Miss Virginia Henderson has become a part of our lives. And as a proof to that, here are some testimonies that honor our "Modern Mother Of Nursing".
Personal Realizations By Philip Andrew Salarda:
As I ponder on the theory of Virginia Henderson, I came to a realization that nursing is not that complicated. I always see a nurse as having the most difficult and demanding job in the world. There are so many things to do and you have to these things with perfection.
Her theory made me realize that nursing is all about satisfying the needs of the patient. Today’s nurses may have forgotten this principle, especially here in the Philippines where the nursing scene is steadily degrading in quality. It appears that nurses today have so many things to focus and neglecting the care part on the patients. In my own experience for instance, due to the high census in our hospital, I don’t have the time to bond with my patients. I have so many things to do and end up forgetting about connect with my patients. The shift ends with me being so tired, the patient not satisfied and Henderson having a sad face.
Nursing is simple; it’s all about the patient and giving them the strength, will and knowledge to live.
Personal Application of Virginia Henderson’s Nursing Need Theory By Monique GomezGoing back to Module 1’s lesson of the uses of a theory, we can very easily deduce that the fact that it helps, improves and guides nursing practice, research, the discipline’s body and lastly, the communication within the practitioner’s of a profession, simply points to one direction of its purpose. A theory exists for the betterment of our individual applications and practice.
In the similar goals of the enhancement of Nursing that the various Nursing Theories have similarly altogether in their cores, there is always that distinguishing highlight that each theory has to offer. Henderson’s definition of nursing is summarized briefly on aiding the sick or well in the performance of those activities contributing to health or it’s recovery or even to a peaceful death that they can do independently if they were well and to do this as rapidly as possible. However, quite easily, Virginia Henderson’s Need Theory has the 14 Components of Basic Nursing Care as it’s unique birth mark.
What better way to present and convey in the most efficient way, her proposals, but to express them using these 2 defining points.
14 Components of Basic Nursing Care
My Personal Experience of Assisting the Client to attain Health or Recovery
1. Breathe normally.
Being stationed in the Emergency Room, I am often caught with severe bouts of Status Asthmaticus on patients in all ages. In line with helping these breathing compromised patients, a few independent nursing procedures would be to position the patient in tripod position or even just hunched forward and to remove any impeding clothing or accessory on patient. Likewise, in coordination with the Physicians as our counterparts in the Medical Team, administering low flow oxygen therapy at 2-5 LPM , nebulization and possibly starting an I.V line for access to introducing corticosteroids are also usual things to anticipate.
2. Eat and drink adequately.
Eating and drinking adequately for me, not only covers making sure your clients are ingesting food or drinking but also, based from Ward Assignments, making sure that there diet is suitable for their condition and aiding to their normalcy. As the Point Guard in the ward, I learned to synchronize with the Physician who orders the diet for the patient and the Dietician who apportions the nutritive content of the food by not only verifying the correctness of the food delivered to the clients but also by following appropriate safety limitations like strict Aspiration Precautions, Restriction of Choco-Colored Food and to even periodically restricting diet to none at all for the patient’s safety.
3. Eliminate body wastes.
When you talk about the Emergency Room, you talk about the home of patients from Moto-Vehicular Accidents. In cases of severe trauma, some client’s suffer from Urinary Retention. As an independent Nurse action, I applied cold and hot compress alternately to my client. Keeping in mind the avoidance of the Rebound Phenomena. In cooperation with the Doctors in the medical team, I likewise did Straight Catheterization which is more preferable at several times over attaching an indwelling catheter as aside from the fact that it lessens the risk for infection, it also removes the risk of the patient’s urinary system’s dependency on the helping device. With Straight Catheterization, with their gradual treatment, they can practice urinating when they are gradually able to do so on their own.
4. Move and maintain desirable postures.
For my previous patients who suffered from paralysis due to stroke, it was a common independent nursing responsibility to follow turning schedules implemented every 2 hours. Another intervention was Daily Range of Motion Exercise for these patients so they would not suffer from Flaccid Paralysis from loss of the use of their muscles. According to Henderson’s Definition of nursing, we nurses are to foster the independence of the client to function on their own. With that, although the client may not be mobile at the time of your care, you also make it your own liability to make sure that they would be able to utilize fully, their limbs and body parts when they pull through the debilitating illness they are suffering from. You serve as the keeper and the preserver of their body for them in this case.
