Nursing Theory

Running Head: PUTTING THEORY INTO PRACTICE

Putting Theory into Practice: Utilization of Henderson’s Nursing Theory in Everyday Nursing Practice

Health care around the world and especially in the Western world, has undergone extreme changes over the past few decades, however, the basic principles of nursing such as caring for the sick and elderly have remained the same. Many of those principles come from the teaching of Virginia Henderson.

Her interactional theory of holistic care has helped to form the philosophical base of twentieth century nursing. Following the guidelines set by Nightingale, Ms. Henderson was a humanist who “viewed the education of patients and families as core to nursing care” (Sanford, 2000, p.1). Her theory of nursing brought to the forefront the idea of the nurse as patient educator.

It is for this reason I have chosen Virginia Henderson’s theory, coupled with a Christian Worldview of Nursing, to base my practice of care at the bedside in the intensive care unit (ICU) where I work. The aspect of seeing the entire person as a whole and not in parts is an important aspect in the delivery of my care. I also believe that a patient’s faith and religion play a key role in their well-being, both as an inpatient and in the community which they reside.

Therefore, it is important to care for the entire patient. The fourteen points of Virginia Henderson’s theory, which I will later describe, allow me to implement this theory of practice at the bedside. There is no irrelevant part of the patient’s care; all parts are equally important, as I will discuss.

Worldview

Henderson’s theory is considered a grand theory of nursing. Grand theories consist of a global conceptual framework that defines broad perspectives for nursing practice, ways of looking at nursing phenomena from a distinct nursing perspective. Grand theory explicates key concepts and principles of the discipline.

There are three behavioral theories associated with the profession of nursing: interactive, systems and developmental. Systems theory posits that a person lives within a multidimensional world of systems where stress is present in all interactions. Systems exist in any grouping, from the physical, social and psychological system of the individual to organizations, communities, families and cultures. The developmental model posits that a process of growth exists for all things вЂ" animate and inanimate. There is cause and effect that may be explained in terms of four levels of development; unidirectional, spiral effect, cyclic and branching out (Tourville and Ingalls, 2003).

The theories of Virginia Henderson fall within the third category of behavioral theory, that of the interactive model. Tourville and Ingalls (2003), explain the interactive model as emphasizing “the importance of interpersonal relationships between the nurse and the person. It focuses on identifying any interpersonal problems and providing intervention techniques to "promote optimal socialization" (Fawcett, 1984, p. 16). Benoliel (1977) stated that “the interactive model sees human beings as creatures who define and classify situations, including themselves, and who choose ways of acting toward and within them” (p. 110). Benoliel (1977) also states that

The four main characteristics of the interactive model are perception (how people view the world, people, events), communication (transferring information), role (e.g., parent, spouse, citizen, worker), and self-concept (how people view themselves) (p. 24).

Henderson’s fourteen areas of nursing care are based on health being defined in terms of the physical, psychological, spiritual/moral, and sociological aspects of an individual, formed the foundation for her teaching of principles and practice. The physical area included breathe normally, eat and drink adequately, eliminate body wastes, move and maintain desirable positions, sleep and rest, select suitable clothing, maintain normal body temperature, keep the body clean and well-groomed and avoid dangers and injuries. In the psychological area, the nurse was responsible for communicating with others in expressing emotions, needs, fears or opinions, learning, discovering or satisfying the curiosity that leads to normal development and health and use the available health facilities. In the spiritual or moral area, the nurse should worship according to one's faith, and in the sociological area he or she should work with a sense of accomplishment and play or participate in various forms of recreation (Henderson, 1966, p. 22-23).

The belief that nursing met a specific need and fulfilled a worthy contribution to society fostered the definition for "Functions of the Professional Nurse", which was adopted by the International Council of Nurses. She proposed that the art of nursing begins with caring, extends to being able to communicate (to listen, empathize and provide support) and ends with the integration of the individual and the job. Henderson and Nite (1978) postulated that

Assisting individuals (sick or well) with those activities contributing to health, or its recovery or to peaceful death, that they perform unaided, when they have the necessary strength, will or knowledge; nursing also helps individuals carry out prescribed therapy and to be independent of assistance as soon as possible (p. 14).

Nursing, according to Ms. Henderson, includes both independent and interdependent aspects that must be taken into consideration in the development of the nurse and of nursing as a profession (Evers, 2003).

My perspective of the activities of nursing is geared towards Virginia Henderson’s grand theory. All fourteen points ensure complete and holistic care of the patient. There is an exchange that takes place between those who provide care and those cared for that goes beyond the empirical reality of the moment and incorporates the spiritual. The 'art' of providing care includes an aspect of caring that has metaphysical origins and connotations. It concerns all aspects of the human experience, physical, psychological, spiritual and social. The Gestalt approach to nursing and the inclusion of caring as a primary requisite is the heart of the concept of interactive theory as it applies to nursing and as presented by Ms. Henderson.

Virginia Henderson's definition of nursing focused on the function of nursing as being able to assist