Biography of Virginia Henderson

Virginia Avenel Henderson (November 30, 1897 – March 19, 1996) was a nurse,
theorist, and author known for her Need Theory and defining nursing as: “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.” Henderson is also
known as “The First Lady of Nursing,” “The Nightingale of Modern Nursing,” “Modern-
Day Mother of Nursing,” and “The 20th Century Florence Nightingale.”

Education

Virginia Henderson received her early education at home in Virginia with her aunts, and
uncle Charles Abbot, at his school for boys in the community Army School of Nursing at
Walter Reed Hospital in Washington D.C. In 1921, she received her Diploma in Nursing
from the Army School of Nursing at Walter Reed Hospital, Washington D.C. In 1923,
she started teaching nursing at the Norfolk Protestant Hospital in Virginia. In 1929, she
entered Teachers College at Columbia University for her Bachelor’s Degree in 1932,
and took her Master’s Degree in 1934.

Need Theory

Among her other works, Henderson’s widely known contributions to nursing is the Need
Theory. The Need Theory emphasizes on the importance of increasing the patient’s
independence and focus on the basic human needs so that progress after
hospitalization would not be delayed. The Need Theory is discussed further below.

Virginia Henderson’s Need Theory

The Nursing Need Theory was developed by Virginia Henderson to define the unique
focus of nursing practice. The theory focuses on the importance of increasing the
patient’s independence to hasten their progress in the hospital. Henderson’s theory
emphasizes on the basic human needs and how nurses can assist in meeting those
needs.

“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.” (Henderson, 1960)

Assumptions of the Need Theory

The assumptions of Virginia Henderson’s Need Theory are: (1) Nurses care for patients
until they can care for themselves once again. Although not precisely explained, (2)
patients desire to return to health. (3) Nurses are willing to serve and that “nurses will
devote themselves to the patient day and night.” (4) Henderson also believes that the
“mind and body are inseparable and are interrelated.”

Major Concepts of the Nursing Need Theory

The following are the major concepts (nursing metaparadigm) and definitions of the
Need Theory of Virginia Henderson.

Analysis of the Need Theory

One cannot say that every individual who has similar needs indicated in the 14 activities
by Virginia Henderson are the only things that human beings need in attaining health
and for survival. With the progress of today’s time, there may be added needs that
humans are entitled to be provided with by nurse.

The prioritization of the 14 Activities was not clearly explained whether the first one is
prerequisite to the other. But still, it is remarkable that Henderson was able to specify
and characterize some of the needs of individuals based on Abraham Maslow’s
hierarchy of needs.

Some of the activities listed in Henderson’s concepts can only be applied to fully
functional individuals indicating that there would always be patients who always require
aided care which is in contrary to the goal of nursing indicated in the definition of
nursing by Henderson.

Because of the absence of a conceptual diagram, interconnections between the

concepts and subconcepts of Henderson’s principle are not clearly delineated.

Strengths

Virginia Henderson’s concept of nursing is widely accepted in nursing practice today.

Her theory and 14 components are relatively simple, logical, and can be applied to
individuals of all ages.

Weaknesses

There is an absence of a conceptual diagram that interconnects the 14 concepts and

subconcepts of Henderson’s theory. On assisting the individual in the dying process,
there is a little explanation of what the nurse does to provide “peaceful death.”

Henderson’s theory and the four major concepts

1. Individual

 Have basic needs that are component of health.

  Requiring assistance to achieve health and independence or a peaceful death.
 Mind and body are inseparable and interrelated.
 Considers the biological, psychological, sociological, and spiritual components.
 The theory presents the patient as a sum of parts with biopsychosocial needs.

2. Environment

 Settings in which an individual learns unique pattern for living.

 All external conditions and influences that affect life and development.
 Individuals in relation to families
 Minimally discusses the impact of the community on the individual and family.
 Basic nursing care involves providing conditions under which the patient can
perform the 14 activities unaided

3. Health

 Definition based on individual’s ability to function independently as outlined in the

14 components.
 Nurses need to stress promotion of health and prevention and cure of disease.
 Good health is a challenge -affected by age, cultural background, physical, and
intellectual capacities, and emotional balance Is the individual’s ability to meet
these needs independently.

4. Nursing

 Temporarily assisting an individual who lacks the necessary strength, will and
knowledge to satisfy 1 or more of 14 basic needs.
 Assists and supports the individual in life activities and the attainment of
independence.
 Nurse serves to make patient “complete” “whole", or "independent."
 The nurse is expected to carry out physician’s therapeutic plan Individualized
care is the result of the nurse’s creativity in planning for care.
 “Nurse should have knowledge to practice individualized and human care and
should be a scientific problem solver.”
 In the Nature of Nursing Nurse role is,” to get inside the patient’s skin and
supplement his strength will or knowledge according to his needs.”

Henderson’s and Nursing Process

”Summarization of the stages of the nursing process as applied to Henderson’s

definition of nursing and to the 14 components of basic nursing care.

