2. • Ernestine Widenbach is a nurse theorist who qualified as a
nurse midwife in her forties.
• She is qualified nurse - midwife (1946) and worked in clinical
practice until she was appointed to Yale in 1952.
• She is identified as one of the earliest nurse theorists at Yale
worked with other early nursing theorists.
2
3. She worked in various fields and as a professional
writer for nursing.
Here she developed a graduate – level course in
nurse – midwifery.
3
4. During the late 1940s, Widenbach worked on a
project to provide child birth preparation based on
Dr. Grantey Dick – Read theory (Nickel et.al 1992).
Widenbach’s contribution to nursing theory lies
on the emphasis she placed in her book, Clinical
Nursing - A helping Art (1964).
4
5. Incidentally, she was writing this book when
Margret Myles was writing and revising her
influential British text.
It appears that the comments of Dickoff and
James on this textbook stimulated her thinking
about theory [Nickel et.al.1992].
5
6. Widenbach is considered to have developed her
theory inductively from experience and observation
of practice (Dance et.al 1989).
Although she had worked for 20 years as a nurse, the
development of theory took place while she was
working in the field of maternity care.
6
7. In the preparation of the second edition of Family –
Centered Maternity Nursing Widenbach (1967)
summarizes her theory of nursing.
The theory of accountability, envision the nurse as
accountable for her actions,as well as for the results.
7
8. Five elements (Relatives of Nursing) of
Widenbach’s Conceptual model
(I) THE AGENT (THE NURSE , MIDWIFE OR OTHER
PERSON)
(II) THE RECIPIENT (INDIVIDUAL,THE FAMILY ,
COMMUNITY)
(III) THE GOAL (THE GOAL OF THE INTERVENTION)
(IV) THE MEANS (THE METHOD TO REACH THE GOAL)
(V) THE FRAME WORK (THE SOCIAL ,
ORGANIZATIONAL AND PROFESSIONAL
ENVIRONMENT).
8
9. The Agent – The Midwife
Widenbach’s (1964) Identified four elements
in clinical nursing.
(I) Philosophy
(ii) Purpose
(iii) Practice
(iv) Art
9
10. Nursing is based on an explicit philosophy.
Three points basic to philosophy of nursing are,
(a) Reverence for the gift of life.
(b) Respect for the dignity, worth, autonomy and
individuality.
(a) Resolution to act dynamically in relation to one’s
beliefs.
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11. THE RECIPIENT
(THE INDIVIDUAL, FAMILY, COMMUNITY)
This model is helpful in identifying the need to consider the
beliefs of the individual midwife and the beliefs of her colleagues
(Raleigh1989) .
Care is extended beyond the mother, to the needs of the baby
and father.
This helps to develop inner strength, (power in reserve) – on
which to draw confidence as they prepare for and assume the
role as parents.
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12. The Goal / Purpose
The goal or purpose of the nurse, acc. to Widenbach,
is to meet a person’s need – for help.
Needs are to be recognized by the nurse midwife
and, must be acknowledged by the individual.
The utility of this idea in midwifery practice is
practicable. Ex. Identification of postnatal needs.
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13. The Goal / Purpose – Cont’d…
A need –for – help is any action required and
desired by the individual which has the potential for
restoring his ability to cope with the demands implicit
in his situation (Dane et.al, 1989), .
This restricts the use of model as an infant or
comatose person cannot recognize or express need
-for- help.
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14. The Means
The means of achieving the goal of midwifery care
comprises four phases.
Identification of the patients experienced need -
for – help.
Ministration of the help that is needed.
Validation that the help provided was indeed the
help needed.
Co- ordination of the resources for help
provided.
14
15. The Means – Cont’d…
•The midwife needs to have, knowledge, judgment
and skills to enable the means - steps of care, to
be achieved.
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16. The Means – Cont’d…
Knowledge encompasses everything that
has been comprehended.
Judgment involves the ability of the nurse to
make sound decisions to achieve the appropriate
out comes.
Skills are the nurses ability or competency to
provide care to meet individuals needs. 16
17. The Frame work
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The professional environment
The social environment, and
The organizational environment
