Faye G. Abdellah – Pioneer of 21 Nursing Problems

Faye G. Abdellah

Faye Glenn Abdellah (March 13, 1919 – present) is a pioneer in nursing research who developed the Twenty-One Nursing Problems.” Her model of nursing was progressive for the time in that it refers to a nursing diagnosis during a time in which nurses were taught that diagnoses were not part of their role in health care.

She was the first nurse officer to earn the ranking of a two-star rear admiral and the first nurse and the first woman to serve as a Deputy Surgeon General.

Contents

Early Life


Abdellah was born on March 13, 1919 in New York to a father of Algerian heritage and Scottish mother. Her family subsequently moved to New Jersey where she attended high school.

Years later, on May 6, 1937, the German hydrogen-fueled airship Hindenburg exploded over Lakehurst.

Explosion and destruction of the dirigible Hindenburg
Explosion and destruction of the dirigible Hindenburg

Abdellah and her brother witnessed the explosion, destruction and the fire subsequent to the ignited hydrogen that killed many people. That incident became the turning point in Abdellah’s life. It was that time when she realized that she would never again be powerless to assist when people were in so dire need for assistance. It was at that moment she vowed that she would learn nursing and become a professional nurse.

Education


Fitkin Memorial Hospital's School of Nursing
Fitkin Memorial Hospital’s School of Nursing

Abdellah earned a nursing diploma from Fitkin Memorial Hospital’s School of Nursing, now known as Ann May School of Nursing.

It was sufficient to practice nursing during her time in the 1940s, but she believed that nursing care should be based on research, not hours of care.

Abdellah went on to earn three degrees from Columbia University: a bachelor of science degree in nursing in 1945, a master of arts degree in physiology in 1947 and a doctor of education degree in 1955.

Faye Abdellah, Dean, Graduate School of Nursing, USUHS
Faye Abdellah, Dean, Graduate School of Nursing, USUHS

With her advanced education, Abdellah could have chosen to become a doctor. However, as she explained in one of her interviews that she wanted to be an M.D. because she could do all she wanted to do in nursing, which is a caring profession.

Career and Appointments


As an Educator

At her early twenties, Abdellah worked as a health nurse at a private school and her first administrative position was on the faculty of Yale University from 1945-1949. At that time she was required to teach a class called “120 Principles of Nursing Practice,” using a standard nursing textbook published by the National League for Nursing. The book included guidelines that had no scientific basis which challenged Abdellah to explain everything to what she called the “brilliant” students.

Abdellah named deputy surgeon general in 1981
Abdellah named deputy surgeon general in 1981

After a year Abdellah became so frustrated that she gathered her colleagues in the Yale courtyard and burned the textbooks. The next morning the school’s dean told her she would have to pay for the destroyed texts. It took a year for Abdellah to settle the debt, but she never regretted her actions because it started her on the long road in pursuit of the scientific basis of the nursing practice.

As a Researcher

In 1949, she met Lucile Petry Leone who was the first Nurse Officer and decided to join the Public Health Service. Her first assignment was with the division of nursing that focused on research and studies. They performed studies with numerous hospitals to improve nursing practice.

Induction Ceremony into the National Women's Hall of Fame
Induction Ceremony into the National Women’s Hall of Fame

Abdellah was an advocate of degree programs for nursing. Diploma programs, she believes, were never meant to prepare nurses at the professional level. Nursing education, she argued, should be based on research; she herself became among the first in her role as an educator to focus on theory and research. Her first studies were qualitative; they simply described situations. As her career progressed, her research evolved to include physiology, chemistry, and behavioral sciences.

In 1957, Abdellah spearheaded a research team in Manchester, Connecticut, that established the groundwork for what became known as progressive patient care. In this framework, critical care patients were treated in an intensive care unit, followed by a transition to immediate care, and then home care. The first two segments of the care program proved very popular within the caregiver profession. Abdellah is also credited with developing the first nationally tested coronary care unit as an outgrowth of her work in Manchester.

Hall of Fame Group
Hall of Fame Group

The home care, which is the third phase of the progressive patient care equation, was not widely accepted in the mid-twentieth century. Abdellah explained that people at the time kept saying home care would mean having a maid or a nurse in everyone’s home. They could not figure out that home care with nurses teaching self care would be a way of helping patients regain independent function. Forty years later home care had become an essential part of long-term health care.

Established Nursing Standards

Abdellah and Inouye (left)
Abdellah and Inouye (left)

In another innovation within her field, Abdellah developed the Patient Assessment of Care Evaluation (PACE), a system of standards used to measure the relative quality of individual health-care facilities that was still used in the healthcare industry into the 21st century. She was also one of the first people in the healthcare industry to develop a classification system for patient care and patient-oriented records.

Awards Ceremony: Abdellah (right) with award recipient
Awards Ceremony: Abdellah (right) with award recipient

Classification systems have evolved in different ways within in the health-care industry, and Abdellah’s work was foundational in the development of the most widely used form: Diagnostic related groups, or DRGs. DRGs, which became the standard coding system used by Medicare, categorize patients according to particular primary and secondary diagnoses. This system keeps health-care costs down because each DRG code includes the maximum amount Medicare will pay out for a specific diagnosis or procedure, while also taking into account patient age and length of stay in a healthcare facility. Providers are given an incentive to keep costs down because they only realize a profit if costs are less than the amount specified by the relevant DRG category.

