Dorothea Orem

I define my philosophy of nursing within the three nursing domains of person, health, and environment. My goal is to communicate the importance of nursing as a knowledge-based career, depending not only on the nurse fulfilling her role but also on the patient’s compliance. A patient must learn to provide self-care at home in the same capacity as the nurse would provide care in the clinical setting. I discuss various subjects within nursing. I explain why I want to be a nurse, what I believe a nurse’s role is, the different domains of nursing, and where I believe nursing will be in the future. My philosophy demonstrates the interdependence of the nursing domains. You cannot fully evaluate a person without evaluating their health,

When identifying uses and meanings of ‘self-care’, I first looked in a dictionary. The concept was defined in the Shorter Oxford dicitonary as, “Self-care (noun) taking care of one-self; self-interested behavior.” I searched the internet to get a generalized view of how the concept was being used and it was defined on Wikipedia as, “Self-care refers to actions and attitudes which contribute to the maintenance of well-being, personal health, and promotion of human developent.” I searched data bases for scholary peer reviewed articlew and retrieved limited amount of English articles on self-care. Key word searches consisted of self-care, self-care maintenance, and self-management. The definitions and uses of the concept were fairly broad. I narrowed the search to post-op patients and self-care. The two uses for the concept in the post op patient would be self-care of the post op patient and also supportive care to promote self-care of the post-op patient. The supportive care could be from a nursing system or a family member.

The theory focuses on the ability of a person to meet his or her own needs. Developed in the year 1970, Orem’s theory focused on the three various concepts, namely self-care, self-care deficit, and the nursing system. Self-care is a group of activities or processes that a person performs to maintain health, life, and wellbeing (Orem, 2001). For instance, self-care is being demonstrated when a chronic heart failure patient checks his or her weight daily, takes prescribes medications, and avoids salty foods. Self-care deficit happens when an individual is not able to provide effective self-care (Orem, 2011). Nurses are able to assist patients in this state by educating them with their disease condition and treatment compliance. A nursing

Physical and emotional self-care could be the deciding factor between a good nurse and great nurse. Without taking care of ones self, a nurse cannot take on the responsibility of caring for others. This topic is important to address and is essential for a healthy population, in nursing or not. Self care helps you become more proactive and productive by preventing burn out, reducing stress, and refocusing. This paper will contain the benefit of self-care to your emotional state of well being, as well as the attention to this topic including the problem with self-care, in that it is misunderstood and underused. Nursing and self-care should go hand and hand; therefore this paper will dive in to the current research, insight, and discussions on this topic, in hopes for a healthier and improved nursing career as well as personal life.

The nursing process does not merely treat the patient as a physical body, but rather treats the patient holistically. The central philosophy of Dorothea Orem's self-care deficit nursing theory "is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they're able" (Dorothea Orem, 2012, Nursing Theory). However, although self-care may be the core of Orem's theory, the decision to engage in self-care must be facilitated by the patient's social and physical environment, of which the family can play a critical role in shaping.

The profession of nursing requires a capacity and joy for caring and healing others both mentally and physically. Nurses spend their careers caring for patients and their families often in the worst and most frightening periods of their lives. Nursing responsibilities can be lengthy, stressful and physically and emotionally demanding. The demands of the nursing profession coupled with the nursing shortage and longer work hours put even more stress on nurses. Despite these extreme demands, many nurses do not fully appreciate the importance self-care. Yet without proper care for themselves, nurses are not able to provide the best care for their patients.

