NURSING THEORISTS AND THEIR THEORY
Philosophy
1. ERNESTINE WEIDENBACH
 Born on August 18, 1900, in Hamburg, Germany
EDUCATION
 B.A. from Wellesley College in 1922 R.N. from
Johns Hopkins School of Nursing in 1925
 M.A. from Teachers College, Columbia University
in 1934
 Certificate in nurse-midwifery from the Maternity
Center Association School for Nurse-Midwives in
New York in 1946.
CAREER
 She was influenced by Ida Orlando in her works on
the framework.
 She wrote Family-Centered Maternity Nursing in
1958. Assistant professor of obstetrics nursing in
1954 and an associate professor in 1956.
 She joined the Yale faculty in 1952 as an instructor
in maternity nursing.
DEFINITION
“Nursing is the art of nurturing or caring for someone in a
motherly fashion”
HELPING ART OF CLINICAL NURSING
HELP = care, teaching, and advice
PATIENT ≠ sick, injured
PHENOMENA
1. Observing behaviors consistent or inconsistent
with their comfort,
2. Exploring the learning of their behavior,
3. Determining whether they can resolve their
problems or have a need for help,
4. Determining whether they can resolve their
problems or have a need for help”
NURSING METAPARADIGM
 Ernestine Weidenbach developed the conceptual
model of nursing called the Helping Art of Clinical
Nursing, which was influenced by the works of Ida
Orlando.
THE HELPING ART OF NURSING
 Identifying a patient's need for help through
observation.
 Exploration of the meaning of those symptoms with
the patient.
 Determining the cause of discomfort.
 If the patient has a need for help.
o 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.”
o IDENTIFIES THE PATIENT
 “Any individual who is receiving help of some kind,
be it care, instruction or advice from a member of
the health profession or from a worker in the field
of health.”
PHILOSOPHY, PURPOSE, PRACTICE, ART
 The nurse’s philosophy is his or her attitude and belief
about life, and how that affects reality for him or her.
 Three essential components: reverence for life; respect
for the dignity, worth, autonomy, and individuality of
each human being; and the resolution to act on
personally and professionally held beliefs.
Purpose
 The nurse’s purpose is that which the nurse wants
to accomplish through her actions. It encompasses
all of the activities directed toward the overall
good of the patient.
Practice
 The observable nursing actions are affected by
beliefs and feelings about meeting the patient’s
need for help.
Art
 Understanding the patient’s needs, developing
goals and actions intended to enhance the
patient’s ability, and directing the activities related
to the medical plan to improve the patient’s
condition. The nurse’s focus is also on the
prevention of complications related to recurrence
or the development of new concerns.
Nursing skills are carried out to achieve a specific patient-
centered purpose rather than the completion of the skill itself
being the end goal. Skills are made up of a variety of actions,
and characterized by harmony of movement, precision, and
effective use of self.
The theory explains that knowledge encompasses all that has
been perceived and grasped by the human mind. It may be
factual, speculative, or practical
CLINICAL AND SOUND JUDGMENT
1. The clinical judgment represents the nurse’s
likeliness to make sound decisions, which are
based on differentiating fact from assumption and
relating them to cause and effect.
2. Sound judgment results from disciplined
functioning of mind and emotions and improves
with expanded knowledge and increased clarity of
professional purpose.
HOW DO WE APPLY?
1. Central Purpose - which the nurse recognizes as
essential to the discipline
2. Prescription - the prescription for the fulfillment of the
central purpose
3. Realities - the immediate situation that influences the
central purpose.
2. VIRGINIA HENDERSON and protect the integument
2. Eat and drink adequately 9. Avoid dangers in the environment and
avoiding injuring others
 Born on November 30, 1897, in Kansas City, 3. Eliminate body waste. 10. Communicate with others in
Missouri, United Sates expressing emotions, needs, fears, or
opinions
4. Move and maintain desirable 11. Worship according to one’s faith
EDUCATION postures
5. Sleep and rest 12. Work in such a way that there is a
 1921- She received a diploma in nursing from the sense of accomplishment
Army School of Nursing at Walter Reed Hospital 6. Select suitable clothes 13. Play or participate in various forms of
recreation
and worked at the Henry Street Visiting Nurse. 7. Maintain body temperature 14. Learn, discover, or satisfy the curiosity
Service for 2 years after graduation. within normal range by that leads to normal development and
adjusting clothing and health and use the available health
 1932 - Entered Teachers College at Columbia modifying environment facilities.
