How Nursing was before and How Nursing is Today
? Nursing Theory: How Nursing was before and How Nursing is Today Abstract Nursing has been and will continue to evolve with new theories related to patients, nurses, education, and science. The past and present research and ideas of nursing theorists impact the science of nursing and the standards of the nursing profession. Core components of nursing have resulted from the development of different nursing theories developed over the years which have contributed to guiding the clinical aspect of nursing into what it is today.
Virginia Henderson and Dorothea Orem are both nursing theorists who developed theories that have essentially shaped the foundation of nursing as one had a hand in the development of nursing while the latter contributed to the ultimate shaping of nursing in general. This paper will compare Virginia Henderson’s Nursing Needs-Based Theory against Dorothea Orem’s Self-Care Deficit Theory. The Theory of Need was developed by Virginia Henderson and was derived from her education and nursing practice. “Henderson’s goal was not to develop a theory of nursing, but rather to define the unique focus of nursing practice” (nursingtheory.org, 2013). Virginia Henderson’s theory played a very important role in the development of modern nursing. “Her contributions, especially to evidence based practiced nursing are considered so important that Sigma Theta Tau International Library has been named in her honor” (Jacqueline & Longe, 2006). Henderson believed “that the nurse should help the individual achieve independence as much as possible, and that the nurse should take a patient-centered approach to nursing to be based in evidence and research.
She also believed that a nurse should be considered an independent member of the total healthcare team and that the nurse should only perform nursing functions, neither performing the diagnosis, prescription, and prognosis functions of a physician or any tasks such as serving food and cleaning that were not directly related to helping the patient with the 14 basic nursing functions” (Jacqueline & Longe, 2006). Henderson’s believed that her created functions list was an essential part of basic nursing care. The nurse should help the patientperform some essential functions such as eating and drinking, breathing, communicating, participating in recreation, worshiping, avoiding danger or hurting others, and keeping clean. Once these basic needs were met and the patient was “able to perform all the functions by themselves, then the patient would be considered independent and no longer require the aid of a nurse” (nursing-theory. org 2013). Virginia Henderson also believed that it was important that nursing be based on evidence and research as it was a critical component of improving nursing research.
Henderson had a strong belief that all nursing staff should have access to literature on nursing and current nursing research to help better their practices” (www. nursing-theory. org, 2013). There were three major assumptions that Henderson listed in her model of nursing assumptions: “Nurses care for the patient until the patient can care for themselves, nurses are willing to serve, and that the nurse, devote themselves day and night to the patient, and the nurses should be educated at the college level in both sciences and art” (nursing-theory.org, 2013). Another great theorist, Dorthea Orem, created the Self-Care Deficit Nursing Theory with the assumed philosophy that patients have a desire to be more independent and would want to take care of their own needs thus helping them recover more that patients want to care for themselves and can recover more rapidly and holistically by being as independent as possible.
The self- care components identified by Orem can be categorized into one of three categories: Maturational: progresses the patient to a higher level of maturation Situational: prevents against harmful effects in development Deviation requisites: needs that come up based on patients condition If the patient is unsuccessful in sustaining his or her self-care needs as indicated, then a self-care deficit is identified for the patient and the nurse can intervene “with a varying level of support that can range from complete care, partial care, or simply educating the individual” (currentnursing. com, 2013).
Compare and Analyze the Common Core Concept The commonality between the theories of Virginia Henderson and Dorthea Orem is their attempt to define the role of nursing. Henderson definition of nursing is “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” (nursing-theory. org, 2013). The Self Care Theory developed as a result of Dorthea Orem working toward her goal of improving the quality of nursing in general hospitals in her state.
The theory is relatively simple, but generalizable, to apply to a wide variety of patients “(nursing-theory. org, 2013). Concept Statement Henderson believed that the function of the nurse is to help the patient, whether healthy or ill, in all basic functioning activities that contribute to the patients health status thus leading to either a rapid recovery or peaceful death. She further believed that this assistance by the nurse would prompt the patient to “perform unaided given the necessary strength, will or knowledge, and to do this in such a way as to help the individual gain independence as rapidly as possible” (Henderson, 1966).
