LYDIA HENDERSON

The Nightingale of Modern Nursing

Modern-Day Mother of Nursing.
"The 20th century Florence Nightingale."
Born in Kansas City, Missouri, in 1897.
Diploma in Nursing from the Army School of Nursing at
Walter Reed Hospital, Washington, D.C. in 1921.
Worked at the Henry Street Visiting Nurse Service for 2
years after graduation.
In 1923, started teaching nursing at the Norfolk
Protestant Hospital in Virginia
In 1929, entered Teachers College at Columbia University
for Bachelors Degree in 1932, Masters Degree in 1934.

 Joined Columbia as a member of the faculty, remained until

1948.
Since 1953, a research associate at Yale University School of
Nursing.
Recipient of numerous recognitions.
Honorary doctoral degrees from the Catholic University of
America, Pace University, University of Rochester, University of
Western Ontario, Yale University
In 1985, honored at the Annual Meeting of the Nursing and
Allied Health Section ofthe Medical Library Association.
Died: March 19, 1996.
In 1939, she revised: Harmers classic textbook of nursing for
its 4th edition, and later wrote the 5th; edition, incorporating
her personal definition of nursing (Henderson,1991)

Theory Background
She called her definition of nursing her concept
(Henderson1991)
She emphasized the importance of increasing the patients
independence so that progress after hospitalization would not be
delayed (Henderson,1991)
"assisting individuals to gain independence in relation to the
performance of activities contributing to health or its
recovery"(Henderson, 1966).
She categorized nursing activities into 14 components, based on
human needs.
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"

The 14 components

Breathe normally. Eat and drink adequately.

Eliminate body wastes.
Move and maintain desirable postures.
Sleep and rest.
Select suitable clothes-dress and undress.
Maintain body temperature within normal range by
adjusting clothing and modifying environment
Keep the body clean and well groomed and protect
the integument
Avoid dangers in the environment and avoid
injuring others.

 Communicate with others in expressing

emotions, needs, fears, or opinions.
Worship according to ones faith.
Work in such a way that there is a sense of
accomplishment.
Play or participate in various forms of
recreation.
Learn, discover, or satisfy the curiosity that
leads to normal development and health
and use the available health facilities.

 The first 9 components are

physiological. The tenth and
fourteenth are psychological aspects
of communicating and learning The
eleventh component is spiritual and
moral The twelfth and thirteenth
components are sociologically
oriented to occupation and
recreation

 Assumption
The major assumptions of the theory are:
"Nurses care for patients until patient can care
for themselves once again. Patients desire to
return to health, but this assumption is not
explicitly stated.
Nurses are willing to serve and that nurses will
devote themselves to the patient day and
night A final assumption is that nurses should
be educated at the university level in both arts
and sciences.

 Hendersons theory and the four major

concepts
1. Individual
Have basic needs that are component of health.
Requiring assistance to achieve health and
independence or a peaceful death.
Mind and body are inseparable and interrelated.
Considers the biological, psychological,
sociological, and spiritual components.
The theory presents the patient as a sum of parts
with biopsychosocial needs.

 Environment
Settings in which an individual learns unique
pattern for living.
All external conditions and influences that affect
life and development.
Individuals in relation to families
Minimally discusses the impact of the community
on the individual and family.
Basic nursing care involves providing conditions
under which the patient can perform the 14
activities unaided

 Health
Definition based on individuals ability to
function independently as outlined in the 14
components.
Nurses need to stress promotion of health and
prevention and cure of disease.
Good health is a challenge -affected by age,
cultural background, physical, and intellectual
capacities, and emotional balance Is the
individuals ability to meet these needs
independently.

 Nursing
Temporarily assisting an individual who lacks the
necessary strength, will and knowledge to satisfy 1 or
more of 14 basic needs.
Assists and supports the individual in life activities and the
attainment of independence.
Nurse serves to make patient complete whole", or
"independent."
The nurse is expected to carry out physicianstherapeutic
plan Individualized care is the result of the nurses
creativity in planning for care.
Nurse should have knowledge to practice individualized
and human care and should be a scientific problem
solver.
In the Nature of Nursing Nurse role is, to get inside the
patients skin and supplement his strength will or
knowledge according to his needs.

 Hendersons and Nursing Process

Summarization of the stages of the nursing process as applied to Hendersons
definition of nursing and to the 14 components of basic nursing care.
Nursing Process : Hendersons 14 components and definition of nursing
Nursing Assessment:
Hendersons 14 components
Nursing Diagnosis:
Analysis: Compare data to knowledge base of health and disease.
Nursing plan;
Identify individuals ability to meet own needs with or without assistance, taking into consideration
strength, will or knowledge.
Nursing implementation:
Document how the nurse can assist the individual, sick or well.
Nursing implementation
Assist the sick or well individual in to performance of activities in meeting human needs to
maintain health, recover from illness, or to aid in peaceful death.
Nursing process
Implementation based on the physiological principles, age, cultural background, emotional
balance, and physical and intellectual capacities.
Carry out treatment prescribed by the physician.
Nursing evaluation
Hendersons 14 components and definition of nursing
Use the acceptable definition of ;nursing and appropriate laws related to the practice of nursing.
The quality of care is drastically affected by the preparation and native ability of the nursing
personnel rather that the amount of hours of care.
Successful outcomes of nursing care are based on the speed with which or degree to which the
patient performs independently the activities of daily living

 Maslow's HendersonPhysiological needsBreathe

normally
Eat and drink adequately Eliminate by all avenues of
elimination Move and maintain desirable posture Sleep
and rest Select suitable clothing Maintain body
temperature Keep body clean and well groomed and
protect the integument
Safety NeedsAvoid environmental dangers and avoid
injuring other
Belongingness and love needsCommunicate with others
worship according to one's faith
Esteem needsWork at something providing a sense of
accomplishment
Play or participate in various forms of recreation
Learn, discover, or satisfy curiosity

 Characteristic of Hendersons theory

There is interrelation of concepts.
Concepts of fundamental human needs, biophysiology, culture, and
interaction, communication are borrowed from other discipline.Eg..
Maslows theory.
Her definition and components are logical and the 14 components
are a guide for the individual and nurse in reaching the chosen goal.
Relatively simple yet generalizable.
Applicable to the health of individuals of all ages.
can be the bases for hypotheses that can be tested.
assist in increasing the general body of knowledge within the
discipline.
Her ideas of nursing practice are well accepted.
can be utilized by practitioners to guide and improve their practice.

 Limitations
Lack of conceptual linkage between physiological and other
human characteristics.
No concept of the holistic nature of human being.
If the assumption is made that the 14 components
prioritized, the relationship among the components is
unclear.
Lacks inter-relate of factors and the influence of nursing
care.
Assisting the individual in the dying process she contends
that the nurse helps, but there is little explanation of what
the nurse does.
Peaceful death is curious and significant nursing role.

 Conclusion
Henderson provides the essence of what she
believes is a definition of nursing.
Her emphasis on basic human needs as the
central focus of nursing practice has led to
further theory development regarding the needs
of the person and how nursing can assist in
meeting those needs.
Her definition of nursing and the 14 components
of basic nursing care are uncomplicated and
self-explanatory.