Nursing Theory Critique
Theories are used to distinguish occurrences and manage practice of various disciplines. Theories are staminal in nursing profession as they act as instructions for the nursing practice. Without these theories, nurses will not be capable to discharge functions and obligations successfully putting patient’s security and health in jeopardy. In order to apply nursing theory in a proper manner, it is crucial to know how to defines, investigate, and critique the theory.
Henderson is famous for her Nursing Need Theory. Henderson developed her theory at the beginning of 1937. The theory appeared as the result of her personal education and practice. The theory is very important as it underlines the significance of patient’s independence. It presupposes that the patient will able to progress even after being released from the medical institution (Meleis, 2012, p. 434). Theory provides description of the nurse’s role, which includes substitutive, supplementary and complementary constituents. Substitute role goes about implies various actions, which are directed to the patient. Supplementary role implies the assistance of the nurse in all patient’s actions. Finally, complementary role implies actions directed to the patient who attempts to perform any actions. All of these roles allow the patient to become and maintain as independent as possible (Colley, 2003, p. 33).
Need theory is important due to the fact that the theory has indicated fourteen essential needs, which are very influential in the nursing practice. According to Colley (2003), the Need theory provides nurses with “ a sense of identity and helps patients, managers and other health care professionals to recognize the unique contribution that nurses make to the healthcare service” (p. 37). Theory is highly important as it can be applied to individuals of all ages. Moreover, practitioner can apply this theory in order to guide and improve their practice.
As a matter of act, Need theory developed by Henderson can be applied in various clinical situations in the case when patient does not have the cognition or the ability to take actions, which concern health and well-being. In fact, need theory is highly applicable for the chronic constructive pulmonary disease (Kara, 2005, p. 129). This disease is known to affect millions of people. Usually, the theory is utilized in order to provide individualized care to the patients. As a matter of fact, theory is very useful, as it allows patients with the above-mentioned disease to identify their needs, while helping to fulfill the desired outcomes of maintaining independence and reducing hospitalization due to the COPD complications. The theory provides these patients with the independence. The theory provides the hope to reduce the hospitalization of the patients with COPD (Kara, 2005, p. 132). Usually, the application of the need theory requires five steps. First of all, it is important to memorize and understand all fourteen elements of the need theory secondly, it is crucial to asses the patient according to these components. Thirdly, it is essential to create a nursing plan, which is based on the results and provide clear nurse assistance to the patient, which is applied in the course of physician’s medication of the condition of disease. Fourthly, it is fundamental to implement the plan. It should be taken into account that all requirements are to me addressed on the daily basis. The final step addresses the reassessment of the nursing plan, as the treatment has to be constantly reevaluated (Meleis, 2012, p. 91).
In fact, Virginia Henderson’s theory is logical. All of the theory’s concepts are interrelated. Moreover, the definition of the theory together with the list of theory component is logical. Nevertheless, theory lacks the connection between physiological and other human characteristics. Therefore, all the components can be applied as a guide for the patient or the nurse in achieving the desired objective. Despite the fact that the theory is quite simple, it can be generalized. Nevertheless, the connections between the concepts of the theory seem to be unclear. The theory can be grounded on the hypothesis, which can be applied in order to generate testable hypothesis.
Henderson’s theory is composed of four major concepts, which incorporate human needs, culture, bio-psychology and interaction-communication. These concepts are considered to be fundamental elements of the nursing process. They consider four elements including the human as such, his/her environment, health and nursing. As a matter of fact, Henderson considered a patient to be the person that requires nursing care. Nevertheless, nursing is not restricted to the disease care only. Therefore, Henderson examined psychological, biological, spiritual and sociological elements. The patient was identified as the person with a number of needs that are to be met for the person to be healthy. In fact, Henderson did not distinguish environment in the theory (Alligood, 2014, p. 45). Despite this fact, supportive environment and its maintenance is considered to be a very important constituent in her fourteen activities. Therefore, Virginia Henderson considers a person in regards to his/her family. The environment is discussed from the viewpoint of the society. Thus, the society is a crucial driver for the nursing services, as it expects nurses to act for those individuals who are not capable of performing their functions independently. Nevertheless, the influence of the environment, community and the society on the patient is not discussed in the theory (Alligood, 2014, p. 46). The concept of health was not explicitly differentiated in the theory. Virginia Henderson used the concept of health to define the balance in all spheres of the human life. A number of factors influence the concept of health. In fact, the status of the health can be defined with the help of person’s capability to perform all fourteen elements of need, indicated by Virginian Henderson. Finally, Henderson dedicated a lot of attention to the concept of nursing. In fact, she defined that the major role of any nurse is to help any individuals, whether the person is sick or well. The nurse is supposed to help people to perform their activities and contribute to individual’s health and his/her recovery (Alligood, 2014, p. 46).
