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Ernestine Wiedenbach

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JoeAnne RN

on 29 July 2014

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Transcript of Ernestine Wiedenbach

Wiedenbach believed that every individual experiences needs and that this is a normal part of living. It is any measure or action desired by the individual which has the potential to restore his capability to function normally or optimally.
Ernestine Wiedenbach
Credentials & Background
Major Assumptions
  The theory also assumes that nurses are needed because they “come into being [...because... ] there is a patient that needs her help.” Basic to the commonly shared philosophy among nurses are:
Reverence for the gift of life
Respect for the dignity, worth, autonomy, and individuality of each human being
Resolution to act dynamically in relation to one’s beliefs.
The Helping Art of Clinical Nursing
A report by Emma Maniulit
Early Life
Born on August 18, 1900
Youngest Among 4 daughters in the Family
When she was young, her family migrated from Germany to the United States
Admired the nurses caring for her sick grandmother
Enjoyed hearing stories from a young medical intern her sister was dating
Educational Background
Bachelor of Liberal Arts in 1922
Wellesley College in Massachusetts
First enrolled in Post Graduate Hospital School of Nursing (NY)
Kicked out because of role as a spokesperson for student grievances
Helped by Mary Adelaide Nutting
World's First Nursing Professor
John Hopkins School of Nursing
Graduated in 1925
MA & Certificate in Public Health 1934
Teachers college, Columbia University
Mary Adelaide Nutting
At the Age of 46, graduated with a certificate for Nurse-Midwifery
(Maternity Center Association of New York)
Wellesley College
In 1952, Wiedenbach joined the prestigious Yale University Faculty, where she became the director of the graduate programs on Maternal-Newborn Health Nursing which started in 1956
Wiedenbach taught with Ida Jean Orlando, Patricia James, and William Dickoff
These three individuals had a large influence in the creation and shaping of Wiedenbach’s Helping Art of Clinical Nursing theory as they often shared and had the opportunity to provide feedback on models, theories, concepts and ideas
greatest of these influence is said to be Ida Jean Orlando on her framework,
Graduation from John Hopkins University in 1925
Clinical Nursing:
A Helping Art
Meeting the Realities
in Clinical Teaching
Family Centered
Maternity Nursing
Key to Effective Nursing
Published Work
of Ernestine Wiedenbach
career in review
various nursing positions & public health
agencies in New York
Maternity Center Association of New York -- Professor
Maternity Center Association of New York -- Professor
Retired from Teaching
Ernestine Wiedenbach
passed away on March 8, 1998, her theory is
still exemplified
used today
in various researches and
studies by the nursing profession
Linking Background to Theory
created this theory
during a time that nursing theories were still uncommon
and the
medical model
was mainly used in nursing practice
wanted to address this by creating a theory that fully explains and describes the nurse’s role
a nurse, to effectively carry out her roles, must have or attain the following characteristics:
An Understanding of Human Psychology
Competence in Clinical Skills
The Ability to Initiate and Maintain Therapeutic Communication
The ability to correctly interpret a person’s behavior.
Major Concepts &

  “My thesis is that nursing art is not comprised of
actions  but rather
deliberative actions.

