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Running head: Henderson’s Theory

Henderson’s Theory of Nursing: Analysis and application to nursing Practice

Armandine Longang L

University of the District of Columbia

RN to BSN Transition Course

Professor: Linda Hinnant

March 29, 2011

Born in Kansas City, Missouri in 1897, Virginia A. Henderson was one of the first Theorists who tried to describe the practice of nursing. She was the fifth child of a family of eight children. She was the daughter of Daniel Brosius Henderson, the attorney who won the major case in favor of Native American Indians against the U.S government (George, 2002, p.84). Virginia Henderson began the elementary school at age four. In 1918, at age twenty one she was admitted to the Army School of Nursing at Walter Reed hospital, Washington DC where she graduated three years later (Tomey & Alligood, 2002, P.98). After graduation, she worked as a staff nurse at Henry Street Visiting Nurse Service, NY. Only two years after her graduation, she started teaching nursing at the Norfolk Protestant Hospital in Virginia. Eight years after working as a staff nurse and an educator, she went back to school and graduated with a Bachelor’s Degree in Nursing in 1932 and a Master’s Degree in 1934 (George, 2002, p. 84).Thereafter, Virginia Henderson had a long career as an author and researcher. She was a member of the faculty at Columbia University and a research associate at Yale University. In addition, her later years were characterized by several honors. She received Honorary Doctoral Degrees from the Catholic University of America, Pace University, University of Rochester, University of Western Ontario, and Yale University; and in 1985, she was honored at the annual Meeting of the nursing and Allied Health section of the medical Library association (McBride, 2009). Virginia Henderson’s theory of nursing has influenced the nursing profession, the nursing education, and the nursing research throughout the world. Her definition of nursing, referred to today as Henderson’s theory of nursing, explains the practice of nursing, the specific functions of the nurses, and the unique activities of the nurses.

Virginia Henderson’s definition of nursing derives from her long experiences as a student, a practitioner, an educator, an author, and an active participant in many conferences. She called her definition of nursing her concept (George, 2002, p.86). Henderson believed that it is important to increase the patients’ independence so that patients can recover and return home faster. In 1955, Henderson’s definition of nursing was published. It states: “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to the health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to this in such a way as to help him gain independence as rapidly as possible” (Tomey & Alligood, 2002, p.101). Henderson’s definition of nursing is the first one that visibly differentiates nursing from medicine. This definition focuses on assisting individuals in performing activities that contribute to health. According to Henderson, the nurse is a substitute to the patient because the nurse is doing for the patient, a supplement because the nurse is helping the patient and a complement because the nurse is working with the patient. In addition, Henderson proposed fourteen components of basic nursing care that the nurse should assist patients to perform. These components are based on human’s needs. They are:

1. Breathe normally.

2. Eat and drink adequately

3. Eliminate body waste

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.

10. Communicate with others in expressing emotions, needs, fears, 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 (George, 2002, P.86 – 87).

When we look at these components of basic nursing care, one can observe that the first nine components are physiological needs, the tenth and fourteen are psychological needs that are part of communication and learning; the eleventh component is spiritual and moral; and the twelfth and thirteenth components are sociological needs that are oriented to occupations and recreations (George, 2002, P 88). People have basic needs that are component of health. Health is the ability to function independently, and it is not always easy for the nurse to help a person achieve good health. From Henderson’s theory, we can assume that the patient as a human being wants to return to his or her previous level of functioning. He or she wants to stop being reliant on the nurse and other healthcare providers. As a result, nurses need to provide high quality care to patients; therefore, nurses need to be devoted and prepared to serve patients 24 hours a day and 7 days a week.

Another important aspect of Virginia Henderson’s theory is its theoretical assertions. To understand this aspect, three important factors need to be analyzed. First, the nurse–patient relationship is an important factor in patient recovering. When the patient is severely ill, the

nurse acts as a replacement for the patient. The patient depends on the nurse and other healthcare providers; therefore, the nurse is a replacement of what the patient lacks to be complete. Henderson wrote : “The nurse is temporarily the consciousness of the unconscious, the love of the suicidal, the legs of the amputee, the eyes of the newly blind, the means of locomotion for infant, the knowledge and confidence for the young mother, the mouthpiece for those too weak or withdrawn to speak and so on (Sisk, 2007). When the patient is on period of recovery, the nurse acts as an aide to the patient. The nurse assists the patient to gain his or her independence, which according to Henderson is “the state of health” (George, 2002, P 100). The nurse and the patient work together to formulate a plan of care that is realistic for both. Second, the function and the role of the nurse are unique, and different from the doctor’s function. Henderson stated that the nurse does not only follow physician’s orders, but the nurse can question and challenge these orders because he or she possess sufficient knowledge to do so. Finally, the nurse works in collaboration with other healthcare professional to provide excellent quality care to patients. The nurse and other staff members’ help each other in providing patients care, but one staff should not do another staff member’s job.

