of
injury.
II. NEEDS THEORY
 Henderson conceptualized the 14 Fundamental Needs of Humans. These needs are:
1. Breathe Normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain a desirable position or posture
5. Sleep and rest
6. Select suitable clothes - dress and undress
7. Maintain body temperature within a normal range by adjusting clothing and modifying the
environment
8. Keeping the body clean and well groomed and protect the integument (skin)
9. Avoid dangers in the environment and avoid injuring others
10. Communicate with others in expressing emotions, needs, fear or opinions
11. Worship according to one’s faith
12. Work in such a way that there is a sense of accomplishment
13. Play or participate in various forms of recreation
14. Learn, discover or satisfy the curiosity that leads to normal development and health, and
use the available health facilities.
  She emphasized the need to view the client and his family as a single unit. The client needs
support system (emotional needs) which in many cases is provided by the family.
 She postulated that nurse functions in relation with the client, physician, and other members of
the health team and each type of relationship gives nurses specific responsibilities and roles.
a) The Nurse - Patient Relationship
Henderson stated that there are three levels comprising the nurse-patient relationship:
1. The nurse as the substitute for the client - the nurse serves as the substitute as to
what the client lacks such as knowledge, will, and strength in order to make him
complete, whole, and independent once again.
2. The nurse as helper to the client - the nurse served as the helper when the client
cannot meet his needs. These needs are needed to achieve health therefore, the
nurse focuses her attention in assisting the client meet these needs to regain
independence.
3. The nurse as partner with the patient - the nurse and the patient formulate a plan
together as a team. The nurse can empower the client to make effective decisions
since he or she is both an advocate and a resource person.
b) The Nurse - Physician Relationship
According to Henderson, the nurse functions independently from physicians. Despite that
the nurse and the client work as partners, it is still necessary for them to work on the prescribed
therapeutic plan of the physician. Henderson insisted that nurses do not follow doctor’s orders
but they follow in a philosophy which allows physicians to give orders to clients or other health
care team members. She emphasized that a lot of nursing roles and responsibilities overlap with
those of the physician’s.
c) The Nurse as a Member of the Healthcare Team
The nurse as a member of the healthcare team, works and contributes in carrying out the
total program of care.

III. ACCEPTANCE BY THE NURSING THEORY

1. Practice
Henderson’s approach focuses on decision-making and is deliberate in such a way that in
every step of the Nursing Process, it plays very important roles. Even though Henderson
believed that the Nursing process is a problem-solving process that could be used to answer the
client’s needs, the steps involved are not that strange to nursing alone.
a) Assessment Phase
 the nurse would assess the 14 fundamental needs of the clients and check which one is
lacking or fully met. She gathers data by observing, smelling, feeling, and hearing. To
complete this phase, the nurse uses critical thinking and analyzes every data collected
to come up with a clear picture of the condition of the client.
b) Planning Phase
 Involves giving the plan of care to meet the needs and personality of the client. It must
serve as a record and at the same time must fir in the prescribed plan made by the
physician. To make the plan the same with the goals of the healthcare team, the roles
and responsibilities of each professional member must be included and integrated to
the care plan.
c) Implementation Phase
 The nurse uses the 14 basic needs in answering the factors that are contributing to the
illness state of the client. These interventions are focused in maintaining health, to
recover from illness, or to aid an peaceful death. She performs these activities that are
directed in helping the client attain his independence as fast as possible.
d) Evaluation Phase
 The nurse and the client review the relationship and decide whether the goals are met
or not. The nurse also assesses if the client attained independence and if health is
achievep d.