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DEFINITION  OF  NURSING  

VIRGINIA  HENDERSON  

VIRGINIA  HENDERSON  
•  Born  in  Kansas  City,  Missouri  in  1897.   •  Received  a  Diploma  in  Nursing  from  the  Army  School   of  Nursing  at  Walter  Reed  Hospital,  Washington,  D.C.   in  1921.   •  Worked  at  the  Henry  Street  VisiIng  Nurse  Service  for   2  years  aJer  graduaIon.   •  In   1923,   started   teaching   Nursing   at   the   Norfolk   Protestant  Hospital  in  Virginia   •  In   1929,   entered   Teacher’s   College   at   Columbia   University  for  her  Bachelor’s  Degree  in  1932  and  her   Master’s  Degree  in  1934.  

•  Her   definiIon   of   nursing   was   one   of   the   first   statements   clearly   delineaIng   nursing   from   medicine:   •  "The   unique   func9on   of   the   nurse   is   to   assist   the   individual,  sick  or  well,  in  the  performance  of  those   ac9vi9es   contribu9ng   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   h i m   g a i n   i n d e p e n d e n c e   a s   r a p i d l y   a s   possible"  (Henderson,  1966).  

•  She   emphasized   the   importance   of   increasing   the   paIent’s   independence   so   that   progress   aJer   hospitalizaIon   would   not   be   delayed   (Henderson, 1991)   •  She  described  the  nurse's  role  as  subs9tu9ve  (doing   for  the  person),  supplementary  (helping  the  person),   complementary  (working  with  the  person),  with  the   goal   of   helping   the   person   become   as   independent   as  possible.   •  She   categorized   nursing   acIviIes   into   14   components,  based  on  human  needs.    

THE  14  COMPONENTS  
1.  2.  3.  4.  5.  6.  Breathe  normally.     Eat  and  drink  adequately.   Eliminate  body  wastes.   Move  and  maintain  desirable  postures.   Sleep  and  rest.   Select  suitable  clothes-­‐dress  and  undress.  

THE  14  COMPONENTS  
7.  Maintain   body   temperature   within   normal   range   by   adjusIng  clothing  and  modifying  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   emoIons,   needs,  fears,  or  opinions.   11. Worship  according  to  one’s  faith.  

THE  14  COMPONENTS  
12. Work   in   such   a   way   that   there   is   a   sense   of   accomplishment.   13. Play   or   parIcipate   in   various   forms   of   recreaIon.   14. Learn,   discover,   or   saIsfy   the   curiosity   that   leads   to   normal   development   and   health   and   use  the  available  health  faciliIes.  

THE  14  COMPONENTS  
•  The  first  9  components  are  physiological.  The   tenth   and   fourteenth   are   psychological   aspects   of   communicaIng   and   learning   The   eleventh  component  is  spiritual  and  moral  The   twelJh   and   thirteenth   components   are   sociologically   oriented   to   occupaIon   and   recreaIon.  

The  major  assumpIons     of  the  theory  are:  
•  "Nurses  care  for  paIents  unIl  paIent  can  care   for   themselves   once   again.   PaIents   desire   to   return   to   health,   but   this   assumpIon   is   not   explicitly  stated.   •  Nurses   are   willing   to   serve   and   that   “nurses   will  devote  themselves  to  the  paIent  day  and   night”.   A   final   assumpIon   is   that   nurses   should   be   educated   at   the   university   level   in   both  arts  and  sciences.  

Henderson’s  Theory  and     the  Four  Major  Concepts  
•  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   paIent   as   a   sum   of   parts   with   bio-­‐psycho-­‐social   needs,   and   the   paIent   is   neither  client  nor  consumer.    

Henderson’s  Theory  and     the  Four  Major  Concepts  
•  Environment   •  Sefngs   in   which   an   individual   learns   unique   pagern  for  living.   •  All   external   condiIons   and   influences   that   affect  life  and  development.   •  Individuals  in  relaIon  to  families   •  Minimally   discusses   the   impact   of   the   community  on  the  individual  and  family.  