In 1947, shortly after graduating with her Master’s in nursing, Dorothea Orem accepted a position with the Indiana State Board of Health, where she first thought of her theory of nursing. She left that position to work at the U.S. Department of Health, Education, and Welfare (HEW), the predecessor for the U.S. Department of Health and Human Services, from 1957-1959. While at HEW, she took on the role of curriculum consultant and was tasked with the improvement of nurse training through curriculum development (Johnson & Webber, 2010). It was Orem’s role in this project that provided the impetus for her nursing theories as she began to explore the connections between nursing, education, and self-care. Taylor (2011) notes that Orem’s first published article,

In Orem’s theory, there are two perspectives, from a patient’s and nursing perspective. The study will focus on the patient aspect. The purpose of Orem’s theory is for individuals to change their behaviors and “their environments to regulate factors that affect their own development and functioning, in the interests of life, health, or well-being” (Nunnery, K.R., 2016, p.39). The overall principle of this model is that individuals need to be determined to make changes for themselves and their surroundings to be able to have a healthier life

Orem’s theory has been used in educational programs and healthcare institutions to improve nursing care and make a difference in patient’s lives. Dorothea Orem held many roles throughout her career in patient care and as faculty and dean of Catholic University, the same place where she obtained her bachelor’s and master’s degree in nursing. Her self-care deficit theory is categorized as a systems theory and grand nursing theory. Orem’s theory has stood the test of time, yet has adapted to fit current nursing concerns. She is known as one of the pioneers of nursing theory.

Orem focuses on nursing as a deliberate human action and notes that all individuals can benefit from nursing when they have health-derived or health-related limitations for engaging in self-care or the care of dependent others (Gunther, 2016). The nurse chooses deliberate actions from nursing systems to bring about desirable conditions in persons. The goal of nursing is to move a patient toward responsible self care or to meet existing healthcare needs of those who have health care deficits (Gunther, 2016). Orem expects people to be responsible for themselves and to seek help when they cannot maintain therapeutic self-care or dependent-care (Fawcett, 2003).

Core concepts are the basis for a theory or model; concepts help in the development of theories. Theorists have developed different models or theories but have common core concepts. This paper will identify the core concept of ‘the role of nursing,’ which two theorists, Dorothea Orem and Virginia Henderson both utilized. We will compare and analyze the concept definitions among both theorists, and discuss the practical use of Orem’s self care theory.

Orem’s view was that theories served as a guide in research and as such the self-care theory has led to research in the self-care area. Nursing can use this model and develop guides to instruct and educate patients in the self-care deficit area. The third way the theory has contributed to nursing knowledge is specifying when a self-care deficit exists and what care needs to be provided by nursing and to create a nursing diagnosis and nursing care plan. This is useful for developing assessment tools and developing evidence based protocols (Taylor, 2006).

Nursing Science continued to transform in the 70’s.Dorothea Orem was one of the most prominent nursing personalities that thrived in improving the standards of nursing through self-care deficit theory in 1971. The main objective of care is the self and thus catering every needs that revolve around it to perform self-care. Orem’s work had become so significant today that her Assessment for Care Evaluation method is the standard for evaluating health conditions.

Description of Theory: “ The central philosophy of the self-care deficit Nursing theory is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they are able. “ ( Nursing-theory.org, 2011) There are three requirements to the self-care theory. The first requirement is the patient to be able to obtain basic human needs: air, food, rest and water. The second area that is

Nursing is a profession within health care. It not only focuses on the care of individuals but it also focuses on the care of families and communities so that they may attain, maintain, or recover optimal health and quality of life. Nursing is an art. In nursing, the nurse or provider gives, assist, or specializes in helping people with disabilities as well as people whose health may be deteriorating. People who suffer from disabilities need more than the ordinary assistance necessary used by a healthy individual to meet the needs for self-care. The nurse also participates in the medical care the individual receives from the physician both during their time of stay in a facility or during visits to the health care provider. With that being said, a nurse is an important factor in the medical community and very significant in helping a patient reach the optimal level of health. Along with maintaining the optimal level of health, one of the main goals in nursing is to help clients achieve the ability to care for themselves. This is called self-care. There are many theories that contribute to this goal of nursing as well as nursing as a whole. One of the main theories is Orem’s Self-Care Deficit Theory. This theory was founded between 1959 and 2001 by Dorothea Elizabeth Orem.