Metaparadigms The major concepts of Virginia Henderson’s Need Theory relate to the metaparadigm nursing, health, patient and environment. Person Individual patient or client is a whole, complete, and independent (nursing-theorist, 2011) Mind and body are inseparable (nursing-theorist, 2011). Patient will require assistance to achieve health and independence or peace at death (nursing-theorist, 2011) Health Basic form of functioning (nursing-theorist, 2011). Promotion of health is more important than care of sick (nursing-theorist, 2011).
The quality of health rather than life itself, that margin of mental physical allows a person to work most effectively (nursing-theorist, 2011). Environment Illness or disease has the potential to interfere with a nurse’s ability to exert control over the environment. When possible, the nurse is to alter the environment in such a way as to support the patient 7 essentials in the environment: light, temperature, air movement, atmospheric pressure, appropriate disposal of waste, minimal quantities of injurious chemicals, and cleanliness of surfaces and furnishings in contact with the individual (nursing-theorist, 2011) Nursing
To describe the care that any person requires no matter what the physician diagnosis and prescribed therapy (nursing-theorist, 2011). The nurse’s basic care is the same wheter the patient is considered physically or mentally ill (nursing-theorist, 2011). Care must empower the patient to become self- sufficient as soon as possible (nursing-theorist, 2011). Philosophy
The philosophy of Henderson outlines an “integrated approach to scientific study that would capitalize on nursing’s richness and complexity, and not to separate the art from the science, the “doing of nursing from the “knowing”, the psychological from the physical and the theory from clinical care” (vhenderson2011blogspot. com). Conceptual Model Henderson’s conceptual model of nursing supported a humanistic approach by giving emphasis to the taking care of the sickly, the dying, and the individuals incapable of caring for themselves.
It put more stress on the actions of the nurses and the type of patients that should be cared for by nurses and therefore should belong to the “reciprocal interaction world view category. The functions of nurses were to give intimate care to people who cannot function effectively on their own . It also emphasized that nurses be thought the skills and knowledge that would enable them to help their patients. The model also stressed that as soon as the patients are able nurses should be able to assist them in their recovery and if not to care for them in regaining their dignity and basic functioning” (vhenderson2011blogspot.com). Conclusion Through literature, it is evident that the exact role and nature of nursing is not easily defined and the theories developed by Virginia Henderson and Dorothea Orem solidified this concept. Virginia Henderson’s Needs Theory detailed that there were steps to be assumed in the promoting and sustaining of a patient’s health while Orem’s Self-Care theory indicated the role of a patient in caring for his or her health as well as the component that nursing contributes to encouraging the facilitation of patient self-care.
And although nursing is very multi-faceted and complex, theorists and nurses alike agree that it is an exhilarating profession that is rich in practice and theory. As nurses, it is important that we continue to develop, expand, and contribute to the concepts and ideas that reinforce the core concepts of nursing. References Dorthea Orem’s Theory. (2013). Retrieved from Currentnursing. com: www. currentnursing. com/nursing_theory/self_care_deficit_theory. html Henderson vs.The Nature of Nursing: A definition and its Implications, Practice, Research, and Education. (1966). New Yrok: McMillion Company. Nursing Theorist: Virginia Henderson. (2011). Retrieved from www. vhenderson2011. blogspot. com/p/major-concepts Virginia Henderson’s Need Theory. (2013). Retrieved from Currentnursing. com: www. currentnursing. com/nursing_theory/Henderson. html Henderson Theory of Nursing: The Gale Encyclopedia of Nursing & Allied Health: Ed Jacqueline, L. Longe. Vol. 2. 2nd ed. Detroit: Gale, 2006 (1280-1281)