Virginia Henderson Theory Of Nursing Essay

Nursing theories can be applied to clinical situations when caring for patients. To help nurses make effective clinical decisions in providing the best care, knowledge of nursing theories and models are used in their decision-making process. In order to explore a nursing theory, this essay will examine Henderson’s theory of nursing, its origins and key features of the theory, and how it relates to personal values and beliefs. This knowledge of nursing theory will help in making informed decisions regarding patient care and how to be prepared for future challenges as a nurse.

Nursing Theory

Johnson and Weber (2001) describe nursing theory as information of organized facts, principles, and laws related to nursing experiences. Henderson’s work is considered a nursing theory because it contains a definition of nursing, a nurse’s role and function, and basic needs of nursing care. She focuses on patient care to help patients reach a level of independence and supports her definition with the 14 components of basic nursing care (George, 2002). Virginia Henderson Theory Of Nursing Essay.

Definition of nursing

In 1955, Henderson’s definition of nursing is published in The Principles and Practice of Nursing. Henderson stated the following:

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 a peaceful death) that 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 (as cited in Johnson & Weber, 2001, p. 87).

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Henderson’s basic nursing care

In 1966, The Nature of Nursing: A Definition and Its Implications for Practice, Research and Education published Henderson’s 14 components of basic nursing care:

Breath normally.

Eat and drink adequately.

Eliminate body wastes.

Move and maintain desirable positions.

Sleep and rest.

Select suitable clothing-dress and undress.

Maintain body temperature within normal range by adjusting clothing and modifying the 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 (as cited in George, 2002, pp. 26-27).

According to Marriner-Tomey and Alligood (2006), Henderson’s work can be seen as a philosophy of nursing.Virginia Henderson Theory Of Nursing Essay.  She clarifies her opinions and views of basic nursing care which is published in 1991 of The Nature of Nursing: Reflections After 25 Years. She also describes the nurses relationship to the patient in three levels where the nurse acts as a substitute, helper and partner with the patient. Henderson states that the nurse must “get inside the skin of each of her patients in order to know what he needs” (as cited in Marriner-Tomey & Alligood, 2006, p. 56).

According to Henderson (1990), an excellent nurse can be measured in the following:

Decreased mortality rates among those she serves.

Decreased morbidity rates with respect to certain diseases or conditions such as impetigo in infants, rickets in children, or puerperal sepsis in mothers.

Decrease in symptoms of nursing neglect such as pressure sores or incontinence.

Decrease in psychological withdrawal symptoms, negativism, or mutism.

Decrease in dependency with respect to daily activities or the degree of rehabilitation achieved.

Favorable opinions of care given by the nurse as expressed by the patient, his family, other nurses, or associated medical personnel.

Henderson’s nursing theory focuses on the patient problems, education of nurses, and nursing care. Her contributions to nursing education and practice influenced the development of nursing (Kim & Kollak, 1999).

Origins of the Nursing Theory

Development of the theory

Henderson theory is important to nursing as stated by Jezierski (1997), “Virginia Henderson did for twentieth century nursing what Nightingale did for nineteenth century nursing. She was called the Mother of Modern Nursing” (p. 386). According to George (2002), the development of Henderson’s definition began before the 1920’s when she was a nursing student at the Army School of Nursing. Her nursing education and clinical practice helped influence and form the historical evolution of her definition. While Henderson helped the sick and wounded soldiers during WW1, she realized nursing was about the importance of quickly completing nursing procedures.

Also, Henderson’s nursing experience in psychiatric failed to provide insight in prevention of illness. In pediatric care, family support was not taken into account in the needs of the patient. In community health nursing, Henderson’s experiences included environment and a person’s lifestyle. After graduating in 1921, the focus of Henderson’s education involved experiences in nursing, teaching and research, and influences of nursing colleagues which led her to define a nurse’s role and function (George, 2002).

According to Johnson and Weber (2001), Henderson’s definition can be seen in other nursing theories such as Orem’s self care deficit theory and Orlando’s nursing process model. In 1953, Henderson and Leo Simmons works in the development of nursing was published in Nursing Research: A Survey and Assessment and Nursing Studies Index. Henderson continued to build on her development of theory throughout her life and educate future nursing professionals.

Henderson’s beliefs and values about nursing

Henderson’s definition of nursing and the 14 basic needs of nursing, define her values and beliefs which can be described in the following statement: Virginia Henderson Theory Of Nursing Essay.

I believe that the function the nurse performs is primarily an independent one-that of acting for the patient when he lacks knowledge, physical strength, or the will to act for himself as he would ordinarily act in health, or in carrying out prescribed therapy. This function is seen as complex and creative, as offering unlimited opportunity for the application of the physical, biological, and social sciences, and the development of skills based on them (as cited in George, 2002, p. 107).

