Theory Usage and Application

Ernestine Wiedenbach (1900-1998)

"The Helping Art of Clinical Nursing"

"My thesis is that nursing art is not comprised of rational nor reactionary actions but rather of

deliberative action." Wiedenbach, 1964

Introduction

Ernestine Wiedenbach (1900-1998) was an early nursing leader who is probably best known for

her work in theory development and maternal infant nursing. She believes that there are four

elements to her concept “The Helping Art of Clinical Nursing” which are: a philosophy, a

purpose, a practice and the art.

If a nurse’s attitude and belief is what motivates him/her to act in certain ways, he/she is guided

on nursing philosophy. Three components that may affect the nurse’s philosophy are reverence

for life, respect for the dignity and individuality of each human being, and resolving to act on

personal and professional beliefs. When a nurse wants to accomplish through what he/she does

which is primarily identifying a patient’s need for help, it is based on nursing purpose.

Observable actions which are affected by the nurse’s beliefs and feelings in meeting the patient’s

need show the nursing practice.

The art of nursing is when the nurses understood patient’s needs and concerns.

About the Theorist

Ernestine Wiedenbach – professional educator, writer, practices as nurse-midwife

• 1900 – born

• 1922 – B.A. from Wellesley College

• 1925 – Graduated at John Hopkins School of Nursing and was offered a Supervisory position

thereafter.

• 1934 – earned her Master’s Degree and a Certificate in Public Health from Teachers College,

Columbia University

• 1946 – Earned a degree in Midwifery and a Certificate in Nurse-Midwifery from the Maternity

Center Association for Nurse-Midwives in New York.

• 1952 – appointed as instructor in maternity nursing to the faculty of Yale University School of

Nursing

• 1954– became Assistant Professor of Obstetric Nursing

• 1956 – became Associate Professor of Obstetric Nursing

• 1958 – Wrote a nursing classic, “Family-Centered Maternity Nursing” a comprehensive text on

obstetrical nursing.

• 1964 – Published her second book “Clinical nursing: A helping art. New York: Springer.”

• 1992 – Became an inspiration to the article written by Nickel, Gesse and MacLaren entitled

"Ernestine Wiedenbach: Her Professional Legacy".

• 1966 – Retired from service. She never married and died at the age of 97 on March 8, 1998.

Development of Theory

Wiedenbach’s theory is based on identifying a patient’s need-of-help through nursing interaction

and nursing action. The process by which a patient’s need is identified involves a philosophical

and /or holistic approach as well as nursing knowledge and experience.

Basic Concepts

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Theory Usage and Application

Ernestine Wiedenbach (1900-1998) "The Helping Art of Clinical Nursing" "My thesis is that nursing art is not comprised of rational nor reactionary actions but rather of deliberative action." Wiedenbach, 1964 Introduction Ernestine Wiedenbach (1900-1998) was an early nursing leader who is probably best known for her work in theory development and maternal infant nursing. She believes that there are four elements to her concept “The Helping Art of Clinical Nursing” which are: a philosophy, a purpose, a practice and the art. If a nurse’s attitude and belief is what motivates him/her to act in certain ways, he/she is guided on nursing philosophy. Three components that may affect the nurse’s philosophy are reverence for life, respect for the dignity and individuality of each human being, and resolving to act on personal and professional beliefs. When a nurse wants to accomplish through what he/she does which is primarily identifying a patient’s need for help, it is based on nursing purpose. Observable actions which are affected by the nurse’s beliefs and feelings in meeting the patient’s need show the nursing practice. The art of nursing is when the nurses understood patient’s needs and concerns. About the Theorist Ernestine Wiedenbach – professional educator, writer, practices as nurse-midwife

1900 – born
1922 – B.A. from Wellesley College
1925 – Graduated at John Hopkins School of Nursing and was offered a Supervisory position thereafter.
1934 – earned her Master’s Degree and a Certificate in Public Health from Teachers College, Columbia University
1946 – Earned a degree in Midwifery and a Certificate in Nurse-Midwifery from the Maternity Center Association for Nurse-Midwives in New York.
1952 – appointed as instructor in maternity nursing to the faculty of Yale University School of Nursing
1954– became Assistant Professor of Obstetric Nursing
1956 – became Associate Professor of Obstetric Nursing
1958 – Wrote a nursing classic, “Family-Centered Maternity Nursing” a comprehensive text on obstetrical nursing.
1964 – Published her second book “Clinical nursing: A helping art. New York: Springer.”
1992 – Became an inspiration to the article written by Nickel, Gesse and MacLaren entitled "Ernestine Wiedenbach: Her Professional Legacy".
1966 – Retired from service. She never married and died at the age of 97 on March 8, 1998. Development of Theory Wiedenbach’s theory is based on identifying a patient’s need-of-help through nursing interaction and nursing action. The process by which a patient’s need is identified involves a philosophical and /or holistic approach as well as nursing knowledge and experience. Basic Concepts