Holistic Need Theory views the nursing as a practice, which concentrates on the treatment of the whole person and takes into account fundamental needs of the individual. The theory denies the fact that the person has to be viewed through the illness only. The theory presupposes that the nursing practice will address the interrelations of the spirit, minds, body, emotions, social environment, and socio-cultural context. Theory views all of these factors and the elements, which are to create the individual. The work on these concepts will allow to treat the person, taking into account the influence of the treatment on the health of the patient. Holistic need theory concentrates on the health and well-being promotion, treatment assistance and suffering alleviation or suffering prevention.
The essence of the theory lays in the fact that it demonstrates that it is more important to treat the person, acknowledging person requirements and values rather than dedicating the treatment to the symptoms only. The theory is highly important all the treatment on the one level will obviously influence all other levels. Moreover, theory indicates the importance of the individual importance. It practically means that an individual is considered to be an active part of the medication process and not only the recipient of the medication. Thus, it provides the cognition and self-awareness to the patient, which intensifies the general improvement and facilitates all changes. Moreover, the patient is able to have more control over his/her personal live and needs.
Due to the fact that holistic need theory is a new theory, there may be a lot of barriers for its application. As a matter of fact, the lack of awareness might be considered as the main hurdle for theory application. The access may be difficult for rural populations, minorities, underinsured groups, and vulnerable groups, which encompass chronically and terminally ill patients. However, holistic need theory may be of particular importance for the terminally ill patients, as it allows them to find the meaning of their existence and life experiences, while addressing their basic needs. Theory aims to improve their overall quality of life and potentially eases their suffering (Papathanasiou, Sklavou, & Kourkouta, 2013, p. 2). Due to the fact that terminally ill patients are often sent to medical institutions where they die unseen by the society, this is the most vulnerable category of patients. Holistic need nursing will address all multidimensional problems f terminally ill patients in any setting. It means that the nurse will be present during the period of special requirements. This typically incorporates therapeutic communication, active communication and listening, and touch. Moreover, nurses will assist to recall all previous emotions, needs and experiences in order to facilitate the adaptation to present circumstances, it may also incorporate breathing and meditation techniques, which will help to decrease undesirable symptoms (Papathanasiou, Sklavou, & Kourkouta, 2013, pp. 3-4). Overall, holistic need nursing is addressed to facilitate the acceptance of disease state at the same time deepening and enhancing values and needs of the terminally ill patient.
The holistic need theory is logical. All of the concepts are interconnected and logically grounded. However, due to the fact that the theory is based on hypothesis, it cannot be tested. All of the results can be viewed from the short-term perspective, whereas long-term results cannot be evaluated.
Holistic need theory addresses four major concept, including human, health, environment and nursing. The person is considered to be a whole entity, including their emotions, feelings, interests and needs. The health status is the way of existing inside the world, which is viewed as the environment of the patient. The nursing practice is aimed at promoting harmonic interconnections between the person as the entire whole and the environment, while enhancing the unity and integrity of the patient’s energy field. Nursing practice is directed at achieving the highest possible health potential.
- Alligood, M.R. (Eds.). (2014). Nursing theorists and their work (8th ed.). Marylands Heights, MO: Elsevier Mosby.
- Colley, S. (2003). Nursing theory: Its importance to practice. Nursing Standard, 17(46), 33-37.
- Kara, M. (2005). Preparing nurses for the global pandemic of chronic obstructive pulmonary disease. Journal of nursing scholarship, 37 (2), 127-133.
- Meleis, A.I. (2012). Theoretical nursing: Development and progress (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
- Papathanasiou, I., Sklavou, M., & Kourkouta, L. (2013). Holistic nursing care: Theories and perspectives. American Journal of Nursing Science, 2(1), 1-5.