Autobiography

Virginia Avenel Henderson was described in so many names. Some called her “The Nightingale of Modern Nursing”. Others named her as “Modern-Day Mother of Nursing” and “The 20th Century Florence Nightingale”. She was born on November 30, 1897 in Kansas, Missouri and was the fifth of eight children of Daniel Brosius Henderson and Lucy Minor Abbot..

 The Henderson family moved to Virginia in 1901, where Miss Henderson grew into adulthood. In 1918, she entered the Army School of Nursing in Washington, DC, and in 1921, she received her nursing diploma. She worked at the Henry Street Visiting Nurse Service for 2 years after graduation. Henderson, very much wanted to teach nursing, therefore accepted her first instructor position in 1924 at the Norfolk Protestant Hospital in Virginia.

In 1934 and for the next fourteen years, she remained at tTeachers College, Columbia University where she joined the teacher's faculty and earned her Bachelor of Science and Master of Arts degree in nursing education.

  In 1953, Henderson accepted a research associate position in Yale University School of Nursing. The project was designed to survey and assess the status of nursing research in the United States. From 1959 to 1971, Henderson was funded to direct the Nursing Studies Index Project. The result of the project was the publication of the four-volume Nursing Studies Index, the first annotated index of nursing research. Henderson had now deserved the title of research associate emeritus at Yale University. At 75 years of age, Henderson focused her career on international teaching and speaking engagements.

Achievements

She is a recipient of numerous recognitions for her outstanding contributions to nursing.

• well known nursing educator and a prolific author.
• received honorary doctoral degrees from the Catholic University of America, Pace University, University of Rochester, University of Western Ontario,Yale University
• warranted an obituary in the New York Times, Friday March 22. 1996.
• honored at the Annual Meeting of the Nursing and Allied Health Section of the Medical Library Association In 1985.

Contributions   

In 1937 Henderson and others created a basic nursing curriculum for the National League for Nursing in which education was “patient centered and organized around nursing problems rather than medical diagnoses” (Henderson,1991)

In 1939, she revised: Harmer’s classic textbook of nursing for its 4th edition, and later wrote the 5th; edition, incorporating her personal definition of nursing (Henderson,1991)

Although she was retired, she was a frequent visitor to nursing schools well into her 90’s. O’Malley (1996) states that Henderson is known as the modern-day mother of nursing.

Her work influenced the nursing profession in America and throughout the world. The founding members of ICIRN (Interagency Council on Information Resources for Nursing) and a passionate advocate for the use and sharing of health information resources.

In 1978 the fundamental concept of nursing was revisited by Virginia Henderson from Yale University School of Nursing (USA).
  
Publications

1956 (with B. Harmer)-Textbook for the principles and practices of Nursing.
1966-The Nature of Nursing. A definition and its implication for practice, Research and Education
1991- The Nature of Nursing Reflections after 20 years
Analysis of Nursing Theory Images of Nursing, 1950-1970

The Development of Henderson’s Definition of nursing

Two events are the basis for Henderson’s development of a definition of nursing.

First, she participated in the revision of a nursing textbook. Second, she was concerned that many states had no provision for nursing licensure to ensure safe and competent care for the consumer.

In the revision she recognized the need to be clear about the functions of the nurse and she believed that this textbook serves as a main learning source for nursing practice should present a sound and definitive description of nursing. Furthermore, the principles and practice or nursing must be built upon and derived from the definition of the profession. Although official statements on the nursing function were published by the ANA in 1932 and 1937, Henderson viewed these statements as nonspecific and unsatisfactory definitions of nursing practice. Then in 1955, the earlier ANA definition was modified. Henderson's focus on individual care is evident in that she stressed assisting individuals with essential activities to maintain health, to recover, or to achieve peaceful death. She proposed 14 components of basic nursing care to augment her definition. In 1955, Henderson’s first definition of nursing was published in Bertha Harmer’s revised nursing textbook.


To her the unique fucntion of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery(or to peaceful death), that he would perform unaided if he had the necessary strength, will or knowledge.