University and earned her bachelor’s degree in
nursing NURSING METAPARADIGM
 1934 - She got her master’s degree. Person
 March 19,1996- She died at the age of 98.  A complete and independent being with biological,
sociological, and spiritual components.
DEFINITION  Henderson considered the person to be of primary
“The unique function of the nurse is to assist the individual, importance and that is the reason why we
sick or well, in the performance of those activities categorize her theory as client- centered.
contributing to health or its  To be whole, the person must maintain
recovery (or to peaceful death) that he would perform physiological and emotional balance; the mind and
unaided if he had the body are inseparable.
necessary strength, will, or knowledge, and to do this in such Patient
a way as to help him gain independence as rapidly as  Someone who needs nursing care – not limited to
possible.” illness care
Environment
PHENOMENA  It encompasses all external conditions and
 The major phenomenon of concerns includes influences that affect life and development.
the role of interpersonal relations, the quality of a  The effects of 7 components (light, temperature,
caring process, goal-attainment air movement, atmospheric pressure, proper waste
nature, and the process of adaptation to the disposal, absence of injurious chemicals,
conditions under which care should be provided. cleanliness of surroundings) on the life and
development of a person.
CONCEPTS  “The aggregate of an the external
 She defined nursing in a conditions and influences affecting the life and
functional manner. To her, the nurse plans the care development of an organism.
appropriate to assisting the individual in Health
activities contributing to his/her health. She  It is equated with independence or ability to
further stated that individuals will achieve or perform activities without any aid in the 14
maintain health if they have the necessary fundamental or basic human needs.
strength, will or knowledge. She considered the 14  “Quality of health rather than life itself, that margin
fundamental or basic needs as the basis for the of mental
nurses' basic functions. physical vigor that allows a person to work most
 Henderson's theory placed the person in a primary effectively and to reach his highest potential
position. She considered the person as a level of satisfaction in life.”
whole being having biological, psychosocial, and Nursing
spiritual components, which are operationalized in  “The unique function of the nurse is to assist the
the 14 fundamental or basic human needs. A individual, sick or well, in the performance of
second major component is nursing function, and those activities contributing to health or its
the third is the interaction of the two components recovery (or to peaceful death) that he would
in the process called nursing care. perform unaided if he had the necessary strength,
will, or knowledge, and to do this in such a way as
ASSUMPTIONS to help him gain independence as rapidly as
Three major assumptions. The first is that possible.”
“Nurses care for a patient until a patient can care for him or  "She/he functions independently of the physician,
herself”, though it is not stated explicitly. The second but promotes his or her plan, if there is a
assumption states that nurses are willing to serve and physician in attendance. The nurse can function
that “nurses will devote themselves to the patient day and independently and must if she or he is the best
night”. Finally, the third assumption is that “nurses should be prepared health worker in the situation. The nurse
educated at the college level in both sciences and arts”. can and must diagnose and treat if the situation
demands it "
1. Breath normally 8. Keep the body clean and well-groomed
3. FAYE GLENN ABDELLAH
 March 13, 1919, born in New York City
 May 6. 1937, Faye was 18 years old
when she and her brother witnessed the explosion
of this airship in Lakehurst where her family
resided. Some, together with her brother, ran to
help the injured people.
 1957 – She created a team in Manchester that
later became “progressive patient care”
EDUCATION
1942 – Nursing Diploma from Fitkin Memorial Hospital
1945 – Bachelor’s Degree in Nursing
1947 – Master’s Degree in Physiology
1955 – Doctorate in Education
DEFINITION
“Nursing is based on an art and science that
molds the attitudes, intellectual
competencies, and technical skills of the
individual nurse into the desire and ability to
help people, sick or well, cope with their
health needs.”
PHENOMENA
 Improvement of the nursing education
 ‘Disease-centered’ to ‘patient-centered’
 Assessment, diagnosis, planning, implementation,
and evaluation.
ASSUMPTIONS
1. Learn to know the patient
2. Sort out relevant and significant data
3. Generalize about available data concerning similar
nursing problems presented by other patients.
4. Identify the therapeutic plan
5. Test generalizations with the patient and make
additional generalizations
6. Validate the patient’s conclusions about his nursing
problems.
7. Continue to observe and evaluate the patient over
a period of time to identify any attitudes and clues
affecting this behavior.
