Chapter 5

20th Century Nursing: Ernestine

Wiedenbachs, Virginia
Hendersons, and Lydia Halls
Contributions to Nursing Theory
and Their Use in Practice
Developed by S. Gordon (2010)
Updated by D. Gullett (2014)
Copyright 2015. F.A. Davis Company

On completion of this chapter, students will be

able to:
1. Describe the historical, educational, and career trajectories of each theorist.
2. Describe the impact that Wiedenbach, Henderson, and Hall had on the
development of nursing knowledge.
3. Discuss the relevance of the basic principles proposed by these theorists to
the current practice of nursing.
4. Identify the major contributions of each theorist to the development of
nursing knowledge.
5. Explore and describe each theorists unique approach and process of
developing a theoretical framework for nursing practice.
6. Examine the theoretical perspectives of each theory and identify
commonalities and differences among the theories.

Copyright 2015. F.A. Davis Company

Impact on Nursing
Three of the most important influences on
nursing theory development of the 20th century.
Each of these nurse scholars based theoretical
work on nursing practice.
Today some of their work contributes to what is
referred to as practice theories.
Concepts and terms they first used are heard
today around the globe.

Copyright 2015. F.A. Davis Company

Ernestine Wiedenbach
Born 1900 in Germany to an American Mother
and German father
Migrated to the United States when she was a
child
Earned BA from Wellesley College in 1922
Earned MA from Columbia in1934
Faculty member at Yale University
Developed her Prescriptive theory

Copyright 2015. F.A. Davis Company

Ernestine Wiedenbach

(continued)

Gave us new ways to think about nursing

practice and nursing scholarship
Continued Nightingales work of:
Nursing as a professional practice discipline
Nursing practice theory

Wrote Clinical Nursing: A Helping Art

(Wiedenbach, 1964)
Practice of Clinical Nursing is goal directed,
deliberately carried out, and patient centered
(Wiedenbach, 1964, p.23)
Copyright 2015. F.A. Davis Company

Three Ingredients Essential to the Prescriptive Theory

(1970)

The nurses central purpose in nursing is the

nurses professional commitment.
The prescription indicates the broad general
action that the nurse deems appropriate to the
fulfillment of the central purpose.
The realities are the aspects of the immediate
nursing situation that influence the results the
nurse achieves through what she does.

Copyright 2015. F.A. Davis Company

Components Within Nursing

Situations
Agent: nurse supplying the nursing action
Recipient: patient receiving the action or on
whose behalf the action is taken
Framework: situational factors
Goal: end to be attained through nursing action
Means: nursing actions and devices

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Nursing Situational
Factors

Physical
Psychological
Emotional
Spiritual

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Virginia Henderson
Born in Kansas City, Missouri, in 1897
5th of 8 children
Entered Army School of Nursing during WWI in
response to nursing shortage at Walter Reed
Army Hospital
Questioned regimented nature of patient care
and nursing as ancillary to medicine

Copyright 2015. F.A. Davis Company

Virginia Henderson

(continued)

Considered it a privilege to care for soldiers and the

experience influenced her ethical understanding of nursing
Earned BS (1932) and MS (1934) from Columbia Teachers
College
Continued working on faculty for next 20 years
Known as the modern-day Florence Nightingale
Her own definition of Nursing
to get inside the patients skin and supplement his
strength, will or knowledge according to his needs (Harmer
and Henderson, 1955, p.5)

Copyright 2015. F.A. Davis Company

Virginia Henderson
14 Nursing functions
Caring based
Focused on the need to be clear about the function
of nurses
Posed the following question: What is nursing and
what is the function of the nurse?
Believed this question was fundamental to anyone
choosing to pursue the study and practice of nursing

Copyright 2015. F.A. Davis Company

Hendersons Definition of
Nursing
Nursing is primarily assisting the individual (sick
or well) in the performance of those activities
contributing to health or its recovery (or to a
peaceful death), that he would perform unaided
if he had the necessary strength, will or
knowledge. It is likewise the unique contribution
of nursing to help people be independent of
such assistance as soon as possible (Harmer &
Henderson, 1955, p 4).

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14 Components of Basic Nursing

Care

Breathe normally
Eat and drink adequately
Eliminate body wastes
Move and maintain desirable postures
Sleep and rest
Select suitable clothesdress and undress
Maintain body temperature within normal range by
adjusting clothing and modifying the environment
Keep the body clean and well groomed and protect the
integument

Copyright 2015. F.A. Davis Company

14 Components of Basic Nursing Care

(continued)

Avoid dangers in the environment and avoid injuring

others
Communicate with others in expressing emotions,
needs, fears, or opinions
Worship according to ones faith
Work in such a way that there is a sense of
accomplishment
Play or participate in various forms of recreation
Learn, discover, or satisfy the curiosity that leads to
normal development and health and use the available
health facilities

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Lydia Hall
Born in 1906
1927 graduate of York Hospital Nursing School in
Pennsylvania
Earned BS (1937) and MS (1942) from Columbia
Teachers College
Worked as visiting nurse, faculty at Fordham Hospital
School of Nursing and research activities with the U.S.
Health Services and joined the faculty of Columbia
Teachers College

Copyright 2015. F.A. Davis Company

Lydia Hall

(continued)

Lydia Hall challenged us to think in new ways

about the key role of professional nursing in the
care and rehabilitation of patients.
She founded the Loeb Center for Nursing and
Rehabilitation.

Copyright 2015. F.A. Davis Company

Halls Care, Cure, and Core Model

Person as Patient:
Person
Body
Disease

The focus of nursing is the provision of intimate bodily

care
Nursing care is modified based on pathology and
treatment in consideration of the unique needs and
personality of the patient
Nursing as a professional interpersonal process

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Overlapping Circles of the Nursing

Process
Care
Intimate bodily care

Cure
Shared with medicine
Nurse in role of nurturer and comforter

Core
Using relationships for therapeutic effect
Concept Map using Hall's theoretical framework

Copyright 2015. F.A. Davis Company

Summary
Wiedenbach, Henderson, and Hall introduced
nursing theory to us in the mid-20th Century.
Each of these nurses looked at their nursing,
and explored nurse-patient interactions, using
nursing practice as the basis for their thought
and for their published scholarship.
These nurse theorists defined the ways nursing
is thought about, practiced, and researched,
both in the United States and around the world.

Copyright 2015. F.A. Davis Company