References:

http://currentnursing.com/nursing_theory/henderson
http://nurses.info/nursing_theory_person_henderson_virginia
http://www.mayo.edu/education/nursing_research/henderson
http://www.nursinglibrary.org
http://novelguide.com

Images:

http://nursingstudyguides.net/wp-content/uploads/2010/01/virginia-henderson.jpg

http://www.askthebrain.com/pics/755/Virginia_Henderson.gif

http://67.199.116.138/DNN/Portals/0/20091001/Obit%20Gorodnitzki.jpg

Major Concepts

 THE FOURTEEN BASIC HUMAN NEEDS 

1.INDIVIDUAL

• Have basic needs that are component of health.
• Requiring assistance to achieve health and independence or a peaceful death.
• Mind and body are inseparable and interrelated.
• Considers the biological, psychological, sociological, and spiritual components.
• The theory presents the patient as a sum of parts with biopsychosocial needs, and the patient is neither client nor consumer.                                               

2.ENVIRONMENT

 

• Settings in which an individual learns unique pattern for living.
• All external conditions and influences that affect life and development.
• Individuals in relation to families
• Minimally discusses the impact of the community on the individual and family.
• Supports tasks of private and public agencies Society wants and expects nurses to act for individuals who are unable to function independently. In return she expects society to contribute to nursing education.
• Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided

3. HEALTH

• Definition based on individual’s ability to function independently as outlined in the 14 components.
• Nurses need to stress promotion of health and prevention and cure of disease.
• Good health is a challenge. Affected by age, cultural background, physical, and intellectual capacities, and emotional balance Is the individual’s ability to meet these needs independently?

4. NURSING

• Temporarily assisting an individual who lacks the necessary strength, will and knowledge to satisfy 1 or more of 14 basic needs.
• Assists and supports the individual in life activities and the attainment of independence.
• Nurse serves to make patient “complete” “whole", or "independent."
• Henderson's classic definition of nursing:
• "I say that the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible."
• The nurse is expected to carry out physician’s therapeutic plan Individualized care is the result of the nurse’s creativity in planning for care.
• Use nursing research
• Categorized Nursing : nursing care
• Non nursing: ordering supplies, cleanliness and serving food.
• In the Nature of Nursing “ that the nurse is and should be legally, an independent practitioner and able to make independent judgments as long as s/he is not diagnosing, prescribing treatment for disease, or making a prognosis, for these are the physicians function.”
  
  
  

   “Nurse should have knowledge to practice individualized and human care and should be a scientific problem solver.”

• In the Nature of Nursing Nurse role is,” to get inside the patient’s skin and supplement his strength will or knowledge according to his needs.”
• And nurse has responsibility to assess the needs of the individual patient, help individual meet their health need, and or provide an environment in which the individual can perform activity unaided
• Henderson's classic definition of nursing
  
  

  "I say that the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge.But I go on to say that the nurse makes the patient independent of him or her as soon as possible."

  References: 
  http://currentnursing.com/nursing_theory/henderson
  http://nurses.info/nursing_theory_person_henderson_virginia
  http://www.mayo.edu/education/nursing_research/henderson
  http://www.nursinglibrary.org
  http://novelguide.com
  Images: 
  Microsoft Word Cliparts Online
  http://www.indezine.com/products/powerpoint/cool/images/peopleanimation_02.jpg
  http://www.eddingsassociates.com.au/images/Environment.gif
  http://imagineannie.files.wordpress.com/2009/11/yin-yang1.jpg
  http://cmsd.k12.pa.us/cmsd/cm_health/img/NURSE.png
  

Her Theory and the Nursing Process

Characteristic of Henderson’s theory

• Theories can interrelate concepts in such a way as to create a different way of looking at a particular phenomenon.
• Concepts of fundamental human needs, biophysiology, culture, and interaction, communication and is borrowed from other discipline.E.g.. Maslow’s Hierarchy of human needs; concept of interaction-communication i.e. nurse-patient relationship
• Theories must be logical in nature.
• Her definition and components are logical and the 14 components are a guide for the individual and nurse in reaching the chosen goal.
• Theories should be relatively simple yet generalizable.
• Her work can be applied to the health of individuals of all ages.
• Theories can be the bases for hypotheses that can be tested. Her definition of nursing cannot be viewed as theory; therefore, it is impossible to generate testable hypotheses.
• However some questions to investigate the definition of nursing and the 14 components may be useful.
• Is the sequence of the 14 components followed by nurses in the USA and the other countries?
• What priorities are evident in the use of the basic nursing functions?
• Theories contribute to and assist in increasing the general body of knowledge within the discipline through the research implemented to validate them.
• Her ideas of nursing practice are well accepted throughout the world as a basis for nursing care.
• However, the impact of the definition and components has not been established through research.
• Theories can be utilized by practitioners to guide and improve their practice.
• Ideally the nurse would improve nursing practice by using her definition and 14 components to improve the health of individuals and thus reduce illness.
• Theories must be consistent with other validated theories, laws, and principles but will leave open unanswered questions that need to be investigated.

