THEORETICAL FOUNDATION IN NURING (MIDTERM) ➢ If you’re not an observant, even how good you are in

ASSESING, you will FAILED!

Florence Nightingale (MAY 12, 1820 – AUGUST 13, 1910):
“ENVIRONMENTAL THEORY” NURSING ACTIONS

• The Mother of Modern Nursing • DEPENDENT

• Notes on Nursing: What it is, what it is not. (Book)
• Graduated at Kaiserwerth Hospital in Dusseldorf • INDEPENDENT
Germany. (3 Months)
• Received a request from Sidney Herbert to travel to
• COLLABORATIVE
Scutari, Turkey. LEGACY OF CARING
• St. Thomas Hospital (1st Nursing School established
by Florence Nightingale) ➢ Do this with pure genuine for appreciation to the
patient.
“Nursing Knowledge is distinct & separate from Medical ➢ You left them something to remember.
Knowledge”
PERSON
Nursing Knowledge
➢ (Holistic Being with Spiritual Dimension)
- described as the knowledge that is useful to nurses, whether
it is derived from the discipline of nursing or other disciplines. PRINCIPLE OF AUTONOMY

- A nurse's ability to give quality care to their patient is an ➢ Decision of eldest sibling, siblings, nurse, doctor.
important aspect to a patient's life both now and in the Ethical issue and a legal issue.
future.
BIOETHICS
Medical Knowledge
➢ A must for Nursing of everyone.
- The body of information about diseases, mechanisms and
pathogenesis, therapies and interactions, and interpretation NURSING
of lab tests, which is broadly applicable to decisions about • Nursing the Sick
multiple patients and public health policies, in contrast to
patient-specific data. • Nursing the Well
- Medical knowledge should, where possible, be based on THREE HOSPITALS:
sound evidence from clinical and epidemiological studies,
using valid and reliable methods. 1. New Haven Hospital in Connecticut
2. Massachussetts Hospital in Boston
12 CANONS
3. Bellevue Hospital in New York
1. Health of Houses
“If there is INFECTION, it has a FEVER”
2. Ventilation & Warming
3. Light
4. Noise
5. Variety
6. Bed & Bedding
7. Cleanliness of Rooms & Walls
8. Personal Cleanliness
9. Nutrition & Taking Food
10. Chattering hopes & Advices
11. Observation of Sick
12. Petty Management

FEMALES ARE MORE CARING THAN MALE!!!!!!!

REPARATIVE PROCESS – The ability of the body to repair itself.

ENVIRONMENT (THERAPEUTIC) – Balanced Environment:

Helps in maintaining Balanced Environment.

“CALLING” – She said “God spoke to me & called me to his

service.”

“WHAT TO OBSERVE – HOW TO OBSERVE”

 2. WORKING PHASE
o IDENTIFICATION
HILDEGARD PEPLAU (September 1, 1909 – March 17, 1999): o EXPLOITATION
“THEORY OF INTERPERSONAL RELATIONS” 3. TERMINATION
• Psychiatric Nurse of the Century NEW PHASES OF THE THERAPEUTIC NURSE-CLIENT
• First published Nursing Theorist since Florence RELATIONSHIP
Nightingale. (1850s)
• Taught the first classes for graduate psychiatric 1. ORIENTATION
nursing students at Teachers College, Columbia 2. IDENTIFICATION
University, and she stressed the importance of 3. EXPLOITATION
nurses’ ability to understand their own behavior to 4. RESOLUTION
help others identify perceived difficulties.
• She served as executive director and president of the
American Nurses Association (ANA). (1980).
• Her seminal book, Interpersonal Relations in
Nursing (1952), describes the importance of the
nurse-patient relationship as a “significant,
therapeutic interpersonal process” and is recognized
as the first nursing theory textbook since
Nightingale’s work in the 1850s.
• “The Mother of Psychiatric Nursing”
• Raised in Reading, Pennsylvania by her parents of
German descent.
• In 1918, she witnessed the devastating flu epidemic
that greatly influenced her understanding of the
impact of illness & death on families.
• After the Nightingale era (1900s), hospitals
considered women in nursing as a source of free or
inexpensive labor. 4 PSYCHOBIOLOGICAL EXPERIENCES
• Peplau’s lifelong work was largely focused on
1. Needs
extending Sullivan’s Interpersonal Theory for use in
2. Frustrations
nursing practice.
3. Conflicts
• Created the clinical specialists in psychiatric nursing. 4. Anxieties
• Peplau vigorously advocated that nurses should
become further educated so they could provide truly
therapeutic care to patients rather than the custodial
care that was prevalent in the mental hospital of that
era.
• She borrowed the psychological model to synthesize
her theory of Interpersonal Relations.
• 1943-1945: served as an Army Corps Nurse,
stationed at the 312th field station Hospital in
England.
• After her retirement, she created the University of
Leuven in Belgium.