Nursing process is the process by which nurses deliver care to patients. It is supported by nursing models or philosophies and comprised five steps: assessing, analyzing, planning, implementing, and evaluating (Quan, 2006). Henderson’s definition of nursing and the fourteen components of basic nursing care cover all steps of the nursing process. The nursing assessment is seen in each of Henderson’s fourteen components of basic nursing care. The nurse may use these components to assess patients’ needs. For example, by assessing the first component which is “breathe normally,” the nurse gathers all important data regarding the patients’ respiratory status. After doing this, the nurse moves to the second component that would provide information about nutrition and hydration status of the patient; after that, the nurse move to the next component, and so on. After gathering all the information, the nurse analyzes the data. This is the second step of the nursing process. The nurse must be knowledgeable about what is normal and what is abnormal because the knowledge would allow the nurse to draw conclusion from the analysis. For example, if the patient blood pressure is 180/120, the nurse would know that the patient has a high blood pressure that needed to be taken care of immediately ( Tomey & alligood, 2002, P.107). Then, from the analysis of the data, the nurse would formulate a nursing diagnosis, defined by Henderson as “Identifying the person’s ability to meet human needs dependently or independently while taking into account the person’s strength, will, and knowledge”( George, 2002, P. 93). In addition, with the collection of data and its analysis, the nurse can identify concrete problems like high blood pressure and potential problem may also be identified. For example, component 13 describes the needs of patients to participate in various forms of recreation; a problem may arise because the hospitalization prevents the patient from meeting this need. Once the nursing diagnosis is formulated, the nurse moves into the planning phase. The nurse plans patients’ care based on the patients’ ability to meet their needs with or without assistance. The planning phase should include the discharge planning which should involve other members of the family. The plan should change as the patients’ needs change. After formulating the plan of care, the nurse moves into action. In other words, implementation is helping the patient meet the fourteen components of basic human needs. For example, in helping the patient “eliminate body waste”, the nurse tries the methods of increasing fluid intake and fiber in the diet before giving medication. In addition, the nurse–patient relationship is very important in implementation. The nurse is the one who spends most of the time working with the patient; therefore, the nurse is in the central position to understand patient needs and carries out measures to meet those needs (McBride, 2009). Finally, the evaluation phase should be done according to how fast and how far the person functions independently. The nurse should evaluate the ability of the patients to meet their basic human needs. The outcome depends on the nurse’s professionalism rather than the number of hours of care.

In conclusion, Henderson’s theory has several characteristics. Some of these characteristics are found in her unique definition of nursing and the 14 components of health. Henderson’s definition of nursing and the 14 components of basic nursing care are simple to understand and can serve as a guide for the patient and the nurse in reaching a set goal. Henderson used other disciplines to guide her concepts of fundamental human needs. For example, her 14 components can be compared to Maslow’s hierarchy of human needs. Maslow developed five levels of basis needs which are physiological needs, safety needs, needs of love, and belongingness, needs for esteem, and needs for self-actualization In addition, Henderson’s theory of nursing is applicable to patients of all ages. Also, her work is recognized and well accepted around the world. Many nurses can use her theory as a guide without difficulty. It is believed that by using Henderson’s definition of nursing and the 14 components of basic nursing care, nurses would improve nursing practices, and therefore reduce illness.

References

George, J. B. (2002) Nursing theories (5th ed.). Upper Saddle River, New Jersey: Pearson Education, Inc.

McBride, A. B. (2009). Miss Henderson’s definition of nursing and 14 components of basic nursing care. Retrieved March 21, 2011 from http: // portal/main.aspx

Quan, K. (2006). The nursing process. Retrieved March 28, 2011

From articles/the nursing process.htm

Tomey, M. A. & Alligood, M. R. (2002). Nursing Theorists and their works (5th ed.). St Louis, MO: Mosby, Inc.

Sisk, B. ( 2007). Development of nursing theories. Retrieved March 21, 2011

from http:// nursing theory/development_of_nursing_theo…

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