From Twenty-One Nursing Problems to 21St Century Nursing: Faye G. Abdellah

Running head: From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

Greg Tipton

NRSE 3400-904

June 25, 2011

Dr. Judy McCook From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

On May 6, 1937, in the sky over Lakehurst, New Jersey, the dirigible Hindenburg exploded. Amongst the witnesses was 18-year-old Faye Glenn Abdellah, whose life was forever changed by the experience. As she later told Lessing (2004), “It was then that I decided that I would never again be powerless to assist when people were in so dire a need for assistance. It was at that moment that I thought that I’ve got to do something, I’ve got to become a nurse.”

She subsequently earned her nursing certification from the Ann May School of Nursing, followed by her Bachelor’s, Master’s, and Doctoral degrees in Education from Columbia

University (Faye Glenn Abdellah - National Womens Hall of Fame, 2000).

Since that time, Abdellah has become widely recognized for her career in nursing, education, research, and health policy. She has been Chief Nurse Officer and Deputy Surgeon

General, U.S. Public Health Service, and was the first nurse and woman to serve in this position in 200 years. She has authored or co-authored over 150 publications, as well as having received

11 honorary degrees and 75 professional and academic awards (McAuliffe, 1998).

As a leader in nursing research, Abdellah helped transform nursing theory, nursing care and nursing education. Amongst her primary contributions is her typology of 21 nursing problems. This theory identifies 21 physical, sociological, and emotional needs of the client:

Needs basic to all patients, sustenal care needs, remedial care needs, and restorative care needs.

This patient-centered approach developed from her practice and has been a major force in the development of a scientific basis for nursing, making Abdellah one of the most influential proponents for evidence-based practice (Faye Glenn Abdellah's Nursing Theory, 2011). As

Abdellah told McAuliffe (1998): From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

We must (a) focus on evidence-based research; (b) identify clinical practice guidelines

that identify indicators that measure quality of care; and (c) identify methods or

instruments that monitor the extent to which actions of health care practitioners conform

to practice guidelines, medical review criteria, or standards of quality, and then point out

the policy implications of the research. (pp. 215-219)

Abdellah’s history of public service over the past 50+ years illustrates both the growth and the application of these concepts. Between 1945 and 1949, Abdellah served on the faculty at

Yale University in her first administrative nursing position (Lessing, 2004). As part of this first teaching position, she was required to teach from the 1937 edition of The Curriculum Guide published by the National League for Nursing (NLN). However, after about a year, frustration with the NLN guidelines, which, according to Abdellah “had no scientific basis” (McAuliffe,

1998), grew too great:

I took exception to an outdated and inadequate textbook that was being required for

nurses in the graduate program. Several times I approached the dean about switching to a

more modern and appropriate text, but the dean was adamant that it would not be

replaced with an updated course book. I gathered the books in question and in the Yale

courtyard I torched the mound to the dean’s dismay. (Lessing, 2004)

By 1949, Abdellah had joined the Public Health Service. Her first assignment was with the Division of Nursing, with her focus primarily on research studies. During this time she worked with many state organizations. One such organization, the Western Interstate

Commission for Higher Education (WICHE), allowed Abdellah the opportunity to work with thirteen western states, learning what nursing problems they had and what their research needs From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

4 were. The WICHE helped establish the groundwork for a great deal of subsequent nursing research (Lessing, 2004).

Abdellah’s work at the forefront of nursing theory and research continued throughout her career. In 1957, she headed a research team in Manchester, Connecticut that directed a pilot study for “progressive patient care,” which helped popularize the concept of intensive care units

(ICUs) in the United States (McAuliffe, 1998). During the 1970s, Abdellah established the

Office of Long-Term Care “to examine the problems of nursing homes and setting standards for the care of the elderly” (Lessing, 2004). And in 1981, Surgeon General C. Everett Koop, M.D., chose Abdellah as the first nurse and female to become Deputy Surgeon General, a position at which she remained until her retirement in 1989. Even beyond retirement, Adbellah continued her work in nursing, conducting a study to justify a graduate school of nursing at the Uniformed

Services University of the Health Sciences (USUHS) (Lessing, 2004). Based in part upon

Abdellah’s study, Congressional funding was obtained and in 1993, the USUHS Graduate

School of Nursing opened with 3 students (USU Graduate School of Nursing, 2010).

As I have researched the contributions of Faye G. Abdellah to the science of nursing, my personal and professional goals have been validated. I was drawn to nursing, in part, because of a perception that I would be able to develop a career in a field with a strong basis in science, research, and actions that were based upon logical interpretation of evidence, all while doing something that would leave a positive impact upon the community around me. I have developed a great appreciation for Abdellah’s devotion to progressing nursing from a field where actions are taken because that is how they have always been to one built upon evidence-based practice.

Abdellah’s goals appeal to me, from the idea of national certification or licensure (McAuliffe,

1998), to working with international consultations (Lessing, 2004), to including culture, From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

5 diversity, or complementary medicine in current practice (McAuliffe, 1998). I look forward to developing my skills and knowledge throughout my nursing career, perhaps even into advanced practice. As envisioned by Abdellah, I want to take advantage of the opportunity to “use our skills fully and to conduct outcomes research” (McAuliffe, 1998), progressing from the twenty- one nursing problems identified many decades ago and into a model of 21st century nursing where we are able to meet the needs of the patients, the communities, and the world. From Twenty-One Nursing Problems to 21st Century Nursing: Faye G. Abdellah

Works Cited

Faye Glenn Abdellah - National Womens Hall of Fame. (2000). Retrieved June 21, 2011, from

National Women's Hall of Fame: http://www.greatwomen.org/women-of-the-hall/search-

the-hall/details/2/1-Abdellah

Faye Glenn Abdellah's Nursing Theory. (2011, March 1). Retrieved June 21, 2011, from Current

Nursing: http://currentnursing.com/nursing_theory/Abdellah.html

Lessing, M. (2004). Up close and personal: interview with Rear Admiral Faye Glenn Abdellah.

Military Medicine, 169(11), iii-xi. Retrieved from EBSCOhost.

McAuliffe, M. S. (Fall 1998). Interview with Faye G. Abdellah on nursing research and health

policy. Journal of Nursing Scholarship., 30, n3. p.215(5).

USU Graduate School of Nursing. (2010, May 28). Retrieved June 25, 2011, from Uniformed

Services University of the Health Sciences:

http://www.usuhs.mil/gsn/aboutus/aboutthegsn.html