Helping Art of Clinical

Nursing
 Education Career
q Was born on August 18, q She became a professional
1900 in Hamburg, nurse writer for the
Germany. American Journal of Nursing.
q Completed a bachelor of q Practiced as a nurse midwife;
arts degree at Wellesley q And taught evening courses
College in 1922. at the Teachers College until
q Complete her nursing 1951.
q Taught at Yale School of
degree at John Hopkins in
Nursing and helped start a
1925.
master’s degree program
q Completed her master’s where she directed the
degree and certificate in maternal newborn program.
public health nursing at q Continued to publish,
Teachers College, Columbia textbooks in 1958 about
University, in 1934. family-centered maternity
q Completed a degree in and Clinical Nursing: A
midwifery at the Maternity Helping Art.
Center Association of New q Died at the age of 97, on
York, in 1946. https://yhoo.it/2RhH7rR March 8, 1998.
(Sitzman & Eichelberger, 2011)
 Gen. of their
Principles

Middle Range
Function Theory

Prescriptive
Paradigm

Totality

(Wiedenbach, 1970)
Nursing is a service that is rendered
with compassion, skill, and
Understanding to those in need of
care, counsel, and confidence in the
area of health.

-
Theory Statement
(George, 1995)
 Theory Assumptions
Theory concepts
Nursing: A Environment:
Helping art with Conglomerate of
knowledge and objects, policies,
theories. Goal setting, atmosphere,
Need Nursing directed blending

(Wiedenbach, 1964)
time, human beings,

(Wiedenbach 1970)
of thoughts, happenings past,
for Skills feelings, current or anticipated
perceptions, and that are dynamic,
help actions to unpredictable,
understand the exhilarating, baffling
patient and his and disruptive
condition.

Human being:
Clinical Possesses self
direction & Health:
Judgments relative Not defined

(Wiedenbach, 1964)
independence,
makes best use
of capabilities,
responsibilities,
to maintain self,
Sound Judgment Sound Decisions “functioning
being.”
(George, 1995)
 4 Elements of Nursing
Overt action, directed by
An attitude toward life and disciplines, thoughts and
reality that evolves from feelings toward
each nurse’s beliefs and meeting the patient’s
code of conduct motivates need-for-help,
the nurse to act, constitutes the practice
guides her thinking of clinical nursing goal-
about what to do and directed, deliberately
influences decisions. carried out and
patient centered

That which the The application

nurse wants to of knowledge and
accomplish through skill to bring
what she does - is the about desired
overall goal toward result. Art is
which she is striving individualized
and so is constant. (Wiedenbach, 1964) action.
 Realities
Central
Purpose
Realities

Prescription
Realities
 Based on three factors
Central Purpose : Prescription : Indicates Realities : The aspects of
Constitutes the nurse's the broad general action the immediate situation
professional commitment. that the nurse deems which influence the results
appropriate to fulfillment the nurse achieves through
of her central purpose. what she does.

Purpose: Voluntary Involuntary Five Factors : Five Realities :

Philosophy:
The nurse • Physical • Agent
Beliefs and
wants to • Physiological • Recipient
values which
accomplish • Psychological • Goal
shaped her
through what 1.Mutually understood and • Emotional • Means
attitude
she does is agreed upon action.
• Spiritual • Framework
toward life,
toward fellow the overall 2.Recipient-directed action
human beings, goal toward 3.Practitioner-directed action
and toward which she is
herself. striving.

(Wiedenbach, 1970)
 1. Observing
behaviours 2. Exploring
consistent the meaning of
or individual
inconsistent patients’
with behaviour with
comfort. them.

4 Elements to Identify the Patients Need for Help:

3. Determining 4. Determining
the cause if patients
of the can resolve
discomfort or their problems
incapability. or have a need
for help.
 Process of Nursing

3.
1.
2. Validation that
Identification of Ministration of the action taken
the patient’s the help needed was helpful to
need for help.
the patient

(George, 1995)
 Weaknesses Strengths

ü The theory gives guidelines for

implementing the nursing process and
has stimulated many attempts at ü Concepts such as patient- centered care,
conceptualizing the interaction process, perceptions, validation, and exploration of
but is limited in its power for thoughts, feelings, and actions are used in
prescription. (Rickleman, 1971 as cited by Meleis) many practice settings. (Rickleman, 1971 as cited by
Meleis)

ü The scope of the theory remains limited

to individuals who are conscious who
are in a hospital setting, who are
basically motivated to participate in
their own care, who are inconsistent (in
a state of disharmony with their
surroundings, situation, expectations)
and who are able to perceive their need
for help. (Wiedenbach, 1965 as cited by Meleis)
 Nursing Moments

“Nursing is a helping art- a deliberate

blending of thoughts, feelings, and overt
actions. It is practiced in relation to an
individual who is in need of help, is
triggered by a behavioral stimulus from that
individual, is rooted in an explicit
philosophy, and is directed toward
fulfillment of a specific purpose.”

(Wiedenbach, 1963)
 Vignette
I had a patient who is suffering from scoliosis, she told me that
sleeping in her bed makes her feel uncomfortable that causes her
back pain. I immediately think of a plan on how to address her
situation, I suggested that she should change her sleeping position
from laying back to side position and support her spine with
pillows and if possible find a quality mattress such as
chiropractic mattress that is best for back pain.

After a few weeks, she thanked and told me that the advices I
gave her was really effective it made her nights much
comfortable.

(Buenaventura, Personal Communication, November 2018)

References :

George, Julia.(1995). Nursing Theories: The Based for Professional Practice.

Fourth edition. Appleton & Lange: East Norwalk, Connecticut.

Sitzman,K (2011). Understanding The Work of The Nurse Theorists. Jones &
Barlett Publishers: Sudburry, Massachusetts.

Wiedenbach, E. (1964). Clinical Nursing: A Helping Art. New York: Springer

Wiedenbach, E. (1970). The American Journal of Nursing: Nurses’ Wisdom in

Nursing Theory.

Wiedenbach, E. (1963). The helping art of nursing. American

Journal of Nursong, 63, 53-57