Philosophical claims

• The philosophy reflected in Henderson's theory is an integrated approach to scientific study that would capitalize on nursing's richness and complexity, and not to separate the art from the science, the "doing" of nursing from the "knowing", the psychological from the physical and the theory from clinical care.

Values and Beliefs

• Henderson believed nursing as primarily complementing the patient by supplying what he needs in knowledge, will or strength to perform his daily activities and to carry out the treatment prescribed for him by the physician.
• She strongly believed in "getting inside the skin" of her patients in order to know what he or she needs. The nurse should be the substitute for the patient, helper to the patient and partner with the patient.

• Like she said...

"The nurse is temporarily the consciousness of the unconscious, the love of life for the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the infant and the knowledge and confidence for the young mother..."

• Henderson stated that “Thorndike’s fundamental needs of man”   (Henderson, 1991, p.16) had an influence on her beliefs.

Henderson’s  theory and Nursing Process

Henderson views the nursing process as “really the application of the logical approach to the solution of a problem. The steps are those of the scientific method.” “Nursing process stresses the science of nursing rather than the mixture of science and art on which it seems effective health care service of any kind is based.

NURSING PROCESS	HENDERSON’S 14 COMPONENTS AND DEFINITON OF NURSING
Nursing Assessment	Henderson’s 14 components
Nursing Diagnosis	Analysis: Compare data to knowledge base of health and disease.
Nursing plan	Identify individual’s ability to meet own needs with or without assistance, taking into consideration strength, will or knowledge.
Nursing implementation	Document how the nurse can assist the individual, sick or well.
Nursing implementation	Assist the sick or well individual in to performance of activities in meeting human needs to maintain health, recover from illness, or to aid in peaceful death.
Nursing process	Implementation based on the physiological principles, age, cultural background, emotional balance, and physical and intellectual capacities. Carry out treatment prescribed by the physician.
Nursing evaluation	Henderson’s 14 components and definition of nursing Use the acceptable definition of ;nursing and appropriate laws related to the practice of nursing. The quality of care is drastically affected by the preparation and native ability of the nursing personnel rather that the amount of hours of care. Successful outcomes of nursing care are based on the speed with which or degree to which the patient performs independently the activities of daily living

References:

http://currentnursing.com/nursing_theory/henderson

http://nurses.info/nursing_theory_person_henderson_virginia

http://www.mayo.edu/education/nursing_research/henderson

http://www.nursinglibrary.org

http://novelguide.com

Image:

http://www.gulfcoast.edu/health_sciences/nursing/images/virginia_henderson.jpg

Critique of Her Theory

This presents an analysis and evaluation of Henderson 's nursing theory using Fawcett`s framework of analysis and evaluation of conceptual models of nursin g (2000). Henderson came up with a definition of nursing because of the observed differences in how nursing is defined, both by society and the nurses themselves. She felt it was necessary for nurses to have at least a guiding principle of what to them is nursing and act accordingly to that principle. Moreover, during that time, nurses functions were not identified programs for skills training and even education varied from school to school, to countries and even in hospitals . There were also legal barriers to how nurses should carry out their duties, which made the profession’s position in healthcare ambiguous an d misunderstood. The conceptual model of nursing developed by Henderson followed the humanistic approach, in which it emphasized the caring of the sick, the incapable and even the dying. It stressed more on what the nurses should do and who should they take care of and thus belongs to the reciprocal interaction world view category. The functions of nurses were to give intimate care to people who cannot function effectively on their own .It also emphasized that nurses be thought the skills and knowledge that would enable them to help their patients. The model also stressed that as soon as the patients are  able nurses should be able to assist them in their recovery and if not to care for them in regaining their dignity and basic functioning.The person as defined in Henderson’s model is all encompassing it applies to the sick, the well and the dying. It may be old, young, newborn, and children, normal, abnormal, male, and female, of different races and cultures and religion. For Henderson, the person is alive, breathing,
needs to be loved and cared for, to be talked to and listened to.The environment of the person is described as limiting and keeps him /her from living.

