Dorothea E. Orem and Quality Care
Isabelle Young
SUNY Poly Institute
Theory Foundation of Nursing Practice
NUR500
Dr. Marie Hess
October 28, 2017
Nurses working in hospitals today are challenged with getting their patients safely back home. This challenge begins with admission to the hospital. Nurses have less time to get patients to a state of well-being. Hospital stays are much shorter. Reimbursement for hospitals is based on the quality of care patients receive while in their care. Patient outcomes can be determined by the quality of care patients receive while in the hospital. The Self-Care Deficit Nursing Theory can be applied to improve the well-being of patients. This paper will analyze Dorothea Orem’s Self-Care
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She received many awards throughout her nursing career. Alumni Achievement Award for Nursing from the Catholic University of America in 1980 and the Linda Richards Award in 1991, from the National League of Nursing. In 1992 she was named an honorary Fellow of the American Academy of Nursing. Dorothea E. Orem’ contribution to Nursing Theory is Self-Care Deficit Theory. Dorothea E. Orem died in 2007 after failing health. (http://www.nuring-theory.org)
Self-Care Deficient Nursing Theory
Dorothea Orem developed The Self-Care Deficient Nursing between 1959-2001. It has also been known as the Orem Model of Nursing. This theory is considered a grand nursing theory. This means the theory covers a broad scope with concepts that can be applied to all areas of nursing. A benefit of this theory is that it can be applied to a variety of patients and nursing practices. Orem proposed that the purpose of nursing is to help people meet their self-care needs. Nurses do for others what they cannot do for themselves. Individual well-being affects health. Central philosophy of Orem’s theory is that all patients want to care for themselves and they can recover holistically and quicker when preforming their own care. Orem identified three self-care requisites. The first is universal self-care requisites. These include needs that all people have such as air, water, food, activity, rest, and hazard prevention. Developmental
Orem’s Theory has helped lay the ground work for modern nursing. In 1971 her theory was first published and includes three related concepts: self-care, self-care deficit and nursing systems. Orem’s theory has given direction to many nurses, inspiring them to seek better ways to develop and express the knowledge base of nursing. The purpose of her theory is to help patients and their families maintain control of their health during their lifetime. The theory consists of three parts the nursing system, self-care and self-care deficit. Care is the primary focus and the ultimate goal is health restoration. Patients are allowed to have primary control over their health and letting healthcare providers educate, promote and encourage healthy
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
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
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.
Orem’s theory of self care deficit specifies when nursing is needed. “Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care” (Current Nursing, 2010, para. 16). Orem’s created five methods of helping; which are acting for and doing for others, guiding others, supporting one another, providing an environment that promotes personal development, and teaching one another.
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.
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 self-care deficit theory’s nursing goal is to assist individuals to meet all their self-care needs by teaching them with skillful healthy habits (Hood, 2014, p. 137). In order for nurses to provide the support needed by an individual, they must assess all their patients’ self-care requisites. As explained by Moore (2015), “Orem uses the self-care requisites as a basis for assessment [in] the nursing process.” These self-requisites are universal needs that arise due to illness and/or changes in developmental stages (Hood, 2014). Dennis (1997) described in detail Orem’s basic conditioning factors that must be assessed to gather sufficient information about the individual and about their ongoing and emerging self-care requisites. Orem’s basic conditioning factors include: age, gender, developmental state, health state, health care system, sociocultural/spiritual orientation, family systems, patterns of living, environment, and available resources (Dennis, 1997).
In summary, Dorothea Orem’s Self-Care Theory has greatly influenced the development of nursing research. At a close look at her theory, paradigm and contributions, one discovers the importance of research. Nursing research does and always will have a tremendous influence on nursing practice, thus indicating the importance of research being a
Many different factors can affect these abilities and must be considered by nurses when providing comprehensive care. She referred to this new thought process as the Self-care Deficit Theory of Nursing, which also is known as the Orem Model of Nursing. Orem published the basis for this theory in her book Nursing: Concepts of Practice in 1971. The Self-care Deficit Theory of Nursing earned Orem much acclaim and respect within the medical world. She became a lead theorist in nursing education and practice for the rest of her career. Her book, Nursing: Concepts of Practice, is still widely read today as it enters into its sixth edition. Wayne,
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
Dorothea Orem created the self-care theory in 1959 and continued to build upon her theory until 2001. The purpose of Orem’s theory was to define nursing, discuss the relationship among the nurse and the patient, and to promote a clear understanding of the scope of nursing (Taylor, Self-Care Deficit Theory of Nursing, 2006). Today, Orem’s theory is widely known and is utilized in nursing curriculum, as well as continuing education topics for healthcare providers.
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
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