Application of Nursing Theory

NR501 Week 6 Application of Nursing Theory

Henderson’s Need Theory (The Nursing Need Theory)

Name

Instructor

NR501 Theoretical Basis for Advanced Nursing

Chamberlin college of Nursing

Date

Application of Nursing Theory – The Needs Theory (Henderson)

Introduction

A Nursing Theory is referred to as a body of knowledge applied to support the nursing practice (Alligood, 2014). It is a framework designed or established to organize nursing knowledge and explain phenomena as seen in nursing, in a detailed, specific and more concrete manner. “A nursing theory represents a set of concepts, propositions, definitions, assumptions and relationships derived from different nursing models or other disciplines and that project a systematic, purposive view of phenomena (Alligood, 2014)”. The view is established by designing particular inter-relationships among different concepts to describe, explain, predict, and /or prescribe the phenomena.

There is a great variance in the application of nursing theories in clinical settings, which highly depends on the context of practice (Alligood, 2014). However, addressing the patients’ needs is critical in providing effective and quality care. One nursing theory that focuses on patient needs is the Need Theory by Virginia Henderson. The focus of the theory is on the significance of increasing patient’s independence to hasten their hospital recovery progress (Ahtisham&Jacoline, 2015). In the Needs Theory, Henderson emphasizes the basic and essential human needs explainingthe role of nurses in assisting patients to meeting those needs.

In this assignment paper, Henderson’s need theory of nursing will be applied to practice, to identify its relevance to nursing. The assignment will apply Henderson’s theory to a nursing problem of assisting patients with ambulationafter surgery. The paper begins by description of the issue, then application of the needs theory and finally a conclusion with the new knowledge as regards to the needs theory and its application.

Description of Issue or Concern (Nursing Problem)

This paper has identified ambulation after surgery as the nursing problem. Ambulation is a nursing outcome, classified in the Nursing Outcomes Classification (NOC), which is an issue to nurse practitioner. It is defined as “the ability to walk from place to place independently with or without assistive device” (Kibler, et al., 2012).A patient’s ambulation soon after surgery is now a fundamental element of nursing care (Kibler, et al., 2012, p. 1) as it is today considered a “must procedure after a surgical operation” that precious medial practice found challenging.

The problem is that some postoperative patients find it difficult to walk or move. The postoperative patient could cite pain or weakness as reasons for not wanting to walk (Morris, et al., 2016), or the patient could just be afraid to move due to related pain. These are valid complaints (Morris, et al., 2016),however if the patient is not encouraged to move or walk, and allowed to remain in bed, there are higher chances of the patient developing deep vein thrombosis (DVT), pneumonia, or an ileus and other severe complications lengtheningrecovery time. Failure to walk can also cause increased gas pains and constipation, and general weakness.

The key role of a nurse is patient care including improving a patient’s health and supporting their recovery. In postoperative patients, nurses must apply all their professionalism in helping the patient get back to normal – including supporting them in ambulation (Ahtisham&Jacoline, 2015). Nurses should not rush patients to walk after a surgical operation without giving them tools to succeed. Previously, having patients walk sooner after surgery created a key challenge in patient care, as regards to the new evidence on the benefits of post-surgery exercise and its positive impact on surgical recovery. However, Kibler, et al. (2012) explain that with good evidence based practice, healthcare now considers facilitating ambulation as a vital part of excellent nursing, especially on postoperative patients (p.1).

Application of Selected Nursing Theory to Issue or Concern

This assignment will apply Henderson’s Needs theory in ambulation after surgery. Early post-surgery walking is a crucial thing to do to prevent post-surgery problems. The doctor will order a post-surgery activity that is best for the patient, which is to be implemented with the help of a nurse. While in bed, nurses should apply leg pumps to help promote the patient’s blood flow in the legs. At the moment to get out of bed, the nursing staff (nurse practitioner or assistant) should help the patient dangle at the bedside, move to the chair from the bed and walk in the hall way. The nurse must be able to support the patient with all these needs, as applied in Henderson’s needs theory.

The three major assumptions identified in Henderson‘s Need Theory are that: (1) Nurses offer care for the patients until they can once again care for themselves. Even though not accurately explained, (1b.) the desire of patients is to return to good health. (2) It is in the will of nurses to serve and they will devote themselves and time to the patient night or day. (3) To serve, nurses need proper college education in both the art and science of service. Henderson further believes that the “body and mind are interrelated and inseparable.” Working with these assumptions Henderson identified an explained how to serve the needs of the patient (Ahtisham&Jacoline, 2015).