Usefulness

• Nursing education has been deeply affected by Henderson’s clear vision of the functions of nurses.
• The principles of Henderson’s theory were published in the major nursing textbooks used from the 1930s through the 1960s, and the principles embodied by the 14 activities are still important in evaluating nursing care in thee21st centaury.
• Others concepts that Henderson (1966) proposed have been used in nursing education from the 1930s until the present O'Malley, 1996)

Testability

• Henderson supported nursing research, but believed that it should be clinical research (O’Malley, 1996). Much of the research before her time had been on educational processes and on the profession of nursing itself, rather than on; the practice and outcomes of nursing , and she worked to change that.
• Each of the 14 activities can be the basis for research. Although the statements are not.
• Written in testable terms, they may be reformulated into researchable questions. Further, the theory can guide re search in any aspect of the ind ividual’s care needs.

Limitations

• Lack of conceptual linkage between physiological and other human characteristics.
• No concept of the holistic nature of human being.
• If the assumption is made that the 14 components prioritized, the relationship among the components is unclear.
• Lacks inter-relate of factors and the influence of nursing care.
• Assisting the individual in the dying process she contends that the nurse helps, but there is little explanation of what the nurse does.“Peaceful death” is curious and significant nursing role 
 

 References:
Journal of advanced nursing ( 7,103-109)
Henderson,V-Nursing Process 1987
Henderson,V The nature of Nursing,1991
Hhenderson,V basic principle of nursing 1997.

 

Application

Implications for Practice
 

The nurse who sees herself as reinforcing the patient when he lacks will, knowledge, or strength will make an effort to know him, understand him, “get inside his skin,” as I have said. This process of putting oneself in another’s place is always difficult and only relatively successful. It requires a listening ear and constant observation and interpretation of nonverbal behaviour. It also demands of the nurse self-understanding and the recognition of emotions that block her concentration on the patient’s need and helpful responses to those needs. It calls for a willingness so that a mutual understanding may develop between a nurse and a patient. [p.24]
    The nurse who wants to understand and help each patient will welcome opportunities to see and talk with his friends and family. If the cause of his illness is to be known, if his independence is to be established and a recurrence prevented, the nurse who participates in all these aspects of comprehensive care must work with and through others. Her greatest contribution may be to help a member of the family to understand what the patient needs from him or her. [p26]
    No matter what the setting, the nurse who is reinforcing, or supplementing the patient will help him perform all the 14 fundamental or basic human needs. She will make with the patient, his family and other members of the health team some sort of individualized plan, or daily regimen, that meets the wide range of human needs. [p.26]
    The rehabilitation of all patients in the hands of the nurse begins with her first service to him. With this point of view, and if she has a wide range of competence, the nurse can be the prime rehabilitative agent. Such a nurse judges her success with each patient according to the speed with which or the degree to which he performs independently the activities that make, for him, a normal day. This primary function of the practicing nurse must be performed in such a way that it promotes the physician’s therapeutic plan. The means helping the patient carry out prescribed therapeutic treatments or administering the treatment herself. [pp.26-27]
    Finally, to close the discussion of how my definition affects practice, I point out that the nurse who sees her primary function as a direct service to the patient will find an immediate reward in his progress toward independence through this service. To the extent that her practice offers this reward, she will be satisfied; to the extent that the situation deprives her of it, she will be dissatisfied. And she will use whatever influence she has to foster conditions that make social rewards for practice at least commensurate with those for teaching and administration. [p.31]

 Virginia Henderson

In Practice:

• Assist nurses to  describe, explain, and predict everyday experiences.
• Serve to guide assessment, interventions, and evaluation of nursing care.
• Provide a rationale for collecting reliable and valid data about the health status of clients, which are essential for effectiv e decision making and implementation.
• Help to describe criteria to measure the quality of nursing care.
• Help build a common nursing terminology to use in communicating with other health professionals.
• Ideas are developed and words are defined.
• Enhance autonomy (independence and self-governance) of nursing through defining its own independent functions.

In Education:

• Provide a general focus for curriculum design
• Guide curricular decision making.

