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 Gomez
Going
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
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My Personal Experience of Assisting the Client to attain Health or Recovery
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1. Breathe normally.
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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.
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2. Eat and drink adequately.
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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.
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3. Eliminate body wastes.
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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.
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4. Move and maintain desirable postures.
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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.
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5. Sleep and rest.
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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.
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6. Select suitable clothes—dress and undress.
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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.
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7. Maintain body temperature within normal range by adjusting clothing and modifying environment.
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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.
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8. Keep the body clean and well groomed and protect the integument.
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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.
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9. Avoid dangers in the environment and avoid injuring others.
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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.
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10. Communicate with others in expressing emotions, needs, fears, or opinions.
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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.
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11. Worship according to one's faith.
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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.
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12. Work in such a way that there is a sense of accomplishment.
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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.
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13. Play or participate in various forms of recreation.
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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.
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14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.
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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.
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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
-Monique Gomez
-Namnama Joy Matias
-Monique Gomez
-Namnama Joy Matias
-Philip Andrew Salarda
References:
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.
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