Redefining what nurses do
Henderson's need theory comes from Virginia Henderson (1897–1996), often called "the first lady of nursing." She trained at the Army School of Nursing during the World War I era, graduating in 1921, then studied and taught at Teachers College, Columbia University. For years she wrestled with one question: does nursing have a function of its own, beyond carrying out physicians' orders?
Her answer appeared in the 1955 fifth edition of the Textbook of the Principles and Practice of Nursing: "The unique function 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. And to do this in such a way as to help him gain independence as rapidly as possible." When the International Council of Nurses published her booklet Basic Principles of Nursing Care in 1960, the definition and its 14 components were translated into dozens of languages. She refined them again in The Nature of Nursing (1966), and later compiled the landmark Nursing Studies Index at Yale.
The 14 basic needs
Henderson framed nursing as helping people do the following on their own—starting with the body and moving toward mind, society, and spirit.
| Domain | Basic needs |
|---|---|
| Physiological and safety | 1. Breathe normally 2. Eat and drink adequately 3. Eliminate body wastes 4. Move and maintain posture 5. Sleep and rest 6. Choose suitable clothing, dress and undress 7. Keep body temperature within normal range 8. Keep the body clean and protect the skin 9. Avoid environmental dangers and avoid injuring others |
| Psychosocial and spiritual | 10. Communicate emotions, needs, fears, and opinions 11. Worship according to one's faith 12. Work in a way that brings a sense of accomplishment 13. Play or take part in recreation 14. Learn, discover, and satisfy curiosity |
The list echoes Maslow's hierarchy of needs, and nurses often use the two together to set priorities. Henderson, though, didn't insist on a strict hierarchy; she saw the needs as an integrated whole in one person.
Three nursing roles
Depending on how independent the patient is, the nurse acts as a substitute (meeting needs for an unconscious patient), a helper (assisting a recovering patient), or a partner (planning and working with the patient on health goals). That push toward independence leads naturally to the self-care focus of Orem's self-care deficit theory.
Using it in practice
The 14 needs double as an assessment framework. For a stroke survivor with hemiplegia, the nurse checks breathing, swallowing, elimination, mobility, and positioning for deficits, then looks at communication, work, recreation, and learning for psychosocial issues. Rehab goals aim at what the patient can do unaided, and the nurse shifts from substitute to helper to partner as recovery progresses. Many fundamentals-of-nursing textbooks still organize chapters—hygiene, activity, sleep, nutrition—along these lines.
Strengths and limitations
Henderson gave nursing a concise, portable definition and a holistic view that runs from physiology to spirituality, shaping nursing education worldwide. Critics point out that the theory doesn't explain how the 14 needs relate to one another or how to rank them, and that its individual focus underplays family, community, and the environment.
See also
Nursing theory · Nightingale's environmental theory · Orem's self-care deficit theory · Maslow's hierarchy of needs · Roy adaptation model
FAQ
- Is it a "theory" or a definition?
- Henderson saw her work as a definition of nursing; later scholars classified it as a need theory because it explains when and how nursing intervenes.
- Any trick for remembering the 14 needs?
- Think of 1–9 as body and safety, and 10–14 as mind and life: communicate, worship, work, play, learn.
Sources reviewed: 2026-10-26
References
- Henderson, V. (1966). The Nature of Nursing: A Definition and Its Implications for Practice, Research, and Education. New York: Macmillan.
- Henderson, V. (1960). Basic Principles of Nursing Care. Geneva: International Council of Nurses.
- Harmer, B., & Henderson, V. (1955). Textbook of the Principles and Practice of Nursing (5th ed.). New York: Macmillan.
- Alligood, M. R. (Ed.). (2021). Nursing Theorists and Their Work (10th ed.). Elsevier.