Henderson’s beliefs about nursing include a nurse’s responsibility to provide the best care for a patient; maintaining a patient’s balance in health; and developing knowledge and skills in nursing to communicate with individuals, families and societies.

Key features of the Theory

Metaparadigm concepts according to Henderson

The four basic metaparadigm concepts in nursing include person, environment, health, and nursing. The person is the patient’s interactions with the nurse to facilitate communication. Environment can be a hospital, clinic, or home where communication is involved. Health is a person’s well being related to their environment and nursing deals with incorporating a plan of care (Tourville & Ingalls, 2003). Henderson’s concept of a person or individual is made up of fourteen basic needs that can be grouped into biological, psychological, sociological, and spiritual components. The physiological component includes Henderson’s one to nine needs. Psychological is the tenth and fourteenth need. Sociological is the twelfth and thirteenth need and the spiritual component is the eleventh need (George, 2002). A person requires knowledge and strength to perform activities of daily living and have the essentials for survival. The sick or well individual requires help to become healthy, independent or die peacefully and there is a connection between mind and body (Wesley & McHugh, 1992).

Henderson’s concept of environment includes an individual’s relationship with family, community involvement, for example private and public agencies, which provide health care and society to help with nursing education (George, 2002). Also, environment can harm a healthy individual through personal factors such as age; and physical factors such as air pollution that can cause illness (Wesley & McHugh, 1992).

Health is defined by Henderson’s fourteen basic needs which require an individual to perform effectively.Virginia Henderson Theory Of Nursing Essay.  Henderson emphasizes the importance of promoting health and preventing disease because optimal health may be difficult for some to obtain. Also, she discusses how factors such as age, race, emotional balance, and physical and mental abilities influences the health and needs of an individual (as cited in George, 2002, p. 89).

The nursing concept is defined by Henderson as caring for a sick or well individual until they are able to care for themselves independently. Nursing involves being able to work as part of the health care team according to an individualized care plan. Nursing is an understanding of social sciences and humanities which has led to a university nursing education. Also, knowledge of social and religious customs is important to nursing when looking at an individual’s health needs (Wesley & McHugh, 1992).

Concepts and propositions of the theory

According to George (2002), there are four main concepts of Henderson’s theory which are basic human needs, bio-physiology, culture and interaction-communication. These concepts relate to Henderson’s definition of nursing and how they are essential components to nursing. The 14 basic needs can be compared to Maslow’s hierarchy of human needs. Physiological and safety needs include Henderson’s number one to nine needs. Love and belonging, esteem, and self-actualization needs include Henderson’s number ten to fourteen needs.

The bio-physiology concept in Henderson’s theory uses knowledge of the human anatomy and biological systems to find out what is the best nursing care to help an individual get better or help prepare for a peaceful death. The culture concept includes family and society which can influence human needs. In Henderson’s theory, the nurse can help an individual meet these human needs. The interaction-communication concept uses to establish therapeutic relationship between a nurse and patient, as well as friends and family. The nurse should be able to share feelings and have an understanding for different cultural values and beliefs into the planning of care (George, 2002).

These four concepts of human needs, bio-physiology, culture and interaction-communication connect with each other in Henderson’s 14 basic needs of nursing. Bio-physiology concept include Henderson’s number one to nine needs. Human needs and culture concepts include a combination of number six to fourteen needs. Interaction-communication concepts include number ten to fourteen needs.Virginia Henderson Theory Of Nursing Essay.  By using Henderson’s basic concepts of nursing, the appropriate care can be provided to patients (George, 2002).

Henderson’s and Maslow’s needs table

The following table illustrates how well Maslow’s hierarchy of human needs matches with the 14 basic needs of Henderson (Wesley & McHugh, 1992, p.27).

Table 1

Comparison with Maslow’s Hierarchy of Needs

Maslow’s Hierarchy of Needs

Henderson’s Basic Needs

Physiological Needs

Breath normally

Eat drink adequately

Eliminate body wastes

Move and maintain desirable positions

Sleep and rest

Select suitable clothing

Maintain body temperature

Safety Needs

Maintain bodily cleanliness and grooming

Avoid dangers in the environment

Love and Belonging Needs

Communicate with others to express emotions, needs, fears, or opinions

Worship according to one’s faith

Esteem Needs

10. Communicate with others to express emotions, needs, fears, or opinions

Self-Actualization

Worship according to one’s faith

12. Work that provides a sense of accomplishment

Play or participate in various form of recreation

Learn, discover, or satisfy the curiosity that leads to normal development and health

