Nursing Theories

Florence Nightingale was born on May 12, 1820, in Florence, Italy. From an early age, she felt she had a calling to be a nurse. She "trained" to be a nurse at a hospital in Kaiserworth, Germany, and returned to London. She led nurses during the Crimean War at Scutari, Turkey; gathered extensive statistics about the health of the soldiers she and her nurses served; and began a life-long effort to improve health by improving the environment. Her Notes on Nursing emphasized that a clean environment, warmth, ventilation, sunlight, and a quiet environment lead to good health. A statistician and epidemiologist, she died August 13,1910. Faye Abdellah, RN, Ed.D., Sc.D., FAAN, was the founding dean of the Graduate School of Nursing at the Uniformed Services University, Bethesda, MD. She was the first Deputy surgeon General of the U.S. Public Health Service. (Parascandola, 1994). She developed a list of 21 unique nursing problems related to human needs in the 1960s. Her early writings contributed to the idea that nurses use a problemsolving approach to practice rather than merely following physician orders, complementing the 1965 statement from the American Nurses Association recommending baccalaureate education as entry into nursing practice. Abdellah's 21 problems are actually a model describing the "arenas" or concerns of nursing, rather than a theory describing relationships among phenomena. In this way, distinguished the practice of nursing, with a focus on the 21 nursing problems, from the practice of medicine, with a focus on disease and cure. Hildegard Peplau used the term, psychodynamic nursing, to describe the dynamic relationship between a nurse and a patient. She described four phases of this relationship: orientation, in which the person and the nurse mutually identify the person's problem; identification, in which the person identifies with the nurse, thereby accepting help; exploitation, in which the person makes use of the nurse's help; and resolution, in which the person accepts new goals and frees herself or himself from the relationship. She also identified six nursing roles of the nurse: Counseling Role - working with the patient on current problems Leadership Role - working with the patient democratically Surrogate Role - figuratively standing in for a person in the patient's life Stranger - accepting the patient objectively

Resource Person - interpreting the medical plan to the patient Teaching Role - offering information and helping the patient learn

Virginia Henderson graduated from the Army School of Nursing, Washington, D.C., in 1921. She is part of the "Columbia school" of nursing theory, having graduated from Teachers College, Columbia University, with a M.A. degree in nursing education, and having been a member of the faculty from 1930 to 1948. She wrote and/or edited several editions of the The Principles and Practice of Nursing, along with Harmer in the early years of the fundamentals text and Nite in the later years. Virginia Henderson defined nursing as "assisting individuals to gain independence in relation to the performance of activities contributing to health or its recovery" (Henderson, 1966, p. 15). 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), or complementary (working with the person), with the goal of helping the person become as independent as possible. Her famous definition of nursing was one of the first statements clearly delineating nursing from medicine: "The unique function of the nurs 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, p. 15). She was one of the first nurses to point out that nursing does not consist of merely following physician's orders. Lydia Hall was a rehabilitation nurse and one of the Columbia University/Teachers College school. Her "Care, Core, and Cure Model" was an early model of nursing practice used at the Loeb Center for Nursing and Rehabilitation in Westchester County, New York. The Loeb Center was nurse directed, developed to prevent the fragmented care common in the 1950's and 1960's. According to the Care, Core, and Cure" model, nurses work in three arenas: care (hands on bodily care), core (using the self in relationship to the patient), and cure (applying medical knowledge). Hall was another nurse to the delineate the practice of nursing from the practice of medicine.