In Research:

• Offer a framework for generating knowledge and new ideas.
• Assist in discovering knowledge gaps in the specific field of study.
• Offer a systematic approach to identify questions for study; select variables, interpret findings, and validate nursing interventions.
• Approaches to developing nursing theory
• Borrowing conceptual frameworks from other disciplines.
• Inductively looking at nursing practice to discover theories/concepts to explain phenomena.
• Deductively looking for the compatibility of a general nursing theory with nursing practice.
• Questions from practicing Nurse about usi ng Nursing theory

References:
Henderson, Virginia. The Nature of Nursing. Macmillan USA. 1966.
http://currentnursing.com/nursing_theory/henderson
http://nurses.info/nursing_theory_person_henderson_virginia
http://www.mayo.edu/education/nursing_research/henderson
http://www.nursinglibrary.org
http://novelguide.com
Image:
http://www.library.vcu.edu/tml/speccoll/vnfame/images/henderson.JPG

Reflections :)

WE MAY NOT BE ABLE TO FORMULATE A CONCEPTUAL FRAMEWORK AND MAY NOT BECOME A GREAT NURSING THEORIST. BUT AS A NURSE WHO SELFLESSLY SERVE MANDKIND, WE ARE A NATURAL HERO. TO CARE IS OUR HABIT, OUR COMPASSION IS PRICELESS, THE STRENGTH WE POSSESS IS NEVER ENDING.

SPENDING  OUR LIVES IN  SERVICE TO OTHERS, 

WE CAN SOMEHOW SAY, WE MADE  A BIG DIFFERENCE IN THEIR LIVES IN OUR OWN LITTLE WAY.
ALLOW US TO SHARE SOME EXPERIENCES THAT WOULD SOMEHOW

REFLECT THE MAR K WE HAVE LEFT IN THEM.

Being a nurse, I was able to give them advices with regards to their health in order to prevent, protect and maintain their healthiest status. By these, I was able to promote  health, educate them, be an advocate of health and be someone who guides them to healthy living. And I am glad to be that person who helps them to realize that being healthy and living another day with their loved ones is worth living for.

                                                                                                                               Joanne Rivera, RN

There are things in life that you simply don’t appreciate because it is what you have been doing everyday. With the concepts of Henderson’s Theory, these have been applied for many years and yet we still use it as a core in our profession. When I was still a Medical-Surgical Ward Nurse, I was driven by this theory, and during my rounds, I’ll do a quick mental nursing process just to identify the problems of my patient. I would then base it from the identified 14 human needs, checking if the patient is capable of doing activities of daily living, and evaluating if a patient can do it by his or herself. As a nurse, I am there to make sure that in one way or another, independence is achieved. For stroke patients, it is more on compliance at home and making sure that the environment is free from any form of dangers. We nurses must not ignore that we also have independent nursing roles, and that is being independent from the physicians. For instance, for patients who have distended bladder, we don’t call the attending physician immediately, but instead, we try our best to do nursing management such as hot/cold compress or stimulation of environment. In this way, you helped the patient in achieving its goal without any invasive measures.

Now as I became a head nurse, I made rounds everyday to all patients making sure if they have been satisfied with the kind of services that we gave them. Through this, I was able to encourage all patients and its significant others to communicate by expressing their emotions and opinions. And consequently, reflecting once again that I have applied this theory in my everyday work field.

                                                                                       Ma. Lourdes Laigo, RN

Outcome of Experienced that made a difference in the patient’s life.


A. CARING FOR A PATIENT WITH DIGNITY

This story is about a patient who was admitted in the ward with pnuemothorax, requiring a chest drain. As per Sheik Khalifa Medical City, (hospital I’m inn today) policy this procedure is carried out in Operating room or in Radiology department. The Doctor approached me stated that the patient required a chest drain to relieved his condition, to be performed at bedside which I discussed that intensive procedures to be done in OR / in radiology department, however the Dr.insisted  and did it at bedside, so everything was then prepared.Dr prescribed for paracetamol 500mgs prior to procedure which I disagree considering the procedure at bedside and patient should not suffer, insisted to give morphine 5mgs S/c instead, next there was neither consent nor time out signed and did not don sterile gown and gloves, called Drs attention explained that all health team should follow policy andprocedures, but refused, procedure was hold I immediately call the Consultant, who guided the specialist throughout the procedure. The patient was saved from pain, maintained comfort and potential infection.I made a difference in the patient’s life in that I used my authority, critical thinking and knowledge as a nurse to prevent malpractice by a colleague, by being   a patient’s advocate. Although the doctor was not happy with my intuition, he respected my judgement, that patient was grateful that someone stood up for him and did not endure severe pain, comfort and safety was then maintained.In this case, Virginia Henderson’s theory and Nursing process, was applied through proper assessment, correct judgment through critical thinking, knowledge and skills thus maintained good health, safety and helping client restore health.

