Virginia Henderson (1897–1996) is often called “the first lady of nursing” and “the modern-day Florence Nightingale”. Her definition of nursing, adopted by the International Council of Nurses, and her list of 14 basic human needs remain among the most practical frameworks a nurse can use, from a busy medical ward to a patient’s home.
This guide explains who Henderson was, her definition of nursing, the 14 needs with clinical examples, how to use them in assessment and care planning, and the strengths and criticisms of her model.
Imagine a woman in her seventies, three days after a stroke. Her medical notes list her diagnosis, scans and medicines. But what does she need from nurses today? She cannot swallow safely, cannot reach the call bell, is embarrassed about needing help to the toilet, misses church, and is frightened she will never go home. Henderson would say: those are her needs, and helping her meet them until she can do it herself is the heart of nursing.
Who was Virginia Henderson?
Virginia Avenel Henderson was an American nurse, educator and author. She trained at the Army School of Nursing in Washington, D.C., during the First World War, and later taught and studied at Teachers College, Columbia University, and Yale University. She revised the influential Textbook of the Principles and Practice of Nursing, wrote Basic Principles of Nursing Care for the International Council of Nurses (1960) and The Nature of Nursing (1966), and led a major index of nursing research literature. The international nursing library of Sigma is named after her.
Henderson’s definition of nursing
In summary, Henderson said the unique function of the nurse is to help a person, sick or well, carry out the activities that contribute to health, recovery or a peaceful death, which they would do without help if they had the necessary strength, will or knowledge, and to do this in a way that helps them become independent as quickly as possible.
Three key ideas follow:
- Nursing supports independence: the goal is for the patient to do things for themselves again.
- Three reasons people need help: lack of strength, will or knowledge.
- Peaceful death is part of nursing, not a failure of it.
The 14 basic needs, with examples
| # | Need | Example of nursing care |
|---|---|---|
| 1 | Breathe normally | Positioning, oxygen therapy, breathing exercises, inhaler technique |
| 2 | Eat and drink adequately | Swallow screening, assisting with meals, fluid balance, nutrition screening |
| 3 | Eliminate body wastes | Toileting help, continence care, catheter care, bowel charts |
| 4 | Move and maintain desirable postures | Repositioning, mobilisation, falls prevention, pressure area care |
| 5 | Sleep and rest | Reducing night noise, pain control, sleep routines |
| 6 | Select suitable clothes, dress and undress | Encouraging own clothes, adaptive clothing, dignity |
| 7 | Maintain body temperature | Monitoring temperature, adjusting clothing and environment |
| 8 | Keep the body clean and protect the skin | Personal hygiene, oral care, skin inspection |
| 9 | Avoid dangers and avoid injuring others | Infection prevention, safe medicines, risk assessment, safeguarding |
| 10 | Communicate with others | Hearing aids, interpreters, communication boards, listening |
| 11 | Worship according to one’s faith | Chaplaincy, prayer times, dietary and ritual needs |
| 12 | Work in a way that gives a sense of accomplishment | Setting goals, involving patients in decisions, return-to-work plans |
| 13 | Play or take part in recreation | Activities, visits, hobbies, especially in long stays |
| 14 | Learn, discover or satisfy curiosity | Patient education, answering questions, health literacy support |
The first nine needs are mainly physiological; communication is psychological and social; worship is spiritual; and the last three relate to occupation, recreation and learning. Henderson’s model is therefore holistic, decades before “holistic care” became a common phrase.
Using Henderson’s model in practice
Assessment
Use the 14 needs as a checklist during admission: for each need, ask what the patient can do independently, what help they need, and why (strength, will or knowledge).
Care planning
Write goals that move towards independence. Example: Need 4, movement: “Patient will walk to the bathroom with a frame and one nurse by day 3, and independently with a frame by discharge.”
Patient education
When the barrier is knowledge, teaching is the intervention, for example inhaler technique or blood glucose monitoring.
End-of-life care
Henderson’s inclusion of peaceful death guides comfort-focused goals: breathing comfort, mouth care, positioning, spiritual support and family presence.
Strengths and criticisms
| Strengths | Criticisms |
|---|---|
| Simple, practical and easy to remember | Focuses on the individual more than family and community |
| Holistic: physical, psychological, spiritual, social | Does not explain how needs interact or which to prioritise |
| Emphasises independence and dignity | Less suited to health promotion in well populations |
| Applies across settings and countries | Some argue it describes tasks more than a full theory |
Henderson compared with other models
Henderson’s needs are similar to Maslow’s hierarchy, and influenced the Roper-Logan-Tierney model of activities of living, widely used in the UK and Africa. Orem’s self-care theory also builds on the idea of helping people do for themselves.
Frequently asked questions
What are Virginia Henderson’s 14 needs?
Breathing, eating and drinking, elimination, movement, sleep, dressing, temperature, hygiene, safety, communication, worship, work, recreation and learning.
Why is Henderson called the first lady of nursing?
For her influential definition of nursing, textbooks and lifelong contribution to nursing education and research.
How do I use Henderson’s model in a care plan?
Assess each need, identify the reason for dependence (strength, will or knowledge), and set goals towards independence.
Is Henderson’s model still used?
Yes, especially in nursing education and as a basis for assessment frameworks.
But is a list of needs really a theory?
Some scholars say it is more a definition and framework than a full theory. Yet its simplicity is its power: it reminds every nurse that breathing, eating, dignity, faith and learning all belong to nursing care.
Your next step: Use the 14 needs as a checklist for your next admission. For each need, write one line on what the patient can do alone and what help they need.
Related: Spiritual care in nursing · Patient education · Famous nurses who changed the world
Sources: Henderson V. Basic Principles of Nursing Care (International Council of Nurses, 1960); Henderson V. The Nature of Nursing (1966); Sigma Theta Tau International (Virginia Henderson Global Nursing e-Repository); nursing theory textbooks (e.g. Alligood, Nursing Theorists and Their Work).
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