Henderson’s needs theory as a nursing model can be applied to help nurses evaluate, assess and assist post-operative patients with after-surgery ambulation. The strategy is to apply the fourteen componentsas identified by Henderson’s needs theory of basic human to assist and educate the patient to in an effort to facilitate recovery. The needs are classified into components.

• Strategy

The theory’s first nine components are physiological, while its tenth and fourteenth components are psychological aspects of learning and communicating. The eleventh component has been identified as moral and spiritual, while the twelfth and thirteenth components have social orientation to reaction and occupation(Ahtisham&Jacoline, 2015). It is clear that human needs are categorized in to social, psychological, physiological moral and spiritual needs.

Often, post-operative patients experience abdominal pain, which can increase when there is any strain on this region. The nurse should encourage the patient to take adequate breaths to allow more oxygen intake, and prevent pneumonia or atelectasis. Proper pain management techniques can promote efficient breathing. For instance, positioning techniques during bed rest e.g. using a pillow, as a first ambulation activity, can help reduce pains during deep breaths (Collucci et al., 2015). Morris, et al., (2016) also explain that walking encourages increased oxygen flow all through the body, which helps to maintain normal breathing function.

• Breathe normally

Before surgery, patients are advised not to eat or drink anything. This means that they are always very hungry after the surgery. At the doctor’s advice, the nurse must help the post-surgery patient eat appropriate meals adequately. The nurse should educate the patient to eat the meal slowly, and report any nausea related symptom. Nutritious fluids are oftengiven until the patient can resumeproper oral intake. Gradual oral food intake is advised after surgery, Charoenkwan&Matovinovic (2014), to supportsoonerresumption of bowel function, increase satisfaction and aid earlier recovery (p. 17). Releasing the gas pressure in the body helps to decrease pain, allowing easier movement and patient ambulation.

• Eat and drink adequately

Upon removal of the foley catheter, the nurse should assess the patient and ensure that the bladder is properly working, measure the patient’s intake and output andencouragethe patient to urinate within four to six hours after foley catheterremoval. This gives patients an opportunity to prepare to ambulate before the need to void (Ahtisham&Jacoline, 2015).

• Eliminate body wastes

It is advisable for a post-surgery patient to move and maintain desired postures for proper healing and recovery; including resuming walking sooner after surgery, through assistance and encouragement. Prolonged bed stay will make the patient’s muscles to weaken, and experience general delay of return to strength. Nurses should assess the patient’s barriers to ambulation, like general weakness, fear, pain, etc. (Ahtisham&Jacoline, 2015).

• Movement and postures

Surgery is a risky endeavor. It is important that the patient takes a rest and sleeps after the risk and to facilitate recovery. Nurse should be vigilant of such aspects as insomnia or dark circles around the eye and help the patient address them appropriately(Ahtisham&Jacoline, 2015). Rest is also encouraged between activities to facilitate healing.

• Sleep and rest

It is the responsibility of nurses to ensure that patients are dressed and undressed appropriately. Suitable clothing means dressing and undressing in appropriate clothing that will support healing and recovery of post-op patients (Collucci et al., 2015). Nurses should assist patients in dressing and undressing, in areas around the IV tubing, and areas the patient can’t reach due to painful movement. Before walking the hallways the nurse should ensure that the patient is appropriately dressed. In appropriate dressing embarrasses patients hence inhibiting proper ambulation. It is important that nurses are always conscious about the patients’ clothing (Charoenkwan&Matovinovic, 2014).

• Select suitable clothing

Maintain body temperature

For proper recovery, the body temperature of the patient must be maintained within the normal range by modifying the environment and adjusting clothing in the room, hallways or outside when the patient is ambulating.This is the responsibility of the nurse (Ahtisham&Jacoline, 2015). Such symptoms or signs of hyperthermia or hypothermia should be recorded whenever experienced.

Keep the body clean and well groomed

It is important to keep the patient’s body clean and well-groomed and protect the integument.To avoid infections and promote healing, the patient’s hygiene must be given top priority (Collucci et al., 2015). When the patient reports lack of proper hygiene, or blood on their body or clothing care should be taken to address the matter appropriately. The incision must not be dump and must always be intact as proper body and clothing hygiene promotes ambulation.

Avoid dangers in the environment and avoid injuring others.

