The Nursing Theory

Virginia Henderson’s theory is essential to nursing as she did nursing for the twentieth century. She was called the “Mother of Modern Nursing .”Her development of the nursing definition began before the 1920s when she was a student nurse at the Army School of Nursing. Her education and clinical practice in nursing helped influence and form her definition’s historical evolution. Henderson helped the sick and wounded soldiers during World War 1, and it made her realize that https://nursingpaperessay.com/benefits-of-using-the-holistic-approach-in-nursing/nursing was about the importance of completing nursing procedures fast.

Her nursing experience in psychiatry failed to provide insight into disease prevention. In the needs of the patients in pediatric care, family support was not taken into account. Henderson’s experiences included lifestyle and the environment in community health nursing; After her graduation in 1921, her education mainly focused on experiences in nursing, influences of nursing colleagues, teaching, and research, which led her to define a nurse’s role and function (George, 2002).

Henderson’s definition of nursing and the 14 basic nursing needs defined her beliefs and values.
Her beliefs about nursing include a nurse’s responsibility to maintain a patient’s balance in health, provide the best care for a patient, and develop knowledge and skills in nursing to communicate with individuals, families, and societies.

Virginia Henderson’s definition of nursing

Many theorists made significant contributions to nursing care for patients and associated needs in the past years. One of the significant contributors was Virginia Henderson, a theorist who emphasized patient needs and laid down the many features of a healing process. She believed that nursing was much more than medication, but the philosophy and ideology required a knowledge base for practice distinct from that of medicine. She outlined the 14 basic human needs that speculated the role of a nurse in assisting patients in performing activities that they would perform without any assistance if they had the necessary knowledge will, or strength to contribute to their recovery. She focused on nursing practice to enhance the independence of patients. She developed this model through the experience she had acquired from her education and practice. According to The Principles and Practice of Nursing, Virginia Henderson defined nursing as stated below:

“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”

Virginia Henderson’s Needs Theory

Virginia Henderson developed the needs theory when patients’ basic needs were the primary concern. According to the theory, Henderson believes it is vital to reduce the patient’s dependability for quick recovery.
Henderson identifies the nurse function as related to patients, physicians, and other health care professionals, each of them with different responsibilities for each type of these relationships. She identified three levels involved in the nurse-patient relationship.
According to her theory, the nurse is doing for the patient, which makes her a substitute, the nurse is helping the patient, which makes her a supplement, and the nurse is working with the patient to gain independence, making her a compliment (Parker, 2001). In addition, Henderson proposed fourteen components of primary nursing care based on human needs. Henderson wrote ‘the nurses is temporarily the consciousness of the unconscious, the love of life for suicidal, the leg of the 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).

The Nursing Meta-paradigm Concepts

There are three major assumptions that Henderson identified in her model of nursing.

Nurses are obligated to care for a patient until a patient can care for him or herself.
Nurses have the will to serve, and “nurses will devote themselves to the patient day and night.”
Nurses should gain more knowledge in both sciences and arts at the college level.

Henderson addressed four major concepts in her nursing theory; An individual, the environment, health, and nursing.

Individual

According to Henderson, an individual is someone who requires basic needs that are components of health. The individual may require assistance to achieve independence and health or die peacefully. She also stated that the individual’s mind and body are interrelated in any aspect, including biological, sociological, psychological, and spiritual components. The theory also presents the patient as combined parts with biopsychosocial needs.

The environment

She explained the environment as a setting where individuals are influenced to learn different living patterns. The external conditions also affect the life and development of a person. The environment also includes relations between families. The theory highly impacts the community because primary nursing care involves all 14 human needs, which are also affected by the environment.

Health

In Henderson’s theory, health is the ability of an individual to perform tasks independently.
It also states that we should focus on disease prevention of disease and promoting the health of our clients. Having good health is a challenge because it is affected by many factors; age, cultural background, gender, lifestyle, and emotional balance

Nursing

For Henderson, nursing assists individuals in achieving the 14 basic human needs if they lack the necessary strength, will, and knowledge to satisfy them. The primary goal is for the nurse to assist and support the individual in attaining independence. The nurse needs to have the knowledge to perform individual and human care as per the physician’s therapeutic plan and be a scientific problem solver.

