Choose a theory related to work.

Identify one positive and one negative effect of using the theory to
understand clinical practice.

Nursing theories can be applied to clinical situations when caring for patients. Among the nurse
theorists who laid the foundation for contemporary nursing would be Virginia Avenel Henderson. Her
theory of nursing brought the idea of the nurse as patient educator. It is for this reason I have chosen
Virginia Hendersons theory to base my practice of care at the bedside in the pediatric intensive care unit
(PICU) where I work. The aspect of seeing the entire person as a whole is an important aspect in the
delivery of my care.

Theory Background
She emphasized the importance of increasing the patients independence so that progress after
hospitalization would not be delayed (Henderson, 1991).
She described the nurse's role as substitutive (doing for the person), supplementary (helping the
person), complementary (working with the person), with the goal of helping the person become as
independent as possible.
Her definition of nursing was:
"The 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" (Henderson, 1966).
She conceptualized the 14 Fundamental Needs of humans. These needs are:
1. Breathing normally
2. Eating and drinking adequately
3. Eliminating body waste
4. Moving and maintaining a desirable position
5. Sleeping and resting
6. Selecting suitable clothes
7. Maintaining body temperature within normal range by adjusting clothing and modifying the
environment
8. Keeping the body clean and well groomed to protect the integument
9. Avoiding dangers in the environment and avoiding injuring others
10. Communicating with others in expressing emotions, needs, fears, or opinions
11. Worshipping according to ones faith
12. Working in such a way that one feels a sense of accomplishment
13. Playing or participating in various forms of recreation
14. Learning, discovering, or satisfying the curiosity that leads to normal development and
health, and using available health facilities

Positive Effect:
Henderson's Definition of Nursing is still very applicable to nursing today. We, nurses, work to
assist patients in activities of daily living, especially those who are incapable of doing so. Patients in the
ICU require more intensive treatment and since I am in the pediatric ICU, patients here are very vulnerable
because theyre just kids and it may be more frightening for the family. Patients in the PICU might include
those with severe breathing problems from asthma, serious infections, certain heart conditions, some
complications of diabetes, or those involved in a serious automobile accident or near-drowning. For
example, breathing is vital and Hendersons first basic need of breathing normally is at most assessed at all
times. Administration of oxygen should be given accordingly. Her application on nursing gives assertion to
initiate immediate provision of biological needs.

Meeting the 14 fundamental needs of the client has been a great basis to further improve our
performances towards nursing care. It has been the day-to-day components of delivering nursing care from
infancy to adulthood.
The 14 Fundamental Needs described by Henderson, has been very influential in the practice of
nursing. It is very evident in the clinical settings how the nurse carries the tasked to assist the client in
meeting his or her needs - may it be physical, social, emotional or spiritual by addressing the patients
ability to breath normally, eat and drink adequately and eliminate body wastes as primary concerns that the
nurse should address.
The concept of nursing formulated by Henderson in her definition of nursing and the 14
components of basic nursing is uncomplicated and self-explanatory. Therefore, it can be used without
difficulty as a guide for nursing practice by most nurses.

Negative Effect:
There is a lack of conceptual linkage between physiological and other human characteristics. One
cannot say that every individual who has similar needs indicated in the 14 basic human needs by
Henderson are the only things that human beings need in attaining health and survival. With the progress
of todays time, there may be added needs that humans are entitled to be provided with by nurses.
Some of the activities listed in Hendersons concepts can only be applied to fully functional
individuals indicating that there would always be patients who always require aided care.


Provide case scenario analysis. Present the care and the concept of chosen theory.












In using the 14 Fundamental Needs of Henderson, she would be able to determine that the ability
of Shia to independently perform her activities of daily living was affected. She depends on others to take
care of her. Almost all her activities are restricted by her impaired mobility.
As the nurse, using the concepts of Henderson, I would prioritize the intervention towards
attainment of independence through the performance of the basic human needs and restoration of her self-
esteem.
As a nurse, being a substitute for the patient, actions must be directed in having her participate
gradually over her care. To boost her confidence and self-esteem, I will have her make decisions actively
over her care with confidence and with full understanding of her plan of care by explaining it to her and
encouraging her to express her feelings about her condition. This is related to the concept of Henderson,
Shia, 25 years old, has been taken to the Emergency Room of Veterans Regional
Hospital after sustaining multiple injuries from a mountain hiking accident with her two
friends. The incident happened so fast that her friends couldnt do something to stop
her from falling. She accidentally slipped on a rock and fell from a small cliff. Luckily,
her head didnt hit the rocks. X-rays were taken which revealed fractures on the right
femur, 3
rd
and 4
th
ribs and a fractured right wrist. Surgery was immediately done to
correct some of the dislocated bones and to stitch some open wounds. She was placed
on several casts, and an external fixator, to support fractured bone, was attached on
her right leg, which limited her movement for months. Her family frequented their
visits and tried to raise her confidence and assured her that all would be fine.
However, Shia appeared to manifest self-pity and low self-esteem when she
said Nothing is fine! Im paralyzed! Im worthless now! after having failed to bathe
and feed herself. Every morning, when her family tries to bathe her, she will say shes
not paralytic. Sometimes, she also directs her anger to the nurses by raising her voice
during the routine daily care.

the 10th component of basic nursing care: Communicating with others in expressing emotions, needs,
fears, or opinions.
I will be her helping hand when she cant reach or the voice which would carry her thoughts to
people whose decisions directly affect her care and future. This is also applied from the 12
th
component of
basic nursing care: Working in such a way that one feels a sense of accomplishment. As for her family, I
will be there to continuously update and educate them about the progress of Shias condition, I will support
them because I know that they are already strained with their care-giving role.

Saint Marys University
School of Health Sciences
GRADUATE SCHOOL DEPARTMENT
Bayombong, Nueva Vizcaya





Theoretical Foundations of Nursing
MSN 203




Submitted to:
Maritoni dela Cruz, RN, MSN
Clinical Instructor


Submitted by:
Alma Vanessa M. Zapatero, RN
Student





August 2014