6 NURSING ROLES

1. Stranger
2. Resource Person
3. Teacher
4. Leader
5. Surrogate
6. Counselor

OLD PHASES OF THE THERAPEUTIC NURSE-CLIENT

RELATIONSHIP

1. ORIENTATION
 • She stressed nursing’s duty to the patient rather than
to the doctor and providing a scientific basis for
nursing.
• 60 years of service as a nurse.
• The 1st truly international nurse.

BASIC PRINCIPLES OF NURSING

➢ Became one of the landmark Book in Nursing.

➢ 27 languages

“As a nurse, we basically help patients to recover. (magkaiba

yan sa) We do not cure patients we help patients to recover.”

HENDERSON’S DEFINITION OF NURSNG:

“If recovery is not possible, the responsibility of a nurse shift’s

FELT NEED!!!! from assisting the patient to recovery to assisting the patient
to a peaceful death.”
FACTORS IN ORIENTATION PHASE
1. Past-experiences THE NURSE MAKES THE PATIENT INDEPENDENT OF HIM/HER
2. Culture AS SOON AS POSSIBLE!!!!!
3. Race
4. Pre-conceived ideas
5. Values 3 LEVELS OF NURSE-PATIENT RELATIONSHIP
6. Beliefs
7. Religion/religions preference 1. Substitute – doing for the person (doer, for)
2. Supplementary – helping the person (helper, to)
“The nurse needs to be open minded” 3. Complementary – working with the person
(partner), with the goal of helping the person
THERAPEUTIC NURSE-CLIENT RELATIONSHIP become as independent as possible. (with)
- A professional & planned realationship between 14 COMPONENTS OF VIRGINIA HENDERSON’S NEED THEORY
client & nurse that focuses on the client’s (14 BASIC HUMAN NEEDS)
needs, feelings, problems, & ideas.
• A “Need Theory”
- Involves interaction between two or more
• Focuses on increasing the patient’s independence to
individuals with a common goal
hasten their progress in the hospital.

14 BASIC HUMAN NEEDS/ EMOTIONAL BALANCE

- First 9 Needs are – Physiological

VIRGIANIA HENDERSON (1897-1996): - 10th &14th – Psychological
“NURSING NEED THEORY” - 11th – Spiritual & Moral
• American Nurse, Researcher, Theorist, & a writer. - 12th & 13th – Sociological (Occupation and Recreation)
• Known as the “First Lady of Nursing”
• Has been called “arguably the most famous nurse of
the 20th century” and “The quintensential nurse of
9 NEEDS PHYSIOLOGICAL
the 20th century.”
• “The Nightingale of Modern Nursing.” 1. Breath Normally
• “The 20th Century Florence Nightingale.” 2. Eat & Drink adequately
• Born in Kansas City, Missouri 3. Eliminate body wastes
• Enrolled in the Army Nursing School at the Walter 4. Move & maintain desirable postures
Reed Hospital in Washington. 5. Sleep & Rest
• At the age of 17 years old, she took a temporary job 6. Select suitable clothes-dress &undress
caring for WORLD WAR I wounded. 7. Maintain body temperature within normal range by
adjusting clothing & modifying environment
 8. Keep the body clean & well groomed & protect the 4. NURSING – Nurse is viewed as one who serves to
integument make the patient “complete”, “whole”, or
9. Avoid dangers in the environment & avoid injuring “independent”.
others
Henderson wrote three books that have become nursing
PSYCHOLOGICAL classics:

10. Communicate with others in expressing emotions, 1. Textbook of the Principles and Practice of Nursing
needs, fears, or opinions. (1955)
2. Basic Principles of Nursing Care (1960)
14. Learn, discover, or satisfy the curiosity that leads to 3. The Nature of Nursing (1966).
normal development & health & use the available health
facilities

SPIRITUAL & MORAL • Her major contribution to nursing research was an

11-year Yale-sponsored Nursing Studies Index Project
11. Worship according to one’s faith published as a four-volume-annotated index of
SOCIOLOGICAL nursing’s biographical, analytical, and historical
literature from 1900 to 1959.
12. Work in such a way that there is a sense of • In 1958, the nursing service committee of the
accomplishment International Council of Nurses (ICN) asked
13. Play or participate in various forms of recreation Henderson to describe her concept of nursing. This
now historical definition, published by ICN in 1961.
• Through the interpersonal process, the nurse must
*Nurses care for patients until patient can care for themselves get “inside the skin” of each of her patients in order
once again. to know what help is needed.

* Nurses should be educated at the UNIVERSITY LEVEL in both

arts & sciences.

• If Peplau largely focused on extending Sullivan’s

Interpersonal Theory, Henderson applied Maslow’s
Hierarchy of needs for use in nursing practice.

HENDERSON’S METEPARADIGM

1. PERSON – a holistic being tat is composed of

physical, psychological, sociological, & spiritual
dimensions that are defined by their corresponding
needs as defined by the 14 basic needs.
2. HEALTH – Viewed based on the individual’s ability to
function independently as outlined in the 14
components.
3. ENVIRONMENT – environment conditions under
which the patient can perform the 14 activities
unaided or independently.