Henderson’s 14 Basic Human Needs

The role of a nurse is “to get inside the patient’s skin and supplement his strength will or knowledge according to his needs” as explained by Virginia Henderson. Nurses will assess the patient’s needs, help the individual meet health needs, and provide an environment in which the patient can perform activities independently. Henderson’s theory focuses on a person coming from a hospital while healthy because the nurse’s expected task is to nurse the individual to get back to his healthy state(having regained the ability to perform tasks independently.)

The 14 components are based on human needs that make up nursing activities. The components are:

Breathe normally. The human body requires gaseous exchange to maintain patient health and life continuity. The nurse should know about the respiratory function of a person and have the ability to identify the possible problems. The nurse’s role should be to monitor the breathing rate, check for obstructions, help with correct positioning of the body, be alert to sounds during breathing and be aware of any secretions and mucus.

Eat and drink adequately. For survival, we need fluids and nutrients. The nurse should know the nutritional requirements of the patient (diet and hydration) and the treatment as per the physician’s order. Awareness of feeding schedules and quantities, age and weight, religious and cultural beliefs, and chewing and swallowing abilities is critical.

Eliminate body wastes. The average elimination of wastes like feces, urine, and sweat must occur for the body to function appropriately. The nurse should provide maximum hygiene to prevent the development of other ailments.

Move and maintain desirable postures. The nurse should improve the patient independence by helping the body mechanics of the person and motivating him to perform physical activity and exercise while considering limitations like deformities.

Sleep and rest. Nurses should prioritize rest for all patients as it is essential for quick recovery. Taking note of the patient’s rest habits, insomnia cases, and sensitivity to noise is also essential.

Select suitable clothing. That is dress and undress appropriately. When a patient can select and wear the desired clothing, a sense of independence is influenced. Clothing will represent individual privacy, identity, and personality.

Maintain body temperature within normal range by adjusting clothing and modifying the environment. The nurse should take note of the factors that influence the patient’s rise or fall in temperature. The average body temperature ranges between 36.5 and 37 degrees. Changes in clothing, opening in the room doors or windows, and drinking water affects thermoregulation.

Keep the body clean and well-groomed and protect the integument. Maintaining the patient’s hygiene has psychological value. When bathing a person, the nurse should consider the frequency of cleaning the body, the means and items used, and the patient’s level of mobility and independence, among other factors.

Avoid dangers in the environment and avoid injuring others. Nurses should educate patients on the importance of safety and evaluate if they can be alone for a long time without hurting themselves or others when carrying out activities.

Communicate with others in expressing emotions, needs, fears, or opinions. The nurse should promote and motivate healthy communication between the patient and room to air their views to help their emotional balance. Social interaction with others will guarantee positive mental health.

Worship according to one’s faith. Patients have different values and particular beliefs, which the nurse should respect. These values form foundations for making decisions and exercising specific actions or thoughts.

Work in such a way that there is a sense of accomplishment. The nurse should promote the patient’s scope of goals and achievements with their effort. This provides a sense of personal fulfillment that will influence self-esteem and mental health.

Play or participate in various forms of recreation. Activities promote the health of the body and mind. The nurse must know the interests of the patients and motivate them to participate in activities that are motivating.

Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. Nurses should keep the patient developing favorable skills and knowledge for health. This will improve the mental productivity of the person.

These 14 components holistically approach nursing and include the physiological, psychological, emotional, spiritual, and social components. The theory is quite similar to Maslow’s Hierarchy of Needs Theory.

Similarities with Maslow’s hierarchy of needs

Breathe normally, Eat and drink adequately, Eliminate body wastes, Move and maintain desirable posture, Sleep and rest, Select suitable clothing, Maintain body temperature, Keep the body clean and well-groomed and protect the integument related to Maslow’s physiological needs. Avoiding environmental dangers and injuring others relate to Maslow’s Safety needs. Communicating with others and worshiping according to one’s faith relate to Maslow’s Belongingness and love needs. Work at something providing a sense of accomplishment, and Learn, discover, or satisfy curiosity relate to Maslow’s Esteem needs.

According to Henderson’s model, an excellent nurse can be measured in many things. They include:

Decreased mortality rates among the patients.
Decreased morbidity rates for specific conditions such as rickets in children, impetigo in infants, or puerperal sepsis in mothers.
Decreased symptoms of nursing neglect such as incontinence or pressure sores.
Decrease in psychological withdrawal symptoms, mutism, or negativism.
Decrease in dependency for daily activities or the degree of rehabilitation achieved.
Favorable opinions of the nurse’s care are expressed by the patient, his family, other nurses, or associated medical personnel.

