The purpose of this paper will be to explain the components of Dorothea Orem’s self-care deficit theory, the current significance of the theory, and the application of this particular nursing theory. A nursing theory is an explanation of a division of nursing that “describes, explains, predicts, or prescribes” that particular division. (Perry, Potter, Stockert, & Hall, 2013, p. 41). Orem developed her personal theory, the self-care deficit theory, to assess a patient’s ability to perform vital daily tasks and how it affected the patient’s. (Hartweg & Pickens, 2016). This theory is a grand theory, which means it can be used in almost all areas of nursing. There are five components or methods that compose this theory that nurses will practice when working with a patient who needs to reach the self-care deficit. (Edney, Jaime, & Young, 2016). It is used today and has been included in several studies that have proven it to be effective in shortening hospital visits when used on critically ill patients. (Hohdorf, 2010). This particular theory has helped advance nursing practice since Orem’s first publication.
Dorothea Orem’s philosophy in nursing is consistent with my own personal philosophy. Knowing your own capability and limits predicts almost always the final result. One must
Dorothea Orem’s theory accepts and describes the premise of self-directed personal care (Alligood et al., 2010). Orem’s theory also explains and predicts when the nurse will be needed once the illness has challenged an individual's functional capacity. The purpose of the theory is to focus on individual’s being able to care for themselves on their own, identify when nurses are needed to help individuals progress to better health. Besides, self-health care is put in place to acknowledge that nurses can aid individuals to get back to their functional baseline abilities on time. (Alligood et al.,
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
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.
Orem’s Self-Care Deficit Theory views every individual as practicing “self-care, a set of learned behaviors, to sustain life, maintain or restore functioning, and bring about a condition of well-being.” (Creasia & Friberg 2011) The nurse uses her/his abilities to assist the patient to overcome current self-care deficits and help the patient achieve her/his best level of self-care. As time passes many of the elderly need more assistance with the activities of daily living. Taking care of themselves physically becomes more difficult, sometimes there is decreased mental acuity, as well as a loss in social contact. In every one of these areas the nurse assists the patient to achieve her/his highest level of self-care. This includes diet, eating, elimination, activity, social interaction, education, awareness of obligations, and the promotion of health. Where possible the nurse will help the patient achieve self-care. Since there are no true cures to the aging process the nurse will be needed more and more
Dorothea Orem is known as one of the foremost nursing theorists. She is credited with the development of a nursing grand theory, the self-care deficit nursing theory (SCDNT). The beginning of her career can be traced back to Washington, D.C. in the mid 1930’s. Though she was a Baltimore, Maryland native, Orem pursued her nursing education at Catholic University of America (CUA) in Washington, D.C., graduating with baccalaureate and Master’s degrees in 1939 and 1945 respectively. Following her education, Orem held many job positions across multiple nursing disciplines, including working as a private nurse, nurse educator, administrator, director, and private contractor (McEwen & Wills, 2011).
Dorothea Orem was born in1914 in Baltimore, Maryland. She earned her nursing diploma from the Providence Hospital School of Nursing in Washington, D.C., in 1930, before she went on to complete her Bachelor of Science in Nursing and Master of Science in Nursing at Catholic University of America in Washington, D.C., in 1939 and 1945 respectively. Orem occupied numerous high profile nursing positions during her lifetime. She was director of nursing in various institutions and was a member of group of nursing theorists who formulated the framework for North American Nursing Diagnosis Association. She proposed Self-Care Deficit Theory of Nursing, which is made up of
Dorothea Orem’s self-care nursing philosophy encourages patient autonomy and gives patients a voice. Consequently, it increases patient responsibility and participation in their care. It provides nurses with a solid foundation to give patients’ self-sufficiency and control in caring for themselves. The self-care model is achieved when patients transform from dependent, unreceptive patients to active, engaged
Dorthea E. Orem is a well recognized and a very well educated nursing theorist. She had a lot of experience as a nurse, and this greatly helped her provide insight into her views of nursing practice, education, and science. “The question that directed Orem’s thinking was, “What condition exists in a person when judgments are made that a nurse(s) should be brought into the situation?”” (Berbiglia & Banfield, 2014) Her biggest focus was the Self- Care Deficit 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).
Dorothea Orem's self-care deficit theory was born while Dorothea Orem (1917-2007) was working in the Department of Health Education and Welfare (HEW) as a curriculum consultant. At this time in the history of the profession, nursing was just emerging as a unique academic discipline. Orem's theory was designed to answer the fundamental question: What is nursing? Orem defined nursing as a way of realizing every patient's desire to engage in self-care in a manner to "sustain life and health, recover from disease or injury and cope" with the consequences of major health events and daily life (El-Kader n.d.). Major assumptions of the theory include that "people should be self-reliant and responsible for their own care and others in their family needing care" (Dorothea Orem's self-care deficit theory, 2012, Current Nursing). Fundamentally, nursing and the nursing process is designed to enhance self-care and to address deficits in self-care.
The foundation for the nursing profession that provides principles to generate knowledge defines nursing theory. Successful nurses must be rooted in theory and understand the philosophy that drives their actions. Dorothea Orem is a nurse with a vision that studied human behavior, with the core concept of self-care in the patient/nurse relationship. This paper seeks to explain Dorothea Orem’s Theory including the contribution of her research as it relates to nursing development and paradigms of nursing.