NURSING THEORISTS (HENDERSON,
WIEDENBACH, LEVINE)
VIRGINIA HENDERSON
• Nightingale of Modern Nursing
• Kansan City, Missouri
• November 30 1887 – March 19, 1996
• 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 Bachelor’s Degree
in 1932, Master’s Degree in 1934.
• Joined Columbia as a member of the
faculty, remained until 1948.
• Since 1953, she was a research associate
at Yale University School of Nursing.
• 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 of the Medical Library Association.
• In 1939, she revised: Harmer’s Classic
Textbook of Nursingf or its 4th edition, and
later wrote the 5th; edition, incorporating
her personal definition of nursing.
NURSING NEED THEORY
• She called her definition of nursing her
“concept”
• She emphasized the importance of
increasing the patient’s independence so
that progress after hospitalization would
not be delayed.
• "Assisting individuals to gain independence
in relation to the performance of activities
contributing to health or its recovery"
• 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), and
complementary (working with the person),
with the goal of helping the person become
as independent as possible.
"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).
MAJOR CONCEPTS OF NURSING THEORY
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.
2. 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
3. Health
• Definition based on individual’s 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 individual’s ability to meet
these needs independently.
4. 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
physician’s therapeutic plan
Individualized care is the result of the
nurse’s 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 patient’s skin and
supplement his strength will or
knowledge according to his needs.”