8. Explore the patient’s and family’s reaction to the
therapeutic plan and involve them in the plan
9. Identify how the nurse feels about the patient’s
nursing problems.
10. Discuss and develop a comprehensive nursing care
plan.
NURSING METAPARADIGM
Person
 Having physical, emotional, and sociological needs.
 Needs may be OVERT largely physical needs
 COVERT emotional, sociological, and interpersonal
need (Nursing Responsibilities)
 Patient is described as the only justification for the
existence of nursing
Health
 “Total health needs” and “a healthy state of mind
and body” in her description of nursing as a
comprehensive service.
Environment
 Home or community from which patient comes
 Society is included in “planning for optimum health
on local, state, national and international levels.”
Nursing
 Based on art and science
 Service to individuals, to families, and therefore to
society.
 The goal of nursing is the fullest physical,
emotional, intellectual, social, and spiritual
functioning.
ABDELLAH’S TYPOLOGY OF 21 NURSING PROBLEMS
 Physical, Sociological, Emotional Needs of patients
 Types of interpersonal relationships between the
patient and nurse
 Common elements of patient care.
Basic to all Patients
1. Good hygiene and physical comfort.
2. Optimal activity: exercise, rest, sleep
3. Safety by preventing accidents, injuries, or other
trauma and preventing the spread of infection.
4. Good body mechanics and prevent and correct
deformity.
Sustenal Needs
5. Supply of oxygen to all body cells
6. Nutrition for all body cells
7. Elimination
8. Fluid and electrolyte balance
9. Physiologic responses of the body to disease
conditions – pathologic, physiologic, and
compensatory.
10. Regulatory mechanisms and functions
11. Sensory function
Remedial Needs
12. Positive and negative expressions, feelings, and
reactions.
13. Interrelatedness of emotions and organic illness.
14. Effective verbal and nonverbal communication.
15. Development of productive interpersonal
relationships.
16. Achievement and personal spiritual goals.
17. Therapeutic environment.
18. Awareness of self as an individual with varying
physical, emotional, and developmental needs.
Restorative Care Needs
19. Light of limitations, physical and emotional
20. Community resources as an aid in resolving
problems that arise from an illness.
21. Social problems as influencing factors in the cause
of illness.
4. JEAN WATSON
 Earn bachelor’s degree in nursing in 1964
 Master of science in psychiatric and mental health
nursing in 1966
 Ph.D in educational psychology and counseling in
1973.
CAREER
 Served faculty and administrative positions in the
School of Nursing faculty.
 Established the Center for Human Caring at the
University of Colorado.
 1978 – 1981: Involved in the planning and
implementing of the nursing Ph.D. program and
served as coordinator and director of the Ph.D.
program.
 1983 – 1990: Dean of University of Colorado
School of Nursing and Associate Director of
Nursing Practice at University Hospital.
 2008: created a non-profit foundation: Watson
Caring Science Institute, to further the work of
Caring Science in the world.
PHENOMENA
Philosophy and Theory of Transpersonal Caring
 The theory stresses the humanistic aspects of
nursing as it intertwines scientific knowledge and
nursing practice
 Caring is demonstrated and practiced by nurses,
Caring for patients promotes growth, Caring
environment accepts a person.
Theory of Human Caring of Jean Watson
 It mainly focuses on how caring for the patients
progresses into better plans to promote
 Health and wellness, prevent illness, restore health.
WATSON’S HIERARCHY OF NEEDS
 Lower order biophysical needs or survival needs
 Lower order psychophysical needs or functional
needs
 Higher-order psychosocial needs or integrative
needs
 Higher-order intrapersonal-interpersonal need or
growth seeking need
ASSUMPTIONS
1. Caring-Interpersonal
2. Caring Factors – satisfaction of patient
3. Positive caring – growth
4. Caring – Patient – Acceptance
5. Caring Environment offers developments
6. Science of Caring and Curing
7. Nursing-Central
CONCEPTS
4 Major Concepts (In Philosophy and Science of Caring)
Human Being
 A valued person, a fully functional integrated self.
Health
 High level of functioning-leading to absence of
illness.
 Unity and harmony: mind, body, and soul
Society
 Norms that determine how one behaves
Nursing
 A human science of person
 Mediates human care transactions
2 Additional Major Concepts
Transpersonal
 A nurse affects and is affected by the individual
Actual Caring Occasion
 measures performed by the nurse and the
individual
SUB-CONCEPTS
1. Phenomenal Field
 The totality of human experience of one’s in the
world.