Henderson’s nursing theory focuses on the problems patients face, the education of nurses, and nursing care.

Analysis of the Needs Theory

Virginia Henderson identified the fourteen basic human needs to attain health and survive, but it is not the only thing human beings need. In our world today, people need more than just the needs nurses can provide. The order and priorities of the fourteen needs were not clearly explained. It is unclear whether the first one is done prior to the other. However, Henderson’s ability to specify and characterize some of the needs of individuals with Abraham Maslow’s hierarchy of needs was remarkable. In Henderson’s concepts, some of the outlined needs can only be performed by fully functional individuals. This is contrary to the nursing goal as defined by Virginia Henderson, as there would always be patients who always require assisted care.

Strengths of Henderson’s 14 Basic Human Needs Theory

The concepts are interrelated. The human needs, culture and interaction, communication, and physiology that Henderson defines are similar to Maslow’s theory. The 14 basic human needs guide nurses and individuals to achieve their goals. The basic human needs can be used on individuals of all ages. Nurses can utilize the need to acquire more knowledge and improve their practice.

Weaknesses of Henderson’s 14 Basic Human Needs Theory

The concepts do not link physiological needs and other human characteristics. There is no concept explaining the holistic nature of human beings. There is an unclear relationship between components if the14 components are prioritized. The theory lacks an inter-relate of factors and the influence of nursing care. The theory does not explain how the nurse helps assist the individual in the dying process.

Henderson’s Nursing Need Theory Implementation Plan

Virginia Henderson’s nursing needs theory guides nursing actions in many ways. It implies that a nurse should follow a treatment plan as prescribed by a doctor. The nurse will only plan personalized care for the patient. Henderson believes that the nurse should investigate all 14 basic human needs. They learn how to assess, plan and evaluate their possibilities regarding those needs. Nurses can clarify the steps on how they help patients maintain their health and promote recovery from illness to help patients regain independence. The nurse should also set long-term goals only to restore the patient’s independence. These goals should be realistic and measurable to assess the success or failure of interventions. The assumptions allow nurses to understand explanations well to improve the field of nursing in different ways. Henderson presents the role of nurses in two ways;

Nurses perform functions that patients lack the will or strength to perform, making them independent specialists in the health care system.
Nurses require ongoing education, knowledge, skills, and the desire to assist in accomplishing the best patient results.

The Implementation Plan

Implementing Henderson’s theory is conducted in four stages

Evaluation of the current staffing problems. Evaluation requires collecting data through nursing interviews regarding the shortage of staff and patient outcomes.
Intervention planning and sampling. The intervention will involve the identification of the sample size, inclusion criteria, and two groups; one for intervention and the other one for control. Participants will receive clarification and clear explanations.
Mediation application. Mediation will involve training nurses in communication skills and interdisciplinary cooperation. Nurses will be expected to apply new knowledge and skills in practice, accompanied by motivation: readiness to help, transparency, and a friendly atmosphere.
Outcome assessment. Data on the intervention results will be collected. When all the daily needs for a specific nursing intervention that has been undertaken are met, it will be possible to assess the outcome and quality of care. Therefore, information on patients’ health will be gathered to obtain qualitative data on how efficient the proposed mediation is.

Conclusion

Henderson had a clear view of the nursing function, which profoundly influenced nursing. She defines nursing according to her beliefs – “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,”
She intended to describe how nursing is unique and focuses on basic human needs as a central function in today’s nursing practice. Her fourteen components of basic human needs in nursing care are simple and are used by nurses globally to describe, predict and explain the daily experiences.

References

Principles and practice of nursing. New York, NY: Macmillan. Henderson, V., & Nite, G. (1978).

Masters, K. (2014). Nursing theories: A framework for professional practice. Burlington, MA: Jones & Bartlett Learning.

Pioneering theories in nursing. London, UK: Andrews UK Limited.Snowden, A., Donnell, A., & Duffy, T. (2014).

Henderson, V. (1966). The nature of nursing. In George, J. (Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange.

Virginia Henderson’s 14 human basic needs