Henderson’s  Theory  and     the  Four  Major  Concepts  
•  Environment   •  Supports  tasks  of  private  and  public  agencies.   Society   wants   and   expects   nurses   to   act   for   individuals   who   are   unable   to   funcIon   independently.   In   return,   she   expects   society   to  contribute  to  nursing  educaIon.   •  Basic   nursing   care   involves   providing   condiIons   under   which   the   paIent   can   perform  the  14  acIviIes  unaided.  

Henderson’s  Theory  and     the  Four  Major  Concepts  
•  Health   •  DefiniIon  based  on  individual’s  ability  to  funcIon   independently  as  outlined  in  the  14  components.   •  Nurses  need  to  stress  promoIon  of  health  and   prevenIon  and  cure  of  disease.   •  Good  health  is  a  challenge.  Affected  by  age,  cultural   background,  physical,  and  intellectual  capaciIes,  and   emoIonal  balance  Is  the  individual’s  ability  to  meet   these  needs  independently?  

Henderson’s  Theory  and     the  Four  Major  Concepts  
•  Nursing   •  Temporarily   assisIng   an   individual   who   lacks   the  necessary  strength,  will  and  knowledge  to   saIsfy  1  or  more  of  14  basic  needs.   •  Assists   and   supports   the   individual   in   life   a c I v i I e s   a n d   t h e   a g a i n m e n t   o f   independence.   •  Nurse   serves   to   make   paIent   “complete”   “whole",  or  "independent."  

•  Nursing   •  T h e   n u r s e   i s   e x p e c t e d   t o   c a r r y   o u t   physician’s   therapeuIc   plan.     Individualized   care   is   the   result   of   the   nurse’s   creaIvity   in   planning   for   care.   •  In   the   Nature   of   Nursing   “that   the   nurse   is   and   should   be   legally,   an   independent   pracIIoner   and   able  to  make  independent  judgments  as  long  as  s/he   is  not  diagnosing,  prescribing  treatment  for  disease,   or   making   a   prognosis,   for   these   are   the   physicians   funcIon.”  

•  “Nurses   should   have   knowledge   to   pracIce   individualized   and   human   care   and   should   be   a   scienIfic  problem  solver.”   •  In   the   Nature   of   Nursing,   Nurse’s   role   is,   “to   get   inside   the   paIent’s   skin   and   supplement   his   strength   will  or  knowledge  according  to  his  needs.”   •  And   the   nurse   has   the   responsibility   to   assess   the   needs  of  the  individual  paIent,  help  individual  meet   their  health  need,  and  or  provide  an  environment  in   which  the  individual  can  perform  acIvity  unaided.  

Comparison  with  Maslow's   Hierarchy  of  Need  
•  •  •  •  •  •  •  •  •  Physiological  Needs   Breathe  normally   Eat  and  drink  adequately     Eliminate  by  all  avenues  of  eliminaIon     Move  and  maintain  desirable  posture     Sleep  and  rest     Select  suitable  clothing     Maintain  body  temperature     Keep  body  clean  and  well  groomed  and  protect  the   integument  

Comparison  with  Maslow's   Hierarchy  of  Need  
•  Safety  Needs   •  Avoid   environmental   dangers   and   avoid   injuring  other   •  Belongingness  and  Love  Needs   •  Communicate  with  others   •  Worship  according  to  one's  faith  

Comparison  with  Maslow's   Hierarchy  of  Need  
•  Esteem  Needs   •  Work   at   something   providing   a   sense   of   accomplishment.   •  Play   or   parIcipate   in   various   forms   of   recreaIon.   •  Learn,  discover  or  saIsfy  curiosity.  

Think  about  this  ………………….  
•  Nurses   dispense   comfort,   compassion,   and   caring   without  even  a  prescripIon.    -­‐  Val  Saintsbury