14 COMPONENTS OF NEED THEORY:

1. Breathe normally. Physiological: #1-#8

2. Eat and drink adequately.
3. Eliminate body wastes.
4. Move and maintain desirable postures.
5. Sleep and rest.
6. Select suitable clothes-dress and undress.
7. Maintain body temperature within normal
range by adjusting clothing and modifying
environment.
8. Keep the body clean and well groomed and
protect the integument
9. Avoid dangers in the environment and
avoid injuring others.
10. Communicate with others in expressing
emotions, needs, fears, or opinions.
11. Worship according to one’s faith.
12. Work in such a way that there is a sense of
accomplishment.
13. Play or participate in various forms of
recreation.
14. Learn, discover, or satisfy the curiosity that
leads to normal development and health
and use the available health facilities.
Safety: #9
Love and Belongingness: #10 and #11
Esteem: #12-#14
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.
ERNESTINE WIEDENBACH
• Hamburg, Germany
• August 18, 1900 - March 8, 1998
• She was an early nursing leader who is
probably best known for her work in theory
development and maternal infant nursing.
• She wrote with Dickoff and James, a
classic article on theory in a practice
discipline that is still used today when
studying the evolution of nursing theory.
• Her interest in nursing began while
watching the care of her sickly
grandmother. Later she enjoyed hearing her
sister's friend, who was a medical student,
 accounts of his experiences in the hospital
setting.
• B.A. from Wellesley College in 1922
• R.N. from Johns Hopkins School of Nursing
in 1925M.A. from Teachers College,
Columbia University in 1934
• Certificate in nurse-midwifery from the
Maternity Center Association School for
Nurse-Midwives in New York in 1946.
THE HELPING ART OF CLINICAL NURSING
Four Elements:
1. Philosophy
• If a nurse’s attitude and belief is
what motivates him/her to act in
certain ways, he/she is guided on
nursing philosophy. There are 3
components that may affect the
nurse’s philosophy: reverence for
life, respect for the dignity and
individuality of each human being,
and resolving to act on personal and
professional beliefs.
2. Purpose
• When a nurse wants to accomplish
through what he/she does which is
primarily identifying a patient’s need
for help, it is based on nursing
purpose.
3. Practice
• Observable actions, which are
affected by the nurse’s beliefs and
feelings in meeting the patient’s
need show the nursing practice.
4. Art
• The art of nursing is when the
nurses understood patient’s needs
and concerns.
CONCEPTS AND DEFINITIONS
Patient
• Any individual who is receiving help of some
kind, be it care, instruction or advice from a
member of the health profession or from a
worker in the field of health.
A Need For Help
• Any measure desired by the patient that has
the potential to restore or extend the ability to
cope with various life situations that affect
health and wellness.
Nurse
• The nurse is a functional human being who
acts, thinks, and feels. All actions, thoughts,
and feelings underlie what the nurse does.
Knowledge
• Encompasses all that has been perceived
and grasped by the human mind. It can be
factual, speculative or practical judgment.
Nursing Skills
• Carried out to achieve a specific patient-
centered purpose rather than completion of
the skill itself being the end goal.
Person
• Each person may it be a nurse or patient, is
gifted with a unique potential to develop self-
sustaining resources.
PRESCRIPTIVE THEORY
• Wiedenbach’s theory is based on identifying
a patient’s need-of-help through nursing
interaction and nursing action. The process
by which a patient’s need is identified
involves a philosophical and or holistic
approach as well as nursing knowledge and
experience.
Three Factors:
• The central purpose, which the practitioner
recognizes as essential to the particular
discipline
• The prescription for the fulfillment of central
purpose.
• The realities in the immediate situation that
influence the central purpose.
CONCLUSION OF THE THEORY
• Nursing is the practice of identification of a
patient’s need for help through
o Observation of presenting behaviors
and symptoms
o Exploration of the meaning of those
symptoms with the patient
o Determining the cause(s) of
discomfort, and
o Determining the patient’s ability to
resolve the discomfort or if the
patient has a need for help from the
nurse or other healthcare
professionals.
• Nursing primarily consists of identifying a
patient’s need for help.
MYRA ESTRIN LEVINE
• Chicago, Illinois
• 1921 – 1996
• Diploma in nursing from the Cook County
School of Nursing in 1944.
• Bachelor of Science in Nursing from the
University of Chicago in 1949.
• Master’s of Science in Nursing from Wayne
State University in 1962.
• Honorary doctorate from Loyola University
in 1992.
• She is known for her
publication, Introduction to Clinical Nursing,
which was first published in 1969.
CONSERVATION MODEL THEORY
MAJOR CONCEPTS OF THE THEORY
• Goal of the model is to promote adaptation
and maintain wholeness using the
principles of conservation.
• Model guides the nurse to focus on the
influences and responses at the organismic
level.
• Nurse accomplishes the goal of model
through the conservation of energy,
structure and personal and social integrity.
FOUR PRINCIPLES OF CONSERVATION
1. Energy
• Refers to balancing energy input and
output to avoid excessive fatigue. It
includes adequate rest, nutrition
and exercise.
2. Personal Integrity
• Recognizes the individual as one who
strives for recognition, respect, self-
awareness, selfhood, and self-
determination.
3. Structural Integrity
• Refers to maintaining or restoring the
structure of body preventing physical
breakdown and promoting healing.
4. Social Integrity
• Exists when a patient is recognized as
someone who resides within a family, a
community, a religious group, an ethnic
group, a political system, and a nation.
DEFINITIONS
Adaptation
• Every individual has a unique range of
adaptive responses (heredity, age, gender,
challenges of illness experiences).
• An ongoing process of change in which
patient maintains his integrity within the
realities of environment.
• Achieved through the "frugal, economic,
contained and controlled use of
environmental resources by individual in his
or her best interest".
Wholeness
• Exist when the interaction or constant
adaptations to the environment permits the
assurance of integrity.
Conservation
• The product of adaptation·
• Achieving a balance of energy supply and
demand that is within the unique biological
realities of the individual
Environment
• Operational environment - consists of the
undetected natural forces and that impinge
on the individual
• Perceptual environment - consists of
information that is recorded by the sensory
organs
• Conceptual environment - influenced by
language, culture, ideas, and cognition

Person
• The unique individual in unity and integrity,
feeling, believing, thinking, and whole.

Nursing
• The human interaction relying on
communication, rooted in the organic
dependency of the individual human being
in his relationships with other human
beings.

ASSUMPTIONS OF THE THEORY

About individuals:
• Each individual “is an active participant in
interactions with the environment…
constantly seeking information from it.”
(Levine, 1969)
• The individual “is a sentient being and the
ability to interact with the environment
seems ineluctably tied to his sensory
organs.”
• “Change is the essence of life and it is
unceasing as long as life goes on. Change
is characteristic of life.” (Levine, 1973)

About nursing:
• “Ultimately the decisions for nursing
intervention must be based on the unique
behavior of the individual patient.”
• “Patient-centered nursing care means
individualized nursing care. It is predicated
on the reality of common experience: every
man is a unique individual, and as such he
requires a unique constellation of skills,
techniques and ideas designed specifically
for him.” (Levine, 1973)