14 basic needs

1. VIRGINIA AVENAL HENDERSON
Liz Anne Asebo-Vista, RN
Graduate School
Our Lady of Fatima University

2. VIRGINIA HENDERSON
 The theorist was born November 30, 1897, in Kansas
City, Missouri, but spent her formative years in
Virginia. In 1924, she graduated from the Army
School of Nursing in Washington, DC, a federally
funded diploma program to help overcome a nurse
shortage. She earned a bachelor’s degree in 1934
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). She then
joined the Yale University faculty, where she continued
to work after she retired until her death on March 9,
1996, at the age of 98.

3. VIRGINIA HENDERSON
 “First Lady of Nursing”
 “First Truly International Nurse”
 Began her career in public health nursing in the Henry
Street Settlement.
 Visiting Nurse Service in Washington D.C.
 First full-time instructor in nursing in Virginia when she
was at Norfolk Protestant Hospital.
 Active in the Graduate Nurses Association of Virginia.
 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.

4. VIRGININA HENDERSON
 Outstanding teacher during her years at Teachers
College
 Her revision of Bertha Harmer’s Textbook of the
Principles and Practice of Nursing became widely
used.
 Nursing Research: A Survey and Assessment an
important publications that grew out of Henderson’s
year at Yale University
 Directed a 12-year project entitled Nursing Studies
Index, four volumes recognized as an essential
reference for many years
 In her book Nature of Nursing, she expressed her
belief about the essence of nursing and influenced the
hearts and minds of those who read it.

5. VIRGINIA HENDERSON
 At the age of 75, she directed her career to
international teaching and speaking.
 Selected to the American Nurses Association Hall of
Fame
 Had the Sigma Theta Tau International Library named
in her honor
 Honored by the Virginia Nurses Association in 1988
when the Virginia Historical Nurswe Leadership Award
was presented to her.
 In 2000, the Virginia Nurses Association recognized
Henderson as one of the fifty-one Pioneer Nurses in
Virginia
 Halloran wrote, “Henderson was to the twentieth
century as Nightingale was to the nineteenth. Both
wrote extensive works that have influenced the world.”

6. METAPARADIGM IN NURSING
 Person
 Referred person as a patient.
 “Person is an individual who require assistance
to achieve health and independence, or in some
cases, a peaceful death

7. METAPARADIGM IN NURSING
 Health
 Viewed health as a quality of life and is very
basic for a person to function fully.
 Health requires independence and
interdependence.
 Influenced by both internal and external factors.
 She gave emphasis in prioritizing health
promotion as more important than care of the
sick.

8. METAPARADIGN IN NURSING
 Environment
 It is important for a healthy individual to control the
environment, but as illness occurs, this ability is
diminished or affected.
 In caring for the sick, it is the responsibility of the
nurse to help the patient manage his surroundings to
protect him from harm or any mechanical injury
 The nurse must be educated about safety and must
be aware of different social customs and religious
practices to assess dangers.
 Nurse must provide physicians data about the safety
needs of the patient, the nurse’s observations and
judgment regarding these needs as the latter uses
this as the basis in prescribing protective devices.

9. METAPARADIGM IN NURSING
 Nursing
 Asserted that nurses function independently from the
physician, but they must promote the treatment plan
prescribed by the physician.
 Help both the sick and well individual.
 The care given by the nurse must empower the
patient to gain independence as rapidly as possible
 Nurse 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 considered as
the “signature” of the profession.

10. 14 BASIC NEEDS
 Breathing normally
 Eating and drinking adequately
 Eliminating body wastes
 Moving and maintaining a desirable position
 Sleeping and resting
 Selecting suitable clothes
 Maintaining normal body temperature by
adjusting clothing and modifying the
environment
 Keeping the body clean and well groomed to
promote integument (skin)
 Avoiding dangers in the environment and
avoiding injuring others

11. 14 BASIC NEEDS
 Communicating with others in expressing
emotions, need, fears or opinions
 Worshipping according to one’s faith
 Working in such a way that one feels a sense of
accomplishment
 Playing or participating in various forms of
recreation
 Learning, discovering or satisfying the curiosity
that leads to normal development and health,
and using available health facilities.

12. THE NURSE-PATIENT RELATIONSHIP
 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.
 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.

13. THE N URSE-PHYSICIAN RELATIONSHIP
 Nurse and the patient , as partners,
formulate the plan of care, it must be
implemented in such a way that will promote
the physician’s prescribed therapeutic plan.
 Nurse do not follow doctor’s order, rather
they follow in a philosophy which allows
physicians to give orders to patients or other
healthcare team members.

14. THE NURSE AS A MEMBER OF HEALTHCARE
TEAM
 The nurse, as a member of the healthcare
team, works and contributes in carrying out
the total program of care. However, working
interdependently, as Henderson indicated,
does not include taking other member’s roles
and responsibilities.

15. ACCEPTANCE BY THE NURSING COMMUNITY
 Practice
 Assessment Phase – The nurse would assess
the 14 fundamental needs of the patients and
check which one is lacking or fully met.
 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.

16. ACCEPTANCE BY THE NURSING COMMUNITY
 Practice
 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.
 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.

17. ACCEPTANCE BY THE NURSING COMMUNITY
 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.

18. ACCEPTANCE BY THE NURSING COMMUNITY
 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.

19. ANALYSIS
 Simplicity
 Henderson’s concept of nursing is complex
rather than simplistic.
 The 14 basic needs had undergone several
revisions so as it make it clear, simple and
concise.
 “The Principles and Practice of Nursing” sixth
edition has given an extremely comprehensive
and well illustrated explanation that makes the
basic needs clear and more understandable.

20. ANALYSIS
 Generality
 The definitions provided by Henderson are broad
in scope. They work in such a way that they
cover all areas of nursing practice and could be
applied in every setting.

21. APPLICATION OF HENDERSON’S THEORY
 Makoy, 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

22. APPLICATION OF HENDERSON’S THEORY
 However, Makoy appeared to manifest self-
pity and lowered self-esteem when he said
“Wala na akong career! Baldado na ako.
Wala ng kwenta buhay ko!” and after having
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.

23. ASSESSMENT
 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.

24. PLANNING
 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.

25. IMPLEMENTATION
 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.

26. EVALUATION
 Upon entering this phase, the entire process is
evaluated and new goals are to be formulated.
As much as possible, the nurse would include
Makoy 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.
 Makoy, as planned, will initiate measures to
regain independence and performance of basic
needs and to achieve a sense of worth and
confidence.

27. THANK YOU!