She described her introduction to nursing as a
“series of almost unrelated procedures, beginning
with an unoccupied bed and progressing to aspira-
tion of body cavities” (Henderson, 1991, p. 9). It
was also at Walter Reed Army Hospital that she
met Annie W. Goodrich, the dean of the School
of Nursing. Henderson admired Goodrich’s intel-
lectual abilities and stated: “Whenever she visited
our unit, she lifted our sights above techniques
and routine” (Henderson, 1991, p. 11). Henderson
credited Goodrich with inspiring her with the
“ethical significance of nursing” (Henderson, 1991,
p. 10).
As a member of society during a war, Henderson
considered it a privilege to care for sick and
wounded soldiers (Henderson, 1960). This experi-
ence forever influenced her ethical understanding
of nursing and her appreciation of the importance
and complexity of the nurse-patient relationship.
She continued to explore the nature of nursing
as her student experiences exposed her to different
ways of being in relationship with patients and
their families. For instance, a pediatric experience
as a student at Boston Floating Hospital introduced
Henderson to patient-centered care in which
nurses were assigned to patients instead of tasks,
and warm nurse-patient relationships were encour-
aged (Henderson, 1991). Following a summer
spent with the Henry Street Visiting Nurse Agency
in New York City, Henderson began to appreciate
the importance of getting to know the patients and
their environments. She enjoyed the less formal vis-
iting nurse approach to patient care and became
skeptical of the ability of hospital regimes to alter
patients’ unhealthy ways of living upon returning
home (Henderson, 1991). She entered Teachers
College at Columbia University, earning her bac-
calaureate degree in 1932 and her master’s degree
in 1934. She continued at Teachers College as an in-
structor and associate professor of nursing for the
next 20 years.
Virginia Avenel Henderson presented her defini-
tion of the nature of nursing in a era when few
nurses had ventured into describing the complex
phenomena of modern nursing. Henderson wrote
about nursing the way she lived it: focusing on what
nurses do, how nurses function, and on nursing’s
unique role in health care. Her works are beauti-
fully written in jargon-free, everyday language. Her
search for a definition of nursing ultimately influ-
enced the practice and education of nursing
around the world. Her pioneer work in the area of
identifying and structuring nursing knowledge has
provided the foundation for nursing scholarship
for generations to come.Introducing the Theories
Virginia Henderson, sometimes known as the
modern day Florence Nightingale, developed the
definition of nursing that is most well known inter-
nationally. Ernestine Wiedenbach gave us new ways
to think about nursing practice and nursing schol-
arship, introducing us to the ideas of: (1) nursing as
a professional practice discipline, and (2) nursing
practice theory. Ida Jean Orlando was perhaps the
first nurse to use qualitative research methods and
was the first to articulate nursing concepts based on
both her practice and her research. Each of these
nurses helped us focus on the patient, instead of on
the tasks to be done, and to plan care to meet needs
of the person. Each of these women emphasized
caring based on the perspective of the individual
being cared for—through observing, communicat-
ing, designing, and reporting. Each was concerned
with the unique aspects of nursing practice and
scholoarship and with the essential question of,
“What is nursing?”WIEDENBACH
Initial work on Wiedenbach’s prescriptive theory is
presented in her article in the American Journal
of Nursing (1963) and her book, Meeting the
Realities in Clinical Teaching(1969). Her explana-
tion of prescriptive theory is that: “Account must be“Account must be taken of the motivating
factors that influence the nurse not only in
doing what she does but also in doing it
the way she does it with the realities that
exist in the situation in which she is func-
tioning.”taken of the motivating factors that influence the
nurse not only in doing what she does but also in
doing it the way she does it with the realities that
exist in the situation in which she is functioning.”
(Wiedenbach, 1970, p. 2.) Three ingredients essen-
tial to the prescriptive theory are:72 SECTION II Evolution of Nursing Theory: Essential Influences