basic principles of nursing

M A R I T E S C . VA L E N C I A , R N

Virginia Henderson’s

Basic Principles of Nursing

Introduction

“Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings.

Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment,

research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.”

-International Council of Nurses

Virginia Avenel Henderson

DOB: Nov. 30, 1897Kansas City, Missouri5th of the 8 childrenDad: Atty. Daniel HendersonMom: Lucy AbbotRIP: 99 y/o; March 19, 1996

Nurse and Educator

1921: Received Diploma in Nursing from the Army School of Nursing at Walter Reed Hospital, Washington, DC

1921-23: worked as staff nurse at Henry Street Visiting Nurse Service

1923: Teacher at Norfolk Protestant Hospital in Virginia1932: BS Degree at Teacher’s College at Columbia

University 1934: MA Degree 1929-1948: Faculty of Columbia University 1953: Research associate at Yale University School of

Nursing

Author and Researcher

Co-authored the 4th edition of Bertha Harmer’s Textbook of the Principles and Practice of Nursing

5th edition includes VH’s own definition of Nursing

Her book, The Nature of Nursing, was published in 1966 and describes her concept of nursing’s primary, unique function. It was reprinted by the National League of Nursing in 1991.

The sixth edition of the Principles and Practice of Nursing, published in 1978, was coauthored by Henderson.

Recognitions

Received honorary doctoral degrees

Mary Tolle Wright Founders Award for Leadership

First Christianne Reimann Prize

Received a special citation of honor

“Twentieth Century Florence Nightingale”

Historical Influence and Influences

Main Influence:

The ultimate goal of the nurse is to practice autonomously in helping patients who lack

knowledge, physical strength, or strength of will in growth toward independence.

Because of this function nurses seek and promote research, education, and work settings that facilitate this goal.

Historical Evolution and Influences

a definition/concept rather than a theory

First, she revised the textbook Principles and Practice of Nursing in 1939. Henderson identifies her work for this text as the source that made her realize the necessity of being clear about the function of nurses.

Second, was her involvement as a committee member in a regional conference of the National Nursing Council in 1946. Her committee work was incorporated into Esther Lucile Brown’s 1948 report, “Nursing for the Future”. Henderson says this report represented “my point of view modified by the thinking of others in the group.”

Third, the American Nurses Association’s (ANA) 5 year investigation of the function of the nurse interested Henderson, who was not fully satisfied with the definition adopted by the ANA in 1955.


Her ideas about the definition of nursing were influenced by her nursing education and practice by her students and colleagues at Columbia University School of Nursing, and by distinguished nursing leaders of her time.

First, she participated in the revision of a nursing textbook.

Second, she was concerned that many states had no provisions for nursing licensure to ensure safe and competent care for the consumer.


Henderson recognized the need to be clear about the functions of the nurse. She believed that a textbook that serves, as main learning source for nursing practice should present a sound and definitive description of nursing.

Henderson was committed to the process of regulating nursing practice through licensure by each state.

VH’s definition of Nursing:

“Nursing is primarily assisting the individual (sick or well) in the performance of those

activities contributing to health or its recovery (or peaceful death) that he would perform unaided if he had the necessary

strength, will, or knowledge. It is likewise the unique contribution of nursing to help the

individual to be independent of such assistance as soon as possible.”

MAJOR CONCEPTS

Virginia Henderson’s The Basic Principles in Nursing

HUMAN BEING

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, and the patient is neither client nor consumer.

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.

Supports tasks of private and public agencies Society wants and expects nurses to act for individuals who are unable to function independently. In return she expects society to contribute to nursing education.

Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided

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?

14 BASIC NEEDS

1. Breathe normally. 2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable postures. 5. Sleep and rest. 6. Select suitable clothes-dress and undress. 7. Maintain body temperature within normal range by adjusting

clothing and modifying environment8. Keep the body clean and well groomed and protect the integument9. Avoid dangers in the environment and avoid injuring others. 10. Communicate with others in expressing emotions, needs, fears, or

opinions. 11. Worship according to one’s faith. 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. 14. Learn, discover, or satisfy the curiosity that leads to normal

development and health and use the available health facilities.

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.”

Henderson’s classic definition of nursing: “I say that the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible.”

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.

MAJOR ASSUMPTIONS


MAJOR ASSUMPTIONS

Independence is valued by the nurse and the patient, more than dependence.

Health has a meaning shared by the society at large.