2. Self
 Perception of the characteristic and relationship
of “I” and “me”
3. Time
 States how incidents in the past, present, and
future merge and fuse.
NURSING METAPARADIGM
Human Beings/Person
 A human being is a person in and of themselves to
be cared for, respected, nurtured, understood,
and assisted, a person’s view as a fully functional
integrated self. A human is viewed as greater than
and different from the sum of his or her parts.
Health
 Defined as a high level of overall physical. Mental,
and social functioning, a general adaptive-
maintenance level of daily functioning, the
absence of illness, or the presence of efforts
leading to the absence of illness.
Nursing
 A science of persons and health-illness experience
mediated by professional, personal, scientific, and
ethical care interactions.
CARATIVE FACTORS (Philosophical Foundation)
1. Forming humanistic-altruistic value systems
2. Instilling faith-hope
3. Cultivating a sensitivity to self and others
4. Developing a helping-trust relationship
5. Promoting an expression of feelings
6. Using problem-solving for decision-making
7. Promoting teaching-learning
8. Promoting a supportive environment
9. Assisting with the gratification of human needs
10. Allowing for existential-phenomenological forces.
5. BETTY NEUMAN ASSUMPTIONS
 Born in Lowel, Ohio on September 11, 1924 Each client system is unique, a composite of
EDUCATION factors and characteristics within a given
 Earned RN diploma in 1947 from the People’s range of responses.
Hospital School
 Earned BSN in 1957 and MSN in Mental Health Many known, unknown, and universal stressors exist. Each
from UCLA in 1966 differs in its potential for disturbing a client's usual stability
 Earned Ph.D in clinical psychology from Pacific level or normal line of defense. The interrelationship of client
Western University in 1985 variables at any point in time can affect the degree to which a
 Earned 2 Honorary Doctorates: One from client is protected by the flexible line of defense against
Neuman College and one from Grand Valley State possible reaction to stressors.
University
CAREER Each client/client system has evolved a normal range of
 Worked as a community meal health nurse responses to the environment that is referred to as a normal
 Worked as a lecturer at UCLA in community health line of defense. The normal line of defense can be used as a
nursing standard from which to measure health deviation.
 Published first book, The Neuman Systems Model
in 1982 When the flexible line of defense is no longer capable of
 Spent rest of career educating professors and protecting the client/client system against an environmental
nurses as a speaker and author stressor, the stressor breaks through the normal line of
defense.
PHENOMENA The client, whether in the state of wellness or illness, is
Focus on stressors perceived by the patient or caregiver dynamic composite of the interrelationships of the variables.
 Patient responses Wellness is on a continuum of available energy to support
 Internal and external environmental factors the system in an optimal state of system stability.
 Nursing actions
Implicit within each client system are internal resistant
CONCEPTS factors known as lines of resistance, which function to
Major Concepts stabilize and realign the client to the usual wellness state.
I. Person Variables: Physiological, Psychological,
Sociocultural, Developmental, and Spiritual The client as a system is in a dynamic, constant energy
II. Central Core exchange with the environment.
III. Flexible Lines of Defense
IV. Normal Line of Defense NURSING METAPARADIGM
V. Lines of Resistance Human Being, Health, Environment, Nursing
VI. Reconstitution
VII. Stressors: Intrapersonal, Interpersonal and NEUMAN SYSTEM MODEL
Extrapersonal A unique, open-based perspective that provides a unifying
VIII. Prevention: focus for approaching a wide range of concerns.
Primary prevention - relates to general knowledge
that is applied in client assessment and  Based on stress and the client’s reaction to the
intervention, in identification and reduction or stressor.
mitigation of possible or actual risk factors  Composed of 5 client variables: Physiological,
associated with the environment stressors to Sociocultural, Developmental, and Spiritual
prevent possible reactions.  Contains nursing interventions through 3
prevention modalities: Primary, Secondary, and
Secondary prevention - relates to symptomatology Tertiary Prevention.
following a reaction to stressors, appropriate  Aims towards the development of a person in a
ranking of intervention priorities, and treatment to state of wellness and having the capacity to
reduce their noxious effects. function optimally.
 The main role of the nurse is to help a person
Tertiary prevention - relates to the adjustive adapt with environmental stimuli
processes taking place at reconstitution begins and
maintenance factors move the client back in a
circular manner towards primary prevention.
6. PATRICIA BENNER
 August 31, 1942, in Hampton, Virginia