Theory applied to clinical situations

Theory can help nursing students understand the importance of theory and to determine which theory can be used in clinical situations. According to Colley (2003), nursing theory “gives nurses a sense of identity, and help patients, managers and other healthcare professionals to recognize the unique contribution that nurses make to the healthcare service” (p. 37). Henderson (2006) explains how to teach the concept of nursing. She would pair up a student with a knowledgeable preceptor. Virginia Henderson Theory Of Nursing Essay. The student will watch, than participate until they are able to work independently. Learning to assess the basic needs of a patient, developing and implementing a nursing care plan and evaluating the effectiveness of practice (Johnson & Weber, 2001). Henderson’s theory includes her definition of nursing and the 14 basic principles of nursing to help guide nurses in working with individuals, families and groups. Henderson’s theory can be used in any clinical situation where a patient does not have the understanding or capacity to perform activities related to health or a peaceful death (George, 2002).

Congruence with the Student’s Nursing Practice

Own values and beliefs about nursing

My values about nursing include helping and caring for patients to establish trusting relationships. Religious beliefs and family values such as strength and community are important to me in nursing. As wells as, the value of a higher education to expand my knowledge and skills in critical thinking.

My values and beliefs are similar to those of Henderson’s in that we both believe in helping provide the best care with patients, having healthy relationships and the importance of education in nursing.

Conclusion

In conclusion, Henderson’s work is considered a nursing theory because it contains a definition of nursing and basic needs of nursing care. She focuses on patient care to help patients reach a level of independence which include nursing care and education. By exploring Henderson’s nursing theory and understanding its origins and key features, and how it relates to personal values and beliefs I am able to apply her theory to clinical situations.

Nursing is an art of caring. Nursing has undergone a dramatic change over the past few decades. But the basic principal of nursing ‘caring’ remained unchanged. Caring the main aspect of nursing is difficult to measure. Virginia Henderson Theory Of Nursing Essay. So it is necessary to have a well-defined nursing theory to explain and analysis what nurses do. Nursing theory is defined as’ a conceptualisation of some aspect of nursing reality for the purpose of describing, explaining, predicting nursing care’ (Meleis, 1997 as cited in Parker 2001, p.5). Nursing theory describes and explains the phenomena of interest to nursing in an organised way to provide understanding for use in nursing practice and research (Parker, 2001, p.5). Benefits of a well-defined nursing theory includes better patient care, improved communication between nurses, enhanced professional status for nurses and guidance for research and education (Catalano, 2009). One of the most famous nursing theories is Virginia Henderson’s Nursing Theory, which is also known as ‘The Needs Theory’.

In this assignment the author will be focusing on Virginia Henderson’s, the needs nursing theory and the concepts of four meta paradigms which include person, health, environment and nursing. The Meta paradigm offers the boundaries and limitations of a discipline, recognise the common perspective and helps to focus the activities of members of that discipline. A meta paradigm is the most abstract component of knowledge in a discipline that set forth the phenomena of concerns to that discipline (DeLenue & Ladner, 2011). Additionally the author will explore the application of Virginia Henderson’s theory in rehabilitation setting.

Virginia Henderson’s Needs Theory

Virginia Henderson’s theory was developed in an era where patients need was the primary concerns. So it often called as the needs theory. Henderson believes that it is important to increase patient’s independence so that patient can recover and return home faster. Virginia Henderson (1964) defines ‘nursing as assisting the individual sick or well in the performance of those activities contributing to health or its recovery or to peaceful death that he wold 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’ (as cited in Abrams, 2007, p. 382). Henderson’s definition of nursing is the first on that visibly distinguish nursing from medicine. It focuses on assisting individuals in performing activities that contribute to health.

Henderson postulates that nurse function in relation with patient, physician and other health care professionals. Each type of this relationship gives nurses specific responsibilities. She stated that there are three levels in nurse-patient relationship. According to her, the nurse is a substitute to patient because the nurse is doing for patient, a supplement because the nurse is helping the patient, a complement because the nurse is working with patient to gain as much independence as possible (Parker, 2001).

In addition Henderson proposed fourteen components of basic nursing care. These are based on human needs. They are ‘Breathe normally, Eat and drink adequately, Eliminate body waste, Move and maintain desirable body position, Sleep and rest, Select suitable cloth –dress and undress, Maintain body temperature by adjusting cloth and modifying the 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 emotional needs, fears or options, Worship according to one’s faith, Working in such a way that there is accomplishment, Play or participate in various form of recreations, Learn discover or satisfy the curiosity that lead to normal development and health and use the available health facilities’ (George, 2002 p.87). Virginia Henderson Theory Of Nursing Essay.

Henderson wrote ‘the nurses is temporarily the consciousness of unconscious, the love of life for suicidal, the leg of amputee, the eyes of 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’ (Halloran, 1996 p.20). This statement is most applicable in rehab settings.