The environment of a post-op patient must be free of danger to the patient and to others. The caregiver nurse should be vigilant of fatigue or feeble walk. The environment should be safe for ambulation e.g. a clear path from the bed to the bathroom (Charoenkwan&Matovinovic, 2014). The nurse will implement fall precautions, e.g. educating the patient to call for assistance before ambulating. Falls can cause major setbacks in a patient’s recovery.

Communication

Communication is as important to a post-op patient as it is before diagnosis. Encourage the patient to communicate with others as he expresses his emotions, needs, fears, or opinions.This way, it will be easier to know how the patient feels and how ambulation is helping in recovery or if there is anything that need to be improved but only known to the patient (Ahtisham&Jacoline, 2015). The nurse can establish a relationship of trust so that the patient will be comfortable sharing his fears related to ambulation.

Worship according to one’s faith

Different cultures have different worshiping methods – and some people are also not spiritual at all. It is important to respect the patient’s beliefs and religious practices and allow the patient to express faith or beliefs related to healing (Ahtisham&Jacoline, 2015).

Work to accomplish

The nurse should work in such a way that there is a sense of accomplishment. The nurse should ensure that the patient has a sense self-care and has an urge to be healthy again. If this urge and sense is missing the patient will have an emotional mind not to heal, which can impede recovery lengthen hospital stay (Charoenkwan&Matovinovic, 2014).

Observe recreation

The nurse should help the post-op patient play or participate in various forms of recreation. This encourages socialization and relaxes the mind. If there are home activities that the patient practiced before operation, this is the good time to reintroduce them to help the patient’s social interaction and urge of healing and recovery. This willimproveambulation.

Learn, discover, or satisfy the curiosity

The patient, with the help of the nurse, should learn, discover and satisfy the curiosity that leads to normal development and health and use the available health facilities. The patient should be encouraged to avoid finding difficulty to cope with her stress and present illness (Ahtisham&Jacoline, 2015). Encourage the patient to have a healthy life style, and find information that promotes healing and recovery.

According to Ahtisham&Jacoline(2015), these 14 components of Henderson’s Needs Theory are applicable to nursing practice and encourage nurses to set goals. Meeting such a goal of achieving these 14 needs of a patient can form a great basis for a nurse to further improve performance and achievement towards nursing care. To a post-op patient, they are a great way to support healing and recovery as they provide 14 different ways of ambulation for the patient.

Conclusion

The lesson from this paper is that the 14 components of Henderson’s Needs Theory are the definition of care nursing. The theorydirsectly shapes and guides the nursing profession, and nursing practice. Henderson’s emphasis on the basic human needs as the central focus of nursing practice is the essential definition of nursing (Alligood, 2014). Nursing is about care and service to the patient’s needs. The role of a nurse can now be clearly explained as “to get into the patient’s skin and supplement his strength will or knowledge according to his needs (Morris, et al., 2016).” It is the nurse’sresponsibility to assess a patient’s needs, help him meet health needs, and offer an environment that enables the patient to perform healing activity unaided. The need theory as seen, is relevant to all clinical settings and serves as a framework for recognizing caring needs, evaluate and delivering holistic nursing care.

References

Alligood, M. R., (2014). Introduction to Nursing Theory: Its History, Significance, and Analysis. Nursing Theorists and Their Work. (8th Ed.). Pp. 6, 11, 45, 46. Mosby, Elsevier, St. Louis, MO.

Ahtisham, Y. &Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice; Virginia’s Henderson Need Theory. International Journal of Caring Sciences, 8(2), 443-4449

Charoenkwan, K., &Matovinovic, E., (2014). Early versus delayed oral fluids and food for reducing complications after major abdominal gynecologic surgery. Cochrane Database of Systematic Reviews. 12, (CD004508), p. 17. DOI: 10.1002/14651858.CD004508.

Colucci, et al. (2015). Cough impairment and risk of postoperative pulmonary complications after open upper abdominal surgery. Journal ofRespiratory Care. 60, (5), Pp. 673-678.doi: http://dx.doi.org/10.4187/respcare.03600

Kibler, V. A., Hayes, R. M., Johnson, D. E., Anderson, L. W., Just, S. L., & Wells, N. L. (2012). Cultivating Quality: Early Postoperative Ambulation: Back to Basics. AJN, American Journal of Nursing, 112(4), 63. doi:10.1097/01.naj.0000413460.45487.ea [PubMed]

Morris, B. A., Benetti, M., Marro, H., & Rosenthal, C. K. (2016). Clinical Practice Guidelines For Early Mobilization Hours After Surgery. Orthopaedic Nursing, 29(5), 290-316. doi:10.1097/nor.0b013e3181ef7a5d