5. Sleep and rest.
At times, because of the saturated assignments that we get, we nurses tend to take into a last account, the comfort of the patient on the delivery of our care. One concrete example I have experienced of fostering the component of sleep and rest independently is through just basically clustering care in the night shifts. I made sure that all medications, as prescribed by the physician and other necessary procedures like enema were done at the time prior to the patient’s time of sleep in as much as I could. Likewise, as the frontliners and the immediate guardians of the patient in the Medical Force, I also saw to it that the Hospital Environment was as quiet and relaxing as possible to endorse a calming and tranquil atmosphere for the client who is as it is in internal turmoil.
6. Select suitable clothes—dress and undress.
Prepping the client for delivery or surgical procedure would involve dressing the client in the apt gown. Likewise, when the patient is guided back to the Ward, I also see to it that they would wear clothing that would not be impeding or to constricting or even merely helping them to dress or undress when they are unable.
7. Maintain body temperature within normal range by adjusting clothing and modifying environment.
Recalling my exposure hours when I was a student, I was also stationed at the Post Anesthesia Care Unit where post surgical patients were brought to until they have the effects of the Anesthesia wore out. In cases of the need for General Anesthesia, shivering or trembling is a very common side effect that occurs in about 40 percent of patients. Shivering is partly due to the heat loss that usually occurs in frigid-cold operating rooms but also in a direct result of the anesthesia — the body's temperature thermostat resets while under general anesthesia, allowing it to tolerate the colder temperatures. When a patient wakes from the anesthesia, the body's thermostat returns to normal and may react to a lingering low body temperature by shivering. To help meet homeostasis, application of a thermal blanket was done and likewise, increasing the thermostats temperature is imperative. I did this up to the point that the patient’s temperature has normalized totally.
8. Keep the body clean and well groomed and protect the integument.
Among the essentials of nursing care is the delivery of bed baths. I, for one, have done this to countless bed ridden and bed rest recommended patients to make sure that they do not arbor any bacteria in their bodies that may further lead to other complications. Downright, combing the patient or clipping their nails. I also fond myself in enjoyable practice of this in the Hospital Nursery, rendering the procedure to newborn babies and strictly observing the numbered procedures to the fragile young ones. In advocacy to patient independence, it was also my job to room in the baby and educate the Mother on the steps in grooming and bathing their new child.
9. Avoid dangers in the environment and avoid injuring others.
A hospital cannot be without an Oxygen Tank. It is a no-no for anyone in Hospital vicinity to smoke with the several Oxygen Tanks turned on. Whatever it takes, I always impose this strict ban on smoking on anyone I catch, may it be an unknowing patient or stubborn medical practitioner. Our patients go to the hospital as a hospice from danger and we nurses need to take that heavily on our own shoulders at whatever expense. Very easily as well, another application would be putting side rails of stretchers and beds up, locking transport wheels of beds and stretchers when the patient is in the destination and the provision of foot stalls to help patients position themselves in the bed easily.
10. Communicate with others in expressing emotions, needs, fears, or opinions.
Therapeutic Communication is a must for every nurse to master by heart. Now that I think of it, it is one thing that makes the nurse special from the rest of the Medical Team. I once had a minor for a patient, who was suspected for Parental Physical Abuse. She was observed for the classic signs of bruises healing at different rates. At first, she was not up to opening up to anyone especially with her abuser around. You need to empathize and put yourself in the shoes of the child and the fear she had for telling on someone in authority of her. But slowly, by just showing the client the team’s trustworthiness and by just selflessly displaying that you are there to help, the client opened up bit by bit which made us pick up on stronger evidence of maltreatment. Proper channels were likewise followed to make sure that the child was referred to Social Services.
11. Worship according to one's faith.
With the Philippines being a predominantly Catholic country, I usually encounter Catholic patients too. I once had a patient who was not just catholic but also was with a significant other who was a monk nun. She had to seek special permission to go out of the convent to care for her terminally ill father. I frequently saw her saying the Rosary in other’s view and saw to it that to show respect of the Catholic practice, that I did not interfere when possible during the said activity. As requested by the family and the client, I also arranged for Anointing of the Sick through an outside chaplain as well as for a communion. In this scenario, I did not only advocate the practice of their religion but also eventually sponsored a peaceful death and rest to the client who I think felt at ease with his depart from his family and his feeling of reuniting with his maker.
12. Work in such a way that there is a sense of accomplishment.
I did not encounter much outdoor activities for patients in the E.R and the Ward. I did, however, encounter this for my previous Student Exposure in the Psychiatric Ward where we had daily activities in the open. One of these activities include an Arts and Crafts Session. One of the patient’s had been diagnosed with Postpartum Psychosis and was really good at drawing. She was excellent in using pencil as a medium; pastel, color pens and even watercolor paint. You can see that she is in fact lucid during these activities and I can safely say that it brought back a good remembrance of her life and what she was good at. Other patients also joined our Singing and Dancing Activities and you could clearly spot the stars and those who seemed in the element when they were singing or dancing. Although these patients were mentally ill, who’s to say that there condition is a dead end. Making them feel like they are a regular person with things that they excel is also a duty you need to fulfill as well.