Individuals desire health or a peaceful death and will act in such a way to achieve this.

Individuals will perform activities leading to health if they have the knowledge, capacity or will.

MAJOR ASSUMPTIONS

The individual’s goal and the nurse’s goal are congruent.

The 14 basic needs represent nursing’s basic function.

Nursing’s goal may be subsumed into the medical treatment plan.

The major explicit assumption is Henderson’s content that the nurse is an independent practitioner.

FRAMEWORK

THE THEORIST’S WORK AND THE CHARACTERISTICS OF A THEORY


CHARACTERISTICS

Theories can interrelate concepts in such a way as to create a difference.

Theories must be logical in nature.

Theories should be relatively simply yet generalize.

Theories can be the bases for the hypothesis that can be tested or for theory to be explained.

CHARACTERISTICS

Theories contribute to and assist in increasing body of knowledge within discipline through research.

Theories can be used by practitioner to guide and improve their practice.

Theories must be consistent with other validated theses, laws, principles, but leave open unanswered questions that need to be investigating.

THEORY SYNTHESIS


Nursing Process

ASSESSMENT Henderson’s 14 components

DIAGNOSIS Analysis: Compare data to knowledge base of health and disease.

PLANNING Identify individual’s ability to meet own needs with or without assistance, taking into

consideration strength, will or knowledge. IMPLEMENTATION

Document how the nurse can assist the individual, sick or well. Assist the sick or well individual in to performance of activities in meeting human needs

to maintain health, recover from illness, or to aid in peaceful death. EVALUATION

Henderson’s 14 components and definition of nursing 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.

Case Scenario

Gina, a 79 year old grandmother rushed to the comfort room to urinate. On her way to the CR she slipped thus, resulting to a hip

dislocation. Upon going to the Emergency Department and underwent x-ray they

found out that she needed to wear braces and have to undergo surgery to replace a damage hip joint. After a week of wearing braces and taking medications she is scheduled for an elective

surgery.

Nursing Process: Case Scenario

ASSESSMENT

Breathe normally. Eat and drink adequately. Eliminate body wastes. Move and maintain desirable postures. Sleep and rest. Select suitable clothes-dress and undress. Maintain body temperature within normal range by adjusting clothing and

modifying environment Keep the body clean and well groomed and protect the integument Avoid dangers in the environment and avoid injuring others. Communicate with others in expressing emotions, needs, fears, or opinions. Worship according to one’s faith. Work in such a way that there is a sense of accomplishment. Play or participate in various forms of recreation. Learn, discover, or satisfy the curiosity that leads to normal development and

health and use the available health facilities.


PLANNING

Short- term goal: Patient will be able to verbalize willingness to demonstrate participation

in activities. Verbalize understanding of situation or risk-factors and individual

treatment regimen and safety measures.

Long-term goals: Identify alternative ways to maintain desired activity level. Participate in conditioning or rehabilitation program to enhance ability

to perform. Demonstrate techniques/behaviors that enable resumption of activities. Maintain position of function after surgery and skin integrity as

evidenced by absence of contractures and pressure sores.


IMPLEMENTATION

Doing for the patient (substitutive) Support the affected body part/joints using pillows to maintain position of

function and reduced risk of pressure ulcers. Assist with treatment of underlying condition causing pain and or dysfunction. Administer medication prior to activity as needed for pain relief to permit

maximal effort and involvement in activity.

Helping the patient (supplementary) Assist the patient on reposition on a regular schedule (frequent shifting of

weight). Limit fatigue, maximizing participation.

Working with the patient (complementary) Encourage participation Schedule activities with adequate rest periods during the day to reduce fatigue Encourage participation in self-care, occupational, diversional, and recreational

activities. Enhance self concept and sense of independence.

Application of the Theory

NURSING PRACTICE Nurses function to assist patients in activities of daily living,

especially those who care incapable of doing so because of debilitating condition.

NURSING EDUCATION One of her long list of contributions is her well known definition of

nursing which calls for the nurse to be an expert and an independent practitioner being equipped with the right knowledge in basic nursing care to achieve its goal’s definition.

NURSING RESEARCH Research is a breakthrough of unending search for the betterment

of patient care. Her work has been a foundation for improving the preparation for

nursing. She even emphasized the importance of research in evaluating and improving the nurses’ practice.

Theory Derivation

Thank you and Have a nice day!

basic principles of nursing

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