Wiedenbach conceptualizes nursing as the practice of identification of a patient's need for help through observation of presenting behaviors and symptoms, exploration of the meaning of those symptoms with the patient, determining the cause(s) of discomfort, and determining the patient's ability to resolve the discomfort or if the patient has a need for help from the nurse or other healthcare professionals. Nursing primarily consists of identifying a patient's need for help. If the need for help requires intervention, the nurse facilitates the medical plan of care and also creates and implements a nursing plan of care based on needs and desires of the patient. In providing care, a nurse exercises sound judgment through deliberative, practiced, and educated recognition of symptoms. The patient's perception of the situation is an important consideration to the nurse when providing competent care. Nursing Metaparadigm The patient

“Any individual who is receiving help of some kind, be it care, instruction or advice from a member of the health profession or from a worker in the field of health.
The patient need not be ill since someone receiving health-related education would qualify as a patient. A need-for-help
“Any measure desired by the patient that has the potential to restore or extend the ability to cope with various life situations that affect health and wellness. It is crucial to nursing profession that a need-for-help be based on the individual perception of his situation. Nurse
The nurse is a functional human being who acts, thinks, and feels. All actions, thoughts, and feelings underlie what the nurse does. Knowledge
Knowledge encompasses all that has been perceived and grasped by the human mind.
Knowledge may be: (1) factual (2) speculative or (3) practical Judgment
Clinical judgment represents the nurse’s likeness to make sound decisions.
These decisions are based on differentiating fact from assumption and relating them to cause and effect.
Sound judgment is the result of disciplined functioning of mind and emotions, and improves with expanded knowledge and increased clarity of professional purpose. Environment
- Not specifically addressed Health

 Nursing primarily consists of identifying a patient’s need for help. PRESCRIPTIVE THEORY 3 FACTORS:  The nurse’s central purpose in nursing is the nurse’s professional commitment – the nurses goals are grounded in the nurse’s philosophy:

reverence for the gift of life
respect for the dignity, autonomy, worth and individuality of each human being and
resolution to act dynamically in relation to one’s belief  The prescription indicates the broad general action that the nurse deems appropriate to fulfillment of her central purpose – The nurse will have thought through the kind of results to be sought and will take action to obtain these results, accepting accountability for what she does and for the outcomes of her action.  The realities are the aspects of the immediate nursing situation that influence the results the nurse achieves through what she does.- within the situation are these components:
The agent – who is the nurse supplying the nursing action
The recipient – the patient receiving the action
The framework – situational factors that affect the nurse’s ability to achieve nursing results
The Goal – the end to be attained through nursing activity
The Means – the actions and devices through which the nurse is enabled to reach the goal. Application in Nursing: Practice  Her years of experience as a nurse midwife contributed to the area of labor and delivery process based on the article she published "Childbirth as Mothers Say They Like It"

 She believed strongly in patient care  Provides a foundation for assessing, or explaining,patient conditions  Influenced many core concepts in nursing today,including nursing assessment,nursing process and nursing diagnosis such as self-care deficits  Considered nursing a "practical phenomenon " that involved action Education  Nursing education serves the practice of nursing in four major ways, as proposed by Weidenbach (Marriner-Tomey, 1995)

It is responsible for the preparation of future practitioners of nursing.
It arranges for nursing students to gain experience in clinical areas of the hospital or in the home of patients
Its representatives may function in the clinical area and work closely with the staff.
It offers educational opportunities to the nurse for special or advanced study.  Weidenbach's model when applied to the clinical settings requires the nurse to have a broad knowledge both the normal and the pathological side, an extensive understanding to human psychology, clinical skills competence, and the nurses' ability to effectively initiate and maintain good communicate to both patient and family. (Marriner-Tomey,

Evaluation The theories made by Weidenbach and the other theorist made way for a more clearer path on how nurses can render a holistic approach when it comes to nursing care. Weidenbach emphasized that Help is an integral part of nursing. And with her theory, this undeniably brought changes as to how nurses thought about their practice and made way for revised research questions investigated in the discipline of nursing. If we would sum it all up, the ideas incorporated in the theory are part and parcel of our discipline.

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Theory Usage and Application