13. Play or participate in various forms of recreation.
During Ward Classes, it was my responsibility as a student to deliver some important information to not only the clients but also to their significant others, watching after them. When you are in the hospital as a patient, I would understand how you would feel bored and feel enclosed in the four corners of the infirmary. Back then, we made sure that we kept our little sessions far fro boring and that during intermissions or what not, that we usually stuck to interactive numbers like Action Songs or just about any activity that was enjoyable and required the client’s participation. I did see that during those activities, that it was not only we Student Nurses that had fun but that our patients-they smiled and their faces lit up somehow, isolating them from their then incapacity.
14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.
One of the biggest wards and one that presented the biggest challenge as well was the Orthopedic Ward in the, perhaps biggest Hospital in Cebu that I got rotated to when I was a Student Nurse. It thrived of different shapes and sizes of prosthesis, braces, halo systems, pulleys, etc. I made sure that with every patient I encountered, I educated them and their significant others of the maintenance and purpose of the said devices so that they themselves would not only understand and grasp the treatment plan but that they would keenly partake in the delivery of that care. I believe that as a Nurse, you should be open to the patient not just with regards hospital facilities but also to the curiosity of the Medical Team’s plan. It is only through understanding, that it is for his good, I deem, that a patient willingly subjects himself to a treatment regimen.
Nurse as a Substitute, Helper, and Partner by Princess Shyne G. Austria
“Nursing is assisting the individual in the performance of those activities contributing to health that the individual could perform unaided if he had the necessary strength, will, and knowledge.” This is the most memorable assumption that I can remember most about Virginia Henderson’s contribution to the nursing profession. Her 14 fundamental needs served as the pioneer in recognizing the priorities needed in caring for a patient.
In my current experience, the theory of Henderson served as my fundamental tool in rendering the best care. I would like to share my experiences in handling Cancer patients in the institution who gave me a fulfilling role of being an Oncology Nurse.
I believe that patients diagnosed with Cancer deserve the best and ultimate care because it is one of the most depressing illnesses of all times. My therapeutic approach on each Cancer patient is based on Henderson’s statement that the mind and body of a person are inseparable. Because of the seriousness of the diagnosis, they are very emotional about it. Even the family and significant others also dwell on the depression. Therefore, being a nurse as a substitute, helper, and a partner is of utmost benefit for these types of patients.
Since they are emotional individuals, I serve as a substitute for their lack of knowledge about their illness so that they can be able to overcome the difficulties of having a Cancer. I also can be a substitute for any deficiencies of a patient like their lack of will and strength to face the treatment options like Chemotherapy and Radiotherapy.
When they start to receive treatment modalities such as Chemotherapy they experience the side effects that may impede their ability to do the activities of daily living. Being a helper to them in terms of meeting their basic needs is one of my roles to achieve health. The 14 Fundamental Needs of humans according to Henderson are always used. It is important to impart that in earlier stages of Cancer they can still be as independent as possible. According to Henderson, assisting the patient and regaining their independence as quickly as possible are important considerations.
On the other hand, being a partner with the patient is also a major factor because a care plan is a mutual understanding between the patient and the healthcare provider. In my experience in dealing with Cancer patients, they are initially very dependent. It is in the middle part or the working phase that they show the same interests and goals. That is having the patient achieve health and independence.
I can truly conclude that Virginia Henderson introduced the independent mode of a Nurse which makes us distinct and unique from other professions. This became the first huge step in improving nursing as a scientific-based discipline. It also believes in the decision-making abilities of a nurse with regards to assessing the deficiencies of a patient. As an Oncology Nurse, I have practiced the craft of discernment. Being able to develop the skills of deliberately assessing their needs are very important. I thank Virginia Henderson of becoming a model for every compassionate nurse. Her famous words as I quote, “ The nurse is temporarily the consciousness of the unconscious, the love life for the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the infant, knowledge and confidence for the mother, the mouthpiece for those too weak or withdrawn to speak and so on.” In my experience as an Oncology nurse, I served as the fighting spirit of the hopeless Cancer patients.
Testimony by Namnama Joy Matias
Henderson’s theory is indeed a client centered theory because it focuses on humans 14 basic needs which are definitely significant for our survival.
1. Breathe normally—one of the primary needs of the individual is oxygen. Its already proved that any alteration in breathing will be an hindrance to the human survival. In my case, I have some experiences of asthma attack and its really hard to go back to work or to continue my activity when its aggravated by smoke, dust, and to much work load. Another example is people who are in ventilator. These people lost their ability to breathe on their own and can’t survive without the ventilator.
