Profiles In Nursing

Virginia A. Henderson (1897–1996), Wrote the Book on Modern Nursing

The 20th century’s answer to Florence Nightingale

Virginia Henderson in black and white is smiling away from the camera

Nursing care is more than performing a series of tasks — it is a holistic focus on restoring a patient’s health and independence. This once-revolutionary concept is just one of the core elements of nursing practice articulated by Virginia Henderson, a prolific author and editor whose many works helped to literally define the modern nursing profession.

The Textbook Project

Born in 1897 to a large family in Missouri, Henderson received her nursing diploma in 1921 from the Army School of Nursing. She practiced nursing in various New York hospitals until 1924, when she became the first and only teacher of Virginia’s Norfolk Presbyterian Hospital School of Nursing.

She then decided to further her own education, earning her master’s in nursing education from Teachers College, Columbia University in 1934.

While on the nursing faculty there, Henderson began her first really important project: an updated fourth edition of Principles and Practice of Nursing, Bertha Harmer’s popular nursing textbook.

Henderson built on Harmer’s framework of nursing, which stressed health promotion and teaching, while adding an important new concept of her own: that the goal of nursing was to enable the individual “to attain or maintain a healthy state of mind and body; or, where a return to health is not possible, the relief of pain and discomfort.”

Henderson’s update, published in 1939, also brought the textbook in line with the new National League of Nursing Education curriculum guidelines for nursing school accreditation (still a voluntary process in those days). As a result, her ideas achieved widespread prominence, which only grew with Henderson’s revised fifth edition, published in 1955.

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A New Understanding of Nursing

This newest edition further expanded the scope of nursing. Many earlier nursing texts defined nursing as a series of tasks to perform.

Henderson’s holistic definition emphasized the nurse’s role in helping the patient to perform basic human activities and “gain independence as rapidly as possible” — anticipating our modern conception of individualized, patient-centered care.

Her ability to express complex philosophical ideas about the profession in clear, succinct terms won Henderson considerable popularity. When she completely revamped Principles and Practice of Nursing in the late ‘70s, she added the latest evidence while stripping the text of jargon so that it would be accessible to nurses and lay readers alike.

A World Before Google

Henderson’s textbooks strongly emphasized the importance of research and clinical evidence, often including lists of recommended readings.

In 1953, while still working on the fifth edition of Principles and Practice of Nursing, she left Teachers College to become a research associate at Yale School of Nursing, where she began an ambitious survey of nursing research.

Henderson later obtained funding for a truly mammoth undertaking: creating an annotated index to over 60 years of nursing literature, a huge project that took her 13 years to complete.

In 1972, at the age of 75, Henderson released the fourth and final volume of her annotated Nursing Studies Index. In an era before search engines, those four hefty volumes were the definitive resource on nursing publications in English.

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Setting a Global Standard

Henderson authored many of editorials for nursing journals, arguing for a greater emphasis on actual clinical nursing care. She also wrote an important pamphlet for the International Council of Nurses (ICN) entitled “Basic Principles of Nursing Care.”

First published in 1960 and widely circulated in many languages, the document broke nursing down into fundamental elements that would apply even in the most primitive settings. Henderson later expanded her original essay into a book, published in 1969.

Henderson’s robust career continued into her 70s and 80s, when she began speaking and teaching internationally while continuing her ongoing scholarly work.

“The Foremost Nurse”

Towards the end of her life, Henderson received numerous awards, fellowships and honorary degrees for her contributions to nursing. One honor of which she was especially proud was lending her name to the Sigma Theta Tau International Library and e-Repository.

In a 1996 reflection in Journal of Advanced Nursing, Edward J. Halloran, RN, Ph.D., FAAN, called Henderson’s written works “the 20th century equivalent of those of the founder of modern nursing, Florence Nightingale” in their scope, sensitivity and impact.

After Henderson died later that year, she was posthumously inducted into the ANA Hall of Fame, which described her as the “foremost nurse of the 20th century.”

Modern Ideas for Modern Practice

While Henderson’s works were published many years ago, her theories and precepts still hold true in modern healthcare. Her advocacy for universal healthcare, patients’ involvement in their own care, and the importance of putting patients before profits still live on in the heart of nursing.

Throughout her long career, Henderson worked hard to affirm that nurses are more than clinical functionaries — they are also researchers, innovators and scientists dedicated to advancing health in all its forms.

JESSICA DZUBAK, RN, MSN, is the director of nursing practice for the Ohio Nurses Association and a freelance writer specializing in the healthcare industry.

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