Virginia Henderson, the architect of nursing, made a huge contribution to the theory, practice, education, and research in the field of nursing. This theorist provided one of the most accurate definitions of nursing profession and, most importantly, a scientifically grounded theory of nursing that is based on a holistic approach to a patient, his or her health, and environment.
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By the time of the end of World War I, Henderson had already studied at the Washington Army Medical School. Having received her first diploma in 1921, she went to work (Terry, 2013). Interestingly, it was noticed that she was able to explain the basics of the profession and the rules of care to other nurses, relatives of patients, and even patients themselves. Two years later, the theorist became the first full-time nursing instructor at the Protestant Hospital in Norfolk, Virginia. Henderson is the owner of honorary doctorates at twelve Universities, the awards of Christian Reimann Prize from the International Council of Nurses as well as of her name.
Key Aspects of the Theory
Henderson is recognized as “Nightingale of modern nursing” due to her innovative approach to nursing ideas. The theorist defines the paramount goal of nursing in the following way: “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” (Yoost & Crawford, 2016, p. 3). The theory by Henderson puts more emphasis on physiological needs rather than psychological and social ones, which can be satisfied through nursing care. One of the indispensable conditions for this model is a patient’s involvement in care planning and implementation. According to Henderson, every patient has fundamental human needs in food, shelter, clothing; love and goodwill; a sense of necessity and interdependence in the context of social relationships (Ahtisham & Jacoline, 2015).
Henderson distinguishes between everyday needs that are usually satisfied by a healthy person. However, during illness, pregnancy, childhood, or oldness, a person cannot satisfy these needs on his or her own. In this case, a nurse is expected to help a patient in the performance of these functions that he or she cannot meet independently (Alligood, 2014). The theorist claims that nursing care should be aimed at the timely restoration of human independence. Thus, Henderson identifies 14 needs of a person: normal breath, eating, and drinking, elimination of body wastes, free movement, sufficient sleep and rest, personal hygiene, care of appearance, etc. The mentioned needs are physiological. Nonetheless, the theorist also pays attention to some psychological aspects, including communication with other people, expressing emotions and opinions, religious stance, and satisfaction of curiosity through learning and discovering activities (Burggraf, 2012).
Personally, the performance of Henderson is directly related to her theory. Throughout her professional work, the theorist adheres to the principles and needs that were identified earlier in this paper. Henderson follows comprehensive nursing intervention approach, including environment, society, psychology, and physiology aspects. The nursing care model she proposed and adhered to, which focuses on the complementary capabilities of a patient, provides a clear and excellent guide for the entire health care system. Henderson is a significant figure in nursing whose role was recognized by contemporaries and modern theorists and practitioners. There is the International Library of the Nursing named Virginia Henderson International Nursing Library in her honor. Henderson allowed her name to be used, provided that the electronic system would help in improving the work of nurses, being the source of relevant and useful information.
Relevance to Health Care and Patients
The theory created by Henderson is used by nurses all over the world. If before it, the complete focus in care of a patient was given to a doctor and a diagnosis, after it, the emphasis transferred on a person with his or her needs (Terry, 2013). In other words, Henderson changes the attitude to the profession along with its purpose. The theorist believes that a nurse should set only long-term goals in restoring a patient’s independence by meeting 14 needs (Terry, 2013). Indeed, short-term and intermediate goals also have the right to exist yet only in acute conditions such as shock or infection, for example. The author recommends making a nursing care plan and assessing the results of nursing interventions. Thus, the theory offered by this theorist serves as guidance to modern nurses in their approach to patients, clearly representing the key points to be evaluated and improved so that the latter may reach independence.
Application to Research and Practice
It should be noted that in spite of the fact that Henderson’s performance was primarily focused on theoretical issues rather than practical ones, she provides essential contribution both to theory of nursing and its practice. The theorist clearly specifies the process of collaboration with a patient based on her theory. In particular, it is stated that at the stage of the initial assessment of a patient’s condition, a nurse together with a patient should determine which of the 14 needs should be met first. Moreover, a nurse should make the decision for a patient only in the event that he or she is not able to do it (Terry, 2013). For example, if the patient refuses to take food, so his or her need for food is not satisfied. In collaboration with a patient, a nurse determines the possible causes of this problem, considering that there can be poor appetite, fastidiousness, etc. and sets reasonable goals for resolving the problem. In case a patient is disturbed by sleep disorder, a nurse should establish the causes of this problem: uncomfortable bed, stuffiness, snoring of a neighbor in the ward, and so on and then determine the goals of nursing care and intervention. At the same time, Henderson suggests evaluation guidelines, starting with the final evaluation of the implementation of the care plan and satisfaction of issues that were identified. A nurse should determine the extent to which the goal was achieved in meeting certain needs. If the goal is not reached, new nursing interventions or change in the goal formulation are to be planned.
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To sum it up, Henderson believes that a person should fully and independently meet his or her daily needs, and, therefore, the long-term goal of nursing care is to achieve a patient’s maximum independence. To solve this problem, nursing intervention should be aimed at strengthening a patient’s health and promoting independence both on physical and psychological levels that are the key strengths of the theory. The limitation of Henderson’s theory relates to the unclear relations between 14 needs in the context of nursing care.
Ahtisham, Y., & Jacoline, S. (2015). Integrating nursing theory and process into practice: Virginia’s Henderson need theory. International Journal of Caring Sciences, 8(2), 443-450.
Alligood, M. R. (2014). Nursing theorists and their work (8th ed.). Maryland Heights, MO: Elsevier.
Burggraf, V. (2012). Overview and summary: The new Millennium: Evolving and emerging nursing roles. Online Journal of Issues in Nursing, 17(2). Web.
Terry, A. J. (2013). The LPN-to-RN bridge: Transitions to advance your career. Burlington, MA: Jones & Bartlett.
Yoost, B. L., & Crawford, L. R. (2016). Fundamentals of nursing: Active learning for collaborative practice. St. Louis, MO: Elsevier.