Ernestine Wiedenbach

The Helping Art of Clinical Nursing

Ernestine Wiedenbach is known for her work in theory development and maternal infant nursing
developed while teaching maternity nursing at the School of Nursing, Yale University. Wiedenbach taught
with Ida Orlando at Yale University and wrote with philosophers Dickoff and James a classic work on
theory in a practice discipline that is used by those studying the evolution of nursing theory (Dickoff,
James, & Wiedenbach, 1968). She directed the major curriculum in maternal and newborn health nursing
when the Yale School of Nursing established a master’s degree program (Kaplan & King, 2000) and
authored books used widely in nursing education. Her definition of nursing reflects her nurse-midwife
background as follows: “People may differ in their concept of nursing, but few would disagree that nursing
is nurturing or caring for someone in a motherly fashion”.

Wiedenbach’s orientation is a philosophy of nursing that guides the nurse’s action in the art of
nursing. She specified four elements of clinical nursing: philosophy, purpose, practice, and art. She
postulated that clinical nursing is directed toward meeting the patient’s perceived need for help in a vision
of nursing that reflects considerable emphasis on the art of nursing. She followed Orlando’s theory of
deliberate rather than automatic nursing and incorporated the steps of the nursing process. In her book
(1964), Clinical Nursing: A Helping Art, Wiedenbach outlines nursing steps in sequence.

Wiedenbach proposes that nurses identify patients’ need for help in the following ways:

1. Observing behaviors consistent or inconsistent with their comfort

2. Exploring the meaning of their behavior

3. Determining the cause of their discomfort or incapability

4. Determining whether they can resolve their problems or have a need for help Following this, the nurse
administers the help needed (Figure 5-4) and validates that the need for help was met (Figure 5-5)
(Wiedenbach, 1964). Wiedenbach proposed that prescriptive theory would guide and improve nursing
practice. Her work is considered a philosophy of the art of nursing.