2. Eat and drink adequately- Lack of food and nutrition can cause diseases like malnourishment especially in children. Food that we eat must also adequate in nutrition to have a healthy body. For instance, part of the healthy food pyramid is eating more vegetables and fruits. Take note that people who suffer from colon cancer are usually has histories of lack of eating veggies and fruits. In addition, drinking of at least 8 to 10 glasses per day is needed. In my case, I had experienced lost of sodium due to dehydration when I’m new here in Saudi Arabia. Due to this, I experienced usually feeling drowsy, weak and tired.
3. Eliminate body wastes—alteration in eliminating of body wastes is really a threat to human’s survival. People with end stage renal diseases die due to the bad effects of uremia, toxins affect the other organs of the body. For instance, I have patients who suffered from uremic endocarditis. I also encountered patients who had altered thinking due to uremia.
4. Move and maintain desirable position – studies have shown that proper body mechanics and proper positioning are important to avoid any accidents like slipped disk. Another effect of improper body mechanics are muscle guarding, acute strains and sprains and joint stiffness, and osteoporosis.
5. Sleep and rest- all of us may suffer from lack of sleep and rest due to too much work load and stressors. Studies have shown than lack of sleep can decrease metabolism. Diseases such as anemia and acne problems are due to lack of sleep too.
6. Select suitable clothes—different climate may vary from different countries. People chooses clothes in accordance with their climate o be able for them to survive. For instance, light clothing are use in countries like Philippines and Saudi Arabia during summer months, while jackets and scarf’s are use during winter here in Saudi and in countries which has cold climate.
7. Maintain body temperature within normal range by adjusting clothing and modifying environment
--- Clothing can increase or decrease body temperature. People nowadays can modify environment easier using latest technoly. For instance, air conditioner is considered a necessity here in Saudi Arabia due to the weather. On the other hand, heaters are use in cold countries. Too much heat can cause disease like heat stroke, while hyponatremia can be an effect of unable to survive to cold weather.
8. Keep body clean and well groomed and protect the integument
Daily hygiene is important to prevent diseases due to the bad bacteria that we encounter in our everyday living. Handwashing for example, is considered as the most important procedure in the hospitals to prevent infections. Protecting the skin is important because this act as a barrier from the outside world and protect the inner side of the body from infections and dusts. For instance, patients who have open wounds specially the diabetic patients can cause serious injury due to infected wounds.
9. Avoid dangers in the environment and avoid injuring others--Nowadays, dangers in the environment such as guns and deadly weapons are not allowed in public places. Another example is giving some precautionary warning in public places in hospital such as “ careful, wet floor”, warning signs in the public road if the road is slippery, curve or accident pone area.
10. Communicate with others by expressing emotions, needs, fears, or opinions--Indeed, people needs companion for survival. In times of distress, people need someone to talk to. Studies have shown that some people who had psychological incapacity such as people who are depressed and other mental disorders are those people who are lack of support from others. For instance, I had encountered patients who lacks communication with their family feel depressed and got neglected with their treatment.
11. Worship according to one’s faith--We must believe in our faith. Each of us, have the right to worship our God. Sometimes, when I am losing my control over undesired events, I just ask some guidance to our Almighty Father. Such will make me feel comfortable about the stress events that I am encountering.
12. Work in such a way that there is a sense of accomplishment--Working with satisfaction is one way to be free from stress. Each of us, should be working with a sense of accomplishment because will only mean happiness to us. I observed that people who are not satisfied with what they achieve from their work such as unable to get promotions even qualified may feel some loneliness, depression, and anger.
13. Play or participate in various forms of recreation--Recreational activities are one way to survive here in Saudi Arabia. Sports tournament activities here are way of gaining new friends and promote healthy body.
14. Learn, discover, or satisfy the curiosity that leads to normal development and health, and use the available health facilities--Nowadays, technological advancement is used for the purpose of better development of treatment. For instance, a new method now called stem cell therapy is used to treat cancer cells. In addition, we can now satisfy our curiosity about the gender of the baby inside a mother’s womb.
With the above examples that I stated, Henderson’s 14 basic needs are used not only in the health care setting but also in our everyday lives.
-Princess Shyne Austria
-Namnama Joy Matias
-Namnama Joy Matias
-Philip Andrew Salarda
Anonuevo,C. and Abaquin, C. et al. (2005). N207 Theoretical Foundations of Nursing. Philippines: UP Open University.
Balita,Carl E. (2005) Ultimate Learning Guide. Philippines: Ultimate Learning Services.