- Wiedenbach, 1964
"Nursing is a Helping Art. It is a goal directed, deliberate blending of thoughts, feelings, perceptions, and actions to understand the patient and his condition, situation, and needs, to enhance his capability to improve his care, prevent the recurrence of the problem, and to deal with anxiety, disability, or distress”
Wiedenbach, 1964 as cited in Rosario, 2011
The Key Terms Found in the Theory, lifted from Tomey & Alligood in 2000, include:
Any Individual who is receiving help of some kind, be it care instruction or advice, from a member of the health professions or from a worker in the field of health.
A Need is described as anything the individual may require to maintain or sustain himself comfortable or capably in his situation.
Meeting the need for help
Any measure or action that enables an individual to overcome whatever interferes with his ability to function capably in his situation.
A functioning human being, who not only acts but thinks as well (Del Rosario, 2011).
That which the nurse wants to accomplish through what she does---the overall goal to which she is striving.
An attitude towards life and reality that evolves from each nurse’s beliefs and code of conduct, motivates the nurse to act, guides her thinking about what she is to do and influences her decisions.
Overt [outwardly/openly/not hidden] action, directed by disciplined thoughts and feelings towards meeting the patient’s need-for-help and constitutes the practice of clinical nursing
Encompasses all that has been perceived and grasped by the human mind. The scope and range of this is infinite. It has potentiality for use in directing, teaching, coordinating, and planning care of the patient.
Represents the nurse’s potentiality to make sound decisions, stemming from the cognitive process.
Comprises of numerous and various acts and is characterized by the harmony of movement, expression and intent, by precision and adroit [clever or skillful] use of self
Identification involves three processes:
The act of providing the need for help.
the thoughts and feelings of the nurse are important because they are intimately involved with her actions and her means of carrying out these actions.
Actions are directed towards the achievement of a specific purpose
Factual Knowledge
Speculative Knowledge
Practical Knowledge
Knowledge which is accepted as being true or existing.
Knowledge which encompasses theories, general principles offered to explain a phenomena, beliefs or concepts, and the context of such special subject areas as the nature of natural sciences.
the knowledge of the application of factual or speculative knowledge to the situation at hand.
Procedural Skills
Communication Skills
Capacity for implementing skills that the nurse may need to initiate and carry out for the patient to meet the need-for-help.
Capacity for the expression of thoughts and feelings that the nurse desires to convey to her patient and to others associated with his care. Both verbal and non-verbal expressions may be used.
Whether the need is a need-for-help, a need that the patient is unable to fulfill his or her self.
Whether he recognizes that he has a need (patient related process).
Whether the patient has a need (nurse-related process).
involves the individualization of the patient, his experiences, and recognition of the patient’s perception of his condition.
Evidence that the patient’s functional ability was restored as a result of the help given.
Striving for continuity and unity in the services rendered to the patient to ensure that the care is not fragmented.
Act of presenting information.
Act of exchanging and comparing ideas, to ascertain the care already received and to plan for future care.
The helping process is triggered by a stimulus/stimuli which is the patient’s presenting behavior.
the comparison of perception with expectation.
Rational Action
The act of providing the need for help.
Reactionary Action
Evidence that the patient’s functional ability was restored as a result of the help given.
Deliberative Action
Striving for continuity and unity in the services rendered to the patient to ensure that the care is not fragmented.
The act of exchanging knowledge and skill to bring about desired results---It is an individualized action. This is carried out by the one-on-one relationship with the patient. The art of clinical nursing is directed towards the achievement of four goals and these include:
Understanding the patient and his condition, situation, and need.
Enhancement of the patient’s capability
Improvement of condition or situation within the framework of the medical plan for his care.
Prevention of problem recurrence or the development of new problems.
Framework of Nursing
Represents the limits or boundaries of nursing as a profession. The scope of what nurses can or cannot do in respect to laws, licensing requirements, the hospital or agency policies, and the like.
It is also related to the mechanisms of the continuous improvement of practice which include (Del Rosario, 2011):
Key to progress in practice
Systematic Study
Indirect Influence
Nursing Education
Nursing Administration
Nursing Organization
Direct Service
the patient should want to be healthy, comfortable, and capable and when unimpeded, he strives by his own efforts to achieve such states
The concept of environment is also one that is not directly defined in Wiedenbach’s theory though the theorist provides several implications on the term. In one such statement, the theorist said that the environment should “Facilitate the efforts of the individual to overcome the obstacles which currently interfere with his or her ability to respond capably to the demands made of him.(Wiedenbach, 1964 as cited in Tomey & Alligood, 2002)” From this statement it is implied that the environment may contain obstacles for meeting and addressing the patient’s needs.
  The concept of health is not discussed directly in the theory of Wiedenbach, though the definitions of nursing, patient, and the need for help provides implications and relationships to the concept of health, and implies that the health related assumptions are related to the nurse-patient situation.
Clarity of Purpose - Knowing exactly what you are here for/what you are here to do
Mastery of skills and knowledge essential for completing that purpose
The ability to establish and maintain purposeful relationships among other individuals, regardless of background, professional or non professional.
Interest in advancing knowledge ain the area of interest and in creating new knowledge.
Dedication to furthering the goal of human kind rather than supporting self-aggrandizement (self-progression; a means of ‘transcendentalism”).
Five Essential Attributes of a Professional
   Additionally, Wiedenbach proposes that each person has the four assumptions related to their innate human nature (Tomey & Alligood, 2002). These include:
Each human being is endowed with the unique potential to develop.
The human being is strives towards self-direction and relative independence and desires to not only to make best use of his capacities but also to fulfill his responsibilities.
Self-awareness and self-acceptance are essential to the individual’s sense of integrity and self-worth
Whatever the individual does represents his judgment at the moment of his doing.
The Patient
Clinical Nursing:
The relationship between it's focus & its constituents
Theoretical Assertions
Identifying the Need for Help
Ministering Help Needed
Validating Measures
nurse takes all necessary steps and measures to identify the presence of expressed need or implied need
observational cues, exploring the meaning behind what is said, determining the cause of the discomfort, and determining the ability to meet these needs
act of actually rendering nursing care
identified need, causes, means of meeting the need, and possible hindrances
carefully planned
"consented to plan"
assessment of ability
to personally meed needs
checks to see first if the need for help has been met
If the needs have not been met at this time or if new needs arise, the nurse once again goes through the process of identifying these needs and ministration of help to ensure that all needs are holistically met
Alligood, M. & Tomey, A. (2010). Nursing theorists and their work. 7th Edition. Elsevier (Singapore) LTD. Pp. 57-60.

Alligood, M. & Tomey, A. (2002). Nursing theorists and their work. 5th Edition. Elsevier (Singapore) LTD. Pp. 84-97

Current Nursing. (2012). The Helping Art of Clinical Nursing: Ernestine Wiedenbach. Accessed at: http://currentnursing.com/nursing_theory/Ernestine_Wiedenbach.html on August 23, 2013.

Del Rosario, L. (2011). “Ernestine Wiedenbach: The Helping Art of Clinical Nursing” [Unpublished Report]. Holy Angel University, Graduate School of Nursing.

Eichelberger, L. (2000). Nursing Theory, School of Nursing: Ernestine Wiedenbach. Accessed at: http://www.clayton.edu/health/nursing/nursingtheory/wiedenbach on August 23, 2013.

George, J. (2011). Nursing theories: The base for professional nursing practice. Prentice Hall. Pp. 193-195.
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