RITIKA SONI ASS. PROF.

1. VIRGINIA AVENAL
HENDERSON‘s
NEED THEORY
PRESENTER:
MS. RITIKA SONI

2. Biography :
o The theorist was born in November 30, 1897 , in
Kansas City, Missouri, but spent her formative
years in Virginia.
o She was 5th child of a family of 8 children.
o In 1921, she graduated from the Army School of
Nursing in Washington, DC, a federally funded
diploma program in nursing to help overcome a
nurse shortage.
o Worked at the Henry street visiting nurse
service for 2 years after graduation.
o In 1923, worked in teaching nursing at Norfolk
protestant hospital in Virginia for several years.

3.  In 1932, She earned a bachelor’s degree
and in 1934 master’s degree from
Teacher’s College, Columbia University, in
New York City.
 She served on the faculty there from 1934
to 1948.
 Over the ensuing years, she revised the
Textbook of the Principles and Practice of
Nursing and published Basic Principles of
Nursing for the International Council of
Nursing (ICN).
 1n 1953, She then joined the Yale
University as a faculty as well as research
associate, where she continued to work
after she retired until her death on March
9, 1996, at the age of 98.

4.  “Nightingale of modern nursing”
 O’ MALLEY (1996),states:
“modern day mother of nursing” .
 Halloran wrote, “20th century Florence Nightingale”.
 In 2000, the Virginia Nurses Association recognized
Henderson as one of the fifty-one Pioneer Nurses in
Virginia

5.  Outstanding contributions to nursing as a
teacher during her years at Teachers College
 Nursing educator & a prolific author
 Received honorary doctoral degree from:
- Catholic university of America
- Pace university
- Yale university
- University of western Ontario
- University of Rochester
 In march 22,1966, warranted an obituary in
New York Times as a nurse, teacher, author,
researcher & consumer health advocate.
 In 1985, honored at the Annual meeting of the
nursing and Allied health section of the medical
library association.

6.  In 1939,Her revision of Bertha Harmer’s Textbook of the Principles
and Practice of Nursing(4th edition) became widely used( 5th
edition).
 After retirement, frequent visitor to nursing schools well in
to her nineties.
 Directed a 12-year project entitled Nursing Studies Index, four
volumes recognized as an essential reference for many years
 Early Advocate for the Introduction of Psychiatric Nursing
in the curriculum and served on a committee to develop such a
course at Eastern State Hospital in Williamsburg, Virginia in 1929.
 1978, revised fundamental concepts of nursing from Yale university
school of nursing.

7.  1956- (with B.Harmer) – textbook for the
principles & practice of nursing
 1966- the nature of nursing: a definition and
its implication for practice, research,
education.
 1991: the nature of nursing reflections after
20 years.

8. Henderson's interest in
nursing began during world
war-1 and grew out of her
desire to help the sick and
wounded in the military.

10. 1 . Breath normally
2 . Eat and drink adequately
3. Eliminate body wastes
4 . Move and maintain a desirable posture
5 . Sleep and rest
6. Select suitable clothes-dress and undress
7 . Maintain body temperature within normal
range by adjusting clothing and modifying the
environment
8. Keep the body clean and well groomed to
promote integument (skin)
9. Avoid dangers in the environment and avoiding
injuring others

11. 1 0 . Communicat with others in expressing
emotions, need, fears or opinions
11. Worship according to one’s faith
12.Work in such a way that one feels a
sense of accomplishment
1 3 . Play or participate in various forms of
recreation
14.Learn, discover or satisfy the curiosity
that leads to normal development and
health, and using available health
facilities.

15.  The first 8 components are physiological and
nine relates to safety
 Ten and eleventh relates to belongingness
and love needs
 Twelfth ,thirteenth & fourteenth relates to
self esteem needs
 Fourteenth’s one component “satisfy" more
relates to self actualization.

19. According to Henderson,
“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. And to do this in
such a way as to help him gain independence
as rapidly as possible”.
Nurses must be knowledgeable in both
biological and social sciences and must have
the ability to assess basic human needs.
Henderson’s definition of nursing was
consideredas the “signature” of the
profession.

22.  The nurse as a substitute for the patient.
In times of illness, when the patient cannot function
fully, the nurse serves as the substitute as to what the
patient lacks by assessing basic needs of patient.
 The nurse as a helper to the patient.
In situations where the patient cannot meet his
basic needs, the nurse serves as a helper to
accomplish them.
 The nurse as a partner with the patient.
The nurse and the patient formulate the care plan
together. Both as an advocate and as a resource-person,
the nurse can empower the patient to make effective
decisions regarding his care plans.

