Nursing Theory : Virginia Henderson's Nursing Need Theory

Virginia Henderson is famous for her definition of nursing, “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" (Blais, 2012). Her philosophy supports that caring is the foundation, the center of all patient healing.

“If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault of not of the disease, but of the nursing. I use the word nursing for want of a better” (Nightingale, 1860, p. 8). While Nightingale stressed the impact of one’s environment to promote healing, Virginia Henderson aimed to establish on the fundamental needs as a knowledge base to guide Professional nursing practice. Henderson emphasized on fourteen components required for effective nursing care which includes: breathing normally, eating and drinking adequately, elimination of body wastes, movement and posturing, sleep and rest, select suitable clothes-dress and undress, maintaining body temperature, keeping body clean and well groomed, avoiding dangers in the environment, communication, worship according to one’s faith, work accomplishments, play or participate in various forms of recreation, and learn, discover, or satisfy the curiosity (Fernandes et al., 2015). Her division of the fourteen components acknowledged patient needs with a holistic approach that is applied through the nursing process in a clinical setting.

Regrettably, the existence of nursing depends on the medical inadequacy of others. Unfortunately, nursing exists because people get hurt, cannot care for themselves, or need assistance with daily activities. Carol Taylor (2011), author of Fundamentals of Nursing: The Art and Science of Nursing Care, writes, “Nursing care involves any number of activities, from carrying out complicated technical procedures to something as seemingly as holding a hand” (p. 5). Taylor explains it is the duty of a nurse not only to learn the pertinent skills but also to bond with and comfort others. Nurses have to do and become many things: They must be stern when necessary, compassionate when needed, open minded

Virginia Henderson’s contribution to the nursing profession has been very influential. One of her contributions is her well known definition of nursing which request the nurse to be an expert independent practitioner equipped with the right knowledge in basic nursing care to achieve the goals of proper patient care (McCrae, 2012). Her definition along with the fourteen basic needs brought huge changes in nursing practice. The fourteen fundamental needs gives support and assistance to provide proper nursing care. In addition, Henderson also understood the importance of using the nursing process, she stated as part of the nursing process, it was vital for the nurse to collect, analyze and develop an optimal plan of care to ensure the best quality of care and patient outcomes (McCrae, 2012). Henderson defined nursing as a concept. Henderson regarded person, health, environment and nursing as follows, Person: The patient is a person who needs support attaining independence and well-being or sometimes peaceful passing. The body and mind are one entity, not to be separated in care. Patient and

Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of

Barbara Dossey is truly a visionary in the holistic nursing movement and her theory is able to further the development of holistic nursing in its entirety as well as bolster patient outcomes. The context in which the theory was developed was in relation and connection to the products and ideas of Ken Wilbur, in an attempt to fortify the fundamental concept of healing (Dossey & Keegan, 2003). Dossey's four quadrant model in certain respects is a reaction to and influenced by the work of Wilbur, namely that his volumes stress that no particular or sole researcher, philosopher or theorist can describe, establish or clarify the constituents of reality (Dossey & Keegan, 2003). Dossey and Keegan emphasize that the obstacle and objectives in nursing is to bolster one's integral awareness while boosting one's overall strengths and abilities in nursing in general (2003). Ultimately, the theory developed in the context of the belief that healing occurs when the delicate balance and harmony of body and mind and spirit is successfully addressed and how ancient ideas can be effectively integrated in the realm of caring for patient in everyday living (Dosseydossey.com).

In Henderson’s philosophy, Person is the recipient of nursing care who is composed of biological, psychological, sociological, and spiritual components. Environment is the external environment, temperature, dangers in the environment, and impact of the community on the individual and the family. Health is based on the patient’s ability to function independently; and nursing assists the person, sick or well, in performance of activities and helps the person gain independence as rapidly as possible (Clark, 1997).

Since the early 1900’s nurses have been trying to improve and individualise patient care. In the 1970s this became more structured when the nursing process was introduced by the general nursing council (GNC), (Lloyd, Hancock & Campbell, 2007) .By doing this their intentions were to try and understand the patient in order to give them the best care possible (Cronin & Anderson, 2003). Through the nursing process philosophy care plans were written for patients. It was understood that this relationship would ensure the patient received the best care possible to suit them individually. This would consist of not just the patient as a physical being but their spiritual emotional and holistic being also (Cutler, 2010). The

They needed a shift from a “body-system disease framework to a more holistic model that articulated both the art and science of contemporary critical care nursing practice” (Curley, 2007b, p. 255). The model is seen as rooted in the practice of nursing as explained by Virginia Henderson, known for her Nursing Need Theory (Curley, 2007a).

Everyone’s values and beliefs about the profession of nursing are all different. The four concepts of nursing are interrelated and all mean something different to every person, too. Throughout this paper, I will be reflecting on my values and beliefs about nursing through the four concepts while comparing them to a nursing theorist with views that are most similar to my own.

The two theories that have helped to form my personal perspective on nursing are Erickson; and Rogers. Helen Erickson’s model is based on caring for an individual patient based on their own unique needs and perspective (Nursing Theories and Models, 2017). Erickson’s model took concepts from several other theorists such as Maslow, Padget, Seyle, and Lazarus and combined them to create a nursing model that takes care of each individual patient based on their needs ( Reed, 2017). This theory helps me to be more cognizant of the individual needs of my patient, not all patients regardless of disease process are the same. Each patient may have different underlying factors or circumstances that affect their health and current situation. Rogers’ theory is broader, viewing nursing as both an art and science, promoting health and wellbeing to patients regardless of where they are (Nursing Theories and Models, 2017). The science of nursing involves the knowledge and research of nursing, and the art is applying that science for the betterment of the patient. This theory views an individual as part

One of the complexities of 21st century medicine is the evolution of nursing care theories in combination with a changing need and expectation of the stakeholder population. Nurses must be advocates and communicators, but must balance these along with an overall philosophy of ethics while still remaining mindful of budgets and the need for the medical institution to be profitable. It seems as if these issues comprise a three-part template for nursing: respect for patient value & individuality, education of patients, and cognition and respect for the realities of contemporary medicine. In many ways, too, modern technology has advanced further than societal wisdom, especially when confronting the issue of death. The modern nurse's role is to create a nurse-patient culture that encourages the individual to take responsibility for their healthcare and, in partnership with the nurse, to be involved in their recovery. The modern complexities of healthcare, then, when combined, focus us towards a multidimensional template (combining at least psychology, biology and philosophy) (Beckstead and Beckstead, 2004).

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed

“The basic concept of the theory is that the nurse and patient communicate information, set goals together, and then take actions to achieve those goals. It describes an interpersonal relationship that allows a person to grow and develop in order to attain certain life goals. The factors that affect the attainment of goals are roles, stress, space, and time” (Nursing Theory, 2011).   King desired to advance the profession of nursing by developing a framework and theory that can be understood and used by all nurses, in any situation. She not only developed the theory but she always remained active in the profession and availed herself to nursing students around the clock to aid with their knowledge and application of the theory right up until her sudden death in 2007.

The profession of nursing has matured from the time of Florence Nightingale. Nursing has gone from just treating dying soldiers on the battlefield to helping guide people through their entire lives from birth to death. The maturation of nursing has led to changes in nursing philosophy and allowed for practitioners of Nursing to meld these philosophies together to form their own philosophy. In this paper I will explain my philosophy of nursing and compare it to Virginia Henderson 's definition of nursing along with discussing some of the changes to Nurse philosophy I will also discuss some of the difficulties to being a patient advocate.