                                                                                                                         Divina Digap, RN

       

A good nurse  does not think of the number of patients but the number of things he/she can do to his/her patients. Our service need not always be recognize. We  nurses,are bound to offer ourselves as a means of comfort to others. As I communicate  to my patients, i let them feel at ease that they would be able to express their concerns to me freely. This only means that I was able to gain their trust which is the most important factor for a nursing care to be rendered effectively.  In taking care of my patients,  I put myself in their shoe, so i would feel what they feel. In this way, i keep myself aware with their needs. But No matter how exhausting  the day is, a smile, and a  touch from my patients gives me comfort,  enough to suffice the meaning of my profession.  And a THANK YOU,,which suggest that I have made a difference in them.

                                                                                                    Mienalyn Lim Dammang, RN

A nurse assists the person in meeting his needs in meeting his 14 fundamental needs.

              When I passed and topped the Philippine Nursing Licensure Examination, I had brought great joy and pride to my family. Coming from a middle-class family, we had undergone and overcome a lot of struggles to send me to nursing school, for we are not well-off. It had been difficult. I felt bad for during graduation I was not able to bring home an award. So I promised that during the board examinations  I would do better. I had dreamed and wished pass and top the board examinations, but never knew that it would come true. Hard work, prayers and the support of my family and friends had paid off.  It has brought hope for a better future for me and my family. I am not yet financially stable, I had become independent from my family, which is a great help for my family. I am no longer a burden but an asset. They worry less about my future, for they know that I have a great path ahead of me. I also influence my family to be more health oriented and help them in meeting their health needs.

              For my friends and my school, I try to and had somehow become a source of inspiration for them. Every now and then, I visit my alma mater and meet with students especially those who are about to take the board examinations. I share with them my experiences as a nurse and as a student, giving them confidence and courage in entering the wonderful world of nursing. I try to impart with them that anything is possible, if they just put our hearts and minds into our endeavors, that they can make their dreams into a  reality. I share with them the joys of being able to help patients maintain or restore health or even a peaceful death. Being an ICU nurse, I tried to remind them the great tasks nurses face daily in life and death situations. I also talk with my teachers and mentors, sharing with them what i experience in the clinical setting. I continuously learn from them and I hope they can learn from me too.

                As an ICU nurse, I had been trained to work decisively, effectively and efficiently in life and death situations. I had tried to provide utmost care to the patients and support to their family. Most patients in the ICU are totally dependent to the nurse, being in severely-ill or sometimes, comatose states. At times, their lives and health depend upon the careful monitoring of the nurse and timely treatment of their conditions. I always need to be on guard for the patients are in unstable states and are at risk of developing life-threatening complications.

                   Sometimes, when I am on duty and the ICU is in full-house mode (13-14 patients),  I ask myself why I am a nurse, doing tasks such as morning care, bathing, oral hygiene, changing of diapers, suctioning, feeding, turning, titrating drips and inotropes, administering medications, and dealing with different body fluids such as vomit, stool, sputum, blood; things other profession need not go into. But when I receive  thank you from conversant patient , or a smile from an intubated patient, or a word of gratitude from their  relatives, I feel proud that I am a nurse. The financial reward (Philippine setting) may not be much, but knowing you made a difference in their lives is the greater reward, and makes sleeping at night a whole lot better.  It brings me great joy when I am able to endorse to the general wards patient who had once been in the brink of death.It gives me a sense of fulfillment when I am able to endorse to the next nurse on duty my patient in stable condition, or if not (GCS 3/15), at least still alive. Now, I even have a previous patient who is now my friend in facebook.

                  I had tried to encourage my patient to be strong and take part in their treatment, especially when the prognosis is good. But for those with poor prognosis,  I had learned to accept death and to deal with relatives who have the great challenge of accepting their loved one's passing. In my one year stay in the ICU, I assisted four patients in meeting their peaceful death. I had my fair share of experience with relatives who are hysterical, quiet, reserved, angry etc. I had learned to deal with different emotions and behaviors of patients and their relatives, and had provided them emotional support. I had provided spiritual comfort by inviting priests for annointing of the sick and spiritual healing of patients. Not everyone is given the rare chance of being a part in the person's most trying moments in life. But nurses are given this rare gift to be part of their life and even their death. We make a lot of difference. 

                                                                                                   Hazel Joy Jimenez, R.N