Military Nursing Service

Faye G. Abdellah and C. Everett Koop
Faye G. Abdellah and C. Everett Koop

During her 40-year career as a Commissioned Officer in the U.S. Public Health Service from 1949 to 1989, Abdellah was assigned to work with the Korean people during the Korean War. As a senior officer, she was alternatively assigned to Japan, China, Russia, Australia, and the Scandinavian countries to identify the role of the Public Health Service in dealing with various health problems. She was able to assist and initiate, in an advisory role, numerous studies in those countries.

Abdellah (right) presides at awards ceremony.
Abdellah (right) presides at awards ceremony.

She served as Chief Nurse Officer from 1970 to 1987 and was the first nurse to achieve the rank of a two-star Flag Officer and was named by U.S. Surgeon General C. Everett Koop as the first woman and nurse Deputy Surgeon General from 1982 to 1989. After retirement, Abdellah founded and served as the first dean in the Graduate School of Nursing, GSN, Uniformed Services University of the Health Sciences (USUHS).

Abdellah’s Typology of 21 Nursing Problems


Main Article: Faye G. Abdellah’s 21 Nursing Problems Theory

Abdellah is well known for her development of the “Twenty-One Nursing Problems Theory that has interrelated the concepts of health, nursing problems, and problem-solving.

She views nursing as an art and a science that mold the attitude, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help individuals cope with their health needs, whether they are ill or well.

She used Henderson’s 14 basic human needs and nursing research to establish the classification of nursing problems. Abdellah’s 21 Nursing Problems are the following:

  1. To maintain good hygiene and physical comfort
  2. To promote optimal activity: exercise, rest, sleep
  3. To promote safety through prevention of accident, injury, or other trauma and through prevention of the spread of infection
  4. To maintain good body mechanics and prevent and correct deformity
  5. To facilitate the maintenance of a supply of oxygen to all body cells
  6. To facilitate the maintenance of nutrition for all body cells
  7. To facilitate the maintenance of elimination
  8. To facilitate the maintenance of fluid and electrolyte balance
  9. To recognize the physiologic responses of the body to disease conditions—pathologic, physiologic, and compensatory
  10. To facilitate the maintenance of regulatory mechanisms and functions
  11. To facilitate the maintenance of sensory function
  12. To identify and accept positive and negative expressions, feelings, and reactions
  13. To identify and accept interrelatedness of emotions and organic illness
  14. To facilitate the maintenance of effective verbal and nonverbal communication
  15. To promote the development of productive interpersonal relationships
  16. To facilitate progress toward achievement and personal spiritual goals
  17. To create or maintain a therapeutic environment
  18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs
  19. To accept the optimum possible goals in the light of limitations, physical and emotional
  20. To use community resources as an aid in resolving problems that arise from illness
  21. To understand the role of social problems as influencing factors in the cause of illness

Works


As a consultant and educator, Abdellah shared her nursing theories with caregivers around the world. She led seminars in France, Portugal, Israel, Japan, China, New Zealand, Australia, and the former Soviet Union. She also served as a research consultant to the World Health Organization. From her global perspective, Abdellah learned to appreciate non traditional and complementary medical treatments and developed the belief such non-Western treatments deserved scientific research.

Women's Memorial
Abdellah at Women’s Memorial

Also, she has been active in professional nursing associations and is a prolific author, with more than 150 publications. Her publications include Better Nursing Care Through Nursing Research and Patient-Centered Approaches to Nursing. She also developed educational materials in many areas of public health, including AIDS, hospice care, and drug addiction.

Abdellah considers her greatest accomplishment being able to “play a role in establishing a foundation for nursing research as a science.” Her book, Patient-Centered Approaches to Nursing, emphasizes the science of nursing and has elicited changes throughout nursing curricula. Her work, which is based on the problem-solving method, serves as a vehicle for delineating nursing (patient) problems as the patient moves toward a healthy outcome.

Abdellah with three nurse award recipients
Abdellah with three nurse award recipients

Additional works written by Abdellah include: Preparing Nursing Research for the 21st Century: Evolution, Methodologies, Challenges; New directions in Patient-Centered Nursing: Guidelines for Systems of Service, Education, and Research; Effect of Nurse Staffing on Satisfactions with Nursing Care: A Study of How Omissions in Nursing Services, as Perceived by Patients and Personnel, Are Influenced by the Number of Nursing Hours Available; Patients and Personnel Speak, A Method of Studying Patient Care in Hospitals; Appraising the Clinical Resources in Small Hospitals; Nursing’s Role in the Future: The Case for Health Policy Decision Making; Overview of Nursing Research, 1955-1968; Surgeon General’s Workshop, Health Promotion and Aging proceedings. March 20-23, 1988; and Words of Wisdom from Pivotal Nurse Leaders.

Awards and Honors


The National Women's Hall of Fame
The National Women’s Hall of Fame

Abdellah is recognized as a leader in the development of nursing research and nursing as a profession within the Public Health Service (PHS) and as an international expert on health problems. She was named a “living legend” by the American Academy of Nursing in 1994 and was inducted into the National Women’s Hall of Fame in 2000 for a lifetime spent establishing and leading essential health care programs for the United States. In 2012, Abdellah was inducted into the American Nurses Association Hall of Fame for a lifetime of contributions to nursing.

Her contributions to nursing and public health have been recognized with almost 90 professional and academic honors, such as the Allied Signal Achievement Award for pioneering research in aging and Sigma Theta Tau’s Lifetime Achievement Award.

Abdellah’s leadership, her publications, and her lifelong contributions have set a new standard for nursing and for health care. Her legacy of more than 60 years of extraordinary accomplishments lives on nationally and globally.

See Also


References


  • Craddock, J. (2013). Encyclopedia of world biography supplement. Detroit, Mich.: Gale. http://www.encyclopedia.com/doc/1G2-3435000010.html

External Links