Nursing Process Henderson’s 14 components and definition of nursing

Nursing Henderson’s 14 components
Assessment
Nursing Diagnosis Analysis: Compare data to knowledge base of health and disease.
Nursing plan Identify individual’s ability to meet own needs with or without
assistance, taking into consideration strength, will or knowledge.
Nursing Document how the nurse can assist the individual, sick or well.
implementation
Nursing Assist the sick or well individual in to performance of activities in
implementation meeting human needs to maintain health, recover from illness, or to
aid in peaceful death.
Nursing process Implementation based on the physiological principles, age, cultural
background, emotional balance, and physical and intellectual
capacities.

Carry out treatment prescribed by the physician.

Nursing Henderson’s 14 components and definition of nursing
evaluation Use the acceptable definition of ;nursing and appropriate laws
related to the practice of nursing.
The quality of care is drastically affected by the preparation and
native ability of the nursing personnel rather that the amount of
hours of care.
Successful outcomes of nursing care are based on the speed with
which or degree to which the patient performs independently the
activities of daily living

ssComparison with Maslow's Hierarchy of Need

Maslow's Henderson
Breathe normally

Physiological Eat and drink adequately Eliminate by all avenues of elimination

needs Move and maintain desirable posture Sleep and rest Select suitable
clothing Maintain body temperature Keep body clean and well
groomed and protect the integument

Safety Needs Avoid environmental dangers and avoid injuring other

 Communicate with others
Belongingness
and love needs
worship according to one's faith
Work at something providing a sense of accomplishment

Esteem needs Play or participate in various forms of recreation

Learn, discover, or satisfy curiosity

Characteristic of Henderson’s theory

 There is interrelation of concepts.

 Concepts of fundamental human needs, biophysiology, culture, and interaction,
communication are borrowed from other discipline.Eg.. Maslow’s theory.
 Her definition and components are logical and the 14 components are a guide for
the individual and nurse in reaching the chosen goal.
 Relatively simple yet generalizable.
 Applicable to the health of individuals of all ages.
 can be the bases for hypotheses that can be tested.
 assist in increasing the general body of knowledge within the discipline.
 Her ideas of nursing practice are well accepted.
 can be utilized by practitioners to guide and improve their practice.

Limitations

 Lack of conceptual linkage between physiological and other human

characteristics.
 No concept of the holistic nature of human being.
 If the assumption is made that the 14 components prioritized, the relationship
among the components is unclear.
 Lacks inter-relate of factors and the influence of nursing care.
 Assisting the individual in the dying process she contends that the nurse helps,
but there is little explanation of what the nurse does.
 “Peaceful death” is curious and significant nursing role.

Conclusion

 Henderson provides the essence of what she believes is a definition of nursing.

 Her emphasis on basic human needs as the central focus of nursing practice has
led to further theory development regarding the needs of the person and how
nursing can assist in meeting those needs.
 Her definition of nursing and the 14 components of basic nursing care are
uncomplicated and self-explanatory.
  Fourteen components required for effective nursing care


1Breathe normally.
2Eat and drink adequately.
3Eliminate body wastes
4Move and maintain desirable postures
5Sleep and rest.
6Select suitable clothes-dress and undress
7Maintain body temperature within normal range by adjusting clothing and modifying
environment
8Keep the body clean and well groomed and protect the integument
9Avoid dangers in the environment and avoid injuring others
10Communicate with others in expressing emotions, needs, fears, or opinions
11Worship according to one’s faith
12Work in such a way that there is a sense of accomplishment
13Play or participate in various forms of recreation
14Learn, discover, or satisfy the curiosity that leads to normal development and health
and use the available health facilities
 2ursing Assessment of Ms.XHenderson's 14 ComponentsAssessment
Findings1Breathing normallyShe was experiencing difficulty in breathing;
Respiratory rate-16 irregular, Oxygen saturation 87%
 2Eat and drink adequately.Height 153 cm; weight 45kg; skin turgor good, She
was advised liquid diet but she resisted taking any liquid.
 3Elimination of body wastesFoley's catheter was in placed
 4Movement and PosturingReports fatigue , Feeble to walk, Gait imbalance
 5Sleep and RestExperiencing insomnia for three days, Dark circles around eyes
 6Select suitable clothes-dress and undressWearing loose fitted dirty dress.
 7Maintain body temperature No signs of hyperthermia or
hypothermia;Temperature 37 C
 8Keep the body clean and well groomed Mother reported that she was very
conscious of her physical appearance and hygiene but was not well groomed at
that time.
 9Avoid dangers in the environment Fatigue, feeble walk and history of attempted
suicide.
 10CommunicationShe had damaged larynx and had speech difficulty
 11Worship according to one’s faithReligion; Islam, mother reported that she was
not spiritual.
 12Work accomplishmentLost interest in self-care and inability to perform ADLs
since her marriage was planned as reported by mother
 13Play or participate in various forms of recreationMother reported that she used
to spend time with family but had lost active participation in home activities.
 14Learn, discover, or satisfy the curiosityFinding difficult to cope with her stress
and present illnes