The Four Meta Paradigms

Person

The person is an individual with whom the nurse is interacting (Potter &Perry, 2005). Henderson introduces the idea of the mind and body of a person work as a single unit. She stated that person is an individual who requires assistance in achieving health and independence or a special peaceful death (Tourville & Ingalls, 2003). The fourteen components of nursing care consist of every individual’s basic needs. A person to function to the fullest, he must be able to maintain emotional and physiological balance. Henderson considered patient and family as a single unit (Parker, 2001). In rehab centre family will be involved in patients care. Programs like caregiver training will empower the family members to care for the patient post discharge. Involving family members in patient care will reduce emotional and psychological distress experienced by patient as family is the main support system of the patient.

Environment

Environment encompasses any place where the therapeutic interaction between patient and nurse occurs (Catalano, 2009). As illness occurs the ability of person to control his environment will diminish. It is the duty of the nurse to manage the patients surrounding to protect patient from any harm or injuries. In rehab setting every patient will be asses for fall risk. Virginia Henderson Theory Of Nursing Essay.This assessment will help the nurse to make necessary modification to patient’s environment like adequate lighting, and anti-slippery mat, to ensure patients safety. In rehab, the multi-disciplinary team including the nurse will do a home visit to ensure the home environment is safe for the patient and will provide necessary recommendation in home modification and equipment purchase. The environmental press model is the conceptual frame work used in many rehab settings (Lawton & Simon, 1986). This modal describes how physical environment interact with patient recovery and emphasis on the importance of modified environment to avoid harm to self and others, one of the basic component of Henderson’s basic nursing functions. Modified environment place an important role in the recover of a sick person.

Health

Nursing has viewed health as a continuum. Henderson views health as the quality of life and is the basic for the individual to perform the fourteen components independently (Tourville & Ingalls, 2003). Apart from basic nursing care, nurses play an important role in promotion of health and prevention of illness through health education. Age, culture, physical and intellectual capacities and emotional balance can affect health. The fourteen basic nursing functions are guide for the nurses in health teaching. Promotion of health is more important in caring for sick. In rehab centre, each patient and family receives education about their illness and how to cope with its outcome. Examples include group education for spinal cord injury patients and amputee education. Periodically, the rehab team will discusses each patient’s progress and prognosis and update family and patient. This will enable the patient to be aware of their rehab goals and to work towards achieving these goals.

Nursing

Nursing profession uses assessment, nursing diagnosis, care planning, intervention and evaluation in the care of a person (Potter &Perry, 2005). Henderson asserted that nurses should function independently but in co-ordination with the therapeutic plan executed by the health care team.  Virginia Henderson Theory Of Nursing Essay.Nurses are knowledgeable in social and biological science to assess the fourteen basic needs of a person. Nurse-patient relationship is an important factor in patient’s recovery. When the patient is severely ill, the nurse acts as replacement for patient. When the patient is on the period of recovery, the nurse is act as an aid for the patient. The nurse assists the patient to gain independence. Henderson indicated the many roles of nurses are overlap with that of physicians (Henderson, 1982). The nurse works in collaboration with other health care professionals to provide excellent quality care to patient. Henderson explains that the duty of a nurse is to temporarily assist an individual to satisfy basic needs. The rehab nurses assist the disabled person to adapt with the altered life style and to regain and maintain maximum independence when a partial or complete recovery is possible (Henderson, 1982).

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Strength and Limitation

Henderson’s definition of nursing and the fourteen component of basic nursing care are logical and simple to understand. It can act as a guide for the patient and nurse to reach the chosen goal. Henderson’s idea of nursing are well accepted as a basis for nursing care throughout the world. Her idea of nursing practice and be applied to the well-being of individuals of all ages (Tourville & Ingalls, 2003). Like any other nursing theory, Henderson’s nursing theory has its limitation. The concept of holistic nature of human being not involved in her theory (Tourville & Ingalls, 2003). The relationship among the fourteen component of basic nursing care is unclear. Henderson used other discipline to guide her concept of basic human needs (Turville & Ingalls, 2003). For example her fourteen components of basic nursing care can be compared with Maslow’s hierarchy of human needs. Despite the limitation the author believes that Henderson’s theory is the most applicable theory in rehab setting. Virginia Henderson Theory Of Nursing Essay.

Conclusion

Nursing has deeply influenced by Henderson’s clear view of nursing function. Henderson provides the core of what she believes as a definition of nursing. Her intention was to describe the unique focus of nursing rather than formulate a nursing theory. Her emphases on basic human needs are central focus in today’s nursing practice. Her fourteen components of basic nursing care are simple and are used by nurses globally to describe predict and explain daily experience. This theory is most applicable in rehab settings, where every patient aims to achieve maximum potential. Virginia Henderson Theory Of Nursing Essay.