Virginia Henderson (1897-1996) is a Nursing Grand Theorist who was often referred to as the “first lady of nursing.” In the article by Nicely (2011) it depicts how she developed a nursing model which is based on activities of daily living. She believed that nursing as a profession stood separately from medicine. In this article, I was able to decipher how Henderson’s theory is applied to the specialized area of organ donation for transplantation. It is reflected that although organ coordinators are from different backgrounds such as: allied health professions, physicians’ assistants, and paramedics, most of them are “registered nurses.” Nicely (2011) portrays 14 different activities that Henderson identified for patient assistance which would allow patients to return back to independence: “eating and drinking, elimination of body waste, desirable posture/sleep and rest, select suitable clothing: dress and undress, avoiding dangers in the environment and avoid injuring others, maintaining body temperature within normal range, grooming/protecting the integument, communication with others, worship according to one’s faith, play and recreation, learn and discover” (Nicely, 2011, p.73).
Henderson’s activities reflect on how nurses can provide a good foundation in which they can become more proficient in their abilities to provide care for their patients. She stressed the importance for including the patient’s family. In her theory, Henderson states the “the complexity and quality of the service is limited only by the imagination and the competence of the nurse who interprets it” (Nicely, 2011, p. 77). The article extrapolates very good points about how equally important it is for the nurse to work with the family, as well as the patient. The second article I chose by Merritt and Procter is entitled, “Conceptualizing the functional role of mental health consultation liaison nurse in multi-morbidity,” using Peplau’s theory. This article surmises the role of the mental health consultation liaison (MHCLN) and how it can be integrated to Peplau’s Theory of Interpersonal Relations. In the introduction of the article, it focuses on the importance of “mentally ill” patients being involved actively in their treatment and care planning. This article describes that “it is a global consensus that mental health care should be undertaken collaboratively, no matter where the patients live, and in the least restrictive environment” (World Psychiatric Association, 2009, p.159).
I agree with the above statement, as I work as a mental health consultant and psychiatric nurse. There is not enough being done to help the patients and their families in seeking psychiatric care and providing a continuum of care. It continues to be a “stigma” that needs to be addressed globally, so that the patients who are in utmost need of care are able to receive it. This includes medication, behavioral management, and psychotherapy by specialists in the field. Throughout my many years of practice in the mental health field, I have witnessed so much neglect instilled on the mentally ill patients. Many facilities have closed down, and in particular one research facility called the “Lafayette Clinic” which was linked to Wayne State University in MI, closed due to the government not prioritizing mental health in their budget. As a result, there are more homeless residents living on the streets and not being treated for their mental illness until something happens. At times, people who are living on the streets become loud, argumentative, and combative, hallucinate, injure someone, or themselves before any action is taken. I firmly believe in the stand of the MHCLN in helping to decrease the stigma of mental illness, as well as reducing patient’s symptoms by providing a “means” for treatment.
Education and research are a “key source”, as well as funding for the above to happen. Merritt’s paper represents a stepping stone in my opinion to many patients that are out there suffering and being belittled by their mental illness. The use of Peplau’s interpersonal relations theory if placed fully into practice can help patients adjust to their mental illness, and through education they would be able to have somewhat of a grasp on their illness, the importance of taking their medications, and seeing a psychiatrist and/or psychologist on a regular basis. Once stabilized, the mental health patient can reap the benefits of engaging in a more normalized lifestyle and have a better chance of adjusting to the roles that are not always able to participate in. This paper provides good insight into Peplau’s interpersonal relations theory. The methodologies utilized provide patients with an avenue to work through their psychological distress, and adjustment to changes that occur as a result of their illness.
More research and education is necessary to provide the interventions that are necessary in stabilizing the patients who suffer from mental illness. The nurse is of key importance in facilitating this process with the patient and their families, as well as the psychiatrist, psychologist, social worker, recreational therapist, and mental health worker. In comparing Henderson’s article to Peplau’s article there is some correlation as to the importance in working with families, as well as the patient who is also “stressed”. In Nicely’s article, the donor patient is usually deceased, or if not deceased, the nurse works with both the patient and the family. Henderson’s theory allows the nurse to be patient as well as family focused.
In Merritt’s article, it is both important for the nurse to work with the patient and family as well. In both articles, I feel that the “nurse” serves as an “advocate” in different ways, one from a medical perspective, and the other from a psychological perspective, however these can be intertwined as the families who lost a loved one due to “brain death” and a transplantation will occur, also need emotional support. Nurse-patient relationship encompasses many strategies throughout both articles. In Peplau’s psychodynamic nursing theory four phases of a nurse-patient relationship are identified: orientation, identification, exploitation, and resolution. By utilizing these phases, it will allow a nurse to better identify, respond to patient’s need, and build trust. Both articles stress the importance of “nurses” in different types of roles, one as an “organ donation coordinator”, and the other as a “mental health liaison or consultant” providing psychological and emotional support to families.
Merritt, M. K. & Procter, N. (2010). Conceptualizing the functional role of mental health consultation-liaison nurse in multi-morbidity, using Peplau’s nursing theory. Contemporary Nurse 34(2). 158-166. https://lmscontent.embanet.com/MVU/NURS600/Readings/W3_Peplau.pdf
Nicely, B., & DeLario, G. T. (2011). Virginia Henderson’s principles and practice of nursing applied to organ donation after brain death. Progress in transplantation, 21(1), 72-77. https://lmscontent.embanet.com/MVU/NURS600/Readings/W3_Nicely2011.pdf