Nursing theories: Application, Strategies, and Case Example

Nursing theories are works of nurses that have been imaginatively constructed to define the various aspects of nursing practice in ways that other health practitioners can learn, appraise, and use. Published notions are typically explicitly contested, examined, and also serve as a foundation for future research on the nature of nursing practice. The theorists are nurses who used their professional experiences to document a description of the nursing phenomenon from their perspective (Sitzman & Eichelberger, 2010). Virginia Henderson, for example, created the nursing theory of need based on her experience as a qualified and practicing nurse as well as her education. Nursing theories and perspectives are important as they provide a well-structured guidance aimed at improving the studying and the practice of professional nursing; it is satisfying when a care giver contributes in hastening the recovery process of a patient, or ensures peaceful death where succumbing is inevitable (Henderson, 2006). This paper will analyze the nursing theory of need by Virginia Henderson.


Background and Influencing Factors


Henderson’s definition of nursing, and the development of the theory of need was influenced manly by to events. First, the theorist participated in the revision of Bertha Harmer’s book, The Textbook of the Principles and Practice of Nursing (Alligood, 2014). This role made Henderson realize the significance of clarity of a nurse’s roles. Also having grown up in the America, the theorist had observed that majority States lacked nursing licensure provisions. Hence, Virginia Henderson thought that for a competent and safe nursing practice in the provision of care to patients, the establishment of a clear definition of a nurse was necessary. The theorists did a close examination of the American Nurses Association’s description of the functions of a nurse and considered it as lacking specificity, clarity, and also unsatisfactory.


According to Henderson, a patient is a person who is in need of assistance to be independent and to achieve mind and body completeness. She viewed the nursing practice as not reliant of the Physicians practice, and the functions of the health practitioners to be influenced by many factors. The basis of Virginia Henderson’s theory was the deliberate nursing action’s conceptualization according to Orlando, reference on the works of an American Psychologist, Thorndike, and her personal experiences in rehabilitation nursing and with the Henry House Visiting Nurse Agency. According to Henderson’s need theory, the practice of nursing is based on fourteen basic human needs, which she considered as the central focus of care delivery. The theorist provided her definition of nursing, a precise description of the roles of nurses which she termed as substitutive, complementary and supplementary, geared towards ensuring that the patient under care is independent in all possible aspects (Kim & Kollak, 2006). Henderson believed that the adherence to her concept hastens the hospitalization progress. Her model is widely accepted in the healthcare delivery today due to its simplified logical concepts of nursing and applicability to all.


Underlying Assumptions


The theory of need had some underlying assumptions. First, Virginia Henderson supposed that a nurse provides care up to a level when the patients can independently care for themselves. Also, every ailing individual desires to return to a stable health state. However, she did not give an explicit explanation of this assumption. Secondly, the theorist presumed that nurses are always willing to offer the service of care delivery and are ready to dedicate themselves to the patient at any time of the day. Finally, Henderson assumed that it is a basic necessity that all nurses should acquire at least college level academic qualification in both arts and sciences (Goudreau & Smolenski, 2013). As such, a nurse is expected to have knowledge in both social and biological sciences according to Virginia Henderson.


Major Strengths and Weaknesses of the Need Theory


All the concepts of Henderson in the theory of need are simple and easy to understand; the fourteen components, and the definition of nursing are self-explanatory and therefore easily applicable. Also, the fourteen basic human needs provide a basis for research. A scientist can develop researchable questions and topics. The theory of need’s principles are also appropriate for use by nurses while delivering care to all regardless of their gender, age and race. On the other hand, Henderson’s work lacks a clear interconnection between the human physiological features and other characteristics. A conceptual diagram that depicts the linkage between the fourteen principles of the theory is necessary. Also, the application of the theory is limited to fully functional nursing personnel. For instance, the third assumption requires that all nurses are trained to university level in arts and sciences. In addition, the theory of need in incomprehensive in defining the functions or activities a nurse should adhere to when offering assistance to patients who are in the dying process to enhance a “peaceful death”, which is a significant function of nursing.


Application, Strategies, and Case Example


The application of nursing theories in care delivery practice is common in recent times. However, the employment of these concepts as a guidance in some areas of the field remains uncertain (Patton, 2005). Virginia Henderson’s nursing theory of need, and particularly the fourteen basic human needs and the definition of nursing can be widely applied in today’s practice of care delivery as a professional nurse. The concepts of the theorist are directly consistent with the principle functions of nurses; to provide daily living assistance to patients. The fourteen fundamental needs are patently seen in clinical settings during the routine activities of nurses. The application of the provisions of Henderson’s principles can be achieved by the application of the nursing theory process strategy which contains six elements. First, the nurse collects all the information about the client and assesses it. An in-depth analysis of the available data with reference to the need theory further helps the health practitioner to perform a nursing diagnosis of the needs of the patient. For instance, breathing, the first basic need according to Henderson, is a commonly evaluated activity in the nursing practice, which entails oxygen administration to patients who are incapable of breathing normally without difficulties. Nourishment maintenance may also be achieved through insertion of a nasogastric tube to help in feeding for patient are unable to eat or drink by the mouth. The nurse then develops a care plan that will meet the intended outcome and finally implements. An evaluation of the overall outcome is finally necessary (Ahtisham & Jacoline, 2015).


I personally found myself applying the need theory components when I had an opportunity to care for a paralyzed patient who was recuperating from diabetes and a chronic kidney disease. After a close assessment and analysis of the patient’s data, some of the main needs of the patient included movement and posture maintenance assistance and clothing which are consistent with the fourth and the sixth components of the need theory. I structured a care plan which I adhered to. During the patient’s admission period, she required daily and fulltime assistance in movement and the assumption of different positions while on the hospital bed alongside other social needs. This are activities the patient could not do on her own. The help I offered, thus, aided in the prevention of bedsores development and patient independence was enhanced with time as she regained strength to perform some of the activities on her own.


Conclusion


The nursing theory of need by Virginia Henderson focuses on the significance of assisting a patient to be as independent as possible which will in turn increase the rate of recovery. The model emphasizes on fourteen needs which the theorist cite as basic to the patient and the role of the care giver in helping the patient meet them. Henderson’s model is based on several assumptions, strengths and limitations. The theory of need is widely accepted and directly applicable in today’s nursing practice.


References


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. Missouri: Elsevier Health Sciences.


Goudreau, K. A., & Smolenski, M. (2013). Health Policy and Advanced Practice Nursing: Impact and Implications. New York: Springer Publishing Company.


Henderson, V. (2006). The Concept of Nursing*. Journal of Advanced Nursing, 53(1), 21–31.


Kim, H., & Kollak, I. (2006). Nursing Theories: Conceptual and Philosophical Foundations, Second Edition. New York: Springer Publishing Company.


Patton, D. (2005). Nursing Theorists and their Work- Book Review. International Journal of Nursing Studies, 42(1), 117.


Sitzman, K., & Eichelberger, L. W. (2010). Understanding the Work of Nurse Theorists: A Creative Beginning. Massachusetts: Jones & Bartlett Publishers.

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