24. THE NURSES AS A MEMBER Of
HEALTHCARE TEAM
 The nurses, as a member of the
healthcare team, works and
contributes in carrying out the total
program of care and identify the basic
needs.
 However, working interdependently, as
Henderson indicated, does not
include taking other member’s roles
and responsibilities.

26. 1. Assessment Phase – The nurse would
assess the 14 fundamental needs of the
patients and check which one is lacking
or fully met.
2. Planning Phase – Involves giving the
plan of care to meet the needs and
personality of the patient. It must serve
as a record and at the same time must fit
in the prescribed plan made by the
physician.

27. 3. Implementation Phase – Nurses uses
the 14 basic needs in answering the factors
that are contributing to the illness state of
the patient.These intervention are focused
on maintaining health, to recover from
illness, or to aid in peaceful death.
4. Evaluation Phase -The nurse and the
patient reviews the relationship and
decides whether the goals are met or
not.The nurse also assess if the patient
attained independence and if health is
achieved.

28. Education - Three phases of
curriculum development.
First Phase - Emphasis is made on helping the
patient perform activities of daily living. Priorities
are given on the fundamental needs of the patient
and on the planning of nursing care.
Second Phase – Importance is placed on
assisting patients achieved their needs in times
of marked body disturbances or illness.The
student nurses are confronted with problems
with complexity then understands the rationale
behind the prescribed therapeutic plans made
by the physicians.
Third Phase – Centered on the patient and his
family together with the dynamics affecting the
relationship inside the unit.

29. Research
Henderson supported the use of research in
improving the practice of nursing. She
supported developing nurses at
baccalaureate level, and advocate the use of
library use for research purposes.
It is the nurse’s responsibility to identify
problems, continuously validate her practice,
improving the method used, and reassuring
the effectiveness of her care.

30. Mr. Mikeksh , 25 years old has been taken to the
emergency room of the hospital after sustaining
multiple injuries after his motorcycle crashed in the
course of his race.Multiple x-rays were taken which
revealed fractures on the left femur, 2nd and 3rd ribs,
and fractured right wrist.Surgery was immediately
done to correct some of the dislocated bones and to
stitch some open wounds. He was placed on
several casts, and an external fixator, to support
fractured bones, was attached on his left leg, which
limited his movement for weeks to months. His
family frequented their visits and tried to raise his
confidence and assured him that all would be fine

31. However, Mikesh appeared to manifestself-
pity and lowered self-esteem .Patient is
failed to bathe or feed himself.Every
morning, when his family tries to bathe him,
he will raise his voice and say he’s not
paralytic.At times, he also directs his anger
to the nurses by shouting at them during the
routine daily care.

32. In using the 14 fundamental needs of
Henderson, she would be able to determine that
the ability of Makoy to independently perform
his activities of daily living was affected. Eating
and elimination patterns are altered as his
mobility is restricted by his fixator and casts. He
depends on his family and the nurses to take
care of him. Almost all of his activities are
restricted by his impaired mobility. Because of
continued and prolonged state of dependency,
Makoy developed a negative self-image and
decreased self-esteem manifested by anger
directed at his caregivers.

33. As the nurse uses the concepts
introduced by Henderson, she would
prioritize her intervention towards the
attainment of independence through
the performance of the basic human
needs and restoration of his self-
esteem.

34. On the top of the nurse performing as a substitute for
the patient, action must also be directed in having
him participate gradually over his care. By
empowering and increasing his self-esteem, the
nurse can have the patient actively make decisions
over his care with confidence and with full
understanding of his plan of care. The nurse can
also act as support to the family who could already be
strained with the care-giving role they have. As the
nurse applies the definition of nursing as proposed by
Henderson, she would begin to understand the
concept behind being the “substitute”of the patient by
becoming his hand where he can’t reach or the voice
which would carry his thoughts to people whose
decisions directly affect his care and future.

35. Upon entering this phase, the entire
process is evaluated and new goals are to
be formulated. As much as possible, the
nurse would include Mikesh over setting
new goals and makes sure that his
thoughts and concerns are addressed so
as to assert his independence and his role
as a partner in his care.
Mikesh, as planned, will initiate measures
to regain independence and performance
of basic needs and to achieve a